Feasibility and Effectiveness of Telehealth Occupational Therapy Home Modification Interventions


  • Marnie Renda Chatham University Rebuild Independence LLC
  • Jennifer E. Lape Chatham University




Despite the effectiveness of occupational therapy home modification interventions, persons with disabilities may not receive them due to service delivery costs, limited number of therapists, and expansive geographic service areas.  The need for occupational therapy home modification interventions will increase with the rising U.S. aging population, incidence of chronic illness, and shift toward community-based care.  This study examined the feasibility of telehealth occupational therapy home modification interventions using participant owned smart phones, tablets, or computers.  A pretest posttest design (n=4) demonstrated improvement in home safety and perception of performance of daily activities.  Participants reported satisfaction with the mode of intervention citing ease of use and reduction in client and caregiver burden.  Two key implementation challenges were (1) inconsistent quality of synchronous audio and video and (2) limited funding for home modification interventions.  A large-scale telehealth occupational therapy home modification interventions pilot study is warranted.




Author Biographies

Marnie Renda, Chatham University Rebuild Independence LLC

Owner Rebuild Indpendence LLC, a private practice home modification business in Cincinnati OH specializing in helping elders and persons with disabilities continue to live at home.


Jennifer E. Lape, Chatham University

Faculty, Chatham University

Occupational Therapy Department


AARP. (2004). Beyond 50.05: A report to the nation on livable communities: Creating environments for successful aging. Retrieved from https://assets.aarp.org/rgcenter/il/beyond_50_communities.pdf

Aplin, T., de Jonge, D. & Gustafsson, L. (2013). Understanding the dimensions of home that impact on home modification decision making. Australian Occupational Therapy Journal, 60, 101–109. http://doi.org/10.1111/1440-1630.12022

Aplin, T., de Jonge, D., & Gustafsson, L. (2015). Understanding home modifications impact on clients and their family’s experience of home: A qualitative study. Australian Occupational Therapy Journal, 62, 123–131. http://doi.org/10.1111/1440-1630.12156

Chiu, T., Oliver, R., Ascott, P., Choo., L. C., Davis, T., Gaya, A., . . . Letts, L. (2006). Safety Assessment of Functional and the Environment for Rehabilitation-Health Outcome Measurement and Evaluation (SAFER-HOME), version 3. Toronto, ON: COTA Health.

Clemson, L., Mackenzie, L., Ballinger, C., Close, J. C. & Cummings, R. G. (2008). Environmental interventions to prevent falls in community dwelling older people: A meta-analysis of randomized trials. Journal of Aging Health, 20, 954-971. http://doi.org/10.1177/0898264308324672

Cummings, R. G., Thomas, M., Szonyi, M., Salkeld, G., O’Neill, E., Westburg, C., & Frampton, G. (1999). Home visits by an occupational therapist for assessment and modification of environmental hazards: A randomized trial of falls prevention. Journal of the American Geriatrics Society, 47, 1397-1402. http://doi.org/10.1111/j.15325415.1999.tb01556.x

Davis, R. & Rodd, R. (2014). Providing the effectiveness of community occupational therapy in the equipment and adaptation setting using the Canadian Occupational Performance Measure. British Journal of Occupational Therapy, 77, 91-95. http://doi.org/10.4276/030802214X13916969447236

Dreyer, N., Dreyer, K., Shaw, D. K., & Wittman, P. P. (2001). Efficacy of telemedicine in occupational therapy: A pilot study. Journal of Allied Health, 10(1), 39-42.

Doxy.me (2017). [Computer software]. Rochester, NY: Doxy.me LLC.

Federal Interagency Forum on Aging-Related Statistics. (2016). Older Americans 2016: Key indicators of well-being. Washington, DC: Government Printing Office. Retrieved from https://agingstats.gov/docs/LatestReport/OA2016.pdf

Gitlin, L. N., Corcoran, M., Winter, L., Boyce, A., & Hauck, W. W. (2001). A randomized control trial of home environmental intervention: Effect on efficacy and upset in caregivers and on daily function of persons with dementia. Gerontologist, 41, 4-14. http://doi.org/10.1093/geront/41.1.4

Gitlin, L., N., Miller, K., S., & Boyce, A. (1999). Bathroom modifications for frail elderly renters: Outcomes of a community based program. Technology and Disability, 10, 141-149.

Hoenig, H., Sanford, J. A., Butterfield, T., Griffiths, P., Richardson, P., & Hargraves, K. (2006). Development of a technology protocol for in-home rehabilitation. Journal of Rehabilitation Research and Development, 43, 287-298. http://doi.org/10.1682/JRRD.2004.07.0089

Hoffman, T., Russell, T., Thompson, L., Vincent, A., & Nelson, M. (2008). Using the internet to assess activities of daily living and hand function in people with Parkinson’s disease. Neurorehabilitation, 23, 253–261.

Iwarsson, S., Isacsson, Å., & Lanke, J. (1998). ADL dependence in the elderly population living in the community: The influence of functional limitations and physical environmental demand. Occupational Therapy International, 5, 173-193. http://doi.org/10.1002/oti.74

Law, M., Baptiste, S., Carswell, A., McColl, M.A., Polatajko, H., & Pollock, N. (2014). The Canadian Occupational Performance Measure (5th ed.). Ottawa, Canada: CAOT Publications ACE.

Mann, W. C., Ottenbacher, K. J., Fraas, L., Tomita, M., & Granger, C. V. (1999). Effectiveness of assistive technology and environmental interventions in maintaining independence and reducing home care costs for the frail elderly. A randomized controlled trial. Archives of Family Medicine, 8, 210-217. http:///doi.org/ 10.1001/archfami.8.3.210

Nakamura, K., Takano, T., & Akao, C. (1999). The effectiveness of videophones in home healthcare for the elderly. Medical Care, 37, 117-125. http://doi.org/10.1177/107484070100700401

Ortman, J., Velkoff, V., & Hogan, H. (2014). An aging nation: The older population in the United States (Report No. P25-1140). Retrieved from United States Census website: http://www.census.gov/prod/2014pubs/p25-1140.pdf

Petersson, I., Kottorp, A., Bergstrom, J., & Lilja, M. (2009). Longitudinal changes in everyday life after home modifications for people aging with disabilities. Scandinavian Journal of Occupational Therapy, 16, 78-87. http://doi.org/10.1080/11038120802409747

Petersson, I., Lilja, M., Hammel, J., & Kottorp, A. (2008). Impact of home modifications for people aging with disabilities. Scandinavian Journal of Occupational Therapy, 16, 780-87. http://doi.org/10.2340/16501977-0160

Renda, M. (2016). Summary of Ohio Medicaid evaluations 2013 to 2015. Rebuild Independence LLC, Cincinnati, OH.

Sanford, J. A., Griffiths, P. C., Richardson, P., Hargraves, K., Butterfield, T., & Hoenig, H. (2006). The effects of in-home rehabilitation on task self-efficacy in mobility-impaired adults: A randomized clinical trial. Journal of American Geriatrics Society, 54, 1641–1648. http://doi.org/10.1111/j.1532-5415.2006.00913.x

Sanford, J. A., Hoenig, H., Griffiths, P.C., Butterfield, T., Richardson, P. & Hargraves, K. (2007). A comparison of televideo and traditional in-home rehabilitation in mobility impaired older adults. Physical & Occupational Therapy in Geriatrics, 25(3), 1-18. http://dx.doi.org/10.1080/J148v25n03_01

Sanford, J., Jones, M., Daviou, P., Grogg, K., & Butterfield, T. (2004). Using telerehabilitation to identify home modification needs. Assistive Technology, 16, 43-53. http://doi.org/10.5195/ijt.2017.6218

Sheffield, C., Smith, C., & Becker, M. (2012). Evaluation of an agency-based occupational therapy intervention to facilitate aging in place. The Gerontologist, 53, 907-918. http://doi.org/10.1093/geront/gns145

Snyder, L., & Rudowitz, R. (2016). Trends in state Medicaid programs: Looking back and looking ahead. Retrieved from The Henry J. Kaiser Family Foundation, Commission on Medicaid and the Uninsured website: http://files.kff.org/attachment/Issue-Brief-Trends-in-State-Medicaid-Programs.pdf

Stark, S. (2001). Creating disability in the home: The role of environmental barriers in the United States. Disability and Society, 16, 37-49. http://doi.org/10.1080/713662037

Stark, S. (2004). Removing environmental barriers in the homes of older adults with disabilities improves occupational performance. OTJR: Occupation, Participation and Health, 24(1), 32-39. http://doi.org/10.1177/153944920402400105

Stark, S., Landsbaum, A., Palmer, J. L., Somerville, E. K., & Morris, J. C. (2009). Client-centered home modifications improve daily activity performance of older adults. Canadian Journal of Occupational Therapy, 76, 235-245. http://doi.org/10.1177/000841740907600s09

Steel, K., Cox, D., & Garry, H. (2011). Therapeutic videoconferencing interventions for the treatment of long-term conditions. Journal of Telemedicine and Telecare, 17, 109–117. http://doi.org/10.1258/jtt.2010.100318

Thorpe, K. E., & Howard D. H. (2006). The rise in spending among Medicare beneficiaries: The role of chronic disease prevalence and changes in treatment intensity. Health Affairs, 25, 378-388. http://doi.org/10.1377/hlthaff.25.w378

Wilson, D., Mitchell, J. M., Kemp, B. J., Adkins, R. H., & Mann, W. (2009). Effects of assistive technology on functional decline in people aging with a disability. Assistive Technology, 21, 208–217. http://doi.org/10.1080/10400430903246068

United States Census Bureau. (2015). 2013 Housing profile: United States: American housing survey fact sheet. (Report No. AHS/13-1). Retrieved from http://www2.census.gov/programs-surveys/ahs/2013/factsheets/ahs13-1_UnitedStates.pdf



How to Cite

Renda, M., & Lape, J. E. (2018). Feasibility and Effectiveness of Telehealth Occupational Therapy Home Modification Interventions. International Journal of Telerehabilitation, 10(1), 3–14. https://doi.org/10.5195/ijt.2018.6244