Aging in place services

There are two different assessments and you want both, in this order. An occupational therapist assesses the person: how they transfer out of a chair, whether they can reach the shower controls, what their balance is actually like on a bad day. Occupational therapy practitioners assess the home environment, recommend adaptive equipment, and train family caregivers, per the American Occupational Therapy Association. A contractor assesses the house: where the studs are, whether the shower wall can carry a grab bar, whether the doorway can widen without moving a load-bearing element. The OT tells you what the house needs to do. The contractor tells you what it will take to get there.

The work itself is ordinary trade work done to unusual dimensions. Widening a door is carpentry. A curbless shower is tile and waterproofing. A step-free entry is concrete or framing. There is no special "aging in place trade" — what a specialist adds is knowing which dimensions matter, which ones are negotiable, and which cheap fix will fail in two years. That is worth paying for on bathroom and entry work. It matters much less on lighting or lever handles.

Sequence matters more than scope. If you have limited money, the bathroom and the entry are where falls and lockouts actually happen, so those go first. Lighting is the cheapest meaningful upgrade in the house. Kitchen accessibility is real work but rarely urgent. A contractor who opens by proposing a whole-house remodel before anyone has watched your parent get into the shower is selling, not assessing.

If you are an adult child arranging this from out of state, insist on being on the walkthrough — by video if you can't be there. The person who lives in the house will tell a contractor they're fine. They will not mention the two nights they slept in the recliner because the stairs felt wrong.

How to choose

Get the occupational therapy assessment before the contractor bid

An OT evaluates the person, not the house. Their recommendations give you a scope to bid against, which stops the project from being defined by whatever the contractor happens to sell.

Ask what the contractor has actually built, not just what they're certified in

Ask for two addresses of curbless showers or step-free entries they built more than three years ago, and whether they've had callbacks. A designation is a class attended. A three-year-old shower that still doesn't leak is evidence.

Bid the bathroom separately from everything else

Bathrooms are where the cost and the risk concentrate. Bundling it into a whole-home number makes it impossible to tell whether you're being charged fairly for the part that matters most.

Insist on written scope with dimensions

"Widen doorway" is not a scope. "Widen to 36-inch door slab, 32-inch minimum clear opening measured with the door open 90 degrees" is. Dimensions are what you'll be checking at the end.

Don't buy the whole plan on day one

Needs change. Do the urgent safety work now, get the house structurally ready for later work — blocking in bathroom walls, a bedroom that can move downstairs — and leave the rest until it's actually needed.

Watch for a same-day close after a hospital discharge

Families are most exposed in the week after a fall. Any contractor pushing a signature that week, before an OT has seen the person, is exploiting the timing. Stabilize with temporary equipment and bid the permanent work in a calmer month.