A homeowner postpones selling because the offers are lower than expected. Another decides not to exchange a low mortgage rate for a higher monthly payment. A couple who planned to downsize begins discussing whether they should remodel instead.
For occupational therapists specializing in home modifications, these decisions raise a question that housing-market headlines rarely address:
Can the home people are choosing—or feeling compelled—to remain in actually support their everyday lives?
A softer housing market does not automatically create an aging-in-place remodeling boom. It does, however, create an opportunity for OTs to help people make better-informed decisions about accessibility, caregiving, and future housing needs.
The professional opportunity is decision-support: helping clients understand what their home can support, where its limitations lie, and which changes deserve priority before they commit to construction—or another property.
What Is Happening in the Housing Market?
Realtor.com’s September 2026 report describes a market under pressure from higher mortgage rates and weaker buyer activity. Nationally, 20.8% of listings had a price reduction, up 0.9 percentage points from the previous September. The median listing price was $419,250, down 1.4% year over year, while the stock of homes under contract was down 4.1% (Krimmel, 2026).
These figures require interpretation. A reduction in an asking price is not the same as a decline in a home’s appraised value or final sale price. National trends also do not describe every community: September price reductions and inventory changes varied substantially by region and metropolitan area.
Nevertheless, the broader picture matters. Some households are reassessing whether, when, and where to move.
At the same time, remodeling has its own drivers. The National Association of Home Builders identifies an aging housing stock, mortgage-rate lock-in, and aging-in-place demand as factors supporting renovation. In February, NAHB forecast inflation-adjusted remodeling growth of 3% in 2026 and 2% in 2027. These are projections, not completed-year results (NAHB, 2026).
NAHB also reported that 56% of surveyed remodelers performed aging-in-place modification work, while 73% said requests for aging-in-place features had increased somewhat or significantly over the preceding five years. These figures reflect remodelers’ reported experience—not the proportion of older homeowners undertaking modifications (NAHB, 2026).
The implication is not that every homeowner who postpones a move will renovate. It is that decisions about the existing home may become more consequential.
Staying by Choice Is Different From Staying Because Moving Feels Out of Reach
“Aging in place” can sound like a settled preference. In practice, the decision may be less straightforward.
NAHB (2026) describes mortgage-rate lock-in as a reason some homeowners remain in their current homes rather than purchase another property with a higher-rate mortgage. That mechanism matters for some households, but not equally for mortgage-free owners, renters, or buyers who would not need financing.
Affordability extends beyond the mortgage. Harvard’s Joint Center for Housing Studies reported that 34% of older households were housing-cost burdened in 2023, spending more than 30% of their income on housing. A substantial home asset does not necessarily mean a household has comfortable monthly cash flow or readily available renovation funds (Molinsky, 2025).
For OTs, a useful opening question is:
“What is influencing your decision to stay—and what would need to change for this home to work better?”
That question respects the client’s preferences without assuming that remaining is either the best choice or the only realistic one.
The Clinical Task: Evaluate the Fit, Not Just the Features
Consider this hypothetical situation: a couple planned to sell their two-story home and purchase a smaller property. They postpone the move. One partner is now avoiding the upstairs shower, while the other carries laundry between floors and helps manage the entrance steps.
An accessible bathroom might be part of the answer. But recommending a bathroom renovation before understanding the full routine could miss more important constraints.
An OT assessment can examine:
- Whether essential daily activities can occur on an accessible level.
- How entry, circulation, bathroom access, and sleeping arrangements work together.
- The space and physical demands associated with caregiver assistance.
- Whether likely equipment needs can be accommodated.
- Which barriers can be addressed through adaptation and which require substantial structural investigation.
- How the home supports access to transportation, appointments, and meaningful community activities.
The goal is not to decide for the client whether to move. It is to make the functional consequences of each option clearer.
Construction feasibility and pricing belong with qualified building professionals. Property valuation belongs with real-estate and appraisal professionals. Financing and borrowing decisions require appropriate financial expertise. The OT’s contribution is analyzing the relationship among the person, occupations, caregiver, and environment—and communicating the functional requirements those other professionals need to understand.
An Uncertain Housing Decision Calls for a Phased Plan
A family that is undecided about moving may struggle with an all-or-nothing recommendation: undertake a major renovation or continue managing the existing barriers.
A more useful approach is to organize recommendations around the client’s decision horizon.
Address immediate needs
Identify changes needed now to support essential activities and reduce current difficulty. These may involve equipment, task modification, caregiver instruction, environmental changes, or referral for urgent work.
Immediate does not necessarily mean inexpensive or temporary. It means the need cannot reasonably wait for the housing market to change.
Identify worthwhile interim changes
Some improvements may remain useful even if the client moves later. Others may involve permanent work that should be weighed against the anticipated length of stay.
The OT can explain the functional benefit and limitations; the client can then consider those benefits alongside actual project estimates and personal priorities.
Clarify long-term requirements
For clients considering major investment, describe the capabilities the home needs to support—not merely a list of products.
For example, “provide space for assisted toileting and wheelchair positioning” communicates a functional requirement more clearly than “install an accessible toilet.”
A phased plan gives the client a reasoned sequence rather than an overwhelming collection of recommendations.
How OTs Can Market Their Services in This Market
The housing reports do not establish that OT referrals will increase. The following are practice-development strategies suggested by the market conditions—not predictions of guaranteed demand.
The most effective message is not, “The market is slowing, so remodel.”
It is:
“Before you invest in staying—or commit to another home—understand how the property will support your daily life.”
1. Market around the decision clients are facing
“Home accessibility assessment” describes the service. A decision-focused message explains why someone might seek it now.
Possible language includes:
- “Staying longer than planned? Understand which home changes matter most.”
- “Before you renovate, make sure the design supports the way you live.”
- “Considering a move? Evaluate daily function—not just the floor plan.”
These messages invite earlier consultation without relying on fear, age-based assumptions, or promises that the home can accommodate every future need.
2. Make the service deliverables clear
A client or referral partner should understand what an OT consultation provides.
Depending on the practitioner’s expertise and service model, a defined consultation might include:
- An occupational profile and assessment of priority routines.
- Analysis of current accessibility and caregiver demands.
- Identification of functional barriers and housing constraints.
- A prioritized written plan.
- Functional requirements to discuss with a designer or contractor.
- Follow-up after equipment installation or modification.
A clearly bounded service is easier to explain than a broad promise to “help people age in place.”
3. Build relationships before construction begins
NAHB’s findings suggest that aging-in-place work is already part of many remodelers’ businesses. That creates a potential collaboration point: incorporating person-specific functional analysis before a project’s layout and specifications are finalized (NAHB, 2026).
An introductory message to a remodeler might be:
“I help identify how clients need to enter, move through, and use their homes, including equipment and caregiver requirements. My assessment can provide functional information for your design and construction planning.”
The purpose is collaboration—not suggesting that OT replaces design, code, permitting, or construction expertise.
4. Help real-estate professionals recognize a different kind of property question
A prospective home can look appealing without supporting the buyer’s actual routines.
OTs can offer prospective-home accessibility consultations, where access and timing permit, to examine questions such as entrance usability, bathroom transfers, essential-level living, and caregiver space.
A useful introduction is:
“When a client asks whether a home will work with changing mobility or caregiving needs, I can assess the functional fit. That is different from a home inspection or property valuation.”
This positions OT as an additional source of decision-relevant information, not as the person responsible for the transaction.
5. Use education to demonstrate your reasoning
A short presentation, blog, or case example can show referral partners what OT adds.
Useful topics include:
- “Downsizing Is Not the Same as Improving Accessibility.”
- “What to Assess Before Investing in a Bathroom Renovation.”
- “Staying Another Two Years: How to Prioritize Home Changes.”
- “Why a Single-Story Home May Still Be Difficult to Use.”
The strongest examples show how understanding an occupation changes the recommendation. Avoid claims that an assessment guarantees savings, prevents falls, increases resale value, or eliminates the need for future care.
Maintain Clear Financial and Professional Boundaries
A market-aware service should still be person-centered.
Do not assume clients can borrow against home equity, that renovation is cheaper than moving, or that remaining is necessarily preferable. Recommendations should reflect the client’s priorities and functional needs, with costs and feasibility confirmed by the appropriate professionals.
Similarly, do not imply that a preventive housing consultation is automatically covered by insurance. Explain the service, fees, and any applicable coverage requirements before the client commits.
These boundaries make the consultation more credible, not less valuable.
The Opportunity Is Better Housing Decisions
A slower market may change the timing of a move. It does not resolve the mismatch between a person’s needs and the home they occupy.
For home-modification OTs, this is an opportunity to move the conversation upstream: before the renovation contract, before the next property purchase, and before “we will manage for now” becomes the family’s only plan.
At your next evaluation, ask:
“If you remain here longer than expected, what needs to work differently?”
Then consider your own service message. Does it describe only hazards and equipment—or does it explain how your expertise helps people make informed housing and modification decisions?
For occupational therapists developing this area of practice, explore the education and professional resources at thehomeaccessibilitytherapist.com. Build the skills to translate assessment findings into prioritized, occupation-centered recommendations—and communicate that value to clients, contractors, and housing professionals.
References
Krimmel, J. (2026, September 30). September 2026 monthly housing trends: Price cuts hit 4-year highs as mortgage rates top 7%. Realtor.com. https://www.realtor.com/research/September-2026-data/realtor
Molinsky, J. (2025, August 11). One in three older households is cost burdened. Joint Center for Housing Studies of Harvard University. https://www.jchs.harvard.edu/blog/one-three-older-households-cost-burdenedsupremecourt+1
National Association of Home Builders. (2026, February 18). NAHB expects remodeling growth in 2026 and beyond. https://www.nahb.org/news-and-economics/press-releases/2026/02/nahb-expects-remodeling-growth-in-2026-and-beyond
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