This article was written by Fatima Andrade-Hanoian, a Care Manager for Caregiver Homes in Massachusetts.

One consumer I support in Massachusetts has Alzheimer's disease and uses a wheelchair. When I went on home visits with her nurse, I noticed the consumer needed two people to help her out of the house, supporting her down the entrance steps and into a car. I also noticed the bathroom was very small, making it difficult to use a wheelchair. An accident was inevitable, so I spoke to the family about my concerns. They knew the need for a ramp and a larger bathroom would only become more necessary as time progressed, but they could not afford the home improvements. As a member of a care team, it is valuable to observe potential risks in the home, familiarize yourself with the resources available, and connect caregivers and consumers with services that can make their home as safe and accessible as possible.

There are many state-specific programs and resources available. For any consumer who is in a Home and Community Based Services Waiver, you should first coordinate with the consumer's Waiver case manager. There are many free or low-cost options available to Waiver enrollees, but options will be different depending on the Waiver, the State, and who owns the home in which the consumer and caregiver live. Some case managers refer to home modifications as "environmental adaptations."

I recommended that this particular family research a local Massachusetts Homeowner Rehabilitation program—part of the federal stimulus program. The government allocates money to qualifying towns to improve neighborhoods. Families must qualify based on their income, and can receive funds to add ramps or make repairs on their windows, siding, and roofs. While this option might not work for everyone, it worked well for this family. The caregiver was very proactive. After gathering the necessary paperwork, the approval process took three months. Construction companies bid on the project and whichever company's bid is the lowest wins the job through this program.

The home improvements were completed within a couple of months. Now their home has a new bathroom equipped with handicapped-accessible fixtures. The doorways are wider, so now there is enough room to maneuver her wheelchair. The ramps around their home make it so much easier for the consumer to get in and out of her home.

Care teams have the opportunity to observe and make helpful recommendations. The caregiver was so happy and excited to be able to make her home a safer and more comfortable place for her mother, and I'm happy these updates have improved their day-to-day lives.

Click here to learn about federal Homeowner Rehabilitation programs.