OT in the Home: Guided Safety and Environmental Assessments

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Video Runtime: 59 Minutes; Learning Assessment Time: 46 Minutes

Occupational therapy practitioners play a pivotal role in enabling older adults to age safely and independently in their homes. This course explores a comprehensive approach to home safety and environmental assessments that goes far beyond basic ADL evaluation. With the rising number of older adults choosing to age in place—often in environments not designed for aging—OTs must be equipped to assess and address a wide range of safety, environmental, cognitive, and functional risk factors. Participants will learn how to systematically evaluate the home, utilize evidence-based tools, and develop individualized safety plans that empower patients and support caregivers. Through practical examples and a holistic framework, this course provides actionable strategies for creating client-centered goals and “leave-behind” roadmaps that promote continued safety and participation. This course is appropriate for occupational therapy practitioners working in home health, outpatient, community-based, and transitional care settings.

Learning Outcomes

Identify environmental, cognitive, and caregiver-related safety risks that may be overlooked during basic ADL-focused home evaluations
Recognize when and how to use evidence-based tools for assessing home safety and supporting client-centered intervention planning
List components of a client-centered home safety plan that incorporates meaningful occupations and supports aging in place or rehabilitation
Select a patient-based goal informed by home assessment findings to promote participation in ADLs and IADLs within the patient’s natural environment

Meet your instructor

A smiling woman with long blonde hair and a necklace stands against a pink background, representing medbridge's compassionate approach to healthcare education.

Krista Covell-Pierson

Krista Covell-Pierson is the owner and founder of Covell Care and Rehabilitation, an innovative mobile outpatient practice designed to help adults and older adults live safer, more independent, and engaged lives at home and in their communities. She developed this one-of-a-kind model from the ground up, integrating…

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Chapters & learning objectives

1. Why Occupational Therapy Beyond BADLs in the Home?

This chapter outlines the growing need for home-based OT services and presents compelling evidence for why assessments must extend beyond basic ADLs. Learners will examine national trends in aging, fall-related risks, and the cost-effectiveness of OT-led home interventions. Key frameworks such as the PEO Model and MOHO are introduced to support a systems-based, holistic approach to home evaluation.

2. Where Do We Start?

This chapter breaks down how to initiate a home evaluation, from preparing your toolkit to establishing rapport with the patient and caregivers. Learners will explore how to structure evaluations using impairment-level assessments and environmental scans, moving beyond ADL-specific areas to uncover hidden risks. Guidance is provided on effective observation, patient engagement, and identifying safety and access concerns throughout the home.

3. Assessments to Use in the Home

This chapter introduces two evidence-based tools—the Activity Card Sort and Kitchen Task Assessment—that help OTs gather meaningful, occupation-focused information. These assessments provide insight into a patient’s functional abilities, interests, and executive function in real-world contexts. Sample case scenarios and goal writing examples illustrate how to apply these tools to enhance participation and tailor interventions.

4. Treatment Interventions

In this chapter, learners will discover how to prioritize treatment based on patient goals, safety concerns, and readiness for change. Practical treatment strategies are presented, with examples drawn from prior assessments. The chapter also highlights creative problem-solving, available resources, and adaptive solutions that promote function, safety, and aging in place across diverse areas of the home.

5. Where Do We Go From Here?

The final chapter emphasizes the importance of equipping patients with a roadmap for continued safety and success after OT services end. Learners will gain strategies for connecting patients with community resources, educating families, and planning for follow-up. The chapter also reinforces the OT’s role in ongoing support, advocacy, and lifelong learning to meet the evolving needs of clients at home.

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