For many older Australians, being able to remain safely and independently at home depends on more than receiving care. Sometimes the home itself needs to change. A bathroom may become difficult to use. Stairs may become harder to manage. Getting in and out of the front door may require more effort. A person who was previously confident moving around their home may begin avoiding certain rooms or activities.

This is where an Occupational Therapy (OT) Home Assessment can play an important role. For Support at Home providers, an OT Home Assessment can help identify what is making everyday activities difficult and what practical changes may help a participant remain safe, functional and independent at home.

What is an OT home assessment?

An OT home assessment is an assessment of how a person manages everyday activities within their home environment.

Rather than looking only at potential hazards, the OT considers the relationship between:

• The person’s abilities
• Their functional needs
• Their goals
• Their daily activities
• The physical environment
• Existing equipment or supports
• Potential changes that could improve safety and independence

The assessment is therefore about more than simply looking for things that could cause a fall.

It asks a more important question: “What is making it harder for this person to live the way they want to live at home?”

What does an OT look at?

The exact assessment will depend on the participant’s circumstances, but an OT may consider areas such as:

Bathroom

The OT may assess shower access, transfers, toilet access, flooring, available support and whether existing bathroom fixtures are suitable.

Potential recommendations could include grab rails, shower seating, changes to access or other modifications.

Entrances and exits
The front and rear entrances can become significant barriers as mobility changes.
The OT may consider steps, thresholds, ramps, handrails, pathways and the ability to safely enter and leave the property.

Bedrooms
Getting in and out of bed, accessing clothing and moving between the bedroom and bathroom can all become more difficult as a person’s functional capacity changes.

Stairs
The OT may consider how safely the participant manages stairs and whether changes such as handrails, improved lighting or other solutions could help.

Kitchen and daily activities
An assessment can also consider whether the participant can safely prepare meals, reach commonly used items and perform other everyday activities.

Mobility and transfers
The OT may observe how the participant moves around the home, gets up from chairs, transfers between surfaces and uses mobility equipment.

An OT doesn’t just assess the house

One of the most important aspects of an OT home assessment is that the person comes first. Two people can live in identical houses and have completely different needs. One person may be struggling to shower independently. Another may be concerned about getting safely from the bedroom to the bathroom at night. Another may be perfectly mobile indoors but unable to safely get through the front entrance.

The right recommendation depends on the individual. That’s why a good assessment doesn’t start with: “What product should we install?” It starts with: “What is the person trying to do?”

Can an OT recommend home modifications?

Yes. Where clinically appropriate, an OT may recommend home modifications or assistive technology based on the participant’s individual needs. Recommendations might include:

• Grab rails
• Handrails
• Ramps
• Bathroom modifications
• Shower modifications
• Improved access
• Changes to doorways or thresholds
• Lighting improvements
• Changes to support transfers
• Other accessibility solutions

For home modifications under the Assistive Technology and Home Modifications (AT-HM) scheme, an OT prescription is required. The recommendation should be connected to the participant’s needs and support plan and should help optimise function or manage disability or age-related decline.

The Support at Home provider can then consider the recommendation, funding requirements and appropriate next steps.

What does the provider receive?

Following the assessment, the provider may receive an assessment report containing information such as:

• Participant goals
• Functional issues
• Environmental barriers
• Assessment findings
• Identified risks
• Recommended modifications
• Clinical rationale
• Priority of recommendations
• Relevant installation considerations
• Prescription information where required

This gives the provider a clearer understanding of what the participant needs and why. It can then support the provider’s discussion with the participant and decisions about the appropriate next step.

Why are OT home assessments important for Support at Home providers?

For providers, arranging an OT assessment can involve more than simply finding an available clinician.

There can be:
Referral → OT sourcing → Appointment coordination → Participant communication → Assessment → Report → Recommendations → Provider review

This takes time. A coordinated OT assessment service can simplify the process by giving providers a straightforward referral pathway. Instead of finding an OT and managing each step themselves, providers can refer the participant and have the assessment coordinated on their behalf.

From referral to recommendation

At Home Access Group, our approach is simple.

1. You refer the participant
Provide the relevant participant and referral information.

2. We coordinate the OT
We identify an appropriate OT and arrange the assessment.

3. The OT assesses
The OT assesses the participant, their goals, functional needs and home environment.

4. We return the assessment
The completed assessment and recommendations are provided back to the referring provider.

5. You decide the next step
The provider can then consider the recommendations with the participant and determine the appropriate pathway.

The goal isn’t just a safer home

Safety matters. But the ultimate goal is often much bigger.

It might be:

• Being able to shower without assistance
• Getting safely into the garden
• Preparing a meal independently
• Using the front door without worrying about the step
• Moving around the home with greater confidence
• Continuing to live in the home that already feels like home

A well-designed home modification can be a practical way of supporting those goals.

Read more about the AT-HM scheme

Information about Support at Home and the Assistive Technology and Home Modifications scheme can change. Providers should refer to current Australian Government guidance when making funding and service decisions.