Home Adaptations and Equipment: Making a Home Work for Care

Start with an occupational therapy assessment

Occupational therapy assessments are free through the local council, and they are the single most useful first step. An occupational therapist looks at how the person actually moves through their day and recommends equipment and changes that fit that pattern rather than a generic checklist.

Minor equipment, generally items under a set cost threshold, is normally provided free by the council following assessment. That includes many of the things families are about to buy privately, so it is worth asking before spending.

• Free assessment from the council's occupational therapy team
• Minor equipment under the cost threshold is usually provided free
• Assessments can be requested by you, the GP or a hospital team
• Ask for an urgent assessment if a discharge is pending
• Equipment can reduce the number of paid care hours needed

The bathroom, where most accidents happen

Bathrooms combine hard surfaces, water and awkward movements. Grab rails beside the toilet and in the shower, a raised toilet seat, a shower chair or bath board, and a non slip mat address most of the risk cheaply.

Where washing has become genuinely unsafe, a level access shower replacing a bath is the big intervention. It is disruptive and costly, but it often removes the need for two carers and keeps someone washing themselves for far longer.

Stairs, floors and lighting

A second stair rail is inexpensive and reduces falls immediately. Beyond that, consider whether a stairlift or moving a bed downstairs is the better answer. Downstairs living can feel like a defeat, but it often restores freedom, particularly if a downstairs toilet exists.

Lighting matters more than people expect. Ageing eyes need considerably more light, and most falls at home happen in poor light on the way to the toilet at night. Motion sensor night lights along that route are one of the cheapest safety improvements available.

• Second stair rail and clearly marked step edges
• Motion sensor night lights between bedroom and bathroom
• Remove trailing cables, loose rugs and clutter on routes
• Brighter bulbs, especially in stairwells and kitchens
• Consider a downstairs bed and commode where stairs are unsafe

Kitchen, bedroom and everyday living

In the kitchen, move everyday items to waist height, add a kettle tipper or a lightweight kettle, and consider a perching stool. A microwave at counter height is safer than an oven at floor level for someone unsteady.

In the bedroom, a profiling bed, a bed lever or a mattress raiser helps someone get up independently and reduces the risk of injury to carers. Where transfers have become difficult, a hoist may be needed, and any hoist should come with proper training for everyone using it.

Disabled Facilities Grants and bigger works

For larger adaptations such as level access showers, ramps, door widening and stairlifts, a Disabled Facilities Grant is available from the local housing authority. It is means tested for adults, there is a maximum grant, and an occupational therapist assessment is normally required.

The process takes time, often several months, so start early rather than waiting for a crisis. Councils sometimes run faster small grant or handyperson schemes for minor works, which are worth asking about separately.

• Apply through the local housing authority, not adult social care
• Means tested for adults, with a maximum grant amount
• Occupational therapy assessment normally required first
• Expect several months, so apply before it becomes urgent
• Ask about handyperson and small grant schemes for minor works

Technology worth considering

Personal alarm pendants and falls detectors connect to a monitoring centre and are the most widely used telecare. Automatic medication dispensers help where prompting is the main issue. Simple video calling devices reduce isolation and let family check in without a two hour round trip.

Technology supports care but does not replace it. A pendant only helps if the person will wear it and press it, which is often the sticking point in dementia. Our carers work alongside whatever equipment is in place and will tell you honestly if something is not being used.