Making your home safer and easier to live in

Most homes weren’t built with later life in mind. A step at the front door, a shower over the bath, a dim hallway: none of these matter much at 50. At 80, they can decide whether a day goes smoothly or ends in a fall.

Changing the home isn’t admitting defeat. It’s what lets many people stay where they want to be, near neighbours, gardens and routines. Staying at home is a full, respectable choice, and making the home work for you is part of it.

The earlier changes happen, the more useful they are. A grab rail installed before a fall is worth far more than one installed after.

Many of the changes that help most are modest. Some cost little and can be done in an afternoon. Others, like a new bathroom, are bigger jobs. Here’s what people commonly do.

• Grab rails beside the toilet, in the shower and next to the bath
• Handrails on both sides of steps and stairs, inside and out
• A ramp or a step-free path to at least one door
• A step-free shower, with a shower chair and a hand-held shower head
• Lever-style taps and door handles, which are easier for sore hands
• Brighter lighting, night lights and sensor lights on paths and in hallways
• Slip-resistant flooring or non-slip treatments in wet areas, and non-slip strips on steps
• Removing trip hazards like loose rugs, cords and clutter
• A raised toilet seat or toilet frame, and a firm chair that’s easy to get out of
• Kitchen items moved to between waist and shoulder height
• A personal alarm worn as a pendant or on the wrist

A personal alarm lets you call for help with the press of a button. Some are monitored, which means a response centre answers and calls your contacts or an ambulance. Others call a list of family members or friends directly. Some can detect a fall and raise the alarm automatically, and some work away from home using the mobile network.

Monitored alarms usually have an ongoing fee as well as the cost of the device. Ask what happens when the alarm goes off, who responds, whether it works in the shower and the garden, and what it costs each month.

Personal alarms can be funded in some cases, including through the Assistive Technology and Home Modifications scheme and, for some veterans, through DVA. Check with your provider before you buy.

An occupational therapist, or OT, is a health professional who helps people manage everyday tasks. A home assessment usually means the OT watches how you get in and out of the shower, on and off the toilet, up the steps and around the kitchen, then recommends changes.

That matters because the obvious fix isn’t always the right one. A rail in the wrong place can be worse than none. An OT can also suggest simpler options, like a different way of doing a task, before anything is installed.

For funded changes, an OT assessment is usually part of the process, and more complex equipment and any home modifications need one. You can also pay an OT privately. If you have a chronic health condition, ask your GP whether a care plan could cover part of the cost of seeing one.

Under Support at Home, the Assistive Technology and Home Modifications (AT-HM) scheme gives upfront funding for equipment and changes to your home. It’s separate from any ongoing Support at Home budget, so you don’t have to save up your quarterly funds to pay for a rail.

To get it, you need an aged care assessment through My Aged Care (1800 200 422). If the assessor approves you, your letter and support plan will say whether you’re funded for assistive technology, home modifications or both, and at which funding tier. There are three tiers, and My Aged Care publishes the current amounts.

Funding is usually available for 12 months. Complex home modifications can be given an extra 12 months if the work has started. People with some progressive conditions may get assistive technology funding over a longer period.

Your provider then works with you. For home modifications, they arrange an OT assessment, get your agreement to go ahead, and coordinate installation by a qualified person. Products must be on the government’s AT-HM List. You can buy, rent or borrow equipment, and renting can suit something you only need for a short time.

AT-HM funding has its own priority systems, separate from ongoing services, so you may get it before or after other help. You may pay a contribution towards the equipment or the work itself, at the same rates as other independence services, based on your income and assets. The OT assessment is a clinical support, so you don’t contribute towards it.

The Commonwealth Home Support Programme, or CHSP, is for people who need a little help. It can include some equipment and home modifications, as well as other entry-level services. It also starts with a My Aged Care assessment. Each provider sets its own prices: simple services might cost a few dollars, while home modifications cost more.

Veterans and some family members with a DVA Veteran Card may be able to get aids, equipment and home modifications through DVA’s Rehabilitation Appliances Program. You need an assessed clinical need and either a Veteran Card – All Conditions, or a Veteran Card – Specific Conditions where the item is for a covered condition. Start by seeing your GP, who will assess you or refer you to someone who can. Approved items are supplied and installed by DVA’s contracted suppliers at no cost to you. The program also covers personal alarms.

Many people simply pay for changes themselves, especially small ones. That can be quicker than waiting for funding. An OT’s advice is still worth getting for anything structural, like a bathroom renovation or a ramp.

If you rent privately, you generally need the landlord’s written consent before attaching anything or making changes. The rules differ between Queensland and NSW.

Queensland: under the Residential Tenancies and Rooming Accommodation Act 2008, you ask the lessor using the approved form. The lessor must decide within 28 days, unless you both agree to longer, and must not act unreasonably in refusing. Any agreement must be in writing and can include conditions, such as whether you remove the fixture at the end of the tenancy. If the property is in a body corporate scheme, body corporate approval may also be needed. If you can’t agree, you can apply to QCAT for an order. The Act also allows for changes needed for a tenant’s safety, security or accessibility to be made in circumstances set by regulation. Check with the Residential Tenancies Authority (1300 366 311) for how that currently applies.

NSW: under the Residential Tenancies Act 2010, a landlord can’t unreasonably refuse consent to minor changes. The prescribed list includes installing hand-held shower heads or lever-style taps to help elderly or disabled people, and changes that don’t penetrate or permanently change a surface or the structure. Unless the landlord agrees to pay, the tenant pays. For some changes the landlord can require a qualified person to do the work. Bigger changes, like a ramp or a new shower, need the landlord’s written permission and the minor-change protections may not apply. Different rules apply to heritage properties and some strata, land-lease and social housing properties. Disputes go to NCAT, and NSW Fair Trading (13 32 20) can explain the rules.

If you rent social housing in either state, ask your housing provider. They have their own process for modifications. In a retirement village or land-lease community, check your contract and ask the operator before changing anything.

If your provider is arranging funded work, they coordinate a qualified person. If you’re arranging it yourself, a few checks help.

Queensland: a QBCC licence is needed for building work valued over $3,300, including labour and materials. Some work, such as plumbing, drainage and gas fitting, needs a licence whatever the value, and electrical work must be done by a licensed electrician. Check a licence on the QBCC website.

NSW: a licence is needed for residential building work worth more than $5,000, and work over $5,000 needs a written contract. Specialist work such as plumbing, electrical work, gasfitting and air conditioning needs a licence whatever the cost. Check a licence on the NSW Government’s online licence check.

Get written quotes, ideally more than one. Ask whether the tradie has done this kind of work before, such as rails into tiled walls or step-free showers, and give them a copy of the OT’s recommendations. Be wary of anyone who knocks on the door offering a deal.