If you’ve ever wondered whether home modification programs actually deliver measurable results for older adults in underserved communities, a groundbreaking study just gave us the answer: Yes, they absolutely do.
The Older Adult Home Modification Program (OAHMP) study, published in the American Journal of Occupational Therapy in March 2025, evaluated an interprofessional home modification program serving 65 low-income older adults in an urban setting. The results provide the kind of evidence-based validation our field desperately needs—and practical insights you can apply in your own practice.
What Makes This Study Different
Most home modification research focuses on middle-class homeowners with resources and family support. The OAHMP study intentionally centered a population we don’t see enough in research: predominantly Black women (87.7%), living alone (81.5%), with an average age of 72, in low-income households.
This matters because these are the clients who face the most significant barriers to aging in place—and who stand to benefit most from targeted, affordable interventions.
The OAHMP Model: Three Visits, Measurable Results
The program used a streamlined interprofessional approach with three in-home visits involving an occupational therapist, a home modification team, and a social worker. This collaborative model addressed both environmental barriers and the functional and psychosocial needs of participants.
The results?
- Significant improvements in self-care activities of daily living (ADLs)
- Significant improvements in home safety
- 91% of participants’ personal goals were met or partially met
- Strong positive correlations between health status and improved independence in both ADLs and instrumental ADLs (IADLs)
In other words: the program worked. Participants became more independent, their homes became safer, and their own goals—not just our clinical goals—were achieved.
The Cost-Effectiveness Factor
Here’s where the study gets really interesting for those of us advocating for home modification funding: the average cost of modifications was significantly lower than national averages.
The study explicitly positions home modifications as a cost-effective alternative to nursing home placement. When you’re talking to payers, policymakers, or families hesitant about upfront costs, this is evidence you can point to.
Low-income older adults don’t need expensive, comprehensive remodels to experience meaningful improvements in safety and independence. They need targeted, client-centered modifications delivered by professionals who understand both the environmental barriers and the lived experience of aging in under-resourced communities.
What This Means for Your Practice
1. Interprofessional Collaboration Works
The OAHMP model demonstrates that combining OT assessment and intervention with hands-on modification support and social work services produces better outcomes than any single discipline working alone. If you’re building a home modification program or trying to justify team-based approaches, this study provides the evidence.
2. Client-Centered Goals Matter
The 91% goal achievement rate wasn’t about imposing our clinical priorities—it was about identifying what mattered to each participant and addressing those specific needs. This aligns perfectly with what we know about client buy-in and adherence: when modifications support their valued activities, clients actually use them.
3. Health Equity Is Central to Effective Home Modification
The study’s explicit focus on low-income, predominantly Black older adults living alone addresses a critical gap in our research and practice. Environmental barriers disproportionately affect underserved populations, and this program demonstrates that tailored, affordable interventions can meaningfully reduce those disparities.
4. You Don’t Need Big Budgets to Make Big Impact
The cost-effectiveness findings are crucial. Home modification programs can deliver significant functional improvements without the price tags that typically scare away funders. This is leverage for grant applications, program proposals, and advocacy efforts.
Practical Applications
If you’re developing or refining a home modification program, the OAHMP model offers a replicable framework:
- Three structured home visits (assessment, modification implementation, follow-up) create a manageable scope while ensuring continuity
- Interprofessional teams address multiple dimensions of need simultaneously
- Focus on ADL independence and home safety as primary outcomes—measurable, meaningful, and fundable
- Prioritize underserved populations where environmental barriers create the most significant obstacles to aging in place
Action Steps: Implementing OAHMP Principles in Your Practice
For Individual Practitioners
1. Adopt the Three-Visit Framework
- Visit 1: Conduct comprehensive home safety assessment and ADL/IADL evaluation; identify client-centered goals
- Visit 2: Coordinate modification implementation with contractors or handyperson services
- Visit 3: Follow-up to assess functional improvements and goal achievement
2. Measure What Matters
- Use standardized assessments for ADLs, IADLs, and home safety (the OAHMP study used paired pre/post measures)
- Track client goal achievement rates—aim for the 91% benchmark
- Document cost per modification to demonstrate cost-effectiveness to referral sources
3. Build Your Interprofessional Network
- Identify local contractors willing to work with older adults on modest budgets
- Connect with social workers who serve aging populations to coordinate psychosocial support
- Create referral partnerships with community organizations serving low-income older adults
For Program Developers
4. Prioritize Underserved Populations
- Target low-income communities where environmental barriers create the greatest obstacles to aging in place
- Partner with organizations that serve predominantly Black, Hispanic, and other communities of color
- Design outreach specifically for older adults living alone, who face unique safety and isolation risks
5. Secure Funding with Evidence
- Use the OAHMP study’s cost-effectiveness findings in grant applications and program proposals
- Frame home modifications as alternatives to nursing home placement when pitching to payers
- Emphasize measurable outcomes: ADL independence improvements and home safety enhancements
6. Create Sustainable Service Models
- Start small with a pilot program serving 10-15 clients using the three-visit framework
- Track outcomes rigorously from day one to build your own evidence base
- Develop partnerships with home modification nonprofits or Aging and Disability Resource Centers
For Educators and Researchers
7. Integrate Health Equity into Home Modification Training
- Teach students to assess environmental barriers through an equity lens
- Include case studies featuring diverse, low-income clients like those in the OAHMP study
- Address how economic, racial, and geographic disparities affect home modification access
8. Expand the Evidence Base
- Replicate the OAHMP model in different geographic settings (rural, suburban, other urban areas)
- Study longer-term outcomes: Do improvements in ADL independence and home safety persist at 6 months? 12 months?
- Investigate which specific modifications produce the greatest functional gains for the lowest cost
For Advocates and Policy Influencers
9. Use This Evidence to Drive Policy Change
- Share OAHMP findings with state legislators considering home modification funding bills
- Present data to Medicare Advantage plans and Medicaid agencies exploring aging-in-place benefits
- Connect with Area Agencies on Aging to advocate for increased home modification program funding
10. Amplify the Health Equity Message
- Cite the OAHMP study when discussing disparities in aging-in-place support
- Advocate for programs that specifically target low-income older adults and communities of color
- Frame home modifications as social justice interventions that remove participation barriers
This Week: Your First Step
Choose ONE action step from above and commit to it this week.
Whether it’s reaching out to a potential interprofessional partner, drafting a program proposal using OAHMP evidence, or simply changing how you measure outcomes in your current practice—start somewhere.
The OAHMP study gives us the roadmap. Now it’s time to put it into action.
Why This Study Matters for OT
The OAHMP research validates occupational therapy’s essential role in aging-in-place initiatives. We’re not just nice-to-have consultants—we’re central to designing, implementing, and evaluating programs that measurably improve independence, safety, and quality of life for older adults.
The study also highlights our capacity to address health equity through environmental interventions. By removing physical barriers in homes, we’re simultaneously removing participation barriers that disproportionately affect low-income older adults and communities of color.
The Bottom Line
The OAHMP study proves what many of us have experienced in practice but struggled to quantify: home modifications work, they’re affordable, and when delivered through client-centered, interprofessional models, they produce measurable improvements in ADL independence and home safety—especially for the older adults who need them most.
Whether you’re advocating for program funding, justifying interprofessional collaboration, or simply looking for evidence to support your clinical recommendations, this research gives you the data you need.
Now let’s take these findings and use them to expand access to home modification services for the thousands of older adults still waiting for the support they deserve.
Reference:
Washington, S. E., Edwards, E., Fink, A., & Radocha, L. (2025). Inclusive practices for aging in place: Environmental and home modifications for older adults. American Journal of Occupational Therapy, 79(2), 7902180220. https://doi.org/10.5014/ajot.2025.050987
Want to develop advanced home modification assessment skills? Learn more about our Certified Home Accessibility Therapist (CHAT) program at www.thehomeaccessibilitytherapist.com
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