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Home Safety Assessments:

How the Home Environment Causes Disability 

"Anna is likely not aware that her kitchen oven is the cause of her disability versus the stroke she had"

About the Author:

Carolyn Sithong MS, OTR/L, SCEM, CAPS, FAOTA

Founder & President

Home for Life Design®

April 12, 2021 - Charlotte, NC


Homeowners naturally understand how home improvement projects positively impact life in the home. Kitchen remodels inspire cooking, bedroom additions welcome new family members, and a newly built detached garage meets the needs of the ever-busy tinkerer.


Why is the same principle not applied upon medical necessity or as the homeowner ages? It is during these natural life occurrences that one relies on the environment the most for support. How can you best identify disabling features of your home environment and ensure the next home improvement project to leads to life improvement?

Disability is caused by home environments when they limit access to spaces and places where important function occurs such as bathing, cooking, family caregiving, etc. What most people assume is caused by disease or aging, disability is actually experienced when one cannot ‘do’ or participate in these everyday activities. A Home for Life Design® home assessment uses best practices to remove disabling barriers and create home environments that inspire and enhance independent living.


Let’s walk through a simple case example with a focus on baking in the kitchen.

Case Study: Anna the Baker

Anna is a 63-year-old woman who loves to bake cakes for friends and family. A recent stroke has left her with left-sided weakness in both her arms and legs. This weakness challenges her standing and moving balance and she relies on a hemi-cane for support of her weaker side.

The Baker’s Space

Anna’s current kitchen details a traditional electric stove-top oven that sits on the floor. This oven requires that the user, in this case Anna, have the ability to manually open the oven door from a comfortable reaching height all the way to almost floor level to place and remove cake pans. (See Figure 1.)

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Figure 2

The Home for Life Design® Approach

To help showcase how an environment disables function, an occupational therapy practitioner can perform a Home for Life Design home assessment to measure the impact of Anna’s disabling kitchen space. Using performance-based facilitation and observation, Anna’s action of opening the oven door, resulted in a loss of balance as she lowered the door to its fully opened position. (See Figure 2.) This unsafe and inaccessible space is measured to indicate that improvement to the environment is necessary for Anna’s long-term health.

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Figure 1

"The Mismatch" - Barrier Identified

For Anna, this required ability is not met and supported by this space. Her desire to bake cakes, an important and desired function thus has the potential to become compromised as her ability is challenged by the environment. A prolonged state of inability to participate in activities that give meaning and purpose to person’s lives impact overall health and well-being.

Anna is likely not aware that her oven is the cause of her disability versus the stroke she had, nor is she aware that there is a solution to this environmental barrier. An occupational therapy practitioner can help educate Anna on the benefit of making a change to this space to maintain her occupation of baking thereby increasing her overall health.

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Back to Baking for Friends & Family


Our client-centric approach removes barriers in kitchen as  recommendations are made based on Anna’s ability level to support occupations that she defines as meaningful.


In this case, a wall-mounted oven with a left hinge swing door, enables Anna to maintain her standing balance upon opening the door on a horizontal plane. The stove top is then placed on the counter with knee space below to promote seating while cooking on the stove. (See Figure 3)


A Home for Life Design is driven by metrics, data and occupational therapy practice theories to deliver comprehensive home assessments. This client-centric approach ensures quality outcomes that impact life in the home and community. Our home assessment tool can identify areas that cripple everyday function. Environment is everything when it comes to participation and disability, be sure to speak with Home for Life Design home assessment experts.


Carolyn Sithong, MS, OTR/L, SCEM, CAPS, FAOTA

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