Structural Home Modifications
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Structural Home Modifications
Structural modifications to the home that may assist in the chronically ill enrollee’s overall function, health, or mobility are permitted if those items and services have a reasonable expectation of improving or maintaining the health or overall function of the chronically ill enrollee (e.g., widening of hallways or doorways, permanent mobility ramps, easy use doorknobs and faucets).
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Linking Intervention and Impact
Stillmunkés A, Goubin L, Bismuth S, Nourhashémi F, Oustric S
2015| Janvier| Google Scholar| 10.1684/med.2015.1180
Home adjustments implemented for older adults was the intervention.
Outcome type: Favorable
The most successful interventions involved an occupational therapist. Home modifications helped preserve the autonomy of patients and preventing falls.
Systematic Review
Peer Reviewed
Age > 65
Linking Intervention and Impact
2024| National Council on Aging| Google|
The Home Modification Service Delivery Model, a transdisciplinary home modification intervention that engages occupational therapists, physical therapists, nonprofits, architects, contractors, care managers, primary care providers, and handypersons.
Outcome type: Favorable
Home modifications can help prevent falls, enhance the aging in place experience, and support needs after a hospital stay.
Other
Age > 65
Linking Intervention and Impact
Ainsworth E, Aplin T, de Jonge D, Bennett S.
2023| Disabil Rehabil| Google| 36394257| 10.1080/09638288.2022.2146765
Various home modifications were implemented.
Outcome type: Favorable
The outcomes after a home modification that mattered to the participants were the improvement of emotional and physical health and safety, the independence and empowerment to stay at home, and the ability to plan for the future.
Other
Peer Reviewed
Age > 65
Age ≤ 65
Linking Gap and Impact
Andersson N, Slaug B, Nilsson MH, Iwarsson S.
2023| Scand J Occup Ther| PubMed| 10.1080/11038128.2021.2007998
Outcome type: Favorable
Numerous difficulties relating to the home environment exist, particularly relating to grab bars, stairs, and challenges reaching trash containers
Prospective Cohort Study
Peer Reviewed
Linking intervention and Impact
2022| National Institute on Aging| Google|
Numerous interventions are described to help prevent falls in the home.
Outcome type: Favorable
Changes made to the home like the ones describes can prevent falls and improve home safety.
Other
Age > 65
Linking Intervention and Impact
Szanton SL, Leff B, Li Q, Breysse J, Spoelstra S, Kell J, Purvis J, Xue Q, Wilson J, Gitlin L
2021| Journal of the American Geriatrics Society| Google| 10.1111/jgs.17383
CAPABLE intervention: 10 home-based sessions with occupational therapist, nurse, and handy worker engagement to enhance independence and home environment
Outcome type: Favorable
All studies included in the review showed improvement in activities of daily living among older adults.
Other
Peer Reviewed
Age > 65
Linking Intervention and Impact
Müller C, Lautenschläger S, Dörge C, Voigt-Radloff S.
2021| Disabil Rehabil| PubMed| 31868030| 10.1080/09638288.2019.1700564
FIT-at-Home, a physical exercise training and home modification intervention led by occupational therapists, was implemented.
Outcome type: Favorable
The intervention was found to be feasible and appeared to have positive effects on aging, community-dwelling adults with poor health, functional limitations, and limited mobility.
Other
Peer Reviewed
Age > 65
Linking Intervention and Impact
Pettersson C, Slaug B, Granbom M, Kylberg M, Iwarsson S.
2018| Scand J Occup Ther| PubMed| 28114837| 10.1080/11038128.2017.1280078
Environmental barrier removal in Sweden housing stock was implemented.
Outcome type: Favorable
Removing environmental barriers in the home would have the greatest effects on aging adults with complex functional needs, but would also mitigate accessibility problems faced by all community-dwelling aging adults.
Other
Peer Reviewed
Age > 65
Linking Intervention and Impact
Campani D, Caristia S, Amariglio A, Piscone S, Ferrara LI, Barisone M, Bortoluzzi S, Faggiano F, Dal Molin A
2020| Public Health Nurs| Google| 33340382| 10.1111/phn.12852
Various combinations of home modifications were implemented to reduce falls in the home, including modifications to flooring, lighting, furniture, and layouts.
Outcome type: Favorable
Home modifications can help reduce the number of falls among community-dwelling older adults. To be most successful, interventions should be individualized to the older adult's particular needs.
Other
Peer Reviewed
Age > 65
Linking Intervention and Impact
Mitoku K, and Shimanouchi S
2014| Journal of Gerontological Nursing| Google Scholar| 10.3928/00989134-20140311-02
Various home modifications, most commonly the installation of handrails in the home, were implemented.
Outcome type: Favorable
Mortality among older adults with home modifications was lower than among those with no modifications.
Prospective Cohort Study
Peer Reviewed
Age > 65
Linking Intervention and Impact
Stark S, Keglovits M, Arbesman M, Lieberman D
2017| Am J Occup Ther| PubMed| 28218595| 10.5014/ajot.2017.018887
Home modifications for adults and older adults living independently was the intervention.
Outcome type: Favorable
Home modifications were found to improve the function of people with a variety of health conditions, reduce falls among older adults, and improve caregiving for people with dementia.
Systematic Review
Peer Reviewed
Linking Intervention and Impact
Lee CD, Jung MY, Kim JN
2016| The Journal of Korean Society of Occupational Therapy| Google Scholar| 10.14519/jksot.2016.24.1.07
Client-centered home modification and caregiver education was the intervention.
Outcome type: Favorable
Performance of activities increased after intervention. Increase in independence, difficulty, and safety was maintained after 6 months.
Case Study
Peer Reviewed
Age > 65
Dementia
Linking Intervention and Impact
Ng BP, Lu J, Tiu GF, Thiamwong L, Zhong Y
2021| Health and Social Care| Google Scholar| 10.1111/hsc.13398
Existing bathroom modifications among older community-dwelling adults who experienced a fall in the past year were observed.
Outcome type: Favorable
A slight majority of the older adults had bathroom modifications and half had more than one fall. About 40% of adults with more than one fall did not have bathroom modifications.
Other
Peer Reviewed
Age > 65
Linking Intervention and Impact
Jo Y, Kim H
2018| Korean Journal of Occupational Therapy| Google Scholar| 10.14519/jksot.2018.26.3.07
Home modification and intervention using assistive devices was the intervention.
Outcome type: Favorable
Independence was improved, and the difficulty of activities of daily living at home were decreased. Overall risk factors in the home significantly decreased, particularly in the bedroom and bathroom.
Prospective Cohort Study
Peer Reviewed
Linking Intervention and Impact
Nieto-Sanchez C, Bates BR, Guerrero D, Jimenez S, Baus EG, Peeters Grietens K, Grijalva MJ
2019| PLoS Negl Trop Dis| PubMed| 10.1371/journal.pntd.0007472
Healthy Homes for Healthy Living, a home improvement and health promotion intervention, was implemented.
Outcome type: Favorable
The intervention addressed risk factors for Chagas disease and improved emotional, economic, and social wellbeing
Prospective Cohort Study
Peer Reviewed
Linking Intervention and Impact
Carnemolla P, Bridge C
2019| International Journal of Environmental Research and Public Health| NIH National Library of Medicine| 31159396| 10.3390/ijerph16111951
Participants received various home modifications depending on need, such as ramps, grab rails, handrails.
Outcome type: Favorable
Home modifications were found to reduce the hours of care provided, showing that this intervention can reduce care needs.
Other
Peer Reviewed
Age > 65
Linking Intervention and Impact
Keall MD, Pierse N, Howden-Chapman P, Cunningham C, Cunningham M, Guria J, Baker MG.
2015| Lancet| PubMed| 25255696| 10.1016/S0140-6736(14)61006-0
Home modifications, such as handrails, grab rails, outside lighting, edging on steps, and slip-resistant surfacing, were implemented.
Outcome type: Favorable
Reduction in the rates of falls and injuries caused by falls at home were found in intervention group.
Randomized Controlled Trial
Peer Reviewed
Linking Intervention and Impact
Malmgren Fänge A, Chiatti C, Axmon A.
2021| Int J Environ Res Public Health| PubMed| 34574626| 10.3390/ijerph18189704
Five housing adaptations profileswere used, based on level of disability and age.
Outcome type: Neutral
No consistent trends were found across all profiles.
Prospective Cohort Study
Peer Reviewed
Linking Intervention and Impact
Stevens JA, Lee R.
2018| Am J Prev Med| PubMed| 30122212| 10.1016/j.amepre.2018.04.035
Various evidence-based fall interventions for older adults were implemented, including home modifications led by an occupational therapist.
Outcome type: Favorable
Interventions with home modifications were found to have the greatest potential for impact.
Other
Peer Reviewed
Age > 65
Linking Intervention and Impact
Wilson N, Kvizhinadze G, Pega F, Nair N, Blakely T.
2017| PLoS One| PubMed| 28910342| 10.1371/journal.pone.0184538
Home Safety Assessment and Modification program, which strives to reduce falls in older people, was implemented.
Outcome type: Favorable
The program was found to be cost effective and to produce meaningful health gain.
Other
Peer Reviewed
Age > 65
Linking Intervention and Impact
Goddard KS, Hall JP, Greiman L, Koon LM, Gray RC.
2024| Disabil Health J| PubMed| 38369385| 10.1016/j.dhjo.2024.101590
The Home Usability Program (HUP) was implemented to improve accessibility, safety, and independence in community dwelling people with mobility disabilities.
Outcome type: Favorable
The intervention resulted in increased safety and decreased exertion, leading to more time for other activities, including those outside the home, and enhanced socialization and independence.
Other
Peer Reviewed
Linking Intervention and Impact
Stasi S, Tsekoura M, Gliatis J, Sakellari V.
2021| Cureus| PubMed| 33968539| 10.7759/cureus.14336
"Motor Control Home Ergonomics Elderlies' Prevention of Falls" (McHeELP) - an exercise and home arrangement program - was implemented.
Outcome type: Neutral
Outcome measures such as physical tests and fall screening tools showed significant improvement. No difference was recorded in mobility, self-care, usual activities, or pain or discomfort scales.
Randomized Controlled Trial
Peer Reviewed
Age > 65
Linking Intervention and Impact
Chandola T, Rouxel P.
2022| Lancet Reg Health Eur| PubMed| 35814336| 10.1016/j.lanepe.2022.100397
Internal and external housing modifications were implemented, including widened doorways, ramps, automatic doors, parking and lifts; and rails, bathroom/kitchen modifications, and chair lifts.
Outcome type: Favorable
External housing modifications reduced falls, pain, poor health, and the probability of no social activities and moving homes. Internal modifications had similar but less consistent effects.
Prospective Cohort Study
Peer Reviewed
Age > 65
Linking Intervention and Impact
Greiman L, Ravesloot C, S Goddard K, Ward B.
2022| Disabil Health J| PubMed| 34521604| 10.1016/j.dhjo.2021.101210
Home usability changes through the Home Usability Program was the intervention.
Outcome type: Favorable
The program increased participation in the community for people with mobility disabilities.
Randomized Controlled Trial
Peer Reviewed
Linking Gap and Impact
Brim B, Fromhold S, Blaney S.
2021| J Appl Gerontol| PubMed| 33522379| 10.1177/0733464820988800
Outcome type: Neutral
Using self-reported home safety assessments, researchers found that older adults experience barriers related to home mobility and safety, home improvement and maintenance needs, and general safety and bathroom safety.
Systematic Review
Peer Reviewed
Age > 65
Linking Intervention and Impact
Angelelli J, McCartney D, Roehmer C, Swart ECS, Quinby E, Darwin J, Dicianno BE.
2022| Arch Phys Med Rehabil| PubMed| 34756446| 10.1016/j.apmr.2021.06.021
Home modifications, along with other SDoH interventions, were analyzed.
Outcome type: Neutral
Most interventions scored low using GRADE criteria and limited evidence exists comparing the interventions to outcomes.
Systematic Review
Peer Reviewed
Linking Intervention and Impact
Lektip C, Chaovalit S, Wattanapisit A, Lapmanee S, Nawarat J, Yaemrattanakul W.
2023| PeerJ| PubMed| 37489124| 10.7717/peerj.15699
Interventions were analyzed using home modifications specifically to prevent falls in older adults.
Outcome type: Favorable
Falls can be reduced by thorough and focused home modifications with follow-up.
Systematic Review
Peer Reviewed
Age > 65
Linking Intervention and Impact
Sheth S, Cogle CR.
2023| J Appl Gerontol| PubMed| 36655622| 10.1177/07334648231151669
Various methods of home modifications for older adults was the intervention.
Outcome type: Favorable
Occupational therapist involvement in modifications supplemented with clinical, physical activity, and/or behavioral components showed the most success.
Systematic Review
Peer Reviewed
Age > 65
Linking Intervention and Impact
Schiller G, Seligman A, Lubetsky S, DeCherrie LV, Reckrey J, Kopke V, Bacher N, Bhatia S, Ornstein KA.
2023| J Appl Gerontol| PubMed| 36661352| 10.1177/07334648221142599
Home modification and repair pilot program after needs assessment by social worker was the intervention.
Outcome type: Favorable
Average spending per patient was $528 as part of this program. Mount Sinai staff reported the program was feasible and decreased burnout.
Other
Peer Reviewed
Linking Intervention and Impact
Moon K, Lee Y, Kim D, Kim J
2020| Participative Urban Health and Healthy Aging in the Age of AI (ICOST 2022)| Google Scholar| 10.1007/978-3-031-09593-1_22
A smart home-based home modification program using bluetooth or wifi and zigbee networks was the intervention.
Outcome type: Favorable
High quality of life and improved occupational performance and satisfaction were the results of the intervention.
Other
Peer Reviewed