1|P a g e

Occupational Therapy
Minor Home Modifications Report
Client details
Name: Keith Jing
Address: 123 University Lane
Phone: 0423718905
Date of Birth: 9/2/1951
Age: 72
Alternative contact person: Michelle
Relationship to client: Wife
Phone: 0413258511
Home ownership:
(If not the client, provide the name and contact
details of the Home Owner)

Occupational Therapist: Alana Gordon

Phone: 0412630730
Email: alana.gordon24@gmail.com
Dates of visit/s:
People present on visit:

1. Briefly state the nature of and reason for the recommended minor home
modification(s) (tell the reader why client needs home mods. For e.g. is it
because they need to access their home?. Make reference to their prognosis if it
will impact the speed that you will need the mods to be completed in. Tell us
about if they have had a previous visit or any previous modifications. identified
minor bathroom modifications) Marking criteria - Provides all relevant details of
client’s need for home modifications, with clear links made to prognosis-
Describes any home visits completed (including date, who was present, and
reason for home visit) CURRENTLY AT 249 words
Keith is a 72-year-old man who has been admitted into hospital after experiencing a fall 2
weeks ago which has resulted in left knee pain and a partial left rotator cuff tear. He requires
minor home modifications in the bathroom to enhance his safety, accessibility, and
independence to perform self-care activities. Keith’s prognosis indicates the need for
modifications to support his discharge as he has limited mobility and difficulty performing
certain self-care tasks. Bathroom modifications include installing:
2|P a g e

- Grab bars for shower and toilet to help with stability and balance to stand in the
shower, to support Keith during transfers and to reduce the risk of falls.
- Shower seat for additional safety, stability, and comfort.
- Mounted shampoo and body wash dispensers to eliminate the need for Keith to use
reach and handle bottles. He will be able to use products without using his left hand.
- Colour coded tap by putting stickers on tap (red for hot, blue for cold) to provide a
visual cue for Keith to help with his differentiation.
- Labelled toiletries so Keith can easily see and access toiletries and help him remember
to use them in the shower.
- Visual timer to remind Keith to wash himself in the allocated time.
- Raised toilet seat with armrests to help Keith with transfers and minimize pain.
- Adapted toilet paper holder to make it easier for Keith to grip toilet paper.
- Non slip flooring or mats to reduce the risk of falls
2. Client's health & medical condition
Describe the client's current health and long term medical history
Describe any anticipated medical intervention and the functional implications of this intervention.
(This should be written in sentence format and not dot points. Only disclose relevant info. For e.g.
don’t tell them about psych background if its not relevant to the home mods. Marking criteria -
Provides relevant information on diagnosis and co-morbidities using correct terminology- Discusses
predicted functional implications of prognosis with good understanding and references. CURRENTLY
AT 138 words
Keith experienced a recent fall causing left knee pain (8/10 client-rated pain) and a partial left
rotator cuff tear. He has a history of osteoarthritis primarily in his knees and AC joints. Keith
mobilises with a walking stick using his right hand. He manages pain by medicating with
Endone. His right shoulder has extensive damage due to arthritis, which is being treated
conservatively. Additionally, he has arthritis in his hands causing swollen finger joints. Keith is
required to not flex his left shoulder more than 30 degrees. He wears a sling on his left arm
and can take the sling off to shower. Cognitive testing for dementia is in progress. Anticipated
medical interventions will focus on pain management and shoulder care. The functional
implications include improved pain control but ongoing limitation in shoulder mobility and
potential cognitive challenges.
3. Social Situation
Describe the client's living and social arrangements (broad summary of who lives with the client and
the amount of family support providing as well as any services they receive and finances e.g. are they
on age pension or self funding retiring. Marking criteria- Provides a concise summary of relevant
details of social situation- Strongly links social situation to assistance provided with ADLs/IADLS, family
support, and finances where relevant CURRENTLY AT 77 words
Keith lives with his wife, Michelle, in their home, which they own. They have been married for
50 years, with two daughters and two grandchildren (grandchildren live interstate). Keith and
Michelle’s spend time with friends who provide social support. There is no specific
3|P a g e

information provided about Keith’s financial situation. Keith has retired from working as a
roofer, this suggests a possible source of income or retirement savings. There is no mention
of any external services they receive.
4. Home environment
Describe the type of dwelling, Describe access to dwelling, Describe internal access. (dwelling type,
what the access looks like, the front the rear and internally, the bathroom layout, and the flooring,
mention any rails or equipment in place) Marking criteria- Provides a thorough description of the
dwelling including type, access (front, rear, internal), bathroom layout, and flooring- Uses professional
terminology to correctly describe the environment. CURRENTLY AT 139 words
Dwelling: Keith lives in a double-story house. Keith and Michelle sleep in the bedroom
downstairs that has access to an ensuite bathroom.

Access: Steep, downward slopping driveway leading up to the Garage with a level pathway to
the front door. 165mm threshold step at front door with an existing doorway width of
760mm which is not wheelchair accessible. (I NEED TO CHANGE THIS TO MAKE IT RELEVANT
FOR MY HOUSE BUT IDK WHAT TO SAY)

Internal Access: The main living areas of the home include the bedrooms, kitchen, lounge
room and dining area. Flooring is a mixture of tiles (kitchen, dining area, bathroom, laundry)
and carpet (lounge and bedrooms).

Bathroom: Standard size and layout including a shower, vanity with a sink and a toilet. Has
two doors, one to the bedroom, one to the hallway. The toilet is standard height with no grab
bars. The shower has a rain showerhead and a separate handheld shower hose.

5. Clients functional status

Describe the functional implications of the client's health and medical conditions when undertaking
the following (discuss the level of assistance required in occupations, use subheading, ensure that you
reference the clients functional status in ALL relevant ADL sub domains). Marking criteria- Objectively
describes client’s occupational performance in all areas of occupation using relevant subheadings-
Uses correct measurable, professional terminology to describe occupational performance status in
most instances
5.1 Functional mobility 241 words
Mobility: Due to Keith’s limited mobility, he mobilises using a walking stick in his right hand.
The need for the walking stick suggests reduced mobility and balance, especially when
navigating uneven terrain. This needs to be considered when planning home modifications to
ensure safe navigation in the home environment.
Transfers: Keith’s condition of osteoarthritis causes pain during transfers (toileting and sit to
stand). He currently relies on using the chair arms or rocking forward for momentum to help
with sit to stand transfers.

Sitting: Keith’s dynamic sitting balance has been minimally affected, allowing him to be able
to sit upright in a chair for extended periods. This suggests that he can participate leisure
4|P a g e

activities that involve sitting.

Standing: Keith’s health conditions and injuries have caused him to experience pain when
standing and have poor dynamic standing balance. He reports finding it increasingly difficult
to stand and stabilise in the shower.

Falls: Keith has a history of falling resulting from his knee pain. Due to Keith’s limited mobility,
he has an increased risk of falls during mobility related activities.

Bed mobility: Keith mobilising in bed independently however, he reports challenges as he

finds it difficult and painful to turn in bed or sit up from a lying position.

Transport mobility: Keith is unable to drive his manual car, due to his shoulder injury.
Therefore, has limited community mobility and access, as his wife cannot drive either.

5.2 Self Care ADL 215 words

Eating: While Keith can eat independently, he requires assistance to cut his food with a knife
and fork.

Dressing: Keith’s has difficulty donning and doffing his clothing due to reduced balance and
pain when bending as well as limited use of his left arm. He is currently unable to do up
buttons. He may require assistance from his wife (depending on the complexity of the
clothing items) for tasks such as buttoning or zippers.

Grooming: Keith forgets to clean his teeth regularly and now relies on an electric shaver to
shave. This may be due to challenges associated with holding and manipulating a manual
razor or toothbrush. He is balding so does not brush his hair.

Showering: Keith’s health conditions and limited use of his left arm impact his showering
independence. He has difficulties with various aspects of the task including turning the taps
on and off, adjusting the temperature (due to not remembering which side is hot and cold),
remembering to wash himself, pouring shampoo and body wash into his left hand, and
standing or stabilising in the shower.

Toileting: Keith can use the toilet independently; however, he experiences pain during toilet
transfers, and he has difficulty gripping toilet paper.

Sleeping: Keith currently has trouble finding a comfortable sleeping position due to recent
injuries.
5|P a g e

5.3 Domestic ADL 39 words

Housework: Prior to his admission, Keith took out the garbage, gardened and mowed the
lawns. He expresses a desire to resume these roles but is unsure if this will be possible due to
his health conditions and mobility limitations.
6. Identified Occupational Performance Problems: (what the clients problems are that are
relevant to the bathroom modifications, write at least 3 of these problems, make sure they
are occupational therapy specific, make sure you include the occupation that has been
restricted/impaired/limited and the cause of the problem). Marking criteria- Identifies 5 +
correctly formulated occupational performance problems that are relevant to the client or
carer and their home environment- Strong links made between occupational performance
problems and stated occupational performance levels, and/or prognosis, and/or home
layout- Clearly articulated occupational performance problems including all relevant
information. Currently at 121 words
1. Keith is unable to shower independently due to his restricted shoulder mobility, poor
dynamic standing balance, and instability, which impairs his ability to perform shower-
related tasks.
2. Keith has trouble showering independently due to his inability to turn on and off the
tap and difficulty remembering how to adjust the water temperature.
3. Keith is unable to shower independently due to his inability dispense shampoo and
body wash liquid into his left hand.
4. Keith experiences difficulties gripping toilet paper during toileting due to arthritis in
his finger joints leading to reduced fine motor skills and dexterity.
5. Keith experiences pain during toilet transfers primarily due to his left knee pain and
knee osteoarthritis, affecting his mobility during these transfers.

7. Interim Solutions (include any equipment trialled) - State if these are not suitable for long
term use (should be linked to the impact it has on the client and the carer). Marking criteria-
Recommends appropriate and realistic interim solutions that are clearly described- Strongly
links each solution to impact on client and/or carer. Currently at 185 words
A shower chair with a non-slip seat can help Keith while showering. It can provide immediate
stability and support when engaging in shower related tasks and reduce the risk of slips or
falls in the shower. The shower chair will make showering more manageable and make it less
physically demanding for Keith. It improves Keith’s independence when showering, putting
less strain on the carer to aid with this task. This may not be suitable for the long-term as it
doesn’t address the root causes of his mobility limitations.

Colour-coded or labelled tap markers can be applied to help Keith distinguish between hot
and cold. It provides a short-term solution as it give Keith a visual cue so he can
independently turn on and adjust the temperature. This may not be suitable for long-term as
it does not focus on addressing the cognitive or physical factors contributing to Keith’s
challenges.
6|P a g e

Nonslip mats can be installed to enhance safety during transfers and reduce the risk of falls
for Keith. This is a short-term solution. A long-term solution would involve making permanent
modifications such as installing non-slip flooring.
8. Implications for the client &/or carer should the modifications not be implemented (e.g.
if the client doesn’t get these modifications x and y could occur). Maring criteria- Realistic and
well thought through implications for client and carer are clearly articulated- Sound
discussion of implications for both client and carer if modifications are not completed.
Currently at 120 words
Without the necessary bathroom modifications to address Keith’s challenges and limited
mobility:

- Increased risk of falls and injuries for Keith while performing essential self-care tasks.
This can potentially result in physical harm, prolonged recovery time, hospitalisation,
further decrease of independence which could affect Keith and his carer negatively.

- Loss of independence for Keith as he may rely on his carer for assistance with self-care
tasks. This loss of autonomy can compromise Keith’s overall quality of life.

- Increase burden for carer as Keith may need consistent assistance and supervision in
the bathroom. This can cause the carer to become burnt out and have increased
stress.

- Increased healthcare costs such as hospitalization due to additional falls or injuries.

Signature and designation: _______AlanaG_____________________

The recommendations contained in this form are made after consultation with the client and an investigation of the client's
circumstances and needs. Their purpose is to outline steps required to be taken for the benefit of the client, having regard to his
or her disabilities. They do not purport to reflect other than limited knowledge on the part of the occupational therapist of
structural considerations and building codes. Any queries, concerns or alterations considered necessary for compliance with
current building regulations must be discussed with the occupational therapist before quoting for the cost of the work and
before the work proceeds. The occupational therapist accepts no responsibility for supervision of the work or for the quality of
workmanship.