Anna Grasso, OTD, MS, OTR/L, CAPS, ECHM, assistant professor and academic fieldwork coordinator in the Occupational Therapy (OT) program at Salus, was recently awarded a subgrant in partnership with Rebuilding Together Philadelphia (RTP), the grantee agency, to help low-income older adult homeowners in the Philadelphia area age in place.

The grant was awarded by the U.S. Department of Housing and Urban Development (HUD) Older Adults Home Modification Grant Program (OAHMP), which gave the project more than $824,000 to apply safety and functional home modifications and limited repairs to meet the needs of the local aging population.

Data reported by the U.S. Salus OT students helping a patient learn to put on shoes independentlyCensus Bureau showed that about 14 percent of the 1.58 million people living in Philadelphia County in 2019 were 65 and older. In 2016, the Federal Reserve Bank of Philadelphia projected older adults would make up 22 percent of the Pennsylvania-New Jersey-Delaware area by 2030, a 7 percent increase from 2010. Combine these statistics with a 2018 AARP survey that reported almost 80 percent of people 50 and older said they wanted to stay in their communities as long as possible, but only 46 percent thought they could stay in their current homes, and the project becomes even more essential.

“It's the difference between being able to stay in a home where you have a lot of memories and a lot of comforts and your family is there versus moving into a nursing home facility where you're surrounded by strangers, without your belongings, losing all autonomy and independence in a lot of cases,” Grasso said.

Grasso co-wrote the grant with lead writer Stefanie Seldin, president and CEO of RTP. Grant writing support was also provided by Wendy Woodward, assistant director of Research and Finance at Salus, and Dr. Mitchell Scheiman, dean of Research and director of Graduate Programs in the University’s Biomedicine program. The delivery of the HUD OAHMP grant will allow RTP to provide up to $5,000 in client-centered home modifications for 100 primary homeowners aged 62 and older following a homeowner interview and evaluation by an occupational therapist (OT). Through the partnership with RTP, which Grasso initially established in 2019, she will be able to supervise students in the OT program during their fieldwork rotations through the University’s Occupational Therapy Institute (OTI) throughout the three-year grant period. OT students will gain an understanding of the challenges faced by low-income older adults, along with transferrable clinical skills in cultural competence, empathy, and client-centered assessment and interventions to improve safety, independence, and quality of life.

Grant funds for the project, which is anticipated to begin before the end of the year, will be used to cover contractor costs, deliver portable medical equipment such as shower chairs and raised toilet seats, and provide customized educational materials to each homeowner on topics including fall prevention, energy conservation/fatigue prevention, sleep hygiene, medication management, decluttering and community resources. A standardized assessment tool will be used to collect data reported quarterly to HUD to help determine the strengths and challenges experienced by each older adult homeowner, along with their individual priorities and goals for living independent and fulfilling lives in their own homes.

According to Seldin, even minor home adjustments can have the biggest impact on the mobility of a senior homeowner, preventing unnecessary hospitalizations and nursing facility admissions. 

“One of the homeowners mentioned how invaluable something as little as a bar has been to help her roll over and move around in bed, giving her the ability to function,” she said. “She also mentioned the railing on the steps down to her yard made it incredibly easier for her to actually use her backyard.”

Grasso will be providing OT services for approximately two-thirds of the grant-funded homeowners, along with Jean DelFerro, an RTP Board Member and OT at MossRehab, who will also be volunteering her services for the remaining homeowners. Additionally, both OTs will continue to volunteer their services to senior homeowners served by RTP outside of the HUD OAHMP grant.

“We know that people really want to stay in their homes, and they want to be with their neighbors who they've lived with their whole lives, potentially,” Seldin said. “They want to have that connection with the community they love. To do that, they need to be able to age in place. And older homeowners need occupational therapy services to make that feasible.”