Home Assessments: Beyond Equipment Needs

As a Certified Aging in Place Specialist (CAPS Professional), I go into people’s home almost every day to discuss with the patient or their caregivers about how to best enable them to return home and remain there safely. I have learned a lot about construction, such as where grab bars should and shouldn’t go, the equipment we can use if there is no place to put a grab bar, etc. But one of the biggest things I have learned is that it is not all about the equipment.

Many families have just had their world turned upside down by the injury or illness of a loved one, and they are overwhelmed with all that is going on post-hospital discharge. I have walked into arguments between siblings, the uncertainty of a wife on how to care for her husband, and a husband whose wife took care of everything and now he has to make the decisions in the home. Make sure you really understand the circumstances you are about navigate as you access the home for mobility needs.

Below are some helpful pieces of advice that when going into someone’s home for a CAPS Assessment:

1. Sit down first: Many times I walk in the door and they rush me right to the bathroom without really talking about the issues they are facing. Sit down in the living room or around their dining room table, and discuss their new or ongoing mobility situation first.
2. Listen: When they tell you that their loved one had a stroke and cannot use their right side, do not put a grab bar on the right side of the hallway or shower, unless absolutely necessary. They want to know you heard them and understand their needs. They also may tell you what they are thinking of doing in the home and want to get your opinion. This is usually where you hear great ideas and also very dangerous ones. For instance, when the home has five steps with 35 inches of rise and the family believes a six-foot portable ramp will be enough to be safe.
3. Get therapy involved: You occasionally come across a patient that is in denial about what is going on and does not think the tools you recommend are needed. This is why getting therapists involved is extremely helpful. They have been working with the patient and know what their current level of mobility is, so they will probably have an idea for the future. I have sat down with a family and the therapists to make sure we are all on the same page. Having family members in the meeting is god, too, as they will hopefully be a good support for the loved one in denial.
4. Cluster homes: I call them cluster homes because when I walk in, my first thought is, “What a cluster…..” When you cannot get down their steps safely because they have every issue of People Magazine since 1983 on the steps or they point and say, “The hospital bed will go there,” but you cannot see “there,” it is time to get social work involved. It does not matter how many grab bars you put in the home it is not safe. Letting social work know this information is helpful because they can hold the discharge from the hospital until the home is cleaned up or find another option for the patient.
5. Set-up expectations: Make sure the customer knows when you will be sending an estimate and how they can contact you. Do not make false promises; if you are slammed and do not think you can get an estimate out within 24 hours, then communicate that to them. They have so much going on that the last thing they need is to worry about when they will hear from you and when you can do the install of the needed tools.

At the end of the day, you want the customer to walk away feeling like helped them bring their loved one home to a safer environment, and that they did not have to do much but pick up the phone and call you to make things happen. If you can do this, you will have a customer that will call you again and refer you to others.