Disability Pride Month in July marked 36 years since the Americans with Disabilities Act (ADA) became law, and the 2026 theme, “The World Works Better with US,” is a powerful reminder of that legacy. It’s also a natural moment for those of us in home modification practice to pause and ask a hard question: what happens after we write the recommendation? Galeazzi and colleagues’ 2026 qualitative study on accessible home modifications in Ontario offers a clear answer—clients are often left carrying a heavy load of navigation, advocacy, and problem-solving in order to turn clinical ideas into real changes at home.
The study explored the experiences of 33 community-dwelling adults with musculoskeletal and sensory disabilities (and a few cohabiting caregivers) who had either made home modifications or needed accessible housing. Through semi-structured interviews, the authors identified four major themes: the impact of unmet modification needs, barriers and facilitators in the process, and the benefits when modifications are in place. For occupational therapists who specialize in home mods, these themes feel familiar—but they also highlight where our practice can stretch further (Galeazzi et al., 2026).
When “good enough” isn’t safe enough
Participants described inaccessible homes as “limiting their potential” and, more concretely, limiting access to essential parts of the home—bathrooms, kitchens, entries, stairs, and doorways. In some cases, people could not get to the bathroom in a wheelchair, could not reach the fridge or kitchen sink, and were dependent on others for food, medication, and basic self-care. Others described repeated falls at home entryways and being effectively confined indoors because steps, ice, or lack of maintenance made the environment too risky (Galeazzi et al., 2026).
For us, the takeaway is simple but important: unmet modification needs are not minor inconveniences. They are safety issues, dignity issues, and participation issues. In reports and conversations, naming that explicitly—linking specific environmental barriers to falls, missed medication, emergency egress, and intimate care—can help reframe modifications as essential, not optional (Galeazzi et al., 2026).
The implementation gap: clients as project managers
Galeazzi et al. also highlight a familiar gap: OTs may recommend modifications, but the actual implementation often falls squarely on clients and families. Participants without professional expertise in accessible housing described a lack of information and guidance, and many turned to internet searches, pharmacists, or family doctors for advice on what to do next. They navigated fragmented funding systems—provincial or state aid programs, federal tax credits, nonprofit supports—that rarely cover the full cost. Renters faced added barriers when landlords viewed ramps or visible modifications as “eyesores” or potential legal triggers (Galeazzi et al., 2026).
Disability Pride Month offered a good opportunity for some honest reflection in OT practice. When clients are effectively acting as project managers—researching products, tracking down contractors, and deciphering eligibility rules—it’s worth asking: which parts of that work could reasonably be shared or supported by the therapist or wider team? Even in busy, high-volume settings, there are practical ways to lighten that load (Galeazzi et al., 2026).
Practical ways OTs can bridge the gap
For therapists already working in home mods, the article suggests several actionable shifts:
- Make the pathway clear.
Many of your readers already use structured systems to organize recommendations and workflow. Extending that idea, a simple, client-facing “home modification pathway” handout—assessment → identifying funding options → landlord or housing discussions (for renters) → contractor selection → follow-up—can make the process more predictable and less overwhelming. Including local program names, websites, and typical timelines gives clients a starting map rather than leaving them to “Google their way forward.”(Galeazzi et al., 2026) - Document safety and dignity, not just function.
In this study, inaccessible environments affected nutrition, medication management, bathing, toileting, and social participation. When writing recommendations and justification letters, explicitly connect environmental barriers to those outcomes: falls at entry, inability to exit in an emergency, dependence for intimate care, or inability to prepare food. That kind of language can strengthen funding requests and help other stakeholders understand why a wider door or a zero-threshold shower is more than a convenience (Galeazzi et al., 2026). - Talk about aesthetics early and often.
Participants frequently mentioned the tension between “beautiful” and “functional” spaces. Some were frustrated when designers prioritized looks over usability in common areas; others wanted grab bars and fixtures that blended into their preferred aesthetic. As highlighted in other work on accessibility and aesthetics, people often resist modifications that feel institutional or stigmatizing. Bringing aesthetics into the conversation from the start—asking “How do you want this space to look and feel?”—can improve buy-in and reduce the risk that recommendations are rejected on appearance alone (Galeazzi et al., 2026). - Curate a network of accessibility-literate contractors and allies.
Positive experiences in the study often involved contractors or advisors who understood accessibility or were genuinely willing to learn and adapt. Clients with professional housing expertise felt more confident choosing bungalows over multi-level homes or identifying builders familiar with accessible design. For therapists, intentionally collecting names of contractors, builders, and housing advocates who “get it” can turn a recommendation into a more realistic plan. Over time, that network becomes part of your practice toolbox, right alongside your favorite bath bench or grab bar layout (Galeazzi et al., 2026). - Partner with disability organizations, not just serve individuals.
The broader project used a participatory approach, inviting representatives from disability organizations—who were themselves wheelchair users—to review the research proposal, materials, and findings. That model reinforces a key Pride Month principle: disabled people are experts in their own environments and should be partners in shaping practice and policy. For home-mod therapists, this might look like co-developing educational materials with local disability groups, offering joint workshops for clients and contractors, or channeling client feedback into advocacy efforts (Galeazzi et al., 2026).
Disability Pride and the OT role
Finally, Galeazzi et al. underline the role of occupational therapists in navigating not just the physical environment, but the systems around it. OTs are trained to adapt environments for safety and participation and routinely perform home safety assessments and prescribe home modifications. Yet in a decentralized funding context, there is a risk that our involvement stops at the “what” of recommendations, rather than extending into the “how” of implementation and advocacy (Galeazzi et al., 2026).
Looking back on Disability Pride Month is a chance to reaffirm a broader vision: accessible housing as a human right, and OT practice as a bridge between lived experience, design, and policy. For therapists specializing in home modifications, that pride can show up as one small, concrete shift—refining client-facing pathway handouts, updating your go-to list of accessibility-savvy contractors, or weaving explicit safety and dignity language into your documentation (Galeazzi et al., 2026).
The clients in Galeazzi et al.’s study often had to push hard to get the modifications they needed. Pride honors that self-advocacy, but it also calls us to build systems where people don’t have to fight as hard for basic access at home.
References:
Galeazzi, S., Bacchus-Misir, F., Cohen, E., Sheppard, C., Tomasella, F., Athanasopoulos, P., Yuzwa, K. E., & Hitzig, S. L. (2026). Accessible Home Modification and Impacts: A Qualitative Study. The American journal of occupational therapy : official publication of the American Occupational Therapy Association, 80(2), 8002205110. https://doi.org/10.5014/ajot.2026.051139
Struckmeyer, L., Morgan-Daniel, J., Ahrentzen, S., & Ellison, C. (2021). Home Modification Assessments for Accessibility and Aesthetics: A Rapid Review. HERD, 14(2), 313–327. https://doi.org/10.1177/1937586720960704
The Home Accessibility Therapist LLC. (2026, June 15). Toolbox tips: The organized home mods therapist – Why a better system leads to better recommendations. The Home Accessibility Therapist Blog. https://thehomeaccessibilitytherapist.blog/2026/06/16/toolbox-tips-the-organized-home-mods-therapist-why-a-better-system-leads-t/thehomeaccessibilitytherapist
Yuzwa, K. (2026, March 3). New Research Alert. LinkedIn. https://www.linkedin.com/posts/kyuzwa_accessible-home-modification-and-impacts-activity-7435019560681996289-tnTU
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