A home modification recommendation can be clear in a therapist’s mind and still leave important questions for the people carrying it out.
What is the modification intended to help the client do? Which features are essential? What still needs to be measured or verified? Who should be contacted if the proposed product is unavailable or the installation cannot proceed as planned?
The work of home modification extends beyond identifying a possible solution. AOTA’s home modification practice guidelines describe a process that includes identifying, developing, implementing, and training in the use of modifications. Collaboration and follow-up help connect those stages to the person’s daily activities.
The Home Modification Handoff Checklist is a practical communication aid for that transition. Its purpose is to keep the client’s goal visible while making the next steps, unresolved questions, and responsibilities easier to follow.
Why use a handoff checklist?
Home modification projects bring together different kinds of expertise.
The client brings knowledge of their routines, preferences, and priorities. The occupational therapist contributes assessment and clinical reasoning about the relationship between the person, the activity, and the environment. Construction professionals and suppliers contribute expertise about products, site conditions, and implementation. AOTA describes partnerships between occupational therapy practitioners and construction teams as an important part of community-based home modification work.
A handoff checklist provides a shared place to organize the information those conversations need. It is not intended to turn a therapist’s recommendation into a construction specification or make the therapist responsible for every part of a project.
Instead, it prompts a few essential questions:
- What outcome are we working toward?
- What has been recommended, and what is still being considered?
- What information is missing?
- Who is responsible for the next action?
- How will we consider whether the completed solution works during everyday use?
The checklist is organized around those questions, from identifying the intended outcome through planning the review.
Begin with the activity—not the product
Before describing equipment or construction, identify what the person wants or needs to do.
AOTA’s Practice Smart! recommendations emphasize developing an occupational profile and establishing goals collaboratively with the client and relevant care partners. The client’s priorities should guide the intervention rather than being added after a solution has already been selected.
For example, compare these two statements:
“Provide accessible kitchen storage.”
“Support the client’s goal of preparing breakfast by making frequently used dishes and ingredients easier to retrieve and return.”
The second statement gives the recommendation a purpose. It also provides a useful question when alternatives are proposed: Will this option still support breakfast preparation?
In the first section of the checklist, describe the activity, the current difficulty, and what a useful outcome would look like. Be specific enough that the goal can guide later decisions.
Separate the recommendation from the details still needing verification
A potential solution is not necessarily ready to order or install.
The checklist asks users to distinguish a suggested option from a final selection and identify measurements, compatibility questions, installation details, permissions, and costs that still need clarification.
Use this section to make uncertainty visible. For example:
- A product has been identified, but its fit in the existing space has not been verified.
- The functional features are clear, but the exact model has not been selected.
- A proposed location needs review by the appropriate installation professional.
- The client is considering two options and has not yet made a decision.
Recording these distinctions avoids presenting a preliminary recommendation as a fully resolved plan.
Where technical details remain outstanding, identify the appropriate person to verify them. The checklist should clarify the handoff—not blur professional responsibilities.
Make the next action clear
“Client to follow up” leaves more unanswered than a specific action statement.
For example:
“Client will request a site visit from the installer to review cabinet compatibility before purchasing the proposed storage system.”
Or:
“Therapist will review the proposed alternative’s functional features before the client makes a final selection, within the agreed consultation service.”
The checklist includes space for the next action, responsible person, and target date. Use those fields to document an agreed next step rather than an assumed one.
This approach also makes room for realistic service boundaries. A therapist providing an assessment-only consultation will have a different role from one contracted to participate throughout planning, installation, and follow-up. The handoff should reflect the services actually agreed upon.
Decide how proposed changes will be handled
A change in product or layout may also change how the person uses the solution.
As a practical use of the checklist, identify which changes should prompt another discussion before work proceeds. Examples might include a different operating mechanism, a changed location, or a substitute product with different reach or space requirements.
The goal is not to require therapist review of every construction decision. It is to identify changes that may affect the intended functional outcome and agree on how those questions will be communicated.
AOTA’s description of the Safe at Home program illustrates this connection: the occupational therapy assessment informs a scope of work, with communication between the therapist and contractor during implementation.
Plan to review use—not installation alone
A completed installation answers one question: Was the work done?
It does not, by itself, answer whether the person can use the modification for the intended activity.
AOTA describes post-modification occupational therapy involvement that may include checking fit, providing training, and assessing occupational performance. RCOT also highlights a goal-focused approach in which clients are revisited after adaptations to consider whether their goals have been met.
Where follow-up is part of your service, plan what you will review:
- Can the person use the solution during the intended task?
- What assistance, effort, or instruction is needed?
- Does the arrangement work with the person’s usual equipment and routines?
- Are there unexpected difficulties?
- Is further adjustment, training, or reassessment indicated?
If follow-up is not included, document that boundary and explain how the client can request further help. Avoid leaving the impression that a review has been arranged when it has not.
A brief example: Keeping breakfast preparation in view
The following fictional example illustrates how the checklist might be used.
Maria wants to prepare her own breakfast. Retrieving dishes and ingredients is tiring, and she often asks her daughter for help.
The therapist and Maria discuss a pull-out storage option. Rather than documenting only the product, they record the activity goal and the features Maria needs to use the storage.
The handoff identifies several outstanding questions: cabinet compatibility, operating effort, where frequently used items will be placed, and who will confirm installation requirements.
When an alternative model is proposed, the team returns to those functional requirements before making a decision.
During an agreed follow-up visit, Maria tries the arrangement as part of breakfast preparation. She can retrieve the dishes, but one frequently used item remains difficult to manage. The arrangement is adjusted, and she tries the task again.
The checklist has not replaced assessment or professional judgment. It has provided a way to carry the purpose of the recommendation through the next stages.
How to introduce the checklist into your practice
Start with one project rather than redesigning your entire documentation system.
- Complete the goal and proposed-solution sections after assessment.
- Review outstanding questions with the client and relevant project participants.
- Assign agreed next actions and identify who needs the information.
- Update the checklist when decisions change.
- Use the review section to guide the agreed follow-up or document how further assistance can be requested.
Keep the checklist alongside the clinical documentation and project information it supports. Reference relevant reports, drawings, photographs, or product information rather than expecting a short checklist to contain every detail.
Keep the purpose visible
The Home Modification Handoff Checklist is a communication aid—not a standardized assessment, construction specification, or installation approval.
Its value is in the questions it prompts: what matters to the client, what remains unresolved, who acts next, and how the result will be considered in daily life.
The aim is not simply a completed modification. It is participation.
Download the Home Modification Handoff Checklist and adapt it to your setting, service agreement, and project.
References
American Occupational Therapy Association. (n.d.-a). Home modifications & key community partnerships. https://www.aota.org/practice/practice-settings/home-modifications-key-community-partnershipsaota
American Occupational Therapy Association. (n.d.-b). Practice Smart! https://www.aota.org/practice/practice-essentials/evidencebased-practiceknowledge-translation/practice-smartaota
Goldhammer, T., Scott, S., Waugh-Quasebarth, E., & Wickel, C. (2022, June 1). Safe at Home: A community-based approach for home modification implementation. OT Practice. https://www.aota.org/publications/ot-practice/ot-practice-issues/2022/safe-at-homeaota
Royal College of Occupational Therapists. (2025, March 18). Housing and adaptations. https://www.rcot.co.uk/explore-resources/inclusive-built-environments/measuring-impact-adaptations-independence-wellbeingrcot.co
Siebert, C., Smallfield, S., & Stark, S. (2014). Occupational therapy practice guidelines for home modifications. AOTA Press. https://doi.org/10.7139/2017.978-1-56900-459-3
Disclosure: This article was developed by Sue Doyle, PhD OTR/L, with limited assistance from generative artificial intelligence for literature organization and editorial drafting. The author reviewed the cited sources, provided the professional interpretation, completed substantive revisions, and approved the final version. Sue Doyle, PhD OTR/L, is responsible for the accuracy, integrity, originality, and final published form of this content.
Leave a Reply