Summary

In this Office Hours episode, Sue Doyle, PhD, OTR/L, discusses how skilled home-modification occupational therapists look beyond environmental checklists to understand the client’s routines, priorities, task performance, and participation at home. She shares practical approaches for observing meaningful activity, prioritizing recommendations, addressing client resistance, choosing between equipment and structural changes, and documenting occupation-centered clinical reasoning.

Questions answered in this episode:

Where should I begin during a home-modification assessment: the bathroom, entryway, or somewhere else?

What should I observe beyond obvious home hazards?

How can I frame recommendations around more than fall prevention?

What should I do when I identify many home concerns at once?

How should I respond when a client declines a recommendation?

How do I determine whether equipment is enough or an architectural modification is needed?

How can I document home-modification recommendations in an occupation-centered way?

Mentioned resources and links:

• Certified Home Accessibility Therapist (CHAT): https://www.thehomeaccessibilitytherapist.com/CHAT
• Courses & Memberships:  https://www.thehomeaccessibilitytherapist.com/courses
• Any handouts, checklists, or blog posts referenced: 

Submit a question for a future episode:

• Use the question form here: https://www.thehomeaccessibilitytherapist.com/SubmitQuestion
• Or email your question to: [email protected]

Connect with The Home Accessibility Therapist:

• Website: https://www.thehomeaccessibilitytherapist.com/
• Blog: https://thehomeaccessibilitytherapist.blog/
• Join the newsletter: https://www.thehomeaccessibilitytherapist.com/Newsletter
• Join  our Facebook Group: https://www.facebook.com/groups/homeaccessibilitysafety
• Follow on LinkedIn: www.linkedin.com/in/susan-doyle-38bba3178

Summary
This episode is an audio version of our blog on accessible RVs. Sue Doyle, PhD, OTR/L walks through how to apply home safety and modification principles to motorhomes and travel trailers so you can help clients pursue RV travel without sacrificing safety, independence, or realistic access to ADLs on the road.

In this episode, we cover:

Why standard RV layouts (steps at entry, narrow hallways, tiny bathrooms, high controls, and slippery floors) create major person–environment mismatches for clients using wheelchairs, walkers, oxygen, or with balance/sensory challenges—and why an RV should be evaluated like any other home environment.

Key features that make an RV truly accessible, including no-step or lift entry, widened doorways and interior paths, open floor plans for maneuvering and caregiver assistance, accessible bathrooms and kitchens, securement systems, adjustable beds, smart controls, safe storage and power for medical equipment, and non-slip, well-lit flooring.

A practical three-step OT framework—assess, modify, prepare—for responding when a family says “we’re thinking about getting an RV”: how to evaluate the person, rig, and travel goals; collaborate with accessibility-focused builders or custom shops; and plan for equipment, emergency exits, power management, and day-to-day routines so the trip is both possible and sustainable.

Read the full blog and see visuals:

• Read the article: https://thehomeaccessibilitytherapist.blog/2025/04/18/overcoming-accessibility-challenges-in-recreational-vehicles/
• View any photos, diagrams, or checklists mentioned in this episode on the blog.

Related trainings and courses:

• Certified Home Accessibility Therapist (CHAT): https://www.thehomeaccessibilitytherapist.com/CHAT
• Occupational Therapy for Persons with Hoarding Disorder https://www.thehomeaccessibilitytherapist.com/HoardingCourse
• All Courses: https://www.thehomeaccessibilitytherapist.com/courses

Stay connected:

• Website: https://www.thehomeaccessibilitytherapist.com/
• Blog: https://thehomeaccessibilitytherapist.blog/
• Join the newsletter: https://www.thehomeaccessibilitytherapist.com/Newsletter
• Join  our Facebook Group: https://www.facebook.com/groups/homeaccessibilitysafety
• Follow on LinkedIn: www.linkedin.com/in/susan-doyle-38bba3178

Summary
This episode is an audio version of our blog, “Disaster Planning When Your Client Has Dementia: What Every OT Needs to Know.” Sue Doyle, PhD, OTR/L explores why standard emergency-preparedness advice fails people living with dementia and walks you through an OT-centered framework so you can help families plan evacuations and disruptions in ways that protect safety, function, and dignity.

In this episode, we cover:

• How dementia fundamentally changes the experience of disasters and evacuations, including heightened risks for confusion, behavioral escalation, and even increased post-evacuation mortality when routines and familiar environments are abruptly disrupted.
• A practical OT framework for disaster planning with dementia: building a sensory and behavioral profile, identifying calming inputs and triggers, creating a dementia emergency ID card, planning for wandering risk, medication continuity, and graded “practice” evacuations that build familiarity instead of fear.
• The critical role of caregiver-focused education and community advocacy, from coaching communication and routine strategies in shelters to engaging with local emergency planners and leveraging OT-led disaster-preparedness training to better protect this growing, highly vulnerable population.

Read the full blog and see visuals:

• Read the article: https://thehomeaccessibilitytherapist.blog/2026/06/10/disaster-planning-when-your-client-has-dementia-what-every-ot-needs-to-know/
• View any photos, diagrams, or checklists mentioned in this episode on the blog.

Related trainings and courses:

• Certified Home Accessibility Therapist (CHAT): https://www.thehomeaccessibilitytherapist.com/CHAT
• Disaster Preparedness, Response, and Recovery: A role for OT  https://www.thehomeaccessibilitytherapist.com/Disastercourse
• All Courses: https://www.thehomeaccessibilitytherapist.com/courses

Stay connected:

• Website: https://www.thehomeaccessibilitytherapist.com/
• Blog: https://thehomeaccessibilitytherapist.blog/
• Join the newsletter: https://www.thehomeaccessibilitytherapist.com/Newsletter
• Join  our Facebook Group: https://www.facebook.com/groups/homeaccessibilitysafety
• Follow on LinkedIn: www.linkedin.com/in/susan-doyle-38bba3178

Summary

In this Therapist Thursday episode, Sue Doyle, PhD, OTR/L talks with Lindsey McLean, a COTA and founder of Living Solutions Plus in Michigan, about growing a mobile outpatient OT/PT practice that weaves in home assessments and fall-prevention-focused modifications for older adults. Lindsey shares how seeing repeated fall-related injuries on inpatient rehab led her to step out on her own, navigate the added challenges of doing this work as a COTA, and build systems for billing, referrals, and contractor collaboration that keep clients safer at home.

What you’ll learn in this episode:

How Lindsey moved from a hospital rehab unit north of Detroit to launching Living Solutions Plus, a mobile outpatient OT/PT practice that centers fall prevention and home safety, and what it’s really like to do this as a COTA working in partnership with evaluating OTRs.

Practical strategies she uses in home evaluations, including focusing on smaller, high-impact changes (like shower seats, bath mats, grab bars, and raised toilet seats) instead of defaulting to major remodels, and using her home mods certification to clearly explain recommendations to families, physicians, and senior communities.

Business and operations insights on proving that OTAs can start and grow their own businesses, structuring services under mobile outpatient and home mods, using documentation and billing platforms (such as coding home modifications visits under ADL-related OT codes), blending insurance and private pay, and protecting herself and clients by guiding them to vet multiple contractors rather than tying recommendations to a single company.

Guest details and links:
Lindsey McLean

• Website: https://www.livingsolutionsplus.com/
• LinkedIn: https://www.linkedin.com/in/lindsey-mclean-01068720/

Resources mentioned:

• Certified Home Accessibility Therapist (CHAT): https://www.thehomeaccessibilitytherapist.com/CHAT
• All Courses: https://www.thehomeaccessibilitytherapist.com/courses

Connect with The Home Accessibility Therapist:

• Website: https://www.thehomeaccessibilitytherapist.com/
• Blog: https://thehomeaccessibilitytherapist.blog/
• Join the newsletter: https://www.thehomeaccessibilitytherapist.com/Newsletter
• Join  our Facebook Group: https://www.facebook.com/groups/homeaccessibilitysafety
• Follow on LinkedIn: www.linkedin.com/in/susan-doyle-38bba3178

Summary
In this office hours episode, Sue Doyle, PhD, OTR/L, wraps up the Getting Started in Home Modifications series by focusing on how to stay up to date with equipment, technology, and funding options in a constantly changing landscape. She shares a powerful client story, practical strategies for learning about new products, and ways to match real-world solutions and funding pathways to each client’s needs and context.

Questions answered in this episode:

Why does staying current with bathroom equipment, lifts, mobility devices, and smart home technology matter so much for safety, dignity, and long-term living-at-home outcomes?

How can therapists build a realistic, working knowledge of key product categories—without chasing every “shiny gadget”—by using vendors, webinars, case discussions, and peer networks?

What are some of the main funding “buckets” and community options (waivers, nonprofits, grants, creative financial tools) that can help clients actually pay for the modifications you recommend?

Mentioned resources and links:

• Certified Home Accessibility Therapist (CHAT): https://www.thehomeaccessibilitytherapist.com/CHAT
• Courses & Memberships:  https://www.thehomeaccessibilitytherapist.com/courses
• Any handouts, checklists, or blog posts referenced: 

Submit a question for a future episode:

• Use the question form here: https://www.thehomeaccessibilitytherapist.com/SubmitQuestion
• Or email your question to: [email protected]

Connect with The Home Accessibility Therapist:

• Website: https://www.thehomeaccessibilitytherapist.com/
• Blog: https://thehomeaccessibilitytherapist.blog/
• Join the newsletter: https://www.thehomeaccessibilitytherapist.com/Newsletter
• Join  our Facebook Group: https://www.facebook.com/groups/homeaccessibilitysafety
• Follow on LinkedIn: www.linkedin.com/in/susan-doyle-38bba3178

Summary
This episode is an audio version of our blog, “From Assessment to Action: The OT’s Clinical Map for Hoarding Disorder.” Sue Doyle, PhD, OTR/L walks step-by-step through a practical, evidence-informed process for hoarding evaluations so you can move from feeling overwhelmed at the doorway to using a clear clinical map that supports safety, function, and meaningful change.

In this episode, we cover:

• Why regulating yourself and building a non-judgmental therapeutic alliance is the crucial first intervention when you walk into a cluttered home, and how to use an occupational profile to uncover what matters most to the client about their possessions and daily routines.
• How to weave in validated tools like the Hoarding Rating Scale, Clutter Image Rating, and ADL-H as conversational assessments, then translate those findings into concrete, occupation-based goals and graded interventions that target safety, access, and participation.
• Six practical OT steps—from first impressions to maintenance planning—including structuring sessions, collaborating on acquisition and “one in, one out” agreements, engaging families without enabling, and building long-term supports so gains are sustained rather than lost over time.

Read the full blog and see visuals:

• Read the article: https://thehomeaccessibilitytherapist.blog/2026/06/30/from-assessment-to-action-the-ots-clinical-map-for-hoarding-disorder/
• View any photos, diagrams, or checklists mentioned in this episode on the blog.

Related trainings and courses:

• Certified Home Accessibility Therapist (CHAT): https://www.thehomeaccessibilitytherapist.com/CHAT
• Occupational Therapy for Persons with Hoarding Disorder https://www.thehomeaccessibilitytherapist.com/HoardingCourse
• All Courses: https://www.thehomeaccessibilitytherapist.com/courses

Stay connected:

• Website: https://www.thehomeaccessibilitytherapist.com/
• Blog: https://thehomeaccessibilitytherapist.blog/
• Join the newsletter: https://www.thehomeaccessibilitytherapist.com/Newsletter
• Join  our Facebook Group: https://www.facebook.com/groups/homeaccessibilitysafety
• Follow on LinkedIn: www.linkedin.com/in/susan-doyle-38bba3178

Summary
This episode is an audio version of our blog, “Reframing Hoarding as Occupation: What Occupational Therapists Bring That Nobody Else Can.” Sue Doyle, PhD, OTR/L walks through an occupation-based lens on hoarding disorder so you can move beyond overwhelm and judgment, use structured tools, and design person-centered interventions that truly support safety, function, and meaningful change.

In this episode, we cover:

• Why hoarding disorder is often misunderstood—even within OT—and how reframing hoarding behaviors (collecting, acquiring, arranging, saving) as occupations that meet real needs for safety, identity, continuity, and connection can transform your clinical perspective and therapeutic alliance.
• The unique multi-dimensional role of occupational therapy in hoarding work, including attending simultaneously to psychological factors (attachment, decision-making), environmental risks (clutter, fire risk, falls), functional impact (ADLs and access), and meaningful roles and routines.
• Practical OT tools and strategies you can start using now, such as the Hoarding Rating Scale, Clutter Image Rating, and ADL-H, plus occupation-focused goal setting and motivational interviewing approaches that align interventions with what the client most wants to be able to do—not just what others want them to discard.

Read the full blog and see visuals:

• Read the article: https://thehomeaccessibilitytherapist.blog/2026/06/24/reframing-hoarding-as-occupation-what-occupational-therapists-bring-that-nobody-else-can/
• View any photos, diagrams, or checklists mentioned in this episode on the blog.

Related trainings and courses:

• Certified Home Accessibility Therapist (CHAT): https://www.thehomeaccessibilitytherapist.com/CHAT
• Occupational Therapy for Persons with Hoarding Disorder: https://www.thehomeaccessibilitytherapist.com/HoardingCourse
• All Courses: https://www.thehomeaccessibilitytherapist.com/courses

Stay connected:

• Website: https://www.thehomeaccessibilitytherapist.com/
• Blog: https://thehomeaccessibilitytherapist.blog/
• Join the newsletter: https://www.thehomeaccessibilitytherapist.com/Newsletter
• Join  our Facebook Group: https://www.facebook.com/groups/homeaccessibilitysafety
• Follow on LinkedIn: www.linkedin.com/in/susan-doyle-38bba3178

Summary

In this Therapist Thursday episode, Sue Doyle, PhD, OTR/L talks with Consuela Marshall, an occupational therapist with 30 years of experience—26 of those in home health—about shifting from traditional home health into mission-driven fall prevention, home safety coaching, and nonprofit work in the Baton Rouge area. Consuela shares how repeated fall-related home health episodes, insurance and PDGM constraints, and her passion for lower-resource communities led her to rethink “textbook” home modifications and build a foundation focused on practical, affordable fall prevention education for families and caregivers.

What you’ll learn in this episode:

How Consuela’s decades in home health, frustration with PDGM and Medicare Advantage visit limits, and seeing the same clients return after multiple falls pushed her to focus her OT career on proactive fall prevention and home safety instead of only post-fall rehab.

Practical, client-centered strategies she uses to make home safety both relevant and affordable—such as reframing “home modifications,” respecting cherished items, using creative low-cost solutions (like a screen-door handle in a difficult bathroom), and tailoring recommendations for families with very different financial and housing realities.

Business, advocacy, and nonprofit insights on moving beyond cash-pay and Part B, writing a falls book, founding a 501(c)(3) to serve under-resourced older adults, pursuing a master’s in nonprofit administration, building community partnerships and sponsorships, and encouraging other therapists to “start where you are” with home mods—even before you have every contractor or tool lined up

Guest details and links:

Consuela Marshall

• Website: https://www.findingafoothold.com/
• LinkedIn: linkedin.com/in/consuela-marshall-ot-chat-caps-cdp-3a136a1b9

Resources mentioned:

• Certified Home Accessibility Therapist (CHAT): https://www.thehomeaccessibilitytherapist.com/CHAT
• All Courses: https://www.thehomeaccessibilitytherapist.com/courses

Connect with The Home Accessibility Therapist:

• Website: https://www.thehomeaccessibilitytherapist.com/
• Blog: https://thehomeaccessibilitytherapist.blog/
• Join the newsletter: https://www.thehomeaccessibilitytherapist.com/Newsletter
• Join  our Facebook Group: https://www.facebook.com/groups/homeaccessibilitysafety
• Follow on LinkedIn: www.linkedin.com/in/susan-doyle-38bba3178

Summary

In this office hours episode, Sue Doyle, PhD, OTR/L, focuses on how to actually find and connect with the people in your community who can send you ideal home modification clients. She walks through potential referral sources, how to frame your unique OT value, and simple, relationship-based steps to start building a steady stream of home mods referrals.

Questions answered in this episode:

Who are the key professionals, agencies, and organizations that are already seeing your ideal home mods clients before you, and how can you identify them in your own community?

How do you clearly communicate the unique value of OT-led home assessments—beyond ADA checklists and contractor recommendations—so referral partners understand why they should send clients to you?

What concrete steps can you take to nurture referral relationships over time (multiple “touches,” education, and follow-up) without feeling like a full-time salesperson?

Mentioned resources and links:

• Certified Home Accessibility Therapist (CHAT): https://www.thehomeaccessibilitytherapist.com/CHAT
• Courses & Memberships:  https://www.thehomeaccessibilitytherapist.com/courses
• Any handouts, checklists, or blog posts referenced: 

Submit a question for a future episode:

• Use the question form here: https://www.thehomeaccessibilitytherapist.com/SubmitQuestion
• Or email your question to: [email protected]

Connect with The Home Accessibility Therapist:

• Website: https://www.thehomeaccessibilitytherapist.com/
• Blog: https://thehomeaccessibilitytherapist.blog/
• Join the newsletter: https://www.thehomeaccessibilitytherapist.com/Newsletter
• Join  our Facebook Group: https://www.facebook.com/groups/homeaccessibilitysafety
• Follow on LinkedIn: www.linkedin.com/in/susan-doyle-38bba3178

Summary

This episode is an audio version of our blog, “From One-Off CEUs to a Real Growth Plan: Professional Development for OTs in Home Safety and Home Modifications.” Sue Doyle, PhD, OTR/L unpacks why random CEUs leave you feeling no more confident in home safety and home mods, and shows you how to build an intentional 6–12 month learning plan that actually moves you toward mastery instead of just meeting licensure requirements.

In this episode, we cover:

• The problem with scattered, last-minute CEUs: how discount-driven or convenience-based course choices create fragmented knowledge, low retention, and ongoing uncertainty around complex areas like home accessibility, funding, documentation, and multi-factor home visits.
• A simple but powerful growth-plan framework with three pillars—a clear destination, a realistic 6–12 month timeline, and structured learning tracks (clinical foundations, environmental/design knowledge, and systems/advocacy) that build depth in home safety and home modifications instead of one-off exposure.
• Step-by-step guidance to map your own plan: self-assessing your current gaps, choosing a focused goal, selecting 3–5 aligned learning activities, intentionally applying what you learn with real clients, and using reflection and check-ins (illustrated through “Jordan,” an OT case example) to turn CEUs into real competence and confidence in the home.

Read the full blog and see visuals:

• Read the article: https://thehomeaccessibilitytherapist.blog/2026/05/19/from-one-off-ceus-to-a-real-growth-plan-professional-development-for-ots-in-home-safety-and-home-modifications/
• View any photos, diagrams, or checklists mentioned in this episode on the blog.

Related trainings and courses:

• Certified Home Accessibility Therapist (CHAT): https://www.thehomeaccessibilitytherapist.com/CHAT
• Disaster Preparedness, Response, and Recovery: A role for OT  https://www.thehomeaccessibilitytherapist.com/Disastercourse
• All Courses: https://www.thehomeaccessibilitytherapist.com/courses

Stay connected:

• Website: https://www.thehomeaccessibilitytherapist.com/
• Blog: https://thehomeaccessibilitytherapist.blog/
• Join the newsletter: https://www.thehomeaccessibilitytherapist.com/Newsletter
• Join  our Facebook Group: https://www.facebook.com/groups/homeaccessibilitysafety
• Follow on LinkedIn: www.linkedin.com/in/susan-doyle-38bba3178