Modifying one's home is an important strategy to manage chronic health care conditions, increase independence, and ensure safety of frail older adults. However, in many areas of the country home modifications are difficult to obtain. The purpose of this project is to develop an innovative assessment protocol that will include comprehensive assessment of both function and environment in order to enhance the capacity of nationally recognized home modification specialists to assist underserved populations. Unlike existing assessment instruments, the product developed in this project will provide sufficient information about an individual's housing environment and housing needs such that home modification specialists will be able to prescribe appropriate environmental changes without having to perform on-site assessments. In Phase 1 a review of literature and existing assessment instruments will provide the basis for developing the protocol. The draft protocol will be reviewed and refined by a panel of experts. The final product will be pretested in 10 homes to assess its feasibility in terms of: 1) a high interrater reliability among case mangers who implement the protocol; and 2) a high degree of concurrence between home modification solutions based on the assessment protocol and those based on a typical on-site assessment. Phase 2 of the project will develop and test instructional material to accompany the protocol and demonstrate the effectiveness of the protocol as a tool to expand the availability of home modifications in unserved areas.
The planned protocol will have broad appeal to case managers, occupational therapists, home health nurses, and other providers of aging services, who currently are aware of the role of modifications, but who often lack the expertise to accurately identify problems and effective solutions. The protocol will enable these professionals to conduct on-site assessments and then utilize nationally recognized experts to design and specify appropriate modifications.
