Home Modification Outcomes for Adults Aged 50 Years and Over and Their Relatives: A Scoping Review

Abstract

As people age, they often need home modifications to remain living in the community. This review sought to identify outcomes from home modifications for adults aged ≥50 years living in the community and their family carers. Peer-reviewed literature was reviewed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). Five databases were search (Ageline, CINAHL, Emcare, Medline, Scopus) from 2011 to 2023. N = 38 articles meeting the criteria. Sixteen outcomes were identified (14 positive, two negative) including reduction in falls and falls risk and enhanced quality of life. In addition, five outcomes for family carers were identified (all positive). Only four studies reported costs of home modifications installed. Home modifications can provide substantial benefit to adults aged ≥50 years, supporting their independence and allowing them to remain in their own home.

Plain Language Summary

What Difference do Home Modifications Make to The Lives Of adults Aged 50 Years And Over And Their Family Carers?

As people get older, they sometimes need some changes to their home such as handrails, ramps, and stair lifts. We looked at published papers to see what outcomes people have when they make these types of changes to their homes. We found 19 positive outcomes for people aged 50 years and over and the family members who care for them, such as fewer falls and less pain for older people, and better quality of life for older people and their family carers. We also found two negative outcomes. Some people experienced stigma from having home modifications and did not like the way the changes to their home looked. Overall, home modifications can support people to stay in their home and be as independent as possible.

Keywords

age-friendly homes aging disability home environment environmental modifications older people outcomes

Introduction

Older adults often prefer to remain in their own homes as they age rather than moving into residential aged care (Ratnayake et al., 2022). However, remaining safe and independent at home is not always possible without home modifications, which range from minor (such as rails) to extensive (e.g., bathroom redesign), and include recommendations such as decluttering and improved lighting (Stark et al., 2009). Falls at home are costly to health care systems internationally (Australian Institute of Health and Welfare [AIHW], 2022; Burns et al., 2016; Center for Research Excellence—Prevention of Fall Injuries, n.d.; Haddad et al., 2024) and a major reason why older adults move temporarily or permanently into residential aged care (Collins & Casey, 2019; Craig et al., 2013; Gill et al., 2013).

The cost of home modifications can vary widely from an estimated AU$150 to $200 for a grabrail to several 1000$ for extensive bathroom renovations. Internationally, there are a variety of approaches to support services to enable people to stay at home, which can be government subsidized, grant-based or privately funded. For example, in Australia, as in other developed nations, older adults (aged 65 years and over) can access government supports to remain at home, including the provision of home modifications (Department of Health and Aged Care, 2024). Adults aged 50 to 64 years might seek home modifications due to multimorbidity reducing physical functioning and may be eligible for funding through disability support provisions or other community-based programs. Alternatively, they may self-fund modifications to futureproof their homes for aging in place. Given the cost of funding home modifications and the reasonable expectation that expenditure will continue to increase in the future due to an aging population in developed nations such as Australia, the United States and United Kingdom (Australian Bureau of Statistics [ABS], 2023; Barton et al., 2024; Schaeffer, 2024) it is important for funders and self-funders to understand what outcomes result from investment in home modifications. No review has synthesized this data to date.

Other reviews have been conducted on the topic of home modifications, but none have sought to broadly identify the outcomes from home modifications for adults aged 50 years and over and their family carers. Previous reviews have been limited by methodological approaches (such as only randomized controlled trials e.g., Sheth & Cogle, 2023) or only qualitative studies (Aclan et al., 2023), focused only on consumers (i.e., those whose homes have been modified) with a particular health condition (such as Alzheimer’s disease e.g., Struckmeyer & Pickens, 2016), or a narrow range of outcomes, such as only falls (Chase et al., 2012) or accessibility (Cho et al., 2016; Struckmeyer et al., 2021). Another review included outcomes from home modifications for adults with disability and older adults’ but focused on health-related outcomes and caregiving, rather than broader psychosocial outcomes (Stark et al., 2017) and another review focused only on home automation (Cleland et al., 2024).

The Current Study

This scoping review seeks to identify outcomes from home modifications for adults aged 50 years and over living in the community, and their family carers.

Method

This scoping review was conducted using the five-stage approach outlined by Arksey & O’Malley (2005): identifying the research question, identifying relevant studies, study selection, charting the data, collating, summarizing the reporting the results. We used the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) (Page & Moher, 2017; Tricco et al., 2018). A protocol for this scoping review is available in Open Science Framework (George et al., 2024).

Stage 1: Identifying the Research Question

As outlined in the literature review, a gap exists in identifying and collating the outcomes from home modifications for adults aged 50 years and over. As identified in Arksey & O’Malley (2005) it is important to define terms when setting the research question for a scoping review. This review sought to include peer-reviewed literature reporting outcomes from home modifications for adults aged 50 years and over living in the community; that is, living in their own home (owned or rented) as opposed to a residential care home. Both healthy and participants with existing disability (any physical or cognitive impairment) were included. The review includes any low-tech modification. Low-tech modifications can range from minor modifications, such as rails, which are easy to install, relatively affordable and may meet a singular consumer need, to more substantial and costly modifications, such as the redesign of a bathroom. Such a modification is more complex as well as more costly, would take longer to implement, likely require the employment of several trades to accomplish, and may need to meet professional standards or guidelines relative to the jurisdiction. A complex home modification of this sort may require more consultation with the consumer and aim to meet multiple consumer needs. Modifications operated by technology, such as home automation modifications were excluded from this review. Any primary research study design was included. Included articles had to report at least one outcome which is related to the individual and/or family member (residing or non-residing).

Outcomes from modifications in community care homes, residential aged care homes and supported accommodation facilities were excluded. The review excluded articles on smart home technologies. Studies not published in English, theses/dissertations, reviews, editorials, opinion pieces and conference abstracts and papers were also excluded.

Stage 2: Identifying Relevant Studies

The following five databases were searched: Ageline, CINAHL, Emcare, Medline and Scopus. A search strategy was developed by the authorship team with support from a Research Librarian. The search strategy included terms for home (dwelling, residential), modification (adjustment, adaptation, accessibility), and age (≥50 years, middle aged, older). Once agreed for Medline, the search strategy was translated for the other databases, with the Research Librarian conducting all database searches. The review included articles published from July 2011 to December 2023.

Stage 3: Study Selection

Articles identified were imported into Covidence software (Veritas Health Innovation, 2021) where duplicates were removed. Two authors (CH and HB) independently conducted all title and abstract screening, with conflicts resolved via discussion. Five authors participated equally in full text screening, screening 35 to 36 articles each (CH, HB, AD, CG and SG), with each article being double screened. As before, any conflicts were resolved by discussion.

The following data were extracted: title, author, year of publication, country, study aims, study design, study population (age, gender), sample size, home modification type(s), cost of modifications, outcome identified, and how outcomes were measured. Data were extracted by four authors (CH, HB, AD, CG). The lead author checked data extraction for all articles to ensure that the template was being consistently and accurately applied.

Stage 4: Charting the Data

Chartering the data is the stage where data is synthesized and interpreted. Data was synthesized using a thematic approach with included articles imported into NVivo to support the analysis. Initial codes (outcomes) were identified by the first author (CH). At a workshop attended by all authors, the initial outcomes codes were presented and discussed. This led to some outcomes being consolidated and some split to form separate outcomes. For example, the initial outcome code of “reduced falls and fear of falling” was split into separate outcomes as falls is a physical outcome potentially causing a health event, whereas fear of falling is psychological. The initial code of “enhanced confidence” was merged with “enhanced ability to perform ADLs” as it was these tasks that consumers expressed confidence in performing following the installation of home modifications. Some codes were renamed slightly for consistency of wording across the themes. Full details of initial codes and final codes are shown in Supplementary Information.

Stage 5: Collating, Summarizing and Reporting the Results

Following the workshop, the revised codes were circulated to the authorship team for final approval. The team approved the final list with no further changes. Following this, the first author entered the data extracted on study characteristics into a table and collated the themes (outcomes) for each by study based on the agreed final thematic codes. Outcome measures were included where reported.

Results

A total of 3370 records were identified across the five database searches. With 1,724 duplicates identified by Covidence and 62 identified manually, this resulted in 1,584 articles being screened at the title and abstract stage, and 89 articles being screened at the full text stage. Thirty-eight articles were included in this review (Figure 1).

Figure 1.

PRISMA-ScR Flowchart.

Study Characteristics

Of the 38 articles, most studies were conducted in the United Kingdom (n = 8), United States (n = 8) and Australia (n = 5), with two each in New Zealand, Brazil, Japan, Sweden, and Turkey, and one each in Belgium, Spain, India, Iran, Switzerland, Taiwan, and Thailand. Two papers reported on different aspects of a New Zealand study, with one paper reporting the findings of the whole study population (Keall et al., 2017), and the other paper reporting findings related to an indigenous population sub-sample (Keall et al., 2021). Three papers reported on the BATH-OUT study, with one paper focusing broadly on the findings of the feasibility randomized controlled trial (RCT) study (Whitehead et al., 2018), one paper on the qualitative findings (Whitehead & Golding-Day, 2019) and one paper reporting on the extended follow-up study (Golding-Day & Whitehead, 2020) (Table 1).

Table 1.

Details of Studies Included in This Review.

Authors year	Country	Study aims	Study design	Participants Mean age^a (where specified)	Type of home mods	Cost of home modifi-cations	Outcomes identified (measure if stated)^b
Ahn & Hegde (2011)	United States	To investigate the relationships between the “perceived aspects” of current home environment and home modification behavior	Quantitative survey (bepoke with no standard outcomes measures)	n = 317, mean age = 74 years (range 60–94 years) 18% had home modifications	- Move bathrooms to first/ground floor (13%) - Grab bars (85%) - Widen doorways to 3 feet (22%).	N/R	- Supports remaining at home. - Enhanced home safety.
Ainsworth et al. (2023)	Australia	To investigate the home modification experience and outcomes most valued by older adults /people with disability within the Australian context.	Qualitative	n = 20, mean age = 62 years (range 24-93 years), (n = 19 older adults interviewed plus n = 1 family carer)	- grab rails (65%) - floor coverings (65%) - full bathroom renovation (40%) - Full kitchen renovation (25%). - Stairlift (30%). - Ramp. (20%) - Automatic door (15%). - Threshold ramp/step ramp (20%) Other modifications reported by 5% of sample (i.e. 1 participant) - Paths - concrete in yard - concrete pad at clotheslines. - clothesline modification. - Widen entry/exit doorway. - Re-swung door. - Fale floor in garage to eliminate step - Widen internal doorways - Bath removed and shower installed. - Handheld shower. - False floor in living room to eliminate step - Fold down seat in shower. - Laundry taps altered. - Power points relocated.	Major mods costing at least $1000	- Enhanced emotional well-being. - Enhanced physical health. - Enhanced home safety. - Carers—Enhanced emotional well-being. - Carers—Enhanced safety.
Aitken et al. (2023)	United Kingdom	To explore perspectives on the impact of home adaptations from recipients aged 65 and over	Qualitative	n = 30, ≥ 65 years mean and range N/R	Minor mods: - Grab rails. - Second handrail on stairs. - Extra step at the front of a property. - lighting improvements. Major mods: - stair lifts. - level access showers. - Wet rooms (“a waterproof shower room where the floors and walls have been sealed” (Aitken et al., 2023: 632).	below £1000 (minor) n = 13 over £1000 (major) n = 17	- Enhanced Confidence. - Restoration of usual activities. - Enhanced emotional well-being. - Improved physical health. - Reduction in falls. - Supports remaining at home. - Improved social outcomes. - Visitors—easier access to home. - Reduced need for formal care. - Reduced need for informal care. - Carers—more free time and flexibility. - Carers—reduced emotional burden. - Enhanced value of property. - Negative impact on home aesthetics. - Increased stigma of needing modifications.
Aplin et al. (2015)	Australia	To explore the impact of home modifications on clients and their family’s experience of home.	Qualitative	n = 55, mean age = 64 years (range 25–87 years) (n = 36 interviews with older adults, n = 19 interviews with family carers)	- Grab rails (35%). - Major bathroom modifications (33%). - Handrails (11%). - Step ramp (9%). - Handheld shower hose (9%). - Chair lift (7%). - Hydraulic lift/elevator (7%). - Kitchen modifications (7%). - Stairs installed/replaced (5%). - Widened door / hallway (5%). - Drop down shower seat (5%). - Other modifications (29%). These included: automatic door, repositioning toilet, balustrading, lever taps, concrete paths, re-swinging doors, raising toilet, removal of cupboard, parcel hoist, elevating a driveway, and bed raisers.	N/R	- Enhanced home safety. - Negative impact on home aesthetics. - Restoration of usual activities. - Carer—Reduced physical burden and enhanced safety. - Negative impact on home aesthetics. - Supports ability to remain at home. - Visitors—easier access to home Enhanced access to the community.
Carnemolla & Bridge (2016)	Australia	To examine accessibility and impact of home modifications on QoL.	Quantitative	n =157, mean age = 72 years, age range N/R (n = 20 were aged below 55 years and had a disability)	- Bathroom and kitchen modifications. - Modifications to support moving through the home.	N/R	- Enhanced quality of life (AQoL—The Assessment of Quality of Life)
Carnemolla & Bridge (2019)	Australia	To examine the potential for home modifications to reduce caregiving (formal/informal) in the homes of older adults.	Quantitative (bespoke survey with no standard outcome measures)	n = 157, mean age = 72 years, age range N/R	- Major bathroom modifications. - Kitchen/laundry modification. - Grab rails. - Handheld shower. - Shower screen removal. - Ramp. - Step modifications. - Widened doorways. - Remove wall. - Handrails.	N/R	- Reduced need for formal care. - Reduced need for informal care.
Chandola & Rouxel (2022)	United Kingdom	To examine whether external and internal housing modifications reduce the risk of a range of disability outcomes among older adults.	Quantitative (bespoke, single items per outcome)	n = 10,459, age≥ 60 years, age range N/R, included people with and without modifications (group sample sizes not reported).	External modifications: - Widened doorways. - Ramps. - Automative doors. - Parking - Lift Internal modifications: - Rails. - bathroom/kitchen modifications. - Chair lift.	N/R	External modifications: - Reduction in falls (1%–6%). - Reduced pain (4%–8%) - Enhanced physical health (2%–5%) - Reduced probability of no social activities (5%–7%) - Reduced probably of having to move home (2%–5%) Impacts of internal modifications were similar but less consistent.
Chindapol & Arkarapotiwong (2023)	Thailand	To understand the risk factors associated with falls among older adults and to address how fall risk can be reduced by home modification strategies.	Quantitative	n = 203, mean age = 72 years, age range N/R n = 100 had home modifications	- house modifications to bathrooms (99%) and kitchens (22%), main entrances and corridors (71%), bedrooms (43%), and stairways (29%). Details on modifications not provided.	20,000 Baht per dwelling ($625.20)	- Reduction in falls risk (Thai Falls Risk Assessment Test (Thai-FRAT)).
Cockayne et al. (2021)	United Kingdom	To determine the clinical effectiveness and cost-effectiveness of a home hazard assessment and environmental modification for preventing falls.	Mixed methods, RCT	n = 1,331, mean age = 80 years (range 65–98 years) n = 430 had home modifications	- Non-slip mat (28%) - Shower rails/bath safety bars (81%) - Trolley (e.g. for kitchen) (20%) - Grab rails/banister (76%) - External rails by front/rear access (79%) - Steps/half steps (70%) - Removable bath board (90%) - Furniture raisers (86%) - Sensor operated lights in the house (14%) - Bath lift (100%) - Combination toilet frame & seat (75%) - Raised toilet seat (100%) - Easy reach/grabber (14%) - Bed hoist (100%) - Key safe (100%)	Unit costs provided in appendices (ranged from £9- 657 per item)	- Evidence suggests that modifications did NOT reduce falls risk (Clinical data).
Crowell & Sokas (2020)	United States	To evaluate a program providing no-cost baseline and follow-up home assessment and home modifications to reduce fall hazards among low-income elderly or disabled residents.	Mixed methods	n = 51, ≥ 60 years, age range N/R	Examples provided: - Bathtub railings. - Stair railings. - Stair lifts. - Chair lifts.	N/R, up to $10k funding available	- Reduced fear of falling (Falls efficacy Scale (FES).
Dalvand et al. (2024)	Iran	To investigate the effectiveness of modifying the home environment on falls in older adults with dementia.	Quantitative, RCT	n = 44, mean age = 77 years, age range N/R, n = 22 had home modifications	- Door frames / handles. - Ramps. - Flooring. - Bathroom / toilet. - Lighting. - Rails in bathrooms and stairs. - De-clutter. - Furniture and equipment placement.	N/R	- Reduction in risk of falling (HOME Fall and Accident Screening Tool (HOME FAST).
DeArajo et al. (2018)	Brazil	To evaluate the effectiveness of two home ergonomic interventions on reducing pain intensity and perceived stress and enhancing the QoL in informal caregivers of chronic poststroke patients.	Quantitative, Pilot RCT	n = 33 caregivers of patients with stroke (72.7% were spouse/family members), mean age of caregivers = 55 years, age range N/R	- Ergonomic adjustments and adaptations (unspecified).	N/R	- Carers—reduction in neck pain (Visual Analog Scale). - Carers: improved quality of life. (WhoQoL-Bref).
De-Rosende-Celeiro et al. (2019)	Spain	To examine the relationship between the use of assistive products and independence in the transfers in the bathroom.	Quantitative	n = 193, mean age = 84 years, age range N/R, 57% had a bathroom modification in last 2 years	- Products to support getting on and off the toilet. - Products to transfer in the sitting position in the shower. - Increase the height of the toilet. - Grab bars.	N/R	- Enhanced ability to perform ADLs (Modified Barthel Index). - Enhanced social outcomes (Gijon social-familial evaluation scale—Barcelona Version).
Golding-Day & Whitehead (2020)	United Kingdom	To explore the lived experience of participants who had home modifications 18-24 months after completion	Qualitative	n = 13 older adults, mean age = 76 years n = 3 carers, mean age = 66 years (no details provided on whether carers were family members)	- Accessible flush floor shower modification.	N/R	- Reduction in fear of falling. - Enhanced ability to perform ADLs. - Increased access to the community. - Improved confidence. - Enhanced home safety. - Enhanced social outcomes. - Reduced need to excessively plan. - Improved mental well-being. - Supports remaining at home. - Carers: reduced physical burden. - Carers: reduced emotional burden.
Gürler & Bayraktar (2021)	Turkey	To evaluate the effectiveness of a recurrent fall prevention program for elderly individuals undergoing fracture treatment.	Quantitative	n = 52, mean age = 77 years	- Handrails - Non-slip flooring, - Replace Eastern toilets with Western toilets.	N/R	- Reduction in falls risk.
Hollinghurst et al. (2022)	United Kingdom	To determine whether a national home modification service identified individuals at risk of falls at home and reduced the likelihood of falls	Quantitative	n = 657,536, mean age = 72 years n = 123,729 received home modifications	- Grab rails. - Modify floor coverings. - Handrails. - step lift. - external rails. - Ramps. - Level access shower. - Bathroom re-design. - Hoist.	N/R	- Reduction in falls.
Hwang et al. (2011)	United Kingdom	To analyze the relationship between actions taken to create supportive environments (i.e., environmental change) and length of stay at current housing as a proxy variable for aging-in-place.	Quantitative	n = 376, mean age = 85 years, 36% had home modifications	- Home modifications (indoor/outdoor) to increase accessibility.	N/R	- Supports remaining at home.
Mitoku & Shimanouchi (2014)	Japan	To examine whether home modifications for frail older adults were associated with subsequent progression of frailty and mortality.	Quantitative	n = 547, mean age = 81 years, 34% had home modifications	- Handrails. - Eliminate floor height differences. - change basin, floor materials, and door.	N/R	- Enhanced physical health (reduced risk of mortality and Reduced progression of frailty).
Keall et al. (2017)	New Zealand	To undertake a cost benefit analysis of home modifications	Quantitative, Cost-benefit analysis, RCT	n = 842, 57% had home modifications	- Handrails for steps and stairs. - Repairs to steps - Grab rails for bathrooms and toilets. - Adequate outside lighting. - High-visibility and slip-resistant edging for outside steps. - Fixing of lifted edges of carpets and mats. - Non-slip bathmats and slip-resistant surfacing for outside areas such as decks.	Mean of $560	- Reduction in the cost of falls.
Keall et al. (2021)	New Zealand	To assess the rate of fall injuries at home with and without home modifications in houses with Māori (First Nations) occupants.	Quantitative, RCT	n = 254, n = 126 had home modifications	- handrails at steps/stairs. - Minor repairs to outside steps. - Repairs to window catches (to avert falls from windows). - Grab rails for bathrooms and toilets. - Outside lighting. - High-visibility and slip- resistant edging for outside steps. - Fixing of lifted edges of carpets and mats. - Non-slip bathmats, and slip-resistant surfacing for outside surfaces such as decks.	Mean cost $465	- Reduction in falls.
Korp et al. (2012)	United States	To assess whether the bathrooms of community-dwelling older adults met current safety recommendations and to determine the relationships between adequacy of safety devices and three risk factors for falls: Lower extremity dysfunction (including poor balance and poor strength), fear of falling, and self-reported history of falls.	Quantitative	n = 60, mean age 76 years	- Bathroom grab bars. - Slip resistant surfaces inside and outside bathing areas.	N/R	- Home modifications NOT related to self-reported falls.
Lau et al. (2018)	Australia	To investigate the effectiveness and satisfaction of home modification recommendations made by OTs prior to discharge and the effectiveness and satisfaction of completed home modifications from clients’ perspectives.	Mixed methods	n = 10, mean age 80 years	- Type of modifications not specified.	N/R	- Improved home safety. - Improved accessibility. - Improved privacy. - Enhanced ability to perform ADLs.
Liu et al. (2021)	United States	This study aimed to examine whether CAPABLE improved life-space and falls efficacy among low-income older adults living with disabilities.	Quantitative, RCT	n = 427, mean age = 75 years n = 93 had home modifications, n = 101 control group (without modifications)	- Home modifications/ repair as required (unspecified).	Up to $1300	- Improved accessibility. - Enhanced ability to perform ADLs. - Reduction in falls. - Enhanced access to the community.
Maggi et al. (2018)	Belgium	To determine the risk factors for falls of frail older persons living in the community who have not had a previous fall. To evaluate the impact on fall incidence of home modifications and advice by OTs.	Quantitative	n = 1565, mean age = 82 years, number of participants with home modifications N/R	- Modifications not specified.	N/R	- Reduction in falls.
Mani (2019)	India	To illustrate the OT management of a patient diagnosed with bilateral knee Osteoarthritis in the Indian context of practice.	Mixed methods case study	n = 1, 67 years	- Clutter reduction. - Handrails in bathroom. - Replacing sofa with higher chairs. - Rearrange items to conserve energy.	N/R	- Enhanced physical health and pain reduction (reduced fatigue). - Increased quality of life.
Ng et al. (2022)	United States	To examine the association between older adults socio-demographic factors and fear of falling for Medicare beneficiaries with bathroom modifications.	Quantitative	n = 2404, ≥ 65 years 55% had modifications	- Bathroom modifications (unspecified).	N/R	- Falls was NOT associated with bathroom modifications.
Pettersson et al. (2012)	Sweden	To explore clients’ experience of housing adaptations over time in relation to housing and health.	Mixed methods	n = 4, mean age = 56 years (range 39–75 years)	- Person 1—Bathroom shower and automatic garage door opener. - Person 2—remove thresholds and install grab bars at the door entering the terrace. - Person 3—remove thresholds. - Person 4—shower adaptations, and handrails at the front doorsteps and around the patio were installed.	N/R	- Restoration of usual activities. - Supported staying at home. - Enhanced access to the community.
Schorderet et al. (2022)	Switzerland	To explore expectations and needs for home modifications amongst home-dwelling older adults and their family members. To evaluate the impact of home modification on older adults’ QoL, fear of falling, independence, and difficulties using adapted rooms.	Mixed methods	n = 18 in 15 homes, mean age = 75 years	- Waterproof door in bathtub. - Installing a shower instead of bathtub. - Installing shower seat. - Improving lighting. - Electric blinds - Ramp to kitchen. - Adjusting height of appliances in kitchen. - Leveling thresholds. - Motion detection lamps.	CHF 2300 - 82,200	- Enhanced quality of life. - Reduction in fear of falling. - Enhanced home safety. - Enhanced ability to perform ADLs. - Improved comfort. - Enhanced emotional well-being.
Sheffield et al. (2013)	United States	To determine whether an agency-based, in-home OT intervention for at-risk older adults would improve a range of outcomes including home safety, improved functional status, HRQoL, and fear of falling.	Quantitative, RCT	n = 71, mean age = 82 years (n = 39 had modifications)	- Handheld showers - Suction cup holders. - Reachers. - Tub transfer benches. - Raised toilet seat. - Grab bars. - Bed rails. - Night lights.	Mean = $205	- Improved home safety. - Reduction in fear of falling. - Enhanced quality of life. - No reduction in falls.
Thordardottir et al. (2020)	Sweden	To explore clients’ experiences of participation in everyday life before and after a housing modification.	Qualitative	n = 11, mean age = 71 years	- Ramps. - Grab bars. - Stair lift in the hallway. - Automatic door opener. - Replace bathtub with shower. - Longer kitchen tap. - Widen doorways. - Removal of thresholds indoors. - Oven guard.	N/R	- Enhanced ability to perform ADLs. - Enhanced home safety. - Enhanced confidence.
Torres et al. (2022)	Brazil	To estimate the prevalence of stroke in older adults in Brazil, and to identify the factors associated with independence in daily activities.	Quantitative	n = 536, mean age = 69 years	- Handrails in the bathroom - Ramps.	N/R	- Enhanced ability to perform ADLs.
Tsuchiya-Ito et al. (2023)	Japan	To examine the association between housing modifications and the care needs level deterioration among older adults with frailty.	Quantitative	n = 796, ≥ 65 years 36% had home modifications	- Type of modifications not reported.	Max $1513	- Reduced need for care (lower care needs deterioration).
Van Oss et al. (2012)	United States	To evaluate the bathroom environments of four older adults, provide free modifications to enhance performance and safety, and to determine which modifications were most effective.	Mixed methods case studies	n = 4, ≥ 65 years	- Nonslip bath strips. - Suction-bottom foot scrubber. - Bathtub seat. - Reacher. - Raised toilet seat.	Below $500 per person	- Enhanced safety in bathroom.
Washington et al. (2023)	United States	To examine how the CAPABLE program influenced the functional outcomes of older adults during the COVID-19 pandemic.	Quantitative	n = 31, mean age = 71 years	- Adaptations to lighting. - Grab bars. - Stair railing. - Ramps.	Mean $1885	- Enhanced ability to perform ADLs. - Enhanced emotional well-being & mental health.
Whitehead & Golding-Day (2019)	United Kingdom	To explore the lived experience and outcomes of older adults and their carers who received a bathing modification.	Qualitative	n = 21, mean age = 75 years n = 10 had modifications n = 5 carers, n = 3 caring for older adult with home modifications (4 of the 5 carers were spouse/partner)	- Accessible showering facility (“flush floor anti-slip walk in ‘level access’ facility” i.e. a wet room).	N/R	- Enhanced home safety. - Improved confidence. - Enhanced quality of life.
Whitehead et al. (2018)	United Kingdom	To determine the feasibility of conducting a RCT of bathing modifications, to evaluate whether they improve older adults’ perceived health status and QoL, prevent further functional deterioration, and reduce the use of other health and social care resources.	Quantitative	n = 60, mean age = 77 years n = 31 had home modifications, n = 29 control group (waiting to get modifications)	- Accessible showering facility/wet room (“a flush floor anti-slip walk in ‘level access facility”)	Mean £4878	- Enhanced physical health. - Enhanced emotional well-being & mental health. - Enhanced quality of life. - Carer- Reduced emotional burden.
Yang et al. (2021)	Taiwan	To investigate whether home modifications could reduce family caregivers’ care stress, improve family functions, and enhance their QoL.	Quantitative	n = 72 family carers, mean age of carers = 56 years	- Handrails. - slip-resistant flooring. - Eliminating ground unevenness. - Widening doorways. - Improvements to bathtub/ toilet. - changing door panels - Room repartitioning.	N/R	- Carer—reduced emotional burden. - Carer—Improved family functioning. - Carer—enhanced quality of life (p<.01).
Yeni & Yilmaz (2022)	Turkey	To investigate the effects of home modifications on the family members of home-dwelling older adults with dementia.	Quantitative	n = 42 family carers of older adults, mean age of older adults = 79 years	- Grab bars in toilet/bathroom. - Anti-slip tape in hallway/bathtub. - Brighter lightbulbs. - Anchoring furniture. - Removing / rearranging furniture to have a clear walking path.	N/R	- Reduction in falls.

Note. All home modifications are added unless otherwise stated. ADLs = Activities of Daily Living, CHF = Swiss Franc, HRQoL—Health-related quality of life, N/R = Not reported, OT—Occupational Therapist, QoL—Quality of life, RCT—Randomized controlled trial.

Rounded up to nearest whole number. ^bFor quantitative or mixed methods studies, the outcome measure is detailed if reported by authors.

The majority of studies were quantitative (n = 25, 66%), with seven studies using mixed methods approaches (18%), and six studies adopting qualitative methodology (16%). Samples of adults aged 50 years and over varied from a sample of one person (a case study, Mani, 2019) to 657,536 (Hollinghurst et al., 2022). Eighteen studies (47%) included data from adults with and without modifications to compare outcomes (Ahn & Hegde, 2011; Chandola & Rouxel, 2022; Chindapol & Arkarapotiwong, 2023; Cockayne et al., 2021; Dalvand et al., 2024; De-Rosende-Celeiro et al., 2019; Hollinghurst et al., 2022; Hwang et al., 2011; Keall et al., 2017, 2021; Liu et al., 2021; Maggi et al., 2018; Mitoku & Shimanouchi, 2014; Ng et al., 2022; Sheffield et al., 2013; Tsuchiya-Ito et al., 2023; Whitehead et al., 2018; Whitehead & Golding-Day, 2019).

Most studies focused on older adults (60 years and over, or 65 years and over) but six papers relating to five studies reported lower mean ages and included younger adults (Ainsworth et al., 2023; Aplin et al., 2015; DeArajo et al., 2018; Keall et al., 2017, 2021; Pettersson et al., 2012). Four studies included carers as well as consumers (Ainsworth et al., 2023; Aplin et al., 2015; Golding-Day & Whitehead, 2020; Whitehead & Golding-Day, 2019). Golding-Day and Whitehead’s (2020) provided no socio-demographic details on the carers included in the study although the presented quotes suggest that they were family members rather than paid carers. The other three studies were reported to be exclusively or mostly family members or spouses/partners of the home modification users. Three studies collected data from carers only (DeArajo et al., 2018; Yang et al., 2021; Yeni & Yilmaz, 2022). In DeArajo and colleagues study most (72.7%) of carers were reported to be spouses or family members and the other two studies included only family carers.

Types of Home Modifications

Six papers focused exclusively on bathrooms modifications, including the three papers from the BATH-OUT study (Ahn & Hegde, 2011; De-Rosende-Celeiro et al., 2019; Golding-Day & Whitehead, 2020; Korp et al., 2012; Whitehead et al., 2018; Whitehead & Golding-Day, 2019), whereas the rest of the papers included modifications to various areas of the home, with two studies also including modifications to outdoor as well as indoor areas (Hwang et al., 2011; Liu et al., 2021). A wide range of in-home modifications were included such as grab bars/rails, widened doorways, ramps, re-swung internals doors, fold down seat in shower, taps altered/lever taps, relocation of power points, lighting improvements, balustrading, raising toilet, bed raisers, handheld shower, bathtub railings, eliminating floor height differences, brighter lightbulbs, and anchoring furniture. Some studies included modifications that did not include purchasing any products, such as alterations to furniture and equipment placement and decluttering (Dalvand et al., 2024; Mani, 2019). Studies considering modifications to outdoor areas, included concrete pads to clotheslines, path modifications, extra steps to front doors, improved outdoor lighting, slip resistant edges to outdoor steps, slip resistant ground surfaces, and automatic garage door openers.

Cost of Home Modifications

A small number of studies specified the costs of home modifications included in their study. Van Oss et al. (2012) reported that all modifications made were below $500. In another U.S. study, Washington et al. (2023) reported that the average expenditure across 31 participants was $1885, while a Japanese study reported that the maximum spend per person on modifications was $1513 per home (Tsuchiya-Ito et al., 2023). A study conducted in the United Kingdom where all older adults had bathroom renovations reported the average spend across 60 participants was £4878 (Whitehead et al., 2018).

Outcomes for Adults Aged 50 Years and Over

Across the studies we identified 16 outcomes for adults aged 50 years and over, of which 14 were positive and two were negative, and five outcomes for family carers (Table 2).

Table 2.

Summary of Home Modification Outcomes.

Consumer outcomes	Carer Outcomes
- Reduction in falls and falls risk. - Reduced fear of falling. - Enhanced ability to safely perform ADLs. - Enhanced accessing to the community and social engagement. - Enhanced emotional well-being & mental health. - Supports remaining at home. - Enhanced quality of life. - Enhanced physical health. - Reduction in pain. - Reduced need for formal and informal care. - Enhancement of property. - Reduced need to excessively plan. - Enhanced accessibility (access more areas of home, indoors/outdoors). - Enhanced comfort. - Stigma of needing home modifications. - Negative impact on home aesthetics.	- Reduced physical burden and enhanced safety. - Enhanced quality of life. - Reduced emotional burden. - Improved family functioning. - More free time & flexibility.

Consumer outcomes

Carer Outcomes

- Reduction in falls and falls risk.
- Reduced fear of falling.
- Enhanced ability to safely perform ADLs.
- Enhanced accessing to the community and social engagement.
- Enhanced emotional well-being & mental health.
- Supports remaining at home.
- Enhanced quality of life.
- Enhanced physical health.
- Reduction in pain.
- Reduced need for formal and informal care.
- Enhancement of property.
- Reduced need to excessively plan.
- Enhanced accessibility (access more areas of home, indoors/outdoors).
- Enhanced comfort.
- Stigma of needing home modifications.
- Negative impact on home aesthetics.

- Reduced physical burden and enhanced safety.
- Enhanced quality of life.
- Reduced emotional burden.
- Improved family functioning.
- More free time & flexibility.

Reduction in Falls and Falls Risks

Fifteen studies (39%) reported a reduction in fall or falls risk (Aitken et al., 2023; Chandola & Rouxel, 2022; Chindapol & Arkarapotiwong, 2023; Cockayne et al., 2021; Dalvand et al., 2024; Gürler & Bayraktar, 2021; Hollinghurst et al., 2022; Keall et al., 2017, 2021; Korp et al., 2012; Liu et al., 2021; Maggi et al., 2018; Ng et al., 2022; Sheffield et al., 2013; Yeni & Yilmaz, 2022). For example, Chandola and Rouxel (2022) reported a 3% reduction in falls, and Chindapol and Arkarapotiwong (2023) reported a reduction in falls risk of 52%. A cost-benefit analysis of an RCT study to reduce falls noted a 33% drop in costs associated with home falls (Keall et al., 2017). Dalvand and colleagues (2024) reported a reduced risk of falling between baseline and follow up for those who had home modifications, but that comparing falls risk between the intervention group and control group was not significant. Notably, three studies reported that home modifications did not reduce falls (Cockayne et al., 2021; Korp et al., 2012; Ng et al., 2022).

Reduced Fear of Falling

Four studies (11%) identified reductions in the fear of falling (Crowell & Sokas, 2020; Golding-Day & Whitehead, 2020; Schorderet et al., 2022; Sheffield et al., 2013) with Schorderet et al. (2022) observing a 12.5% reduction in the fear of falls following the implementation of home modifications.

Enhanced Ability to Safely Perform Activities of Daily Living (ADLs)

Fifteen studies (39%) reported that home modifications improved consumers ability to safely perform ADLs (Ahn & Hegde, 2011; Ainsworth et al., 2023; Aitken et al., 2023; Aplin et al., 2015; De-Rosende-Celeiro et al., 2019; Golding-Day & Whitehead, 2020; Lau et al., 2018; Pettersson et al., 2012; Schorderet et al., 2022; Sheffield et al., 2013; Thordardottir et al., 2020; Torres et al., 2022; Van Oss et al., 2012; Washington et al., 2023; Whitehead & Golding-Day, 2019), most commonly showering/bathing independently (Aplin et al., 2015; Golding-Day & Whitehead, 2020; Thordardottir et al., 2020; Whitehead & Golding-Day, 2019) though the restoration of other previous activities included cooking (Aitken et al., 2023), doing laundry (Aitken et al., 2023), and gardening (Aplin et al., 2015).

A mixed methods study reported a 93.4% reduction in difficulties carrying out ADLs (Schorderet et al., 2022), while Aplin et al. (2015) reported a greater sense of safety and reduced anxiety and fear in performing daily activities. Five studies specifically reported an increase in confidence in the performance of ADLs (Aitken et al., 2023; Aplin et al., 2015; Golding-Day & Whitehead, 2020; Thordardottir et al., 2020; Whitehead & Golding-Day, 2019). A qualitative study conducted in the United Kingdom found that, due to finding it easier to bathe, consumers felt clean and were able to be in the company of others without feeling embarrassed about potential body odor (Aitken et al., 2023). Similarly, another study reporting that consumers were able to groom and present themselves in their preferred manner (Thordardottir et al., 2020).

Enhanced Access to the Community and Social Engagement

Seven studies (18%) identified enhanced community access and social engagement from the use of home modifications (Aitken et al., 2023; Aplin et al., 2015; Chandola & Rouxel, 2022; De-Rosende-Celeiro et al., 2019; Golding-Day & Whitehead, 2020; Liu et al., 2021; Pettersson et al., 2012). For example, in a study conducted in the United States, Liu and colleagues (2021) identified a significant improvement on the variable “leaving the house for any reason other than health.” Aplin et al. (2015) identified that being able to exit the house more easily led to being able to walk in the neighborhood for those that were mobile, with or without walking aids. Two studies specifically reported that home modifications increased accessibility for visitors (Aitken et al., 2023; Aplin et al, 2015), including for friends with mobility issues (Aitken et al., 2023). Supporting visitors to enter homes had a positive knock-on positive effect on consumers levels of social engagement (Aplin et al., 2015).

Enhanced Emotional Well-Being and Mental Health

Seven studies (18%) identified enhanced emotional well-being as an outcome from home modifications (Ainsworth et al., 2023; Aitken et al., 2023; Aplin et al., 2015; Golding-Day & Whitehead, 2020; Schorderet et al., 2022; Washington et al., 2023; Whitehead et al., 2018). For example, qualitative studies identified reduced depression, anxiety, and frustration, along with more happiness and improved self-esteem (Aitken et al., 2023), and greater peace of mind and fewer negative thoughts (Ainsworth et al., 2023).

Supports Remaining at Home

Six studies (16%) reported that home modifications supported older adults to remain in their own home (Ahn & Hegde, 2011; Aitken et al., 2023; Aplin et al., 2015; Golding-Day & Whitehead, 2020; Hwang et al., 2011; Pettersson et al., 2012). In their U.K. based study, Hwang et al. (2011) reported that having home modifications was a significant variable in predicting aging in place. A U.S. based study reported that home modifications increased consumers level of satisfaction with their home and their perception of the capacity of the home to meet future needs (Ahn & Hegde, 2011).

Enhanced Quality of Life

Six studies (16%) reported that home modifications were associated with an increase in consumers quality of life (Carnemolla & Bridge, 2016; Mani, 2019; Schorderet et al., 2022; Sheffield et al., 2013; Whitehead et al., 2018; Whitehead & Golding-Day, 2019). A Swiss study reported a 9.8% improvement in quality of life scores after receiving home modifications (Schorderet et al., 2022). An Australian study reported an overall enhancement of quality of life and that the biggest change was that related to a dimension on independent living, which showed a 16% increase (Carnemolla & Bridge, 2016).

Enhanced Physical Health

Six studies (16%) reported that home modifications enhanced physical health (Ainsworth et al., 2023; Aitken et al., 2023; Chandola & Rouxel, 2022; Mani, 2019; Mitoku & Shimanouchi, 2014; Whitehead et al., 2018). For example, Ainsworth and colleagues (2023) reported that home modifications improved physical strength, control over body temperature, and enhanced mobility. An Indian case study reported that home modifications resulted in reduced fatigue (Mani, 2019), while a Japanese study observed a reduction in the progression of frailty, and a halving of the risk of mortality for those with older adults with home modifications compared with those without (Mitoku & Shimanouchi, 2014).

Reduction in Pain

Three studies (8%) identified a reduction in pain as a result of home modifications (Ainsworth et al., 2023; Chandola & Rouxel, 2022; Mani, 2019). For example, one study reported that home modifications provided relief from pain and exertion (Ainsworth et al., 2023) whereas another study reported that pain reduced by 6% (Chandola & Rouxel, 2022).

Reduced Need for Formal and Informal Care

Three studies (8%) identified a reduced need for formal (paid) carers (Aitken et al., 2023; Carnemolla & Bridge, 2019; Tsuchiya-Ito et al., 2023). Aitken et al. (2023) identified that formal care was reduced or withdrawn altogether and that, where formal care continued, it was less intense in nature. Carnemolla and Bridge (2019) identified a mean reduction in care of 0.36 hrs per week in their Australian study, whereas a Japanese study identified significantly lower care needs deterioration in older adults with home modifications compared with those without modifications.

Two studies (5%) identified a reduction in the need for informal care (i.e., care provided by family members or others without payment) (Aitken et al., 2023; Carnemolla & Bridge, 2019), with one study noting a significant mean reduction in informal care of 6 hrs per week (Carnemolla & Bridge, 2019).

Enhancement of Property

Two studies (5%) identified perceptions by consumers that their home modifications enhanced the value of their property (Aitken et al., 2023; Aplin et al., 2015). Although, as identified in the negative outcomes section below, not all consumers felt that modifications enhanced their property or its value.

Other Positive Outcomes for Adults Aged 50 Years and Over

One study (3%) reported the outcomes of reduced need to excessively plan (Golding-Day & Whitehead, 2020, and enhanced accessibility (Liu et al., 2021), with consumers being able to access more of their house as well as outdoor areas. One study reported that consumers experienced enhanced comfort due to being less tired washing, having more space, and perceptions that their space was now more practical for their current and future needs (Schorderet et al., 2022).

Negative Outcomes for Adults Aged 50 Years and Over

In terms of negative outcomes for consumers, one study (3%) reported increased stigma related to needing home modifications (Aitken et al., 2023), and two studies (5%) reported a perceived negative impact on home aesthetics (Aitken et al., 2023; Aplin et al., 2015). In an Australian study, some consumers reported that the appearance of their home was related to their personal identity, and they didn’t like that their home now looked like a person with disability lived there or that it looked “like a hospital” (Aplin et al., 2015: 126).

Outcomes for Family Carers

The most common outcomes identified for family carers were reduced physical burden and enhanced safety which were identified by six studies (16%) (Ainsworth et al., 2023; Aitken et al., 2023; Aplin et al., 2015; DeArajo et al., 2018; Golding-Day & Whitehead, 2020; Whitehead et al., 2018). The studies identified less injury and deteriorating health from lifting and helping with self-care tasks of their care recipients (Ainsworth et al., 2023; Aitken et al., 2023). In a Brazilian study, DeArajo and colleagues observed a significant reduction in neck pain for family carers.

Two studies (5%) observed enhanced quality of life (DeArajo et al., 2018; Yang et al., 2021) and two studies identified reduced emotional burden for family carers (Golding-Day & Whitehead, 2020; Yang et al., 2021). One study (3%) identified improved family functioning due to a significant reduction in family conflict following the installation of home modifications (Yang et al., 2021). Finally, one study (3%) identified that family carers has more free time and flexibility as a result of their older family member having home modifications (Aitken et al., 2023).

Discussion

To date, there has been no review to consolidate the evidence of the outcomes derived from the use of home modifications for adults aged 50 years and over living in the community in their own homes (whether owned or rented). The aim of this review was to address this gap in the extant literature. This review has identified 21 outcomes from the use of home modifications for adults aged 50 years and over as well as for those caring for them. Most of the outcomes identified were positive, although a small number of studies identified negative outcomes (Aitken et al., 2023; Aplin et al., 2015).

Given the focus of many studies on falls prevention, it is not surprising that reduction to falls and falls risk were the most identified positive outcomes across the studies included in this review. Although we note contradictory evidence in that some studies found a positive association between home modifications and a reduction in falls (e.g., Aitken et al., 2023; Hollinghurst et al., 2022) and other studies found no such association (e.g., Cockayne et al., 2021; Korp et al., 2012). Raymond and colleagues (2018) note that occupational therapists prioritize older adults who have already fallen, whereas older adults themselves prioritized access to their home in seeking occupational therapy services. Despite these differences in priorities, it is clear that falls can be a significant issue as people age with declining physical functioning and increasing frailty which are costly to health services in Australia and internationally necessitating acute care as well as longer-term medical treatment (AIHW, 2022; Collins & Casey, 2019; NICE, 2013). Falls are also a significant factor in older adults temporary or permanent moving to residential aged care (Gill et al., 2013). Notably, providing services to older adults in the community rather than in residential aged care settings is not only significantly less costly (Mah et al., 2021), but also supports older adults’ preference for aging at home (Mulliner et al., 2020; Stones & Gullifer, 2016). This review provides evidence to practitioners that home modifications do not always result in a reduction in falls (Cockayne et al., 2021; Korp et al., 2012) and that a range of outcomes might be achieved from home modifications, including those prioritized by older people themselves, namely an ability to remain at home and greater access to inside and outside areas of their home (Raymond et al., 2018).

Indeed, home modifications were shown in several studies to directly or indirectly support older adults remaining at home (Ahn & Hegde, 2011; Golding-Day & Whitehead, 2020; Hwang et al., 2011). This was due to home modifications facilitating the safe navigation of the home environment, and supporting re-engagement with activities of daily living, as well as providing psycho-social outcomes such as reduced fear of falling, and enhanced confidence and emotional well-being (e.g., Aitken et al., 2023; Crowell & Sokas, 2020; Schorderet et al., 2022; Washington et al., 2023). Several studies also identified a reduction in the need for formal and informal care, which could be associated with significant savings, reduced burden and improved well-being for family carers, and increased privacy and independence for older adults (Aplin et al., 2015; Carnemolla & Bridge, 2019; Lau et al., 2018; Whitehead et al., 2018; Yang et al., 2021).

In this review only four studies reported any information relating to the cost of the home modifications undertaken (Tsuchiya-Ito et al., 2023; Van Oss et al., 2012; Washington et al., 2023; Whitehead et al., 2018). Although this data was relatively limited, it suggested that many home modifications are not costly to implement, with combinations of low-tech modifications shown as costing from below $500 (Van Oss et al., 2012) to an average of $1885 (Washington et al., 2023). More extensive home modifications were described in some studies and were more costly, at up to £4878 per home (Whitehead et al., 2018).

Some of the findings of our review aligned with that of other reviews on home modifications which were narrower in scope (only RCTs, only qualitative studies) or focused on a narrower population (e.g., people with Alzheimer’s disease) or different population (e.g., people with disabilities). For example, Aclan et al.’s (2023) qualitative review of home modifications for the same target population identified that home modifications supported independence and remaining at home. A review of home modifications for people with disabilities identified that home modifications improved physical function and reduced falls risk (Stark et al., 2017). Another review that focused on falls found a reduction in both falls and fear of falling (Chase et al., 2012). No review to date has captured the breadth of physical and psychosocial outcomes identified in the current review. However, we note that, as identified by Aclan and colleagues (2023), there was less evidence in relation to adults aged 50 to 64 years than adults aged 65 years and over and, when studies consisted of both age groups, there was no differentiation of experiences or outcomes on the basis of age.

This scoping review provides potentially valuable data to occupational therapists and others involved in prescribing and implementing home modifications as well as funders and policy makers. However, limitations of the review need to also be acknowledged. Although we targeted studies of home modifications for adults aged 50 years and over, some studies did not provide a lot of detail on the age of participants, therefore some studies were included in this review despite involving a small number of participants outside the target age range (e.g., Ainsworth et al. (2023) whose participants range in age from 24 to 93 years but with a mean of 62 years). As outlined above, studies that included those aged 50 to 64 years and 65 years and over, did not differentiate outcomes based on age or highlight any benefits associated with early intervention.

Due to resource constraints, we were not able to conduct consultation with stakeholders (adults aged ≥50 years and their family carers, funders, organizations providing home modifications) as recommended by Levac et al. (2010) to support interpretation of the findings prior to completing the write up of this review. However, the findings were discussed with our multi-disciplinary authorship team which includes academics with expertise in occupational therapy, physiotherapy, social gerontology, psychology, and health economics. Unlike systematic reviews, scoping reviews do not include an assessment of reporting quality. However, our review did focus only on peer-reviewed literature ensuring that article has been subject to critical review prior to publication.

Conclusions

This scoping review consolidates the evidence on the outcomes of home modifications for adults aged 50 years and over living in the community and their family carers, identifying a broad range of physical, and psychosocial benefits. While falls prevention was the most frequently cited positive outcome, the review also highlights the role of home modifications in promoting independence, enhancing emotional well-being, and reducing the need for formal and informal care. These findings reinforce the importance of home modifications in supporting aging in place, aligning with older adults’ preferences while also potentially reducing health care costs. However, contradictory evidence regarding falls reduction suggests the need for further research to clarify the conditions under which home modifications are most effective.

Despite its contributions, this review also identifies key gaps in the literature, including limited differentiation of outcomes based on age and a lack of cost-related data. Future research should explore the long-term economic impact of home modifications, particularly in relation to health care savings and carer burden reduction and examine their benefits for adults aged 50 years and over as a proactive strategy for aging. In addition, stakeholder consultation, including the perspectives of consumers and policymakers, could further contextualize these findings. Nonetheless, this review provides valuable insights for occupational therapists, health care professionals, and policymakers, supporting informed decision-making around home modification interventions for aging populations.

Supplemental Material

sj-docx-1-otj-10.1177_15394492251361086 – Supplemental material for Home Modification Outcomes for Adults Aged 50 Years and Over and Their Relatives: A Scoping Review

Supplemental material, sj-docx-1-otj-10.1177_15394492251361086 for Home Modification Outcomes for Adults Aged 50 Years and Over and Their Relatives: A Scoping Review by Claire Hutchinson, Heather Block, Alison Dymmott, Claire Gough, Kate Laver, Ruth Walker, Lily Xiao and Stacey George in OTJR: Occupational Therapy Journal of Research

Footnotes

Acknowledgements

We extend our thanks to Catherine Brady, a Research Librarian at Flinders University Library Services for her support in developing the search strategy, translating the search terms to all databases, and conducting the searches.

Ethics Approval and Informal Consent Statement

Ethics approval was not required for this scoping review.

Data Availability Statement

Available on reasonable request from the first author.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This project is supported by an Impact Research Grant for Aging Well 2023 from Office for Aging Well, Government of South Australia (Major Project grant, ref: 175010761).

ORCID iD

Claire Hutchinson

Supplemental Material

Supplemental material for this article is available online.

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