SIGNIFICANCE: Home safety is a concern for practitioners who work with community-dwelling older adults; however, there is often a gulf between how residents and clinicians assess the safety of a dwelling. Older adults may be reluctant to accept recommendations for home modifications if they do not believe that their homes possess safety hazards. To effectively address home safety, it is critical to know how older adults’ interpret the construct.

INNOVATION: This research sheds light on the way that low-income homeowners make sense of the concept “home safety.” A better understanding of how older adults’ interpret this construct can help to facilitate communication and guide clinical practice to ensure client-centered care. This study attempts to answer the following research question: How do older adults interpret the concept of home safety? It is critical to learn about the beliefs and values of older adults to ensure that clinicians are best meeting their needs.

METHOD: Semistructured interviews were conducted with 17 community-dwelling homeowners who received services from Rebuilding Together Hartford (RTH). RTH is a nonprofit organization that provides free home repairs and modifications to low-income homeowners. Interviews were conducted in the participants’ homes before home modifications were provided.

Sixteen low-income, community-dwelling homeowners were interviewed. Participants ranged in age from 59 to 93 yr (M = 73.5 yr). Length of time in house was between 15 and 73 yr (M = 37.5 yr).

Interviews were conducted with participants as part of a larger study of the outcomes of home modifications. Interviews were transcribed and analyzed by the principal investigator and a team of research assistants. Transcripts were analyzed to identify preliminary coding categories using open-ended coding. As the analysis proceeded, the preliminary categories were refined to capture four major themes.

RESULTS: Results obtained in the study included the following: (1) participants felt that protecting the home and its occupants from intrusion is the primary meaning of home safety; (2) intimate knowledge of one’s home contributes to feelings of safety; (3) injury prevention is a less salient aspect of home safety; and (4) the connection between the person, the occupation, and the environment is not always apparent to older homeowners.

CONCLUSION: Occupational therapy practitioners are advised to consider a range of factors that may contribute to older adults’ perception of home safety. Implications for clinicians are discussed, particularly as they relate to our ability to help older adults consider modifying their homes and our ability to measure the outcomes of the modifications. Methods to improve communication between clinicians and clients are discussed.

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Lord, S. R., Menz, H. B., & Sherrington, C. (2006). Home environment risk factors for falls in older people and the efficacy of home modifications. Age and Ageing, 35(Suppl. 2), ii55–ii59. http://dx.doi.org/10.1093/ageing/afl088