When working with younger adult clients who require home modifications due to the recent onset of a physical disability, it can sometimes be difficult to make recommendations that the client will be willing to implement. Grab bars, tub transfer benches, and raised toilet seats can be great, but they also, in a sense, advertise to anyone visiting the home that the person who lives here has a disability. And if the disability is anticipated to be relatively permanent, this younger adult client will be facing years of this perceived indignity at your recommendation. So how can we, as occupational therapists, take this dignity aspect into consideration when making recommendations for home modifications?

Ask the client.
The easiest way to determine what a client may or may not be willing to implement is to simply ask them. Rather than saying, “what you need is…” or even “what I recommend is…”, start by asking “are you open to…”. This simple question gives the client an easy out to say they aren’t comfortable with a particular recommendation. Now, that doesn’t mean you don’t later make that recommendation if it truly is necessary, but it does mean you can reframe or modify the suggestion to make it more appealing to the client once you know their specific preferences.

Offer multiple options and price points.
Grab bars are a great example of something that can look either utilitarian or artistic, depending on the style and how much you’re willing to spend. So rather than simply suggesting a specific length grab bar or showing a picture of a standard grab bar, show the client multiple options and price points, including options that blend in with their decor or match their existing fixtures and hardware. This gives them the opportunity to choose what is most important to them—cost or appearance—without sacrificing on what is most important to you—safety.

Consider alternate solutions.
Sometimes clients can come up with pretty creative ways of managing to complete ADLs on their own or with the help of family members. While not all of these solutions are safe or advisable, others may not be such a bad option. So be open to considering solutions clients may have and either accepting or modifying those solutions rather than simply imposing your own.

Always put safety first.
In all recommendations, keep safety first and foremost. When you are recommending something you aren’t sure the client will like or advising against something they’ve been doing, always preface your recommendation by going back to the safety component. Say things like, “I know that has worked so far, but the safety concerns I see are…” or “I know this isn’t something you’re probably going to be a fan of, but for safety reasons I would recommend…”. This makes the recommendation come across as more objective and less of a personal restriction or imposition and can often make a big difference in the client’s ultimate receptivity.

Making home modifications for younger adult clients comes with its own set of challenges, particularly when those recommendations are required due to a recent decrease in function that is not likely to be restored. Being aware of this potential resistance to traditional modification recommendations and being open to working with the client to develop safe solutions to their problems can make a big difference in their overall receptivity to your suggestions as well as their rate of follow through.