Aging in Place: In-Home Therapy and Home Safety

What aging in place means

Staying in your own home as you get older is called aging in place. Many older adults and their families also have concerns about safety, getting around and daily activities. Living at home as you age takes careful consideration and planning, and the plan needs to be revisited as needs change.

Aging in place does not mean doing everything alone. It means having the strength, skills, equipment, home setup and support to keep doing what matters at home. In-home care can be short term, such as recovery after an operation, or long term for ongoing needs.

Planning ahead

The NIA recommends planning early, while you can still make decisions comfortably. A practical plan has four parts.

What changes with age

Aging does not cause dependence by itself. Dependence usually develops when a few specific problems accumulate. The table shows the common ones and how they connect to therapy.

Making the home safe and workable

The NIA suggests going through your home room by room to find potential problems. Correct immediate dangers such as loose stair railings and poor lighting first, then work on longer-term changes. The CDC lists common fall hazards, including broken or uneven steps, throw rugs and clutter.

• Entrances and stairs: sturdy railings on both sides, good lighting, and no loose or uneven steps
• Floors and walkways: remove throw rugs and clutter, secure cords, and keep paths clear
• Bathroom: grab bars, a non-slip surface, a shower chair or handheld shower when needed, and a raised toilet seat if standing is hard
• Bedroom and living areas: night lights, a bed and chairs at a height that is easy to get out of, and a phone within reach
• Kitchen: frequently used items within easy reach, and safe ways to carry things

An occupational therapist or a physical therapist can assess your home and how you actually move in it, and recommend changes in order of importance. You may not need every suggested change, and needs change over time. AdaPTive Mobility Solutions provides in-home safety and fall-risk assessments and equipment recommendations.

Signs it is time to get help

• Falls or near-falls, even without injury. Fewer than half of older adults tell their doctor.
• Avoiding stairs, the shower or going out because of fear of falling
• New trouble getting up from a chair, the toilet or the bed
• Weight loss, skipped meals, or trouble chewing or swallowing
• Missed medicines, unpaid bills, getting lost or repeated confusion
• A recent hospital stay, surgery or illness that left you weaker

Tell your doctor about these changes. Early therapy can often rebuild strength and confidence before a serious fall or loss of independence.

How therapy supports independence

Therapy is most effective when it starts early, is tied to the real tasks and rooms of your life, and includes the people who help you.

In-home support can include help with personal care, household chores, meals, money management, health care such as physical therapy, transportation and safety features. Therapy works alongside these services and helps you do more for yourself, for longer.

What physical, occupational and speech therapy each do

Physical therapy: strength, balance and mobility

• Lower-body strengthening and balance training that gets progressively harder
• Walking and stair practice, plus getting up from a chair or the floor
• Fall-risk assessment and a plan to reduce it
• Recommendations for a cane or walker when it makes you safer
• Pre- and post-surgery conditioning when procedures are planned

Occupational therapy: routines, home and equipment

• Safer ways to bathe, dress, cook and manage medicines
• Home safety review and prioritized modifications
• Adaptive equipment recommendations and training
• Energy conservation and pacing for fatigue and arthritis
• Training for family members who help

Speech-language pathology: memory, communication and swallowing

• Strategies for memory and attention in daily routines
• Voice and speech therapy
• Swallowing evaluation and safe-eating strategies
• Support for communication with family and care providers

Supporting services

Massage and stretch therapy may help with comfort and flexibility when your physician clears it.

What an ELEVATE home visit looks like

• Review: your health history, medicines, goals and your doctors’ recommendations.
• Assessment: strength, balance, walking and daily tasks, with memory, speech and swallowing screening when needed.
• Home review: entrances, stairs, bathroom, bedroom, kitchen, lighting and walkways.
• Plan: goals that matter to you, a written home program, and training for family and caregivers.
• Communication: progress shared with your physician as appropriate.

ELEVATE serves adults in Oakland and Macomb County, Michigan, with licensed physical, occupational and speech-language therapists. See Payments & Insurance for details.

Questions families ask

Trusted resources for aging in place

These organizations are the leading sources of education and support for this condition. We are not affiliated with them.

Related guides

Browse every condition we treat on our Conditions We Treat page.

Sources and medical note

• National Institute on Aging: Aging in Place: Growing Older at Home.
• Centers for Disease Control and Prevention: Facts About Older Adult Falls.
• National Council on Aging: Falls Prevention for Older Adults.

This page is educational and is not medical advice. It does not replace your physician’s care. Always follow your physician’s instructions. For a fall with severe pain, a head injury with confusion, chest pain or signs of stroke, call 911 immediately.