The Hidden Gaps in Home Modifications: What Families Should Know Before Calling a Contractor

I hope this newsletter doesn’t stir up controversy — especially among the contractors, builders, and non‑healthcare professionals who work in accessibility. Truly. Because without these folks, the actual execution of accessibility modifications simply wouldn’t happen. They’re the ones who make ideas real. They’re the ones who pour the concrete, reroute the plumbing, and make sure the grab bar doesn’t fall off the wall the first time someone sneezes near it.

I work with contractors every single day, and I have enormous respect for them. They are skilled, hardworking, and genuinely want to help people. But today’s topic is important, and it comes from a place of wanting to protect families, budgets, and safety — not from a place of criticism.

So let me say this clearly:

The problem isn’t contractors. The problem is relying on contractors alone for accessibility decisions.

Because while contractors are experts in building, they are not trained in functional client assessment, disease progression, recovery after injury, specialized medical equipment, or how daily routines change when environments change. These are things that healthcare professionals — especially occupational therapists — are specifically trained to understand.

(If you missed Edition #1, “Why an OT Makes the Ideal Accessibility Consultant,” now’s a great time to circle back.)

Why does this matter?

I’m bringing this up because I’ve seen some things.. And I don’t mean “saw a raccoon steal a loaf of bread off someone’s porch” kind of things. I mean expensive, well‑intentioned home modifications that ended up being unsafe, unusable, or flat‑out backwards.

Like the $7,000 walk‑in tub installed for someone who couldn’t walk. Beautiful tub. Sparkling. Fancy. Completely inaccessible. I’ve seen this more than once.

Or the walk‑in tub installed for a young man with autism who couldn’t tolerate sitting still while the tub filled… or waiting while it drained. A sensory nightmare. A safety hazard. And again — expensive.

I’ve seen wheelchair ramps built by professionals that were so steep you’d need a running start to get up them. I’ve seen “accessible” sinks installed too low for a wheelchair user to roll under. I’ve seen gorgeous shower renovations ruined by slick flooring that turned the whole thing into a Slip ’N Slide. And I’ve seen hand‑held shower heads installed beautifully… but routed in a way that the person couldn’t actually reach them from the seated position. So they still had to stand — defeating the entire purpose of the modification.

Every one of these projects was done with good intentions. But the routines — the actual way a person moves, bathes, transfers, senses, and navigates their home — were overlooked. And when routines are overlooked, hazards multiply.

And here’s the part that really hurts:

The client still has to pay for the modification, even if it doesn’t work.

For families on fixed or tight budgets — which is most people — that’s not just frustrating. It’s devastating.

So why can’t contactors solve accessibility problems alone?

Well sometimes they can - but sometimes it can be a gamble. You see, contractors are experts in building. They’re good at what they do, and naturally, they tend to recommend the solutions they know best — structural changes, renovations, and construction‑based fixes.

But sometimes the safest, most effective, most affordable solution isn’t a renovation at all.

Sometimes it’s a piece of equipment that costs a few hundred dollars.

Sometimes it’s a device that insurance will cover.

Sometimes it’s a change in routine or layout that costs nothing.

And sometimes, yes, it is a renovation — but one that needs to be planned around a person’s diagnosis, prognosis, mobility, sensory needs, equipment, and long‑term goals.

That’s where healthcare‑rooted accessibility consulting comes in.

What is the value of an OT-Informed Accessibility Consultation?

An occupational therapist looks at the person first — not the house. We look at how someone moves, transfers, bathes, cooks, and navigates their day. That functional assessment is the foundation of safe modification. Without it, you’re building blind.

We also understand disease progression and recovery. A modification that works today may not work six months from now. Planning ahead prevents wasted money and repeated renovations.

We know specialized medical equipment — what exists, what insurance may cover, and how it can work in harmony with home modifications. Sometimes equipment replaces the need for structural changes entirely. Other times, equipment and modifications need to work together like puzzle pieces.

And we understand routines. A home can be “technically accessible” and still completely unusable. Routines matter. Habits matter. Context matters.

What’s the bottom line?

Contractors build the solutions.

Healthcare professionals can help design the right ones.

When you combine the two, you get safety, independence, and long‑term value.

When you don’t, you risk spending thousands on something that doesn’t actually solve the problem.

My role at BridgePoint is to help families understand all their options — from equipment to renovations to insurance‑covered solutions — so they can make informed decisions that fit their needs, their routines, and their budget.

Because accessibility shouldn’t be guesswork.

And it definitely shouldn’t be a gamble.

If this newsletter was helpful, we invite you to subscribe for our twice‑monthly updates. And if you believe a consultation from BridgePoint could support you or someone you know, please reach out or complete the Secure Intake Form. We’re always glad to connect!