Inclusive Practices for Aging in Place: Environmental and Home Modifications for Older Adults.

Abstract

Importance: As the aging population expands, the need to develop home modification programs that effectively support older adults living in low-income households is increasing.

Objective: To examine how an interprofessional team implemented the Older Adult Home Modification Program (OAHMP) at a specific urban site and integrated functional interventions and home modifications to address the safety, accessibility, and functional needs of older adults in low-income households.

Design: This program evaluation study used descriptive analysis to evaluate sociodemographic characteristics, pre- and postimplementation data, and home modifications.

Setting: An urban city environment.

Participants: Sixty-five participants completed the program. The average age was 72 yr (SD = 7.3); participants were predominantly women (95.4%), Black or African American (87.7%), and living alone (81.5%).

Intervention: Three in-home visits by an occupational therapist, a home modification team, and a social worker.

Outcomes and measures: A paired-samples t test was conducted to compare pre- and postimplementation functional scores on the assessments used, and Pearson's r correlation analysis was used to assess relationships between functional measures.

Results: The OAHMP implementation led to significant improvements in self-care activities of daily living (ADLs) and home safety; significant positive relationships were found between health status and improved independence in ADLs and instrumental ADLs.

Conclusions and relevance: The OAHMP enhances ADL independence and home safety for older adults in low-income, diverse communities. By addressing environmental barriers through client-centered modifications and interprofessional collaboration, the program supports aging in place. Its cost-effective approach fosters autonomy, occupational engagement, and health equity, highlighting occupational therapy's key role in safe, sustainable community living. Plain-Language Summary: This study evaluated the Older Adult Home Modification Program (OAHMP), which aims to help older adults in low-income communities age safely in place by addressing home safety, accessibility, and ADLs. Findings showed that participants experienced increased independence in ADLs and reduced home safety hazards, with 91% of personal goals met or partially met. The average cost of home modifications was significantly lower than national averages, making the program a cost-effective alternative to nursing home placement. The results highlight how tailored home modifications, combined with interprofessional collaboration, can promote ADL independence and safety in the home. This study emphasizes the essential role of occupational therapy in developing equitable, client-centered interventions that address environmental barriers, contributing valuable insights to occupational therapy research, practice, and education. Positionality Statement: The authors are one Black female therapist, one White female therapist, and two White female occupational therapy students. We acknowledge that our economic, educational, and cultural backgrounds may influence our perspectives and potential biases in this analysis.