Occupational Therapy and its Passion for Helping Seniors Age in Place

There are a lot of small things that can be done to help senior citizens to stay in their homes and age in place. Brianna Brim, MOT, OTR/L, CPAM, CLIPP, and Anna Grasso, MS, OTR/L, CAPS, both assistant professors in the University’s Occupational Therapy (OT) program, are passionate about helping them do just that.

Brim partners with Ralston My Way – a licensed nonprofit home care agency serving anyone age 55-plus in Northwest Philadelphia – and Grasso partners with Rebuilding Together Philadelphia – which revitalizes communities by transforming vulnerable houses into safe, healthy and energy-efficient homes – to help seniors stay in their homes as long as possible.

Together, they supervise four Level 2 Salus University OT students each year, to learn how to complete home assessments, write reports, complete construction drawings, and connect seniors with much needed support systems within their communities. Within both programs, seniors interested in remaining in their homes are offered free home assessments and free home modifications.

This is the fourth year for the Ralston My Way partnership, and the second year for the Rebuilding Together Philadelphia program at Salus. Former Ralston My Way executive director and current director of engagement, Eric Wilden, approached Brim thinking Ralston clients could benefit from an OT home assessment. With Ruth Farber, PhD, adjunct associate professor in the OT program, and Lauren Sponseller, PhD, OTD, MSOTR/L MEd, chair of the OT department and associate professor, the trio came up with a way to get OT students involved. The project grew when Anna Grasso joined the OT faculty and partnered with Rebuilding Together Philadelphia.

The instructors and students usually spend about an hour and a half with each senior, getting to know them, what their life is like and how they use their homes. They also try to find and inform the seniors of additional resources they can use for home modifications and to find supports within their community. Connecting seniors to programs that offer low-cost meal delivery, decluttering support, cleaning services, or social opportunities can be life-changing. In addition, the Salus group conducts a lot of education about disease processes and how to plan ahead, so seniors can remain in their own homes for as long as possible.

“A lot of people think ‘I just need grab bars or handrails,’ but the reality is that grab bars should be set based on how you use your tub and shower as well as your height,” said Brim. “We also try to take into consideration how it looks, so that it doesn’t look like your home is a medical facility. We try to find things that are stylish and affordable.”

While traditional OT services often focus on regaining or maximizing functional ability after injury or a disability, these services focus specifically on the home and community environments.

“These are seniors who are saying, ‘I want to stay in this house, what can we do?’ It’s a very specific branch of OT,” said Brim. “We’re working under a little different umbrella, so our patients aren’t referred to us by a doctor. We’re not doing any OT treatment. This is about screening and assessing the home.”

Both Brim and Grasso have advanced certification in this area and are pulling students in to learning those skills in addition to core OT skills such as taking an occupational profile and becoming a client advocate.

“Skills for independent living and assessing environments is part of the OT scope of practice, which allows us to go into any type of space and assess it for general accessibility and specific accessibility depending on what someone’s physical limitations or abilities would be. The clients are telling us what they feel their abilities and limitations are,” said Brim.

In addition to the four Level 2 students (who complete 12 weeks at a site and by the end are completing most of the tasks that a supervisor would normally do) involved in the program, there will be 18 Level 1 students (who complete approximately one week with a site at an active observational level) involved this year. The program has worked with approximately 70 families over the past four years.

“We’ve worked with a lot of people who just don’t know how many resources are really available to them, and I think that’s one of the hardest things that we deal with,” said Brim. “We’re working with a lot of seniors from low socio-economic status, a lot of seniors who maybe don’t have the best medical network to begin with, not getting access to the care that they deserve.”

In addition to the training that the Salus OT students are receiving, working with the seniors to assess their needs and guide them to the available resources has been a rewarding experience for the instructors as well.

“It’s really nice to see people who didn’t know there are things out there that can really help them and to be able to connect them with those resources,” said Brim. “Some of them are really simple, but they make a huge difference. Just knowing that there’s a really great jar opener that might be useful to them. Or, they say ‘I really struggle to put my socks on.’ Well, there is a gadget for that. It really is freeing for them.”