Teaming Up with an Occupational Therapist – Part 1

posted on Oct. 23, 2019, at 9:00 a.m.

NKBA Staff

Partnering with an occupational therapist can be as important as any other professional in the remodeling process. By Rosemarie Rossetti, Ph.D.

Editor’s Note: After a 1998 spinal cord injury left Rosemarie Rossetti paralyzed from the waist down and in a wheelchair, she and her husband, Mark Leder, needed to build a new home to accommodate her newly compromised mobility. They worked with the design team and were the general contractors, and founded the Universal Design Living Laboratory in Columbus, Ohio, where they’ve been living since 2012. It is the top-rated universal design home in North America with three national universal design certifications. In this article, the first of a two-part series, she discusses collaborating with an occupational therapist to design spaces with maximum function and safety in mind.

What is an occupational therapist?

Occupational therapists are trained medical professionals who provide comprehensive evaluations of their clients’ homes to determine the homes’ functionality and safety for the occupants. They make recommendations for home modifications and adaptive equipment, as well as provide training and guidance for their clients, family members and caregivers.

However, not all occupational therapists have training and experience in home modifications, which is a specialty emphasis. In an interview with Karen Koch, occupational therapist and licensed builder from the Home Modification Occupational Therapy Alliance (HMOTA), she said, “Home modifications in occupational therapy is a specialty field. Within the home modification field, there is a subset of occupational therapists that specialize in pediatrics, catastrophic injuries, the autism spectrum and neurological impairments such as spinal cord injury, brain injury, Parkinson’s disease, stroke, multiple sclerosis, muscular dystrophy and cerebral palsy.”

Occupational therapists have advanced training in human physiology, debilitating conditions, the aging process and how these issues evolve. This is essential in ensuring the long-term effectiveness of home design for accessibility. They know how a person will need to adapt or remodel their home after an injury or illness, and help people to live safely and independently in their homes.

They are also educated on the Activities of Daily Living, a term used in healthcare to refer to people’s daily self-care activities. Occupational therapists know how a home can enhance or restrict these activities. The Activities of Daily Living are centered around self-care. These activities include bathing, showering, dressing, grooming, toileting, brushing teeth, self-feeding, meal preparation, cleaning, walking, getting in and out of bed and getting in and out of a chair. Occupational therapists focus on enabling the client to engage in the Activities of Daily Living as effectively as possible.

Koch pointed out that occupational therapists work to protect their clients from the risk of falls or injury while improving functional independence. They aim to make their clients as independent as possible. As a result, the client is able to perform the Activities of Daily Living faster and more safely, with less strain on their bodies. Occupational therapists also want to limit the demands on the client’s caregivers, who are often family members.

Occupational therapists are well-informed about the placement of devices from a safety and ergonomic standpoint, with a goal of meeting current and future needs of their clients.

When should I start working with an occupational therapist?

When your client has a medical condition, an occupational therapist should be called in at the start of the project.

How does an occupational therapist work with an interior designer on a design project?

The occupational therapist will evaluate the client and provide design parameters from which to base the design to the interior designer. Design parameters include the client’s measurements and turning radius based on the client’s function and space requirements. Knowing these parameters at the start of the design process saves time and ensures accessibility.

Accessibility needs to be top-of-mind when designing a home for someone living with a disease, disability or injury, as well as going through the natural aging process. An occupational therapist’s knowledge of their client’s needs and functional abilities impact the design. Knowing the client’s space requirements, need for adaptive equipment and alternatives for home modifications make the difference between a mediocre design and one that is exceptional.

Kitchen, bath and interior designers should partner with an occupational therapist in the design of kitchens and bathrooms, since these rooms are where most of the Activities of Daily Living occur.

Koch said the occupational therapist will evaluate the client’s function and then set design parameters based on these needs. These parameters include a recommended turning radius, width of hallways, flooring products, lighting recommendations, height for accessible storage, size of the shower and placement of fixtures, shower controls and seat. In her experience working with interior designers, Koch finds that designers enhance the form and aesthetics of the home while occupational therapists enhance the functionality of the home.

The occupational therapist may recommend a commercial grade vinyl flooring instead of tile, considering the combined weight of the client and wheelchair and the client’s fall risk. The interior designer then identifies the product that is most aesthetically pleasing based on design requirements. For instance, the occupational therapist is likely to recommend flooring that is slip-resistant and the interior designer will select the product that is decorative as well as slip-resistant.

Part 2 of this series will discuss issues including finding a local occupational therapist and some financing options.

Rosemarie Rossetti, Ph.D., CLIPP, is an internationally known speaker, trainer, consultant, and author of the Universal Design Toolkit. The Universal Design Living Laboratory, located in Columbus, Ohio, is the top-rated universal design home in North America with three national universal design certifications. To purchase the Universal Design Toolkit at a 50% discount, or get a free chapter, take a virtual tour, and learn more about her national demonstration home and garden, the Universal Design Living Laboratory, visit To contact Rosemarie and learn about her speaking, training, and consulting services, go

To apply for Certified Living In Place Professional (CLIPP) certification, issued by the Living In Place Institute, click here. (NKBA members get a discount.)

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