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General condition 

What type of construction and the condition of siding, roof, windows, finishes, fixtures and fittings, particularly in the space to be modified.


Look at landscaping, driveways and walkways, path lighting, and outdoor access.


External and internal traffic

Look at pathways, flooring, space, turns and corners, controls, lighting or electrical, and stairs.


Consider the width, threshold, steps, door swing, hardware and security for not only exterior doors but interior doors and cased openings, halls and maneuvering room within spaces.


Surface materials

What materials were used for walls, floors and ceilings? Are there large cracks indicating structural problems? Is there any rough, spiky texture on the walls that could worsen and injure the client during a fall?

Individual rooms

Determine which rooms need to be addressed and to what degree. If a live‐in caregiver might be needed, does the home have a bedroom and bath available for their use?


Safety and security

Investigate the locks, security doors, security systems and keypads to be operated by the client to determine if the home is generally secure and provides a level of comfort to the client when he is home alone. Evaluate fire exits, ease of egress, emergency exit lighting, and interconnected smoke and carbon monoxide detectors.



Mobility and Ambulatory Impairment

This aspect of the evaluation process is extremely important, as how the client moves around the home, including interior and exterior, is critical in determining required modifications and shaping the installation process. Some types of equipment that your client may be using now or possibly in the future along with other mobility considerations include a cane, walker, or wheelchair.

Coordination and Balance

Loss of coordination can take many forms and can range from mild to severe. Fine motor coordination refers to the ability of the hands or fingers to do small tasks smoothly, efficiently and safely. This includes writing, buttoning a shirt or tying shoe laces. Gross motor coordination refers to larger movements, such as reaching for a faucet or walking.


Balance issues are a major reason for home modifications and can have many causes, such as medication interactions, lower extremity weakness, reduced sensation in the feet, inner ear problems, vision loss, tone issues, muscle imbalance or neurological impairments.

Sensory Impairment Considerations

Sensory impairments (vision, hearing, touch, smell) can cause real challenges to safety and independence. Compensating for this sensory loss can be even more challenging if there are multiple impairments.

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