Home Evaluation Occt 645

Home for Life Design
Home Assessment Report

Davis Legaspi-David of Touro University, performed the following occupational therapy home assessment to determine
the safety and current functional status of Turman in the home. This report details Linda Turmans feeling of safety and
measures the accessibility of important occupations that occur throughout areas of the home. Information was
gathered via professional interview with the client and/or family, activity analysis, objective measurements and
photography. This
assessment was performed on: 9/16/2015
Patient Information:
Patient Name:
Address:
Date of Birth: 8/27/1947
Tennant Type:
Housing Type:
Renter
Single Family
No. Floors:
2
Height (in) 62, Weight (lbs) 127
Special Considerations:
Inaccessible Overhead kitchen cabinets
Areas:
If the client has fallen, did the most recent
fall:
Is Veteran:
No
Has HOA:
No
Lives With:
Spouse
Other Considerations:
Assistive Raised laundry basket is the only assistive
Devices: device the client currently uses
Where did the fall occur: Outside the Home
What Room:
Result in Injury: Yes
Fall Cause Type: Physiological
Result in Hospitalization: Yes
Fall Cause Comments: Client lost balance while carrying large

box down driveway and fell.
Result in Rehabilitation: Yes
Consideration Type
Therapist Note
Has a History of Falls
Fell 1 year ago, fracturing surgical neck of R femur
Has Pets
Has 2 small dogs that usually stay out of the way but could
cause tripping
Home and Personal Findings:

The following rooms assessed each indicate the Personal Safety Rating given by the patient and the Therapist
Accessibility Rating determined by activity analysis during skill performance:
A Home for Life Design Solution
http://www.homeforlifedesign.com
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Home Recommendations Based on Findings:

Pre-Assessment
Bathroom, Full bathroom in master bedroom
Post-Assessment
Personal Safety
Rating %
Therapist
Accessibility
Rating %
Personal
Safety
Rating %
Therapist
Accessibility
Rating %
100.00 %
100.00 %
0%
0%
Recommended Modifications:
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Pre-Assessment
Bedroom, Master bedroom on first floor
Post-Assessment
Personal Safety
Rating %
Therapist
Accessibility
Rating %
Personal
Safety
Rating %
Therapist
Accessibility
Rating %
100.00 %
100.00 %
0%
0%
- Organize/Declutter Space
Pre-Assessment Notes:
Client reports no difficulty getting in or out of bed. Client reports discomfort when lying on R surgical side in bed.
Nightstands on each side of bed. Client sleeps on side of bed with limited maneuverability due to couch close to bed.
Post-Assessment Notes:
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Pre-Assessment
Dining Space, Dining area next to kitchen on
first floor
Post-Assessment
Personal Safety
Rating %
Therapist
Accessibility
Rating %
Personal
Safety
Rating %
Therapist
Accessibility
Rating %
100.00 %
100.00 %
0%
0%
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Pre-Assessment
Entryway, Garage door entrance to house
Post-Assessment
Personal Safety
Rating %
Therapist
Accessibility
Rating %
Personal
Safety
Rating %
Therapist
Accessibility
Rating %
100.00 %
100.00 %
0%
0%

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Pre-Assessment
Kitchen, First floor kitchen
Post-Assessment
Personal Safety
Rating %
Therapist
Accessibility
Rating %
Personal
Safety
Rating %
Therapist
Accessibility
Rating %
100.00 %
85.71 %
0%
0%
- Add Accessible Shelving
- Add Raised Dishwasher
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Pre-Assessment
Living/Family Room, First floor living room
Post-Assessment
Personal Safety
Rating %
Therapist
Accessibility
Rating %
Personal
Safety
Rating %
Therapist
Accessibility
Rating %
100.00 %
100.00 %
0%
0%

Pre-Assessment
Hallway, First floor hallway in front of front
door
Post-Assessment
Personal Safety
Rating %
Therapist
Accessibility
Rating %
Personal
Safety
Rating %
Therapist
Accessibility
Rating %
100.00 %
100.00 %
0%
0%

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Pre-Assessment
Outdoor Space, Outdoor backyard and front
yard
Post-Assessment
Personal Safety
Rating %
Therapist
Accessibility
Rating %
Personal
Safety
Rating %
Therapist
Accessibility
Rating %
100.00 %
83.33 %
0%
0%

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Pre-Assessment
Stairs, Stairs near front door going to
second story of home
Post-Assessment
Personal Safety
Rating %
Therapist
Accessibility
Rating %
Personal
Safety
Rating %
Therapist
Accessibility
Rating %
100.00 %
100.00 %
0%
0%

Additional Service Recommendations (e.g. home health, medication management):

Removal or taping down of throw rugs
Raised washer and dryer in laundry room
Reorganize laundry room to remove clutter
Raised dishwasher racks
Rearrange kitchen storage to allow access to items in overhead cabinets
Rearrange couch in bedroom to be further away from bed
Reposition railing in pool to allow access to stairs when getting in/out of pool
Additional Notes:
Overall, client's home is relatively safe & accessible with minimal clutter. However, the multiple throw rugs are
potential fall hazards, & some home appliances that are low to the ground make IADL completion difficult &
painful for the client. Other significant findings include some clutter in laundry room, inaccessibility to kitchen items in
overhead cabinets, limited space to maneuver between bed & couch in bedroom, & difficulty getting out of
pool due to blocked pool stairs. Such environmental barriers only minimally impact the client as she is still able to
complete her daily activities & fulfill her roles, requiring assistance only to obtain items from kitchen cabinets.
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Recommended home modifications to increase safety are listed in the following "Additional Service
Recommendations" box.
Submitted By:
Michelle Versten, , License #

10/21/2015
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Home Evaluation Occt 645

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Home for Life Design

Home Assessment Report

Result in Injury: Yes

Fall Cause Type: Physiological

Result in Hospitalization: Yes

Fall Cause Comments: Client lost balance while carrying large

Result in Rehabilitation: Yes

Has a History of Falls

Fell 1 year ago, fracturing surgical neck of R femur

Home and Personal Findings:

A Home for Life Design Solution

A Home for Life Design Solution

Home Recommendations Based on Findings:

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A Home for Life Design Solution

A Home for Life Design Solution

A Home for Life Design Solution

A Home for Life Design Solution

A Home for Life Design Solution

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A Home for Life Design Solution

A Home for Life Design Solution

A Home for Life Design Solution

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A Home for Life Design Solution

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A Home for Life Design Solution

A Home for Life Design Solution

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Additional Service Recommendations (e.g. home health, medication management):

A Home for Life Design Solution

Michelle Versten, , License #

A Home for Life Design Solution

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