There is a moment many families recognise – a parent gripping the bathroom doorframe a little longer than usual, a spouse moving more cautiously through a corridor they have navigated for decades, or a slow realisation that the home that once felt perfectly suited no longer feels entirely safe. For millions of Australians, this moment arrives quietly, often before any formal health event has occurred.
The desire to remain at home as we age is not simply a preference – it is deeply connected to identity, independence, dignity, and emotional wellbeing. Yet without thoughtful planning, the very spaces that feel most familiar can become the greatest sources of risk. That is where ageing in place, supported by the guidance of an occupational therapist (OT), becomes not just helpful – but genuinely life-changing.
Why Are So Many Australians Choosing to Age in Place?
Ageing in place – the ability to live safely and independently in one’s own home as physical and cognitive needs change over time – is a goal shared by the overwhelming majority of older Australians. Research from the Australian Housing and Urban Research Institute (AHURI) shows that between 78% and 81% of Australians aged 55 and over want to remain in their own home as they age, depending on the age cohort examined.
This preference is not surprising. Approximately 80% of activities an older person undertakes take place within their home. The home is where daily routines are anchored, where relationships are nurtured, and where a sense of self is maintained. Familiar surroundings reduce stress and anxiety – a factor that is particularly significant for those living with cognitive challenges.
Australia’s ageing demographic landscape makes this conversation increasingly urgent. As of December 2025, 17.3% of Australia’s population of 27.8 million people is aged 65 or over. By 2064–65, that figure is projected to reach nearly one in four Australians. The number of Australians aged 85 and over is expected to double by 2042, surpassing one million people.
Across Brisbane, the Gold Coast, Sunshine Coast, Melbourne, and Sydney – and in communities as far-reaching as Noosa, Buderim, Gympie, and Peregian Springs – the question of how to support older Australians in remaining at home safely is one of the most pressing issues in allied health today.
What Risks Does an Unsafe Home Environment Create for Older Adults?
An unmodified home can present considerable safety risks for older adults, particularly as balance, vision, strength, and reaction times naturally change. Falls are among the most significant concerns.
Approximately 40% of falls in older adults occur in the bathroom alone – one of the most hazardous rooms in any home due to wet, hard surfaces, confined spaces, and frequent transfers. Falls in the bathroom are 2.4 times more likely to result in injury compared to falls in the living room. Bathroom injury rates rise sharply with age, reaching 515.3 per 100,000 for those aged 85 and older – nearly nine times the rate seen in younger adults.
Beyond the immediate physical risk, the consequences of a fall frequently extend well beyond the injury itself. The fear of falling again can lead to reduced mobility, social withdrawal, and a decline in overall quality of life. A single preventable fall can trigger a cascade of health events that ultimately result in residential aged care – an outcome that most older Australians actively wish to avoid.
The good news is that proactive, OT-guided home modifications have been shown to reduce falls by 26–30% when environmental changes are tailored to the individual. This is not a small figure – it represents a meaningful, evidence-based intervention that supports both safety and continued independence.
How Does an Occupational Therapist Guide Home Modifications for Ageing in Place?
All occupational therapists practising in Australia must be registered with the Australian Health Practitioner Regulation Agency (AHPRA) and operate under the oversight of the Occupational Therapy Board of Australia. This means that when you engage an OT for a home modification assessment, you are working with a regulated health professional who is accountable to national standards of practice.
An OT’s approach to supporting ageing in place is holistic and person-centred. Rather than applying a generic checklist, a qualified OT assesses how a specific individual moves through and interacts with their unique home environment. The typical process includes:
- Initial consultation – A discussion of daily routines, goals, challenges, and what matters most to the individual and their family.
- Comprehensive home evaluation – A thorough assessment of all areas of the home, including entry points, hallways, the bathroom and toilet, kitchen, bedroom, living spaces, and outdoor areas.
- Functional assessment – An evaluation of how the person moves through their home, identifying specific barriers and safety risks relative to their functional capacity.
- Detailed written report – A clinical report outlining findings, prioritised recommendations, estimated costs, and clinical justification – often essential for NDIS or aged care funding applications.
- Ongoing support – Training in the use of new modifications and a post-implementation review to confirm that outcomes are being achieved.
A mobile OT service – such as Astrad Allied Health, which delivers assessments directly to clients’ homes across Queensland, Victoria, New South Wales, and Tasmania – is particularly well-suited to this process. Conducting the assessment in the actual living environment provides far greater clinical insight than any clinic-based consultation could offer.
What Are the Most Common OT-Recommended Home Modifications for Ageing in Place?
Home modifications recommended by an OT generally fall into two broad categories: minor modifications that can be installed quickly with minimal disruption, and major structural modifications for more significant accessibility barriers.
The table below outlines common modification types, their typical application areas, and their relevant NDIS funding category:
| Modification Type | Common Examples | NDIS Category |
|---|---|---|
| Simple home adaptations | Grab rails, non-slip mats, raised toilet seats, lever taps, handheld shower heads | Under $1,500 |
| Minor modifications (Category A & B) | Level-access shower conversion, improved lighting, threshold ramps, stair handrails | $1,500–$20,000 |
| Complex/structural modifications | Doorway widening, full bathroom redesign, internal ramp installation, stairlift, kitchen remodel | Over $20,000 |
Minor and Simple Modifications
These are frequently the first recommendations made and can have an immediate, meaningful impact on daily safety:
- Grab rails in bathrooms and near the toilet provide critical support during transfers. Research published in 2023 found that participants with access to a grab rail during bathtub exit were 75.8% more likely to recover their balance than those without one.
- Non-slip treatments applied to bathroom tiles or flooring significantly reduce slip risk on wet surfaces.
- Improved and motion-sensor lighting – particularly LED strip lighting along the path from bedroom to bathroom – can reduce nighttime falls by over 30%.
- Shower chairs and toilet raisers reduce the depth of movement required for sitting and standing, lowering strain on joints and improving stability.
- Removal or securing of floor rugs is one of the simplest and most effective interventions to reduce tripping hazards.
Structural and Major Modifications
When barriers are more significant, structural modifications may be recommended:
- Level-access (curbless) shower conversions replace traditional bathtubs or stepped shower recesses, eliminating the need to step over a hob.
- Doorway widening facilitates the use of walkers, wheelchairs, or other mobility aids.
- Ramp installation at primary entry points allows safe access without navigating steps.
- Kitchen modifications, including bench height adjustment and pull-out shelving, support continued independence in meal preparation.
How Can Government Funding Support Home Modifications for Ageing in Place?
For many Australians, the cost of home modifications is a genuine concern. Fortunately, both the aged care system and the National Disability Insurance Scheme (NDIS) provide meaningful funding pathways.
Support at Home Program (from November 2025)
The Support at Home Program – which replaced the Home Care Packages Program – includes a dedicated assistive technology and Home Modifications (AT-HM) Scheme. This provides upfront, separate funding for modifications and assistive technology, meaning eligible participants no longer need to save from their quarterly care budget.
Funding tiers under the AT-HM Scheme include:
- Low tier: Up to $500
- Medium tier: Up to $2,000
- High tier: Up to $15,000 per 12-month period (with potential extension to 24 months)
Critically, prescription, safe installation, and training are treated as clinical supports – meaning they are fully funded with no participant contribution required.
Eligibility generally includes Australians aged 65 and over, or Aboriginal and Torres Strait Islander people aged 50 and over.
NDIS Home Modifications
For NDIS participants, home modifications must be deemed reasonable and necessary and directly related to a participant’s disability. An AHPRA-registered OT report is required to support funding applications, and builder quotes are typically needed for modifications exceeding $20,000.
Is Proactive Planning for Ageing in Place Better Than Waiting?
One of the most consistent findings in ageing-in-place research is that proactive planning – pursuing home modifications before a health crisis occurs – produces significantly better outcomes than reactive responses to falls or hospital discharge.
The first 48 hours following a return home from hospital represent the highest-risk period for adverse events, with 50% of unplanned hospital readmissions occurring by Day 8 post-discharge. An OT-led home assessment conducted either prior to discharge or shortly after can substantially reduce this risk.
For healthy middle-aged and older adults in Brisbane, North Lakes, Sydney, Melbourne, the Gold Coast, and across the Sunshine Coast, a proactive OT home assessment is an investment in future wellbeing – not merely a response to current limitations. Gardens, outdoor pathways, and even kitchens are commonly identified as areas requiring future planning, even when they present no immediate concern.
Universal design principles – such as reinforcing bathroom walls to accommodate future grab rails, installing wide doorways, and selecting non-slip flooring – allow homes to evolve with their occupants, reducing the need for disruptive modifications later.
Making Ageing in Place a Reality, Not Just an Aspiration
Ageing in place is not simply a preference – it is, for most Australians, the deeply held expectation of a life well-lived in familiar surroundings, on one’s own terms. Realising this aspiration requires thoughtful planning, an honest assessment of the home environment, and the clinical guidance of a qualified occupational therapist.
The evidence is clear: OT-guided home modifications reduce falls, support independence, improve mental and physical wellbeing, and delay or prevent the need for residential aged care. Whether you are planning ahead or responding to a recent change in health or function, engaging an OT for a comprehensive home assessment is one of the most practical steps an individual or family can take.
Astrad Allied Health is a mobile occupational therapy service delivering individualised home assessments and recommendations directly to clients in their homes across Queensland, Victoria, New South Wales, and Tasmania – including Brisbane, North Lakes, the Gold Coast, Sunshine Coast, Sydney, and Melbourne, as well as telehealth services across most of QLD, VIC, NSW, and TAS.
Have questions? Need help? Contact Astrad Occupational Therapy today.
