You may think that the person you care for would benefit from adaptations being made to their home or having specialist equipment or aids. However, there are so many different options out there, it can be difficult to know where to start. What will be helpful for the person you care for will be completely unique to them and their own individual circumstances. And getting it wrong could lead to equipment and adaptations that are either not helpful or actually dangerous for them to use.
We therefore recommend that you arrange a home assessment by an occupational therapist, also known as an OT, before you make any decisions. An occupational therapist will be able to look at the space where your friend or relative lives, find out in depth about their condition and what support they might need, and recommend exactly the right equipment and aids that will be of most help.
We give a full overview of what an occupational therapist assessment is and how to get one below.
Occupational therapists are trained professionals whose job it is to help people who have a disability, illness or injury to look after themselves, manage everyday tasks and become more independent.
Part of their role is to conduct assessments of people who require additional help. These assessments allow them decide what extra support that person might need in their own home. They consider not just the person’s medical condition, but also what they want to be able to do, their living conditions and your abilities as their carer too. They look at tasks that the person finds hard and see whether there is another way they can do them instead.
During the assessment, the occupational therapist will look at the whole picture, considering not just what your friend or relative’s physical and mental health is like, but also looking at social and environmental factors too. They want to know about what the person you care for wants to be able to do, and what your goals are as their carer as well.
For the assessment, the occupational therapist will visit the person you care for in their home so that they can see what their living situation is like and how it can best be adapted. If it is appropriate, they will walk around the house with your friend or relative to learn more about what they find difficult. They may also ask them to demonstrate how they do certain tasks around the house. If they don’t feel comfortable doing any of these tasks, it is ok to say no. The occupational therapist will just use other ways to assess the situation instead.
They will also ask questions about what the person you care for would like more help with, what would make things easier for them and what they struggle to do. It is worth being aware in advance that some of these questions might feel quite personal, but this is just information that allows the occupational therapist to build a full picture.
They may also ask about equipment or adaptations the person you care has already tried, and whether they found them helpful or not. Feel free to mention during the assessment if either of you already know any pieces of equipment or adaptations you think would be beneficial. It won’t necessarily mean that they will definitely recommend or provide these for you, but it will still help them to assess what would be best.
It is probably a good idea for you to be there too during the assessment to help explain what you think their struggles are, and what yours are too when caring for them. You could also take notes for the person you care for so that they can refer to the advice they are given later. If you are not able to be there, and neither are any of their other friends or relatives, then they could get an independent advocate to be there with them instead. Take a look at our guide ‘Getting an independent advocate’ for further information.
The assessment is likely to take at least an hour. If there is a particular time of day that is better or worse for the person you care for because of their condition, then you should ask for the appointment to be arranged around this.
After the assessment, the occupational therapist will write up a report about your friend or relative and what equipment and adaptations they would recommend. They will aim to come up with options that help you all to manage better in your day-to-day lives, make sure you are both as safe and comfortable as you can be as well as enabling you to achieve your goals better. They will particularly focus on the smallest changes that can make the biggest difference. The report may include a sketch of the person you care for’s house, including any suggested adaptations. They might also discuss the recommendations they are going to make with you both and give you a chance to provide feedback.
This will differ a great deal from person to person. Their recommendations will be highly tailored to the person you care for’s particular circumstances.
If you would like to get an idea of the sort of equipment and adaptations that are available, some of which the occupational therapist may recommend, then take a look at our guides ‘Equipment and assistive aids to help the person you care for’ and ‘Home adaptations to help the person you care for’.
Alongside recommendations for equipment, aids and home adaptations, the occupational therapist may also provide some additional support too. For instance, they could show you the best way to lift or carry the person you care for without injuring yourself or them.
The person you care for may be able to get a free assessment through the local authority. Sometimes this will be arranged automatically by their GP, social worker or nurse, or will be scheduled at the same time as their needs assessment.
If it is not automatically arranged, then get in touch with their local authority’s adult social services department and ask for a home assessment by an occupational therapist. This can by phone, post or email. If you don’t know which local authority the person you care for comes under, you can find out on the GOV.UK website.
If your friend or relative is coming out of hospital, then they will likely be seen by an occupational therapist before they are discharged. The OT will work out what support is required for the person you care for to be able to manage safely whilst at home. These changes should be put in place before they leave hospital.
Some carers report there are quite long waiting lists for free local authority assessments, so be aware you may have to wait some time. If you do not want to wait or your friend or relative is not eligible for a local authority assessment, then you could consider arranging a private one. You can find a private occupational therapist through the Royal College of Occupational Therapists’ website. When selecting a private OT, it is worth checking their qualifications and credentials and making sure that they are registered with the Health and Care Professions Council (HCPC) beforehand.
If it is being provided by your local authority or the NHS, then the assessment itself will be free of charge. If the occupational therapist recommends particular equipment or adaptations then some of these may be provided for free by the local authority but some may need to be self-funded. Take a look at our guides ‘Financial support for home adaptations’ and ‘Financial help from your local council for home aids and adaptations’ for further information.
If you decide to use a private occupational therapist, then they usually charge between £300 and £500 for a home assessment. Follow-up support and consultations will generally be charged at between £40 and £70 per hour. This will not cover any equipment they recommend, which you will need to pay for on top. It is worth finding out all of their fees in advance and making sure there are no additional costs you were not expecting, such paying extra for a full report to be done or covering their travel time and expenses.
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