Most families put off booking a home assessment because they are not sure what they are agreeing to.

There is usually a worry sitting underneath it. That someone will walk through your mother's house with a clipboard, decide she is not coping, and start a conversation the whole family has been avoiding.

That is not how it works. In fact, it is the opposite of that. Our job is to provide support and recommendations for people to stay in their home for longer, whilst remaining safe and independent for as long as possible.

An occupational therapy home assessment is a practical visit. We come to the home, look at how the person actually moves through and manages their everyday environment and listen to what they are finding challenging. We work with you and your family to identify practical solutions that can make everyday tasks and activities easier and safer. The person whose home it is remains at the centre of the process and in control of every decision that follows.

If you are thinking about a home assessment for a parent in Townsville, Ayr or Ingham, this is what the process looks like from start to finish.

Before the visit

Someone from our team will call to book a time and ask a few questions first. What has changed lately. Whether there have been any falls or near misses. What is harder than it used to be. Who else lives in the house.

None of this is a test. It helps us to make sure that the right therapist is visiting (each therapist has specific skills in different areas of practice) and it helps to prepare the therapist so the visit is spent on the things that matter rather than starting cold.

You do not need to tidy up. A house that has been staged for a visitor tells us very little. If the walking frame usually lives in the hallway and there is always washing on the second step, we need to see that, because that is the house the person lives in. And please don't worry about being judged. Our occupational therapists visit all kinds of homes, in all kinds of circumstances, and we are not there to assess how tidy or organised your home is. We are there to understand how the home works for you and to make practical recommendations that can help you stay safe, independent and comfortable in your own home.

On the day

Most of our assessment is simply a conversation.

The therapist will start by sitting down with you and talking through what a typical day looks like - getting out of bed, showering, making a cup of tea, getting to the letterbox, the car or the clothesline. We want to understand what is working well, what has become more difficult and what matters most to you.

Then we walk through the home together. This part is usually shorter than people imagine. We are looking at the fit between the person and the environment. This might mean looking at the height of the bed in relation to the person's function and ability, whether there is something safe and sturdy to hold onto near the shower, or how easy it is to manage the back step while carrying a laundry basket.

At times the therapist may ask the person to show them something rather than describe it. Standing up from their own chair, for instance, or stepping into the shower recess. Watching someone do a task in their own home tells us things a conversation will not, and it is often where the most useful and practical recommendations come from.

A home assessment usually takes about an hour, sometimes longer if the house is large or there is a lot to work through.

Family members or other support people are welcome to be involved. Some people want a son or daughter there. Others would rather meet with the therapist on their own and have the recommendations shared afterwards. Either is completely fine, and it is the client's choice.

What we are actually looking at

Four things, roughly.

The tasks that matter to that person. Not a generic list of daily activities. If someone's week is built around bowls on a Tuesday and cooking a roast for their family on Sunday, those are the tasks the assessment is built around.

The physical environment. Steps, floor surfaces, lighting, bathroom layout, bed and chair heights, doorway widths, and how far it is from the car to the front door.

How the person moves. Balance, grip strength, how they rise from a low seat, whether they steady themselves on furniture as they cross a room, how they manage the front stairs when they are tired at the end of the day.

What is already there. Many homes already have equipment in them. Often it is the wrong height, in the wrong position, or was never set up properly in the first place. Sorting out what is already in the home is frequently the quickest improvement available.

After the visit

Depending on the type of assessment we complete, you or your provider will receive a written report. It sets out what was observed and what we recommend, ordered so that the things worth doing now sit apart from the things to think about later.

Recommendations tend to fall into a few groups. Changes to the way a task is done. Equipment, from a shower stool through to a bed rail. Home modifications such as grab rails, ramps or changes to a bathroom. Sometimes a referral on, to a physiotherapist for strength and balance work, support for accessing the community or back to the GP.

Nothing in the report happens automatically. It is a set of recommendations, and the person, their family and their provider decide which of them to act on.

What an assessment does not do

It does not put anyone into aged care. An occupational therapy home assessment is not an aged care assessment, and we have no power to move anybody anywhere.

It does not report on the person behind their back. What we observe stays between us and the client unless they ask us to share it. Nothing goes into a report that we haven't already discussed during the assessment – there are no surprises!

It does not mean everything has to change at once. Most reports have one or two things worth doing this month and a longer list that can wait.

This matters, because the fear of losing control of the decision is one of the most common reasons people say no to a visit.

When it is worth booking

There is no age at which everyone should have a home assessment. It is worth booking when something has changed.

A fall, or a near miss that gave everyone a fright. A hospital stay. A new diagnosis. A partner who used to help with showering and can no longer manage it.

Or the quieter version, where nothing has actually happened yet, but you have noticed your father running his hand along the wall on his way down the hallway, having difficulty lifting a heavy kettle, being a bit more unsteady when navigating the back door steps, and you would rather deal with it now than after an ambulance.

The early version of that conversation is much easier than the late one.

How it is paid for

Home assessments can be funded several ways.

Support at Home covers people who have had an aged care assessment and been approved. Funding for equipment and home modifications sits within this program, under the Assistive Technology and Home Modifications scheme.

DVA covers veterans holding a DVA Gold Card, or a DVA White Card where the condition has been accepted. A D904 referral from the GP is needed.

NDIS covers participants who have relevant supports in their plan.

Privately, there is no referral and no waiting on an approval. Families often take this route when they want the matter dealt with promptly, when they want a report with recommendations to take to a provider, when a person is waiting on funding approval or when the person has not had an aged care assessment or when the family want to be proactive and implement some strategies as early as possible.

Our reception team can talk you through what applies to your situation before you commit to anything.

Questions we are asked most often

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