Welcome back!

A home environment is supposed to be supportive of your needs and the needs of your family at all ages and abilities. It should work for you and not work against you, but oftentimes when life throws us a curve ball, we often feel like our homes aren't a good fit anymore. And modifications or changes to the home, need to occur to make life's tasks easier.

Why does life feel off balance when situations like this occur? Well, I'm going to share a reason why. There are three big variables that need to be considered, and then we need to look at the interaction between all three. The variables are people, the home environment, and tasks done there. 

When that curve ball of life happens and you break your leg, your abilities change. The features in a home often look like barriers and simple tasks like getting in and out of bed or taking a shower become much more difficult. Let's dig into this a little bit more because it is super important as we share about home modifications and why occupational therapists are the perfect fit to help guide you through this process.

Occupational therapists use different models and frameworks to help guide our decisions and give us direction when working with clients to guide our reasoning, when setting goals, and working on specific things in our treatment sessions.

We don't normally talk with our patients about their treatment settings and say how we're gonna apply "blank" framework, but it's actually something that is a core to all of our thoughts and ideas as we help make our patients more independent.

It's like a blueprint, or a guide for our thinking. I'm going to briefly talk about one such model, and that is called PEO. Each one of these letters corresponds with a word that we feel is extremely important when considering if a home is a good fit for someone's needs, or a poor fit. Keep in mind that example of a person with a broken leg that I mentioned before.

If you are a visual learner, the PEO model can be best described as a triangle shape with overlapping circles, with the P the person, the E, the environment, and the O, the occupation, each representing a point on the triangle. 

When we think about the P, or the person, we are considering the people in that family or individuals and important characteristics about them holistically. Holistically means that we're looking at a lot of different factors and how they connect in regard to a person's physical, mental, and emotional strengths and weaknesses related to their body. Because everyone comes from a different background and upbringing, each person has a unique set of experiences, identities, and abilities. These factors can help us understand more about a person and their situation. 

The E, or environment in this case, is talking about the home. These are the features of the home and what's there right now or what we'd like them to be. A home is more than just a structure that exists on a plot of land. It's the physical makeup of the structure influencing how one uses it. It's the social hub that facilitates connections in and around it. It's the cultural atmosphere that individuals bring to it. And it's makeup is largely dependent on the socioeconomic factors of the geographic area. 

 The O, or occupation, can be a little tricky here, but as OTs, we think about occupations as activities or things that you want or need to do everyday. So driving, making a sandwich, or brushing your teeth can be considered an occupation. Even roles and routines you have can be considered occupations.

In the very middle of that triangle, where all of these circles overlap, is the sweet spot where all parts of the P, E ,& O are considered. The connection between all three points determines how well the person is thriving as an individual in the things they need or want to do every day. And we call that optimal occupational performance. 

Not paying attention to one of these areas equally in the PEO, can cause the circles of the triangle to shift, resulting in that center section not being as optimal as it should. This in turn results in disengagement or dissatisfaction with one's life rolls, routines, or occupations. It makes life off balance. 

So how do we get the P, the E, and the O balanced again? Well, that person with a broken leg doesn't want to wait several months until they heal, and neither does that person who has a more long-term condition, that might not get better.

That's where we as occupational therapists are skilled in looking at the intersection of all of these pieces, to determine what areas we need to address with the person, the environment, and how they do tasks. Maybe it's changing the way the person moves, the products they use, or the way they do a task, or maybe we change the features in the environment to work with the impairments they're experiencing.

Seem like a complicated puzzle? Yep. It can be. And that's why understanding the interaction of all three of these pieces has together is important when helping people modify their homes. If we don't look at these things, people are stuck, and they feel limited by the environment and the activities become non-meaningful.

While OTs have lots of schooling and practice in using our clinical reasoning to make these connections with how people move and use their environment, we can't do this process without those who have skills and knowledge in building science and design. Collaborating with others to make these modifications is essential.

Homeowners, healthcare professionals and builders, contractors and designers should work together to address each of the parts of the PEO, as to not miss anything important. I do believe that after this course, you will look at your home, or the homes of others in the community, in a different way, and begin noticing things that could be changed to help make life a little easier.

Next up in our home tour, I'm going to show you common situations and homes found in American homes that could be modified for safety and function. I will also be talking about recommendations that mention a wide variety of needs, some may even apply to you. I look forward to seeing you there.