Tag Archive for: Home Modifications


The A to Z of OT: M is For… Modifications

The foundation of the profession of Occupational Therapy is creating Person-Environment-Occupation fit.  We call this our PEO model.  What it means is that optimal function arises from the best interaction of the person, their environment, and those “occupations” that are the daily tasks they need to complete.

So, if someone is struggling to complete daily activities, feeling that they need more support to manage at home, or are worried they might get injured falling in or around their house, perhaps they need to consider home modifications. 

There is a misconception that home renovations for safety or disability need to be expensive.  While this can be true for large-scale projects, there are some quick-fix modifications that are small, but pack a punch.  Learn about these modifications and more in our previous post, An OT Knows Home Modifications that Won’t Break the Bank, also available below in video format.

October is Occupational Therapy Month and to celebrate we will be sharing a new series called the A to Z of OT.  In our attempts to further educate the public about what Occupational Therapists do we will be highlighting twenty-six of the awesome ways OTs provide Solutions for Living.  

We encourage you to follow along and to add to the discussion by highlighting other awesome things OTs help with for each corresponding letter!


Functional Modifications that Won’t Break the Bank

There is a misconception that home renovations for safety or disability need to be expensive.  While this can be true for large-scale projects, there are some quick-fix modifications that are small but pack a punch.  Watch our latest OT-V Episode below for our top 10 pick of modifications you can make for under $100:


Tough Conversations

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

My grandmother always used to say “once an adult, twice a child”.  She was referring to the fact that we start life dependent, and through the aging process, tend to end our life that way as well.  So, what happens when the grown-up “child” needs to become the caregiving adult in a relationship with an aging parent?  It leads to many tough conversations about some pretty big topics.  Recognizing that some conversations are not only difficult, but could cause relationship-changing outcomes, I wanted to give you some pointers for handling the big ticket items adult children might encounter with their aging parents:


We all have a societal obligation to ensure that the roads are safe.  Just like a parent not giving the keys to a teen that has not demonstrated adequate driving skills, adults need to look for this in their older parents too.  While some seniors self-retire their license when they feel they are unsafe, some are not as willing, or able, to make this decision.  I remember my grandmother stopped driving when one day behind the wheel she “woke up and the light was green”.  While we joked about this as a family, we applauded her for making a responsible decision.

Making sure your parents are able to drive safely is important for them, and the general public.  So how do you manage this?  Next time you are out with your parent drive separately and follow them, or get them to drive with you in the car.  Watch for the following:

  • Are they driving to slow or too fast?  Note that driving too slow can be just as dangerous as driving too fast.
  • Are they obeying the traffic signs?
  • Do they have the range of motion to look both ways and check blind spots?  Are they looking around at stop signs, when merging lanes?
  • How are they negotiating directions, are they getting lost frequently?
  • Do they seem to be driving aggressively, or do they seem oblivious to other drivers, cyclists or pedestrians?
  • Do they obey right of ways, manage one-way streets, can they park the car safely and easily in a lot or on a side-street?

If you have concerns about any of the above, you have a moral obligation to bring your concerns to their attention, or to the attention of their treating physician.  If you choose to have this discussion with them directly, be caring and compassionate, but direct.  Tell them about your concerns but instead of just telling them they shouldn’t drive, suggest the involvement of a professional like their doctor, an occupational therapist, or driving assessment.  If you are not comfortable having this conversation with them, bring your concerns to the attention of their treating physician so they can do their own assessment.

Home Modifications

Most seniors want to remain in their own home as long as possible.  Many recognize that some small changes to the home could have a big impact on their safety and function, and some are very hesitant to consider modifications.  I remember I once had a call from a physician who was calling about his own parents, expressing concerns about his mother and how she was managing at home.  We talked about the value of OT and he agreed that a home assessment would help her.  He then asked “so, what should I say to her to get her to agree to this”?  I found that surprising as even as a physician who is required to have difficult conversations with people all the time, he struggled to know how to approach his mom.  I suggested he tell her that he recognizes it was very important to her to stay at home as long as possible, and that he is concerned that if she falls, staying home might not be an option.  I told him to tell her that he wants to have an occupational therapist come and talk to her about her safety to make sure they are doing everything possible to keep her living at home for as long as she can.  He called his mom, and like a kid planning a sleepover, called back and said “it worked, she said yes”!

I think it is important for adults of aging parents to demystify the home modification process and stress to their parents that most changes are minor, removable, or will actually increase the value of their home, while keeping them there for as long as possible.

But honestly, the best approach is usually letting a professional explain to the aging parent what can be done, and what they should consider either now, or in the future, to ensure their home continues to work for them.  In that case, the difficult conversation is more getting the professional in the door, instead of trying to convince the parent of the changes that you feel (without full knowledge of the options) might be needed.  Occupational therapists are great at getting a sense of what people need, explaining the options, and coming up with a plan.  I always chuckle when I meet with seniors and the first thing they say is “I know my son says we need X, Y and Z, but just so you know we are not doing that”.


There may come a time when being the primary caregiver of an aging parent who is trying to live at home, may become too much. Caregiving is a difficult task that often requires time, knowledge or a level of commitment that a working adult-child who might have children of their own, just does not have. Having a discussion with your parent about the need to relocate to get access to skilled or more available care, is difficult.  Like the other conversations, tell your parent that their safety is your primary concern and that you are willing to do all you can to help them get the care they need.  Remind them of your own capabilities and the other responsibilities that you are also trying to balance.  Framing your conversation this way will go a long way to show them you are being supportive, and not just trying to tell them what to do or how to do it.

In the end, yes these conversations will be difficult, but your parents need your love, support and guidance as they navigate the aging process.  I remember having a difficult conversation with my grandmother about her decision to use a walker instead of her wheelchair, when the wheelchair was much safer for her.  She was giving me a hard time and I reminded her that she taught us to care about each other so the fact that I care about her safety was actually her own fault.  She laughed and we had a great conversation about her fears about declining mobility and reducing independence.

I wish you the best as you navigate these difficult conversations with your parents.  But remember, sometimes involving a professional (like an OT) who can assess the situation, come up with solutions, and develop a plan may go a long way to maintaining the parent / adult-child relationship, while keeping the parent safe at the same time.


Seniors: Take Advantage of Renovation Tax Credits

In Ontario the Healthy Homes Renovation Tax Credit is helping many seniors, age 65 and over, take advantage of necessary home improvements at a lower cost.  Many seniors, opting to age in place as long as possible, are modifying and renovating their homes to make them safer and more accessible for their changing needs.  The tax credit from the Ontario Government provides up to $1500 for eligible renovations.  Take a look at the following from Senior City for more on the program and why it pays to hire a professional.

Senior City:  Home Improvement or DIY Disaster – Renovation Tax Credits


Home Modifications for Under $100

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

There is a misconception that home renovations for safety or disability need to be expensive.  While this can be true for large-scale projects, there are some quick-fix modifications that are small, but pack a punch.  Here is my top 10 pick of modifications you can make for under $100.

Offset Door Hinges – if the doors of your home just seem a bit too narrow1, consider that the width of the door, when open, makes the door opening smaller than it is.  Consider purchasing some recessed hinges that will allow your doors to swing as wide as your door frame, giving you an extra few inches to get through with a walker, wheelchair or commode.

Drawer Pulls – if knobs are too difficult to grasp, consider swapping your kitchen and bathroom hardware for U shaped pulls that require less fine motor grasp and control to open.

Easy Grip Shower Head – handheld shower heads are great for allowing people to sit to shower, or to reach difficult areas without bending and twisting, but for people with a reduced grasp, I love these Easy-Grip shower heads from Moen.

Grab Bars – these don’t need to look industrial or institutional and many colors and configurations exist.  One strategically placed grab bar can help you get out of the shower / tub or even on / off the toilet.  Consider the multi-use line from Moen that has grab bars with built in soap or toilet paper holders to help save space.  5

Threshold Ramps – these small ramps are portable and make it easier to transition over small thresholds that are often present at entry doors.   (

Lever Door Handles – sometimes grasping and turning a door handle can be a problem for people with arthritis or who have issues with fine motor control.  Swapping out some door knobs with lever-style handles is a quick fix to help promote someone’s ability to open and close doors themselves.

Removing Shower Doors – often shower doors can get in the way as we get older.  While some people use them to grab and hold, these have a threshold and limit the ability to use a bench or seat in the shower.  Removing the shower doors and replacing these with a curtain provides more versatility for equipment, makes it easier for a caregiver to help you shower, and is easier to clean and maintain.

Railings – installing a basic railing on any stair is an inexpensive way to greatly reduce the risk of falling when going up and down.

Adhesive Shower / Tub Strips – easy to install, these anti-slip strips give you added protection from falling when you are getting in / out or standing in the shower / tub with bare feet on a wet surface. Strips are easier to maintain and clean than a standard bath mat and stick better to the bottom of the tub / shower.

Shower Seats – with or without a back, these sturdy and often height-adjustable seats allow people with reduced endurance or balance problems to sit when showering.  Sitting means less chance of falling, which can cause injury.  The smaller seats are easy to remove for other people who want to use the shower as well.

Do you feel you need a more custom approach to addressing how you manage your activities at home?  Consider the services of an Occupational Therapist as we are the functional experts!


Financing Home Modifications

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

The foundation of the profession of Occupational Therapy is creating Person-Environment-Occupation fit.  We call this our PEO model.  What it means is that optimal function arises from the best interaction of the person, their environment, and those “occupations” that are the daily tasks they need to complete.

So, if you are struggling to complete daily activities, or are feeling that you need more support to manage at home, or are worried you might get injured falling in or around your house, perhaps you need to consider, or are considering, home modifications.

But before you get scared at the thought of a large-scale renovation, it is important to recognize that home modifications can be as small as changing some door handles to as large as installing an elevator.   There is a continuum, and your capabilities, needs, and current environment will dictate a custom approach.  So, what is the process for understanding how home modification can help, and how can you possibly fund these?  I am glad you asked…

Perhaps I am biased, but in my opinion, the process should start with an occupational therapy assessment.  If you call a contractor for a quote to say, renovate your bathroom, he will provide you with the estimate you want.  But what the contractor won’t understand is the PERSON or the OCCUPATIONS that person is struggling to complete.  For example, if there are larger issues, or bigger problems lurking, is the contractor the right person to advise you on this?  What if there are ways to improve your safety in the washroom without engaging in a full renovation of the space?  An occupational therapist will be able to problem solve your concerns with you, while recommending multiple options to consider – from inexpensive to more costly.  The few hundred dollars you will pay the OT may just save you thousands in unnecessary renovation costs.

Once you have considered all the available options, and have confirmed the scope of work, you will need to get estimates on the costs of the work involved.  It is important that you hire a vendor that has completed renovations for accessibility before, as not all contractors will have this knowledge and expertise.

Now you have your price – so how can you pay for it?  Here are some financing suggestions based on my years of experience in this field:


Extended Health – if you are still working, or still have access to extended health benefits, check your coverage.  Many plans have up to $10,000 in coverage for home modifications.  You will need to submit an estimate to them first for approval.

Motor Vehicle – if your disability has been the result of a motor vehicle accident, and you still have an open claim, you may be able to access funding through your insurance provider.

Veterans Affairs – if your disability has been the result of military service, Veterans Affairs may be able to provide funding.

Workplace Safety and Insurance Board – if your disability was the result of a workplace accident, and you still have an open claim, funding may be available through your WSIB.


Traditional Loan – if you are a homeowner with good credit, your bank may be able to provide you with a traditional loan for the monies you need.  As with all loans, there will be interested and a set repayment schedule so budgeting beforehand is important.

Line of Credit – often people borrow money using the equity in their home as collateral.  These are more flexible than a traditional loan and work more like a credit card.  However, it requires discipline to make sure you are paying off some of the principal with each payment, as only interest payments are required on a monthly basis.

Reverse Mortgage – According to the Financial Consumer Agency of Canada, a reverse mortgage “is a loan that is designed for homeowners 55 years of age and older.  Unlike an ordinary mortgage, you don’t have to make any regular or lump sum payments on a reverse mortgage. Instead, the interest on your reverse mortgage accumulates, and the equity that you have in your home decreases with time. If you sell your house or your home is no longer your principal residence, you must repay the loan and any interest that has accumulated” (Understanding Reverse Mortgages).  There are pros and cons to this arrangement, and not all lenders offer this.

Second Mortgage – A second mortgage is basically another mortgage against a property that already has a mortgage.  The second mortgage typically has a higher interest rate and is more risky for lenders and thus not all of them will offer this.

Talk to your lender or bank if you are looking to finance a renovation through one of these channels.

Government Programs:

March of Dimes – The March of Dimes Home Modification Program will provide $15,000 as a one-time home modification grant to people who qualify.  For information on this program, click here.

Ontario Renovates – Formerly the Regional Assistance Program (RAP), this is a municipally-based program for low-income homeowners.  The funding is provided to the municipalities to administer, but basically low-income homeowners apply based on modification needs related to a disability.  The proposed changes need to be prescribed by an occupational therapist and the funds are provided in a forgivable loan, and / or via grant.  The funding can even cover devices such as porch lifts, stair glides, etc.  Each municipality has different funding allotments and qualification criteria.  For the City of Hamilton, the program was just extended into 2019.  For more information about the program, click here or contact your municipality.

Healthy Homes Renovation Tax Credit – while not a loan or grant, this program does allow people to claim a taxable benefit for funds they spent on home modifications.   The maximum taxable return is 15% on $10,000 spent ($1500), and not all renovations are covered.  For more information on this grant, click here.

Remember, properly planned renovations or changes to your home can have a significant impact on how you manage, and can protect you from future injury.  You may not need one solution per problem as the best solutions are often ones that impact many areas of living in one foul swoop.  Seek the services of an Occupational Therapist so they can help you to find the best PERSON-ENVIRONMENT-OCCUPATION fit for your renovation project.