A Holistic Approach to Home Modifications: What I Learned as A Rebuilding Together Fellow

As an Occupational Therapy student (OTS), the dynamic relationship between a person, their environment and activities of daily living (ADLs) has been reiterated through my coursework and research. Maintaining occupational performance and independence is a main goal of our work in this field. Thus, the place where individuals spend the most time, often their home, should be conducive to their unique needs. A home is a place to live, to feel safe, to relax, and it should not be a point of stress. Although, as an OTS I have sadly come to recognize this is not always the case for individuals, especially if their homes are not adapted to their own mobility needs. Environmental factors can easily be either barriers or facilitators for optimal occupational performance. In addition to that, occupational therapists have realized that safe home management is key to promoting access to ADLs for clients of all ages.

I’m grateful for the insight my fellowship with Rebuilding Together Petaluma gave me, being able to observe first-hand the intricacies of modifications and the role OTs can play in the home. Home repairs that fix crucial systems such as windows, walls, the roof, steps, etc. are vital in allowing a resident to stay in their home longer and safer. However, after reading the 25 Safe and Healthy Housing Checklist, I realized just how much detail and thought goes into evaluations as well as repairs. These priorities ensure a holistic approach to every home modification. As an OTS, rather than simply looking at repairs and modifications through a surface level lens, we observe how the person lives in the house and completes their occupations. Through those observations, we can better assess what repairs need to be made and how to make them to ensure occupational justice. This directly relates to the person-centered framework OTs know and love. The home repair process is completely client centered as well, beginning with the homeowner interview where salient information is received. A client centered approach ensures that interventions are tailored to the specific circumstances and preferences of the person receiving the care. Indeed, client centered intervention takes trust. A concept we frequently discussed in our weekly Rebuilding Together meetings was the speed of trust and the acknowledgement that it’s hard for homeowners to admit they need help and even harder to ask/accept that help. Similarly, as an OTS I’ve learned that we have to build a therapeutic relationship with our clients.

This connection between home repairs and occupational therapy can be seen as synonymous due to their shared goals. In both professions, it’s so necessary to recognize that the client's trust is a privilege, demonstrate respect for the client, ensure that a collaborative effort is made and build rapport. I witnessed these concepts in practice during my site visit to Petaluma. My affiliate made certain that trust, respect and reliance was demonstrated while working with clients. This was exhibited in the way they went out of their way to help clients read through paperwork if they were confused or unable to, double and triple check that it was okay to be in their home and gauge any uncomfortableness, and lastly, simply treating clients with kindness.

While the context and objectives of home repairs and occupational therapy differ, they are innately linked in the way they approach client centered care, adapt to different situations, their passion for functional improvement and collaboration, and empowerment of their clients. Home repairs contribute to an individual’s overall satisfaction in physical, mental and occupational health. This holistic approach to care is something I’m familiar with. As an OTS, I’m training to recognize the interconnectedness of physical, mental and social health regarding clients. This means considering all the factors that can affect someone's quality of life. I’ve been able to make the connection that the core essence of both professions lies in enhancing functionality, independence and overall well-being. It’s been an invaluable experience learning about all the innovative approaches, of both professions, that allow individuals to live their most fulfilling and functional lives.

Rebuilding Together's Howard University Fellowship program was made possible through a Rural Capacity Building grant from the Department of Housing and Urban Development (HUD). We are thankful for HUD's commitment to affordable housing and community development activities in rural areas.