Following a spinal cord injury, many individuals require some modifications to their home to enable them to access required areas, to ensure safety for themselves and any carers and to enhance engagement and quality of life. These modifications might be minor or major and could be temporary or permanent.

Returning home after a spinal cord injury

When an individual returns home from hospital following a spinal cord injury, it is essential that they are, at a minimum, able to safely enter and leave the house and move around inside safely and as independently as possible. To enable this to occur, changes to the structure, layout or fittings of the home may be required. Alternatively, equipment may need to be utilised to enable individuals to use certain areas of the home that are not being modified (e.g. equipment to access a shower).

A home does not need to be fully modified to enable an individual to leave hospital. A ‘staged’ approach to modifications can be beneficial. This is where essential modifications or equipment are put in place to enable safe return home, whilst additional modifications (e.g. garden, kitchen, laundry access) can be completed at a later time, once an individual is back in the community and has trialled use of different areas of the home.

Rentals, own home or moving home?

Some individuals may be unable to return to their existing home following their spinal cord injury. This may be due to the cost or extent of modifications required at the home, or due to an inability to obtain permission from the owner of the property to complete the changes required.

In this situation, exploration of alternative accommodation options may be required. An individual’s health care team plays an important role in supporting an individual and their family to identify possible options, based on the individual’s access to funding support.

Occupational therapists

Occupational therapists (OTs) can play an important role in supporting individuals to determine what options are available to them at their home, whether this be temporary modifications, equipment or permanent changes.

An OT can assist with assessing an individual’s function following their spinal cord injury and the home environment and advise on what kinds of changes will be important, based on the individual’s situation. Provision of a written report with recommendations that cover safe access and mobility at home is an important part of this process.

Often, the OT will need to liaise with other parties when assisting an individual with the home modification process. These other parties may include TAC, NDIS, WorkSafe, SWEP or building and access consultants.

Home modification considerations

There are multiple considerations when planning home modifications. Below are some of the key factors to discuss and make plans for when working with an individual who requires changes to their home following their injury.

Home ownership

• Is the home rented, or owned?
• How long will the client be living here?

This may impact upon whether the changes made to the home are temporary (or equipment based), or permanent.

Injury factors and carer needs

• What level of injury does the person have?
• How does this impact upon their space, mobility, equipment and care needs within the home, now and into the future?

Life roles

• What life roles does the individual have and how does this impact on their use of the home?
• How does the rest of the family need to function in the space?

Funding

• Does the individual have access to funding support?

Australian Standards

Home modifications in private dwellings do not have to comply with the Australian Standards. Rather, these can be used as a guide, with consideration given to each individual’s specific space requirements, which may differ from the Standards.

Give it a try

Where possible, a lot of important information can be gained by assessing the home with the individual with a spinal cord injury present. Day leave and overnight leave can also provide invaluable insights regarding what areas of the home are manageable without being modified, and which areas are not. When it is not possible for someone to access their home prior to home modifications, trying to ‘mock up’ the space elsewhere, such as in the therapy gym, can help with determining how spaces might work with the equipment that someone will be using at home.

Respect

Respect that this is a person’s home – the home modifications process can be confronting and challenging and take some time to plan.

Time

How long home modifications take depends on the level of complexity involved. Major home modifications can take many months, particularly when a third party, such as a funding body, is involved. Considering of the use of equipment, a ‘staged’ approach to modifications or alternate accommodation options can assist an individual with returning to their life in the community in a timely manner.

Funding support for home modifications

If individuals are receiving compensation through the Transport Accident Commission (TAC) or WorkSafe, approval and funding for required home modifications can be sought through these organisations.

Information regarding the processes involved can be found on their websites. 

Home modifications funding is also available for NDIS participants. 

For clients without compensation or NDIS involvement, the State-Wide Equipment Program (SWEP) can offer up to $4400 (inc GST) per person across a lifetime. This is funding for home modifications such as ramps, widened doorways and a stepless shower. To be eligible modifications must be recommended by a qualified OT. 

Should individuals live in public housing, requests for completion of disability modifications or special accommodation requirements can be made through the Department of Health and Human Services.

Additional resources