Accessible Home Modification and Impacts: A Qualitative Study

Importance: Accessible home modifications (HMs) can positively influence the lives of people with disabilities (PwDs). Occupational therapists may recommend HMs, but implementation often falls to clients. Research on the experiences of PwD related to implementing accessible HMs in a North American context is lacking. Objective: To describe the process and impacts of implementing accessible HMs from PwDs’ perspective. Design: Qualitative descriptive design with semistructured interviews with codebook thematic analysis to identify themes. Participants: Community-dwelling adults with musculoskeletal and sensory disabilities (n = 31) and 2 cohabiting caregivers from Ontario, Canada, who had either made HMs or required accessible housing. Fourteen of these participants also had professional expertise related to accessible housing. Outcomes and Measures: The primary outcome was participant perspectives and experiences related to HMs. No standardized measures or hypotheses were used, consistent with the exploratory qualitative design. Results: Four themes emerged that depict the process and impacts of implementing HMs: (1) impacts of an unmet need for HMs, (2) barriers to and (3) facilitators of effective HMs, and (4) outcomes and benefits of having HMs. Issues related to independence, safety, and dignity, as well as how structural, financial, and attitudinal barriers intersect in decision-making. Participants also described a lack of guidance on how to approach the HM process. Conclusions and Relevance: Findings highlight the importance of HMs to achieve person–environment fit. Given the complexities of the HM process, occupational therapists are well positioned to support individuals in navigating this process and to contribute to broader advocacy efforts. Plain-Language Summary: This study looked at how people with disabilities make their homes more accessible or how they assist others with this process and the challenges they run into. People who took part said they had to find information on their own and speak up for themselves. They described their independence, individual needs, and finances as being important. The results highlight the importance of helping people make their homes more accessible and ways that occupational therapists can help.