Australian housing quality in question

Research from AHURI found that 70 per cent of households reported one or more major building problems in 2022. Policy for housing quality standards is fragmented across governments and ministers’ portfolios. And industry lobbyists are getting the way of improving the quality of our homes. The Livable Housing Design Standard is a case in point.

Policy for housing standards is weak and overly reliant on voluntary measures. We need a national strategy to improve housing standards.

Image: front cover of the Australian Housing and Urban Research Institute (AHURI) report.

Image from the front cover of the AHURI report showing a street of new single storey homes.

The research report uses two case studies to show that change is possible, but takes persistent effort to overcome lobbyist resistance. They recommend that purchasers get a performance report at the point of sale or lease. The rental sector should also have minimum standards mandated.

Relative to other countries, housing standards are not only fragmented but in some cases ineffectual. Too many standards are voluntary. Without mandated standards we cannot expect improvements in decarbonisation or accessibility for our homes.

The report highlights the lack of national leadership, and a strong lobbyist influence in maintaining the status quo. Governance processes are less than transparent, and voluntary standards are ineffective.

Front of a new house with 12 steps to the front door.

Case studies: Healthy Housing, Livable Housing Design

The case studies focus on the Healthy Housing Standards in Aotearoa New Zealand, and the Livable Housing Design Standard in Australia. The Healthy Housing Standard was eventually watered down to just insulation and smoke alarms.

In Australia, the Australian Building Codes Board controls the National Construction Code. According to the researchers, compared to other rule-making agencies, “there is a lack of transparency in the ABCB”. Among other missing information on their website, there is no annual report of the Board.

The report charts the history of the Livable Housing Design Standard from the National Dialogue on Universal Housing Design to the final Standard. An interview with a property industry professional confirmed their stance on retaining the status quo. That is, they lobbied for no change to standards or regulation. Hence the whole process took 20 years and still the state governments are lagging behind in adopting the Standard. Industry has not given up on their position.

Review reveals weak governance processes

An independent review of the process taken to assess the economics of adopting the Livable Housing Design Standard outlined 8 recommendations. They were based on four guiding principles that the ABCB should follow: transparency, robustness, integrity and fairness.

AHURI researchers found the Livable Housing Design Standard provided important lessons for the ABCB. The processes were not fit for purpose for this Standard.

“When forced to take up the issue by the nation’s building ministers, the ABCB ran a very slow process. They were actively lobbied by the building sector to adopt a voluntary strategy despite the obvious failure of that approach.”

Front cover of the Livable Housing Design Standard showing a single storey home with garage.

The report is lengthy and is really about “why is it so difficult to get changes to the building code when those changes would benefit so many?”

The section on the case studies concludes with the need for significant policy changes. Without them, we are unlikely to address the issues facing the environment and the move to net zero by 2050.

The AHURI report is, A national roadmap for improving the building quality of Australian housing stock. There is a link to the full report, the executive summary, and a policy summary.

Homes for an ageing population in New Zealand

A report for FAAB Small Homes repeats much of what is found in Australia in relation to updating to housing design to suit the current and future population. Yet resistance by the housing industry to updating housing standards and codes remains. And older people are not seeking universal inclusive design in new homes either.

Although we, as individuals, know we are ageing, the concept of universal design and easier access to and throughout the home is not a selling point with consumers. In the report one builder-developer was surprised that older people were not interested.

“We didn’t get much out of it at all … it really surprised me, maybe clients don’t think they will ever be in that situation. … I bring it up with all my clients. But they’re, ‘oh, it’s not going to happen to me’.”

Aerial view of an expanse of a housing estate. Inclusive suburbs for mind and body.

The title of the report is Encouraging new-build small, affordable and accessible homes for an ageing population.

Jane Bringolf reported in 2011 the same issue of ‘selling’ universal inclusive features, even to older people. After all, ageing and disability is not an aspirational factor for one’s ‘dream home’. That is why we need regulation to suit the population into the future. The idea of getting old, even when people observe their parents, does not compute. Hence the market is not asking for it and housing industry stakeholders use this as a means of maintaining the status quo.

In more than ten years, nothing much has changed, particularly in terms of attitudes to ageing. The title of Bringolf’s paper is Hope I die before I get old: The state of play for housing liveability in Australia.

Home designs for living

Designs 4 Living is a magazine by Todd Brickhouse in the US with a focus on home designs for people with disability and older adults. The latest issue covers a wide variety of design solutions. They include home lighting, bathroom and kitchen trends, home workplaces and cognitive and sensory solutions.

Front cover of Designs 4 Living showing a sunset over a lake with birds flying above.

Lighting the home

As we get older our vision degrades and in many instances and higher levels of illumination become more important. However, it’s important to avoid glare and “pooling” of light. Indirect light sources such as recessed lighting under and over cabinets is good. LED lighting uses less power and lasts much longer.

Different scenarios for different rooms in the home are presented in the article along with a useful list of terms used for lighting and illumination. There is a link to a free guidebook to lighting the whole house.

Bathroom trends

Making a bathroom safe and accessible is just the beginning – why not make it look stylish too. That’s the content of the article by Mike Foti. While white tiles are still popular, light wood grains have gained popularity and come as tiles and panels. Flooring can provide the necessary visual contrast to the walls and fittings. Shower and bathroom treatments that don’t involve grout are a bonus. The article has more with links to useful solutions.

Cognitive and sensory solutions

Shelly Rosenberg is an interior designer with ADHD and her article is framed around 8 human senses. We all learned the five senses at school but we need to add Vestibular, Proprioception and Interoception. She begins with vision and the quality of light and level of visual ‘busyness’.

Smell is about air quality, fragrance, memory and mood. Building materials and furnishings can give off toxic gasses. Controlling moisture temperature and using air filters and purifiers are some of the solutions. Rosenberg goes through all 8 senses

Gen X and Baby Boomer needs

This article explores the divergent needs of Generation X and Baby Boomers as they age. Marketing professionals like to label different age groups, but the old labels for older adults don’t gel with Gen X. Indeed, why should older people wear a label at all? And terms such as Silver Tsunami present older people as a burden. An interesting discussion.

The Summer edition 2024 of Designs 4 Living also has items on pets, and workplaces.

Ageing communities: Policy blind spots


Policy makers have been talking about population ageing, ageing-in-place and age-friendly communities for several years. But has there been any progress? The focus is still on residential care homes and this is the policy blind spot. Most older Australians are living in their own homes. So how do policies support them? And what about renters?

Three housing researchers analysed 85 policy documents against the World Health Organization’s (WHO) guidelines on age-friendly cities. They found these policies reflected outdated views of older age. That’s because the policy focus in on care and support services. This means less attention to housing, transport, walkability and cultural diversity.

Most older Australians aren’t in aged care – they are living in the community.

Policy blind spots mean they live in communities that aren’t age-friendly.

Being age-friendly for older people means age-friendly for all ages.

A child is kneeling down by the side of a lily pond. Her mother on one side and her grandmother on the other, also kneeling down. Grandfather is standing behind watching them.

The research also reveals a failure to recognise the diversity and impact of the ageing process. In particular, is the lack of recognition of diverse cultural needs.

“There is almost a complete blindness to their impacts on ageing and other social determinants of health.” Regardless most older Australians want to live where they are.

Two women sit on a bird nest swing.

For more on this topic see Most older Australians aren’t in aged care. Policy blind spots mean they live in communities that aren’t age-friendly in The Conversation.

Stay put or go? Renters lack choice

In another study, researchers asked what motivates older homeowners and renters to age where they are or to relocate. It seems older renters are not given a fair choice. For homeowners, family ties matter.

Owners with children living nearby were more likely to want to stay. They might then have a reason to call on their housing wealth and become the “bank of mum and dad”. Renters, however, want the same choice but face the most disruption. Many had to move out of their neighbourhood to find a place to rent.

This is another area where policy change is needed and for many, social housing is the answer. However, social housing is in short supply.

A family room with a couch, cushions and a throw.

For more see Should I stay or should I go? Most older Australians want to retire where they are, but renters don’t always get a choice, in The Conversation.

There’s a glimmer of hope on the horizon with the new Livable Housing Design Standard. This mandated Standard in the National Construction Code provides for accessible features such as a level entry into the home. It will support many more people to age in place and reduce the need for costly home modifications.

While it will take many years for new accessible homes to make an impact, it does mean that rental housing will be included in mainstream housing stock. However, states and territories are showing reluctance to adopt this essential Standard in the face of industry lobbying. But none of us is getting any younger.

See CUDA’s short online course which provides all the technical detail for implementing the Livable Housing Design Standard.

Universally designed dream home

This is not your average home. This one goes beyond even enhanced features in the Livable Housing Design Standard. However, it shows what is possible with creative design thinking. Depending on where you live, the key features will be embedded in all new homes under the Livable Housing Design Standard. And it’s good for home renovations too.

Contrary to the many myths, introducing universal design features into a home doesn’t compromise aesthetics.

Exterior view of the top part of a two storey home showing a window in the gables of the house. Universally designed dream home.

The video below is from O’Shea and Sons Builders that showcases a high-end of the market home. The additional costs are in the automation, the elevator and some of the fixtures and fittings. However, the key features are possible in mainstream homes at little, if any, additional cost.

As Nick O’Shea says, “… an absolutely amazing home where functionality and style means absolute beauty”. A really great example of universal design in action dispelling the myth that accessibility and functionality are ugly.

Filming by Unveil Media

O’Shea Builders have built other accessible homes so this is not the first. The Independent Builders Network in Queensland has other members doing good work as well. Queensland is also the first state to implement the new Livable Housing Design Standard.

Online learning – Livable Housing Design

CUDA has the licence from the Australian Building Codes Board to run their course on the Livable Housing Design Standard. The course is based on the Handbook and the Standard. This is a technical course for home-building professionals. Find out more about this course.

It covers the various ways to create level entries, doors, circulation spaces, showers and toilets. If you are reading this, take advantage of $30 off with the coupon code NEWS40 at the checkout. Offer ends 10 August.

Front cover of the Livable Housing Design Standard showing a single storey home with garage.

Housing Adaptations Design Toolkit

The Housing Adaptations Design Toolkit comes from Northern Ireland and is focused on government departments collaborating for good social housing outcomes. The aim is to integrate services to promote independent living. As such it has application to government funded home modification services in Australia an elsewhere.

Housing adaptations are a key element in supporting independent living. The other three are assistive technology, social care, and health and wellbeing.

The diagram shows the links between the four elements required for independent living.

Diagram showing the integration of services: health and wellbeing, housing adaptations, assistive technology and social care leading to independent living.

The Department of Communities and the Department of Health collaborated in the development of the toolkit.

The toolkit covers housing adaptions that range from those not needing a referral to occupational therapy services to more complex projects. It has design formats that help service users to visualise the proposed adaptations. Electronic formats facilitate inter-agency communications for the recommended adaptations and specifications.

The toolkit has seven sections. They include design principles for different rooms, space standards for different users, and helpful specification templates. There are three categories of users: ambulant, independent wheelchair user, and dependent wheelchair user.

The development of the toolkit included collaboration with people with disability. It supports a standardised approach to design principles and space standards. The image shows the front cover of the toolkit.

Front cover of the Housing Adaptations Design Toolkit.

The Housing Adaptations Design Toolkit is a guide for government funded adaptations. As such, the toolkit processes could help inform home modifications under Australia’s National Disability Insurance Scheme. This is a very comprehensive approach to bureaucratic processes and technical detail.

Specialist guide for wheelchair housing from UK

Front cover of the guide. Line drawings of housing using light blue, dark blue and lime green

The third edition of the Habinteg Wheelchair Housing Design Guide has input from Centre for Accessible Environments and the Royal College of Occupational Therapists. It is good to see a separate housing design guide for wheelchair users. Not all wheelchair users need the same features. Their abilities vary from part time users of a manual chair to those who are fully dependent on a large powered chair.

When it comes to the concept of “accessible housing” designers tend to think only of wheelchair users when there are many other types of disability that need consideration. Wheelchair housing is not the same as universal design in housing. However, almost all wheelchair users should be able to visit a home designed to the Livable Housing Standard.

Habinteg has instructions on how to purchase in the UK. You can also access a copy via Angus and Robertson

Economic value of wheelchair user homes

The UK organisation for accessible housing, Habinteg, has released new research on the social and economic value of wheelchair users homes. The research was carried out by the London School of Economics. They did a cost-benefit analysis of wheelchair user housing and a qualitative analysis of how their home impacts wheelchair users in everyday life. Together they showed benefits, particularly to government, outweighed the costs.

“… it’s not just the quality
of accommodation and its suitableness for living, but it’s affecting everything else to do with my life.”

“I was living a life that I chose to live, not one that was chosen for me.”

An older man and woman have their head togther and they are smiling happily at the camera. They are on the front cover of the Habinteg report: Living not existing, the economic and social value of wheelchair user homes.

The UK already has a mandated standard of basic access features in new housing called Visitable dwellings. This covers door widths and corridors. However, it fails to guarantee true visitability to everyone and is not adaptable for households over time. There are two other standards which are not mandatory: accessible and adaptable dwellings, and wheelchair user dwellings.

The cost-benefit analysis used three models based on three groups of wheelchair user households.:

  • Households with children who use wheelchairs
  • Working aged, wheelchair user households
  • People in later life who use wheelchairs (aged 65+)

They found that a working age wheelchair user, the benefit was £94,000 over a ten year period. A later years household was £101,000 over a ten year period, and for a child, the benefit was £67,000 over ten years. The financial value was divided between health, local government and the national government.

Benefits of wheelchair housing

The interviews with wheelchair users revealed the personal benefits of improved quality of life. Of being able to work, to come and go independently, and have peace of mind. Being able to work provides additional disposable income and tax revenue for the government. It also means less welfare payments and hours of home care services.

The title of the report is, Living not existing: The economic and social value of wheelchair user homes. The quotes from wheelchair users really tell the story of the difference between existence and living. The analysis shows that when it comes to cost, the real question is, how much and who pays?

Modern homes for Queensland

The Queensland Government is leading the way with their new Modern Homes Standard. Queensland will begin rolling out mainstream universally designed eco-friendly homes based on the new standards in the National Construction Code (NCC) from October 2023. While the energy efficiency requirements might cost more, the universal design features will cost little, if any, more.

The universal design features are a level entry, wider doors and corridors, a toilet on the entry level with extra circulation space, and a step-free shower. The Livable Housing Handbook has more detail.

new home construction site with timber on the ground.

The benefits to consumers are obvious, but the benefits to government perhaps less so. Consumers will eventually have homes that are suited across the lifespan that cater for most life events. Governments stand to save on unnecessary extended hospital stays, and early entry to aged care. They will also save money on government funded home modifications.

However, this has not stopped the housing industry from heavily lobbying against the universal design changes at state level. They claim that the industry has too many problems, it’s technically difficult and it would cost homeowners $40,000.00 more. Are these claims true or are they myths and misunderstandings?

Dispelling the myths

Here are some of the common claims by industry where the cost claims are confused with specialist disability housing or the old adaptable housing standard. So these claims are easily dismissed.

You can download a PDF of this list. 

Myth

Response

You can’t do level entry to the home on steep sites or on small lots.

Steep sites are exempted from dwelling access requirements. Or you can make the entry via the garage.

You can’t do Livable Housing features in a studio apartment.

It’s often easier in studio because they only have 2 doors and no corridors.

These bigger bathrooms really add to the cost.

No big bathroom required because it can be achieved in less than 4sqm. See Livable Housing Handbook.

You can’t do it on narrow lots.

Narrow properties use space smartly with minimal corridors relying on shared circulation and open plan spaces.

Grab rails make the place look ugly.

Grab rails are not required. They can be added later if ever they are needed.

People just want a regular-looking home.

The design tweaks are not noticeable other than a level entry.

People don’t want a disability bathroom.

They won’t get one. The Standard asks for a small extra space in front of the toilet pan.

Some people want a traditional closet WC.

They can have one. Only one toilet pan on the ground or entry level needs to have some extra space in front of it.

People don’t want a front yard full of ramps.

They won’t have one. Access is from the street, parking space or garage.

The extra accessible parking places will add enormous cost to apartments.

There are no changes to parking requirements. Only the internal fit-out applies to apartments.

Door manufacturers will have to re-tool to make new products.

The door sizes are standard already.

Only a few people need these changes.

These provisions are for improving amenity and liveability for everyone. It’s about future-proofing a consumer’s biggest asset.

It’s going to be expensive.

The main cost will be some timber noggins for wall reinforcement in the bathroom.

There’s a cost of living crisis.

That’s why it’s even more important to build homes that protect families from future-shock – the cost of adaptation if life circumstances change. It makes them more sustainable.

I’ve built this kind of home before and I know it costs a lot more.

This is not Specialist Disability Accommodation or housing to the Adaptable Housing Standard. These do cost more. The Livable Housing Standard normalises these common design features. That’s why they are called universal design features. And there is little, if any, extra cost.

It’s bound to cost more because this is all new and we have to learn how to do it.

These features have been applied in seniors living since 2004 and specialist disability homes. Community housing associations apply these features. There is nothing new or onerous.

It’s not a good time for the industry to do this.

It is never a good time for industry. Meanwhile it is a very good time for people wanting to move into a home with no steps.

Why we need it

Building homes based on last century ideas of housing the population has to change and it has to be more than fashion changes. We are living much longer and want to stay put as we age. The pandemic has made people even less eager to go to aged care. People who use mobility devices want to visit family and friends in their own homes. In summary we want homes that are fit for purpose for all family members regardless of what life has in store.

The Livable Housing Design Standard is a tweak to existing designs, but it is these little details that make the difference to longer term liveability for all family members.

The size of Australian homes will easily accommodate all the new provisions in the Livable Housing Design Standard. We wait for Victoria, ACT, NT, South Australia and Tasmania to keep to their promises to follow Queensland’s lead. However, NSW still agrees with industry lobbyists and is saying “no”. ABC News has an article on Queensland’s commitment to housing fit for purpose in the 21st Century.

Bathroom aesthetics and accessibility

A touch of universal design thinking has entered the design of bathroom design and fittings. Research from many quarters has established that people want to stay home in their later years. Consequently designers need to get on board with designs that are functional and look good too. A whitepaper from Nero Tapware updates designers on bathroom aesthetics and accessibility.

“Accessible living spaces are becoming increasingly important as the majority of Australians, both with and without disabilities, have a desire to stay in their current homes rather than enter residential aged care.”

Photo of a wall hung toilet and gold coloured shower and grab rail fittings. Bathroom aesthetics.

The Nero whitepaper discusses the many aspects of design in the context of the new Livable Housing Design Standard in the National Construction Code. However, their bathroom layout and overall style is similar to the public bathroom design. A universal design approach would use the space creatively and leave out grab rails until, or unless they were needed. That’s because grab rails placement needs to fit the individual user’s requirements.

“By modifications to our built environment, architects and designers can promote usability, participation in activities, and enable older users to live comfortably and independently.”

Shower recess from the Mecca Care range with gold coloured fittings.

It is good to see product designers preparing to align with the new Livable Housing Design Standard. However, the photographs in the whitepaper do not align with the universal design concept of the Standard. That is, each picture shows grab rails which are not part of the Standard. However, reinforcement in the walls is required so that grab rails can be added later at any placement the user needs.

Aesthetics impact wellbeing

The whitepaper nicely spells out all the issues including the importance of wellbeing. It notes that a liveable home must be multifunctional and it must feel like home. Lack of colour matching and styling options can end up looking clinical. The whitepaper argues that end users feel undervalued, neglected and uncared for.

The whitepaper is titled Aesthetics, Accessibility & Ageing: Designing Livable Spaces Without Compromising Function or Style. It was published in Architecture and Design. The full 58 page Mecca Care product catalogue has great pictures and a section on assistive living.

The Mecca range is specifically for people who require assistive living designs. While the photographs show nicely designed bathrooms, grab rails take the look and feel away from a “conventional” bathroom. But if these fixtures and fittings keep you at home for longer then at least they can look good. Wall hung toilet pans, however, are a good idea for any home.

Universal in-wall bodies

A companion Nero whitepaper is A Universal Approach to Bathroom Installation. The in-wall body is an installation that separates the in-wall body from the trim kit – the visible bits. In-wall bodies allow builders and customers to select the right fittings after tilers have finished. Customers can delay their design decision informed by the latest trends. At a later date home owners can update their fittings without affecting walls and tiles.

Images from the Nero whitepaper. This post did not receive any sponsorship and is provided as a relevant item of information.

Thinking of wheelchair users…

Lifemark in New Zealand has a handy little brochure that sets out bathroom dimensions and placement of fittings for wheelchair users. They use the term universal design because the features can be used by most people. However, they do look as if they are specifically designed for wheelchair users. And there is no need to make this look like a hospital.

Designers can still be creative and provide style with colour and attractive fittings. One thing the brochure does not mention is colour contrast for people with low vision. Contrast between the floor and the wall is important, and for some, contrasting fittings work well.

The title of the brochure is Universally Designed Bathrooms. Of course, the bathroom is only one element in a home that needs to be accessible for a wheelchair user.

Livable Housing Handbook

The Livable Housing Design Standard applies to all new Class 1a and Class 2 buildings. Class 1a buildings are detached houses, row houses, terraces, townhouses and villa units. Class 2 buildings are apartment buildings and the design requirements apply inside the apartment. Public access requirements cover the public areas. To aid practitioners, the Australian Building Codes Board has produced a Livable Housing Handbook.

The Livable Housing Design Standard sets out minimum requirements for mainstream dwellings.

Front cover of the Livable Housing Design Standard showing a single storey home with garage.

The title, ‘Livable Housing Design’ comes from Livable Housing Australia’s voluntary guidelines. The features in these guidelines form the basis of the mandatory requirements, which are similar to Livable Housing Australia’s ‘silver level’.

The Livable Housing Design Handbook aims to help practitioners understand the relevant sections of the building code. These are Part G7 of NCC Volume One, Part H8 of NCC Volume Two, and the ABCB Standard for Livable Housing Design.

The Handbook covers design issues in generic terms and does not provide specific compliance advice. It aims to assist practitioners develop solutions to comply with the NCC requirements.

The intent of livable housing design is “to ensure that housing is designed to meet the needs of the community, including older people and those with a mobility-related disability.”

Front cover of Livable Housing Design Handbook.

The appendices have examples of bathroom layouts and a guide for meeting compliance with the NCC.

Going beyond the Livable Housing standard

The Australian Building Codes Board has also produced a guide for going beyond the minimum standard. The voluntary standard is generally based on Livable Housing Australia’s “Gold level”. These features provide a greater level of livability across the lifespan for more people, and go beyond the “silver level”. Consequently, exceeding the minimum mandatory requirements will still achieve compliance.

This additional set of non-mandatory technical provisions will better meet the needs of the community. They are similar to the Gold level in the original voluntary Livable Housing Design Guidelines.

Front cover of Livable Housing Design Beyond Minimum Standards guide

Australian homes are some of the largest in the world and the features in the voluntary standard should not be difficult to achieve.

Extensions and major renovations to existing homes will be based on state or territory requirements to comply with the standard. For example, if the works require a council development application.

Online learning – Livable Housing Design

CUDA has acquired the licence from the Australian Building Codes Board to run their course on Livable Housing Design Standard. The course is based on the Handbook and the Standard. This is a technical course for home-building professionals. Find out more about this course. and all the different ways to achieve a level entry.

The long road to Livable Housing

And the journey isn’t over yet. While the Livable Housing Standard is now in the national code, it is up to each state and territory to implement it. Victoria, Queensland, Tasmania, ACT and Northern Territory have agreed to implementation. South Australia has come late to the party but is now working on an implementation strategy.

Australian Network for Universal Housing Design (ANUHD) has been leading the charge for the reforms for twenty years. They believe that Western Australia could also sign up to implement the standard eventually. However, as of September 2023, NSW remains uncommitted. The livable housing story of citizen advocacy is documented in a conference paper.

Universally designed dream home

Not your average home. This one goes beyond even enhanced standards in the Livable Housing Design Standard. The video is from O’Shea and Sons Builders and shows what can be done with creative thinking. While this is a top-end of the market home, all the features are possible in mainstream homes. As Nick O’Shea says, “… an absolutely amazing home where functionality and style means absolute beauty.”

Filming by Unveil Media.

Home modifications: a clash of values

Publicly funded home modifications are a regular feature of My Aged Care and the NDIS schemes. NDIS participants seeking independence and desires to age in place are increasing, but our housing stock is not fit for this purpose. Consequently, homes need adaptation as people age or acquire a disability. However, there is a clash of values between what the client wants, what the funder wants, and what the occupational therapist (OT) deems functional. That’s a finding from researchers at the Hopkins Centre.

Our homes are not designed for disability and ageing. Consequently, modifications are essential for remaining safely and independently at home. They are an essential part of the NDIS and My Aged Care schemes.

The chart shows the key overarching themes from the research

Graphic showing the three values; aligning values and expectations, and quantifying value for money.

Researchers interviewed OTs experienced in prescribing home modifications. They wanted to gauge their experiences in the assessment process. They found that clients (homeowners) value aesthetics and property values. On the other hand, funding bodies value the cheapest option, and OTs are looking for the most functional outcome. OTs are also confronted with different decision making criteria across the various schemes.

Consequently, it is up to the OT to balance the desires of the client with those of the funder using their professional knowledge. Not an easy task, and unlikely to lead to optimum outcomes. And OTs become de facto bureaucrats in this process, which can also be a challenge to their professional values.

But what is “value”?

The research paper discusses the various aspects of value from different perspectives. The best outcomes are achieved when there is open discussion between the client, the funder and the OT. This encourages a better alignment of values.

While this paper is focused on the OT professional, it links closely with the notion of disability and ageing stigma. The idea of having a grab bar or a ramp appears to be an affront to one’s dignity. Older people see this as the beginning of the “downhill run” of life. The new Livable Housing Design Standard will help minimise this stigma by providing a step free entry and better bathroom design. Until we have sufficient stock, OTs will continue to provide home modification assessments.

The title of the paper is, Valuing home modifications: The street-level policy work of occupational therapists in Australian home modification practice.

There is also a webinar on the Hopkins Centre website that discusses client perspectives of home modifications. In a nutshell, they see modifications as value for money if they meet their specific needs to a high standard. Also, the process of getting a modification has to be straightforward without wasting time and money.

Phillippa Carnemolla’s research showed the number of care hours saved and improved quality of life with appropriate modifications.

Future-proofing is best

For those who can afford to renovate their home now, it is worth considering future-proofing, rather than leaving it “until the time comes”. The Livable Housing Design Guidelines are a good reference for anyone updating their home at any point in their life. This Guideline is the basis of the mandated Livable Housing Design Standard, but has more useful information for homeowners.