Environmental Modifications
Environmental Modifications
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Environmental Modifications For The Home
Care at home is the most preferred method for caregivers and their client and/or loved one. Their client is comfortable in their own personal domestic space and have all their belongings at hand. Personal control theory has shown more comfort for caregivers when providing services to the individual (Gitlin et al., 2001). Thus, being at home is the best for caregiver services versus other facilities. However, some clients may require safety modifications at home and/or a more organized space. Having significantly impacted spatial awareness along with memory deficits can be a hazard for the client if they do not know what they are doing. The caregiver may not also be in the same room as them at the time when they require assistance. Individuals with cognitive-communication disorders such as those with right hemisphere dysfunction and/or dementia have reduced self-awareness. Thus, they may not know how limited they are in their living capabilities. Environmental modifications can lead to a safer and more functional way of living (Sohlberg & Mateer, 2001).
How To Implement Modifications at Home
Implementation of intervention is quite easy. A caregiver should observe for any challenges of daily living at home and can report it to the speech-language pathologist and/or other health professional that the individual trusts. The professional can then work with the caregiver to address these challenges and then come up with solutions (Sohlberg & Mateer, 2001). The client, caregiver, and professional can then work together to fix up their home. The client and professional can work together on sorting bins for important materials at home to create a more organized space, create signs that can be easily taped to kitchen walls for instruction on daily use of appliances, label kitchen cabinets, etc. Education for more safety tips at home can also be given to the caregiver by the professional depending on the severity of the client's ability to function at home.
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Cueing & Observations of Individual Needs
Observation is essential! A caregiver and the professional must observe the client's status of executive functioning and see how well they are doing. Clients may do well with their organization of work materials and require less accommodations as they adapt. Meanwhile, other clients may require more visual aids and safety modifications at home. It is essential to note observations in SOAP notes and view how the client does with their goals. Measurement may be taken by counting the amount of times the client functions successfully according to their goals. It should also be noted that caregivers only use 53% of strategies advised to them by a professional, but 66% of caregivers do admit that they help (Soilemezi et al., 2019). The clinician should keep this in mind with what strategies are still being used each time they check-in.
EXAMPLE:
By 03/17/23, the client will be able to access his home office materials in 8/10 opportunities without assistance from his caregiver as observed by an SLP and data.
Who Requires Home Modifications
Home modifications can be different but apply to everyone. According to Soilemezi et al. (2019), applying home modification strategies not only applies to those with executive functioning impairments, but to the elderly as well. Capabilities of daily living are constantly monitored for senior citizens in order to make their residence a safer space if necessary (Soilemezi et al., 2019). To those with cognitive-communication disorders such as right-hemisphere dysfunction, Alzheimer's, and traumatic brain injuries, this is especially helpful as they have much more difficulties with daily living than the average senior citizen. Memory is impacted along with awareness of the space, which results in disorientation. Reasoning and problem solving is also impacted so clients may not be able to remember how to access appliances, organize their space, and may not even be aware of when they are being quite untidy. Home modifications for organization, a tidy living space, and a safe environment are key for the client to thrive without them being a threat to themselves or a cause of concern for caregivers.
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Tips & Tricks to Make A More Friendly Home!
Materials to Help at Home
Resources:
Gitlin, L.N., Corcoran, M., Winter, L., Boyce, A., & Hauck, W.W. (2001). A Randomized, Controlled Trial of a Home Environmental Intervention: Effect on Efficacy and Upset in Caregivers and on Daily Function of Persons With Dementia. The Gerontologist, (41):4–14, https://doi.org/10.1093/geront/41.1.4
Sohlberg, M., & Mateer, C.A. (2001). Cognitive Rehabilitation: An Integrative Neuropsychological Approach. Guilford Press: NY.
ISBN: 978-1-57230-613-4.
Soilemezi, D., Drahota, A., Crossland, J., & Store, R. (2019). The Role of the Home Environment in Dementia Care and Support:
Systematic review of Qualitative Research. Dementia;18(4):1237-1272. doi:10.1177/1471301217692130