The psychological impact of home modifications

Regardless of their age or disability, every Australian has a right to live in a home that is safe, secure and designed to meet their needs. A familiar and comfortable home helps us to achieve a state of good health and positive wellbeing. This article outlines how occupational therapy and home modifications can help ensure an older person or a person with disability can live longer at home. We also cover the surprising psychological and social benefits of external and internal modifications.

Benefits of living at home

It is easy to appreciate the benefits of living at home. When older people and people with disability are supported to remain in their own home, they are likely to be healthier and happier. People who are supported to live at home tend to remain more independent and be active in their community. People who need to move into care homes or nursing homes before they are ready tend to experience higher rates of depression and social isolation.

Safety benefits of home modifications

Home modifications can help an older person or a person with disability to remain living at home longer. To prepare this article, we looked at housing modifications data collected in Australia and overseas. There is strong and consistent evidence that carrying out home modifications at home can have many benefits. The physical benefits of home modifications include:

  • reduction in the frequency and severity of hospitalisations

  • reduction in falls risk

People are less likely to experience injury or falls when home modifications have been installed. A reduced risk of falls also reduces a person’s risk of hospitalisation. These benefits to physical health and safety are easy to understand.

However, high quality longitudinal data has recently presented some surprising findings about the twofold binary disability outcomes of home modifications. Research has found that as well as providing physical safety benefits, home modifications can benefit mental health and wellbeing. The installation of home modifications have had more immediate functional outcomes as well longer term positive psychological benefits.

Psychological benefits of home modifications

As well as reducing the risk of injury, broken bones, fractures and sprains, home modifications can also benefit people in other ways. The psychological benefits of home modifications include:

  • improved confidence

  • improved productivity and mobility

  • poor health decreased and overall mental health and wellbeing improved

Research and studies on home modifications

Very little comprehensive analysis of the benefits of home modifications have been carried out in Australia, however, several housing interventions studies have been conducted overseas. Most housing interventions studies have been undertaken in the UK or the USA.

Amongst these studies, there is strong evidence that completed housing modifications influenced a person’s mental health and promoted positive wellbeing.

A person’s subjective feelings about where they live is not related just to their physical experience in the home. A person has a sense of what home means, and the impact of the home on a person’s health is being increasingly researched and understood.

Our home is associated with our identity, it is an extension of our self-expression. Homes provide us with a sense of belonging, security, comfort and familiarity. Future research will likely continue to show us how important a safe home can be.

Home modifications and disability outcomes

In a 2022 study from England, UK government departments coordinated data collection from around the country. The study, called Home modifications and disability outcomes: A longitudinal study of older adults living in England, was one of the first studies to investigate the impact and benefits of housing modifications on disability outcomes among older adults.

The research specifically addressed and considered both external and internal housing modifications in an effort to determine the level of risk reduction the modifications offered to adults with disability. The study found that home modifications reduced the likelihood of:

  • falls

  • poor health

  • having to move into care

Surprisingly, installing external housing modifications also increased the likelihood of a person’s participation in social activities. This surprise finding demonstrated that people with home modifications are more likely to feel confident to seek out opportunities to connect with and be involved in the community.

Internal modifications tended to reduce these risks at slightly lower rates but were still useful in promoting overall health and wellbeing.

Home modifications for older people

Home modifications that can improve quality of life and safety for older people include:

  • the removal of a bath and installation of a shower

  • installation of grab rails

  • removal of steps or stairs either inside or external to the house

  • lowered light switches, door handles and benchtops

  • electric stair lifts

Equipment and assistive technology can also help older people, including shower chairs, toilet chairs, modified cutlery, tools and appliances.

Another study on the benefits of home modifications for older people found that modifications can greatly increase a person’s feeling of independence. This was particularly noticed when home modifications enabled the older person to better manage their personal care, toileting and hygiene.

Home modifications can give older people a sense of increase control and autonomy. They can reduce reliance on a spouse or carer.

Other beneficial home modifications for some older people increased their capacity to cook and prepare meals. Many older people, particularly women, enjoy cooking and prepare meals for themselves and their families. Lowered benchtops and other kitchen modifications enabled older people to continue cooking and baking.

Study finds that external housing modifications protected safety

This study found indicated that external housing modifications can effectively reduce the risk of various disability outcomes. This study also found that:

  • external housing modifications reduced social isolation and increase social participation

  • external modifications protected a person from falls risks

  • external modifications tended to help a person feel more confident to get outside and out and about

  • external home modifications increased the likelihood that a person would go outside to experience nature, by tending to their garden or simply sitting outside in the sunshine

  • external modifications compared to internal modifications produced more favourable results

The study found an association between psychological wellbeing and confidence and capacity to go outside of the home. For this reason, external housing modifications are an important way we can help older people to experience heathy aging and remain active in their community.

Internal housing modifications reduce risks

Internal modifications also make a positive psychological difference although it seems not to the extent of external modifications.

Internal modifications such as grab rails, ramps and other accessibility modifications certainly reduce the risks of falls and injury. Such internal modifications help people with mobility impairments to access various rooms around the house.

Internal modifications decreased the risks of falls in wet areas, such as the bathroom and toilet. Bathroom modifications were received as highly satisfactory by participants in the study. People were pleased to be able to shower safely and maintain control of their hygiene.

However, in some cases, people described internal modifications as having a significant effect on the design and ambience of their home. In some cases, there was a trade off between improved access and a feeling of homeliness or coziness.

Home modifications for people with disability

Two broad disability outcomes can be achieved by home modifications for people with disability and mobility impairments.

These outcomes relate to easy of access and mobility, and the secondary benefits of achieving of work, social or educational goals through improved use of rooms and spaces at home.

Home modifications for people with disability and significand mobility impairments can include:

  • widening of doorways and hallways to accommodate a wheelchair

  • installation of a hoist for use in personal care, or transfer to a bed or chair

Improved access to hobbies and recreation can improve a disabled person’s wellbeing. Modifications made to built in desks enable people with disability to read, study or enjoy puzzles and crafts.

Home modifications in the NDIS

The NDIS is the primary disability support system in Australia. To access home modifications through the NDIS, a scheme participant makes a request for funding to be allocated within their NDIS plan. An occupational therapy assessment will help determine the most appropriate and affordable home modifications.

Home modifications are changes made to the home environment, to make it safer and easier to navigate. Such housing modifications must be planned and carried out by licensed builders, and with all relevant plans and permissions in place.

Within the NDIS there are three categories of home modifications

  • Category A minor home modifications – less that $10,000

  • Category B minor home modifications – between $10,000 and $20,000

  • Complex home modifications – more than $20,000

Major expenditure housing modifications

Complex home modifications though the NDIS result in significant changes being made to a dwelling. These major changes can involve walls being altered. Complex home modifications are usually based on the Australian Standards for Access and Mobility, a public access standard for design based on wheelchair accessibility in buildings.

In line with the standard, major expenditure home modifications must meet requirements for continuous accessible paths of travel and provide adequate circulation spaces. For major jobs, it’s important to ensure that architectural and planning research is carried out before construction, building and development works get underway.

Nursed Care for services at home and in the community

We are Nursed Care, an experienced and accredited community services provider based in Paramatta and providing My Aged Care and NDIS services throughout metropolitan New South Wales. Our diverse services offering includes personal care, medication management, domestic assistance, social and community participation support and transport.

Our services help people to maintain their independence and carry out the activities of everyday life. We support clients with significant mobility impairments, poor health pain and chronic conditions to get out and about with confidence.

We’re committed to unlocking new opportunities for individuals under the NDIS, ensuring every Australian with a disability can fully participate in society.

We also have specialist accommodation and home modification services. Our teams work together to deliver holistic support and establish pathways linking housing and social programs.

Nursed Care for Housing and disability outcomes

Housing adaptations can make a big difference. Home modifications can eliminate or reduce key risks factors at home. From installing non slip tiles in the bathroom, to improving access to the bedroom or bathroom, Nursed Care home modifications will keep you safe at home.

Our data analysis and literature review have demonstrated the benefits that home modifications will bring. Struggling with mobility and access at home makes you more likely to develop poorer health, feel isolated and increases your chances of having to move into care before you are ready.

We understand that housing modification effects and has a positive benefit for severely disabled older adults. Nursed Care can help bring improvements to your social and physical environment. We can help you plan and build the home of your dreams.

We also manage NDIS accredited housing stock around NSW, if you would like to access short term accommodation or respite. Contact us today.

Related questions

Occupational therapy is a professional service that can help an older person or person with disability to move and carry out activities. Occupational therapy has benefits for both children and adults. It can help shine a light on and measure functional difficulties for people with mobility impairments.

Occupational therapy assessment can help reduce the key risk factors people in encounter at home. The aim of occupational therapy is to reduce risks of falls or injury while carrying out the activities of everyday life. The seven broad outcomes of occupational therapy assessment and services are:

  1. evacuating a person’s habits and activity

  2. prevent muscle wasting and degeneration

  3. improve visual awareness and sight

  4. boost memory

  5. address and respond to pain

  6. improve strength and tone

  7. increase confidence

When considering home modifications, particularly if you are seeking funding or support for these home modifications, there are a number of things you should consider. These considerations relate to both your specific needs, and the location and design of your home.

The building factors that should be considered include:

  • the age of the property

  • the structural integrity of the property

  • who owns the property

  • is the property leased or owned

  • will the modifications alter the home environment?

Need qualified care?

At Nursed, we offer a full range of care and disability support services, assisting you to live the life you want to live. Contact us today.

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