Home Modifications in the Media

March 5th, 2012 by admin

More and more the need for seniors to stay safe at home is becoming more prominent.  Occupational therapists are specialized in the area of seniors and home modifications.  Awareness is growing and now the media is becoming more conscious of the importance of seniors living more independently and safely at home.  Home modifications can range from something as simple as changing a light bulb to something as complex as installing a chair lift.  Occupational therapists have the educational background and working experience to effectively deliver this type of service and more research- based evidence is being complied to prove it, please watch video to learn more…


Miller Calberto, MS, OTR/L, CAPS
Senior partner
Adapting Spaces, LLC

Keeping aging parents and older adults safer at home.

February 18th, 2012 by admin

A recent article in the Los Angeles Times talks about this impending challenge. The article talks about the growing dilemma that children with aging parents face when choosing between their parents safety vs. their autonomy. The article also provides suggestions and strategies to keep aging parents safe at home. One of the main suggestions highlighted by this article is to hire an occupational therapist to inspect the house to make it safer to live in. If you have aging parents or if you care about the safety and well being of seniors, read more.


Esther Gonzalez, MS, OTR/L, Bil TSHH
Adapting Spaces, LLC

8 simple ideas to improve contrast perception for low vision clients while living at home

February 11th, 2012 by admin

Aging reduces an older adult’s ability to discern objects against a background of a similar or related color; this is called contrast.  Several factors are involved in the decline of contrast perception; such as, structural changes in the cornea or lens, diminished sensitivity to retinal receptors, and illness/disease associated with the eye (i.e., Cataracts, Corneal Disease, Glaucoma, and Retinal Pathology).  Examples of how contrast impacts older adults on a daily basis are: the cut out edge of a curb; gray concrete steps without a clearly marked edge; or stairs with carpeting that have a confusing pattern.   Individuals with vision loss can find it very difficult to distinguish between colors and detect differences between light and dark areas.  For this reason, opposites such as black and white offer the best contrast.  Contrasting a dark color against a light one such as, blue against white and yellow against violet, is more effective than orange against red because they are too close to each other in the color spectrum to provide enough contrast.  When evaluating an individual with vision loss, it is important to account the following environmental factors: kitchen, living room, bathroom, bedrooms, hallways, and entry points.  Here are some ways that color and contrast can be used to improve contrast perception while at home:

     1.   Solid bright colors such as red, orange, and yellow are easier to see.

     2.   Lighting can influence the perception of color. Dim lighting can make some

            colors more difficult to see; whereas, bright lights can intensify them.

     3.   Colors can also be used for safety purposes as an indicator of change in surface or

           level such as on steps or doorway thresholds.

      4.   Color and contrast can help with judging depth perception.

      5.   Increasing the contrast between an object and its background will make the object

           more visible.

     6.   Signage (i.e., names and numbers on doors)

     7.   Furnishings (i.e., patterns of fabric)

     8.   Solid bright colors such as red, orange, and yellow are easier to see

The above recommendations may facilitate ease of movement around the living environment and minimize/ prevent personal injuries while at home.

By Esther Gonzalez, MS, OTR/L, Bil TSHH


January 23rd, 2012 by admin

Blindness or low vision affects approximately 1 in 28 Americans older than 40 years (Eye Disease Prevalence Research Group, 2004). It is important for these individuals to have the best lighting conditions wherever they are in order to maximize their vision.  Proper lighting is essential if you experience vision loss.  A good light source can make a dramatic effect on how you perform various activities of daily living such as reading, writing, and food preparation.  It can help you improve your independence and maintain your personal safety while at home.  When considering lighting, it is important to be able to manage or control the quality and quantity of light in your environment.  There are 5 different types of light with distinct characteristics.  Each one has advantages and disadvantages for individuals with vision loss.

1)      Sunlight:

  • The most natural source of light.
  • Can be used while performing any activity.
  • May create a glare problem or shadows.

2)      Incandescent:

  • Light bulbs used primarily for lamps and ceiling fixtures.
  • It is constant light that does not flicker.
  • Can be used for close work activities such as reading, knitting, sewing, etc.
  • May create a shadow or glare spot and uses more heat/ energy.

3)      Fluorescent:

  • Used primarily for ceiling fixtures.
  • Provides better lighting for a wider surface area.
  • Does not create a shadow effect and uses less energy.
  • Light can flicker and can not be dimmed as easily as a incandescent light.

4)      Combination:

  • Incandescent and fluorescent light.
  • Can be used for both illuminating a wide area of space and for close work tasks.
  • May require specialized lighting fixtures which can be expensive.

5)      Halogen:

  • More concentrated than the incandescent light bulbs and is usually used in lamps and recessed ceiling fixtures.
  • Gives good illumination and is more energy efficient than incandescent light bulbs.
  • It is not recommended for prolonged close work because the light is hotter.


Miller Calberto, MS, OTR/L, CAPS
Senior partner
Adapting Spaces, LLC


January 9th, 2012 by admin

As we age, our ability to see diminishes overtime making it more difficult to perform daily routines. In some instances, there are individuals that have been severely affected by their vision loss. Thus, being unable to live both safely and independently while at home.

The “New York City Housing Stock” has come of age and most of it was built before the American Disability Act became a reality. The majority of houses and apartments in the New York City area do not provide suitable living conditions for seniors and individuals with visual impairments. In the next series of blogs, we will briefly discuss how “lighting” and “contrast” can be used to adapt the home environment for individuals with low vision in order to make it safer and user-friendly. One prevalent issue in most consumers’ homes is the lack of contrast in their kitchens. I am always confronted with the “typical” white walls, light colored countertops, and white/ natural wood colored cabinets… I am sure you get the picture. The following suggestions will improve safety and functionality in the kitchen area:

1. Create a contrast between glassware and cookware utilized in the kitchen and the backsplash wall.

2. Stick to solid colors and avoid patterns.

3. Use combination lighting and avoid overhead fixtures.

4. Create color contrast between the floors, walls, and cabinetry.

5. Avoid materials or surfaces that readily reflect the light source causing glare.


Miller Calberto, MS, OTR/L, CAPS
Senior partner
Adapting Spaces, LLC

Holiday Season Safety Tips

December 5th, 2011 by admin


More than 80,000 people a year need hospital treatment for injuries such as falls, cuts and burns during the holiday season.

The holiday season is a time of joy when friends and family members come together to celebrate. However, large crowds, gifts, decorations and alcohol can be the perfect recipe for disaster at home. That is why we have compiled these safety tips so that you can enjoy a happy and safe celebration.

A Safer Kitchen: 

    • Use step stools/ ladders that have a rubber surface on each step to prevent falling 
    • Place anti-slip mats in front of the sink that are securely anchored to the floor
    • Place a small table in the kitchen to allow for easy access when performing cooking activities 
    • Place a chair in the kitchen to allow for frequent rest breaks  
    • Use oven mitts with rubber tips on them to prevent dropping hot objects
    • Use an adjustable stove top guard to prevent burns
    • Use a timer as a reminder to turn off the stove 


Safe and Easy Holiday Decorating:  

    • Buy pre-lit trees  
    • Fasten loose electric wires to walls
    • Remove or firmly anchor area rugs to the floor
    • Use automatic light timers to avoid leaving lights on. They are available for both indoors and outdoors. 
    • Roll up excess electrical cords and keep them away from high traffic areas. Do not run electrical cords under rugs.
    • Never keep an extension cord plugged in when it is not in use.
    • Inspect holiday lights and extension cords before decorating. Replace any that are fraying or damaged.
    • Use shatter-proof ornaments 

Please take a moment to click the link below and watch video.

Holiday decorating hazards


Miller Calberto, MS, OTR/L, CAPS
Senior partner
Adapting Spaces, LLC


September 28th, 2011 by admin

Just to keep things interesting, today I will talk about one of a slew of curious gadgets that are currently out in the market. These products may make life easier not only for older adults and people with disabilities, but for the general public as well. The other day, I went to the store, Bed, Bath and Beyond, to get some items for the house and while I was cruising through the aisles, I spotted a very interesting raised toilet seat. What caught my attention about this product by Ideaworks, was the fact that it lights up and works with noise detection sensors. I bought it because I wanted to try it out.


This product does not require any installation, besides putting in 3 AAA batteries and placing in on top of the toilet bowl. There are no tools needed.


  • Have you ever woken up in the middle of the night to use the bathroom and as you enter and turn on the light switch, you are blinded by the overhead light? Well, this was the first good impression I had with this raised toilet seat. The soothing light turns on as you enter the bathroom providing you with enough light to make use of it, while at the same time, sparing your eyes from the uncomfortable blinding moment. Unlike in previous occasions, I was able to return to bed and resume my sleep without any difficulty. I just think that if it was able to make me feel this comfortable and safe, I am sure it could do the same for an older adult.
  • Another benefit from this product is its height. It allows the user to come from a sit to stand position more easily. It would be good for people with hip problems or hip surgeries, as well as, for seniors to help them regain their balance more easily.
  • One more benefit from this product is that the batteries seem to last forever. It has been more than two months since I started using this toilet seat and the lights are still turning on.


  • I would say that one of the issues that I found with this product is that since it does not firmly attach to the toilet bowl, there is some wiggle room that may make it feel unsafe. I tried shifting weight in all directions and the seat did not come loose. However, because of the slight separation between the raised toilet seat and the toilet bowl, it can give that sense of insecurity.
  • Another issue that I consider to be a drawback is the fact that you cannot put the toilet seat cover down since the height of the toilet seat does not allow for it.

Overall, I think this product maybe a good option to look into if you want your bathroom to be more user friendly without the institutional look. And for those that may have problems coming to a standing position, this maybe a good alternative. It is priced at 49.99 and I believe that you should be able to buy it at any Bed, Bath and Beyond store.


Miller Calberto, MS, OTR/L, CAPS
Senior partner
Adapting Spaces, LLC

Helping individuals with physical limitations during natural disasters

September 13th, 2011 by admin

Last month ended with a reminder to all of us that Mother Nature is unpredictable and powerful. It reminded us that we need to be ready at all times, but what about our seniors and people with disabilities and chronic illnesses. What about those home bound individuals that cannot be reached by home care personnel? What about those individuals that are disabled and cannot evacuate because they live in an old building that is not ADA compliant. These were some of the questions I was left pondering with after the natural events that hit us towards the end of last month.

Everybody talks about preparedness, giving list after list of items that should be included within an emergency kit among other very useful ideas. However, what about making apartments and houses more accessible and user friendly for those with physical limitations. Based on a report published by the Kaiser Foundation in 2005 after Hurricane Katrina, it was found that 45 percent of those surveyed did not leave New Orleans because of a physical disability that made it impossible or they were caring for someone who could not leave. http://www.scribd.com/doc/265355/Survey-of-Hurricane-Katrina-Evacuees. More recently, AARP reported on the devastating effects the earthquake/tsunami had on the elderly population of that nation of Japan. According to the report, 47 of 113 residents of a retirement home died because they were not able to escape to the second floor. http://www.aarp.org/politics-society/around-the-globe/news-03-2011/seniors_hit_hardest_in_japan.html

I think that it is important to make homes and apartments, here in New York, more accessible and user-friendly not only for seniors and people with disabilities, but also to facilitate the work of first responders and caregivers in the event of an emergency. For instance, placing a hand rail with a fluorescent strip along a long corridor can assist with someone’s mobility during a black out. Or placing movement activated lights which are usually battery operated. For communication purposes, we could either have a large button or voice activated telephone connected to a land line, since cellphones have proven to be less than reliable during natural disasters. Another idea is to have a designated medicine cabinet or drawer with a pill dispenser; this can save someone’s life in case of an emergency. These are some quick and simple ideas that can go a long way in saving someone’s life during an emergency caused by a natural disaster.


Miller Calberto, MS, OTR/L, CAPS
Senior partner
Adapting Spaces, LLC


August 29th, 2011 by admin

Hello, I hope that everyone is doing well after such stormy weekend here in NYC. As promised, today, we will be talking about tax benefits, reverse mortgages, and other sources of financing for home modifications.

Personal Income Tax

Home modifications can be claimed as a medical expense by anyone if the criteria put forth by the IRS are fulfilled. Under IRS publication 502 (2010), “Medical and Dental Expenses” an individual can claim any expenses incurred in the acquisition of special equipment of home improvements made to a residence; as long as, these have been deemed medically necessary by a physician. A medical expense claim can be filed if the special equipment is for yourself, your spouse, or a qualifying dependent. The IRS has a broad definition of what is considered a dependent. In order to deduct 100% of the expenses as a medical expense, the IRS requires that the property value not be increased by the installation of special equipment or improvements.  If the property value is found to have been increased due to the improvements, you will only be able to claim some of the expenses.

This is a list of some home improvements that may qualify as a medical expense:

  • Constructing entrance or exit ramps for your home
  • Widening doorways at entrances or exits to your home
  • Widening or otherwise modifying hallways and interior doorways
  • Installing railings, support bars, or other modifications to bathrooms
  • Lowering or modifying kitchen cabinets and equipment
  • Moving or modifying electrical outlets and fixtures
  • Installing porch lifts and other forms of lifts (but elevators generally add value to the house)
  • Modifying fire alarms, smoke detectors, and other warning systems
  • Modifying stairways
  • Adding handrails or grab bars anywhere (whether or not in bathrooms)
  • Modifying hardware on doors
  • Modifying areas in front of entrance and exit doorways
  • Leveling the ground to provide access to the residence

If you would like to obtain more detailed information, please click on the link below:


Tax credit for the elderly or the disabled

Individuals aged 65 or older and retired with a permanent total or partial disability can claim this tax credit; as long as, they fulfill all other requirements put forth by the IRS on publication 524 (2010). Although, the tax credit is only $1,125.00, I think that every little bit counts. For more information about this tax credit, click on the link below


New York State Property Taxes

The New York State School Tax Relief Program (STAR) Enhanced is a tax credit that benefits seniors 65 years or older who own and live in their primary residence. To qualify, the household income cannot exceed $79,050. The maximum tax benefit varies depending upon location, time, and the level of assessment performed by municipality.  It is also based upon the annual adjustment rate based upon inflation. Generally speaking, senior home owners can save hundreds of dollars in taxes. For more information, click on the link below:



Reverse Equity Mortgage

Reverse mortgage is a financial vehicle that allows seniors to use home equity; in order to, cover living expenses or necessary projects such as home modifications. In order for a senior to be eligible for a reverse mortgage, he or she must have enough equity built into the house value.  They must also never have defaulted on a federal debt.  Reverse mortgages as opposed to regular mortgages, do not require a credit history check since the equity on the house is used as collateral.  Another important aspect of reverse mortgages is that they do not need to be repaid right away.  The amount of equity taken out on the house depends upon the client’s age, current interest rates, and the equity built on the house.  Last but not least, the only thing asked of the borrower is that they pay their taxes, insurance, and maintain their homes.  For more information, please click on link http://www.reversemortgage.org/


Miller Calberto, MS, OTR/L, CAPS
Senior partner
Adapting Spaces, LLC

How to fund home modifications for seniors and people with disabilities in New York? Part II

August 8th, 2011 by admin

Hello, everyone! As I continue to explore social services and public funding to pay for home modifications, I become more aware of the complexity to get access to this funding. It is this complexity that makes it even more gratifying for me to bring this information to you. Today, I will be talking about Workers’ Compensation, different types of insurance coverage as well as programs available through the Social Security Administration.

Worker’s Compensation
This is usually managed by the State in order to provide financial assistance for individuals injured in the workplace. Funds are provided in order to cover expenses such as: medical needs; vocational rehabilitation; and compensation for loss of function or death benefits to surviving dependents. Furthermore, worker’s compensation programs usually cover expenses related to modifications done to an existing home or a newly purchased accessible home. For more information, click on the links below:
New York Workers’ Compensation Alliance http://www.nyworkerscompensationalliance.org/
New York State Workers’ Compensation Board http://www.wcb.state.ny.us/

Insurance Coverage
There are three major types of insurance that may cover home modifications: Health, Life, and Long- Term Insurance. As more and more insurance companies are seeking ways to decrease health care cost and become more competitive, they are turning to options such as home modifications for answers. Many life and long-term insurance companies are including home modifications in their packages. For instance, “whole” life insurance policies build up cash value over time. These funds can be used at anytime for any purpose and are re-paid at very low rates. However, making an early use of these funds decreases the payout when the policyholder dies. Since not all long-term insurance companies have home modifications and provision of durable medical equipment as part of their policies, it is recommended that you ask your insurer beforehand. Below is a list of long- term insurance companies we have identified as offering home modifications within their insurance policies. For more information, click on the links below:
Genworth Life Insurance Company www.genworth.com
John Hancock Life Insurance Company www.johnhancocklongtermcare.com
State Farm Mutual Insurance Company www.statefarm.com
The Prudential Insurance Company of America www.prudential.com

Impairment Related Work Expenses (IRWE)
The Social Security Administration offers this program to individuals who receive Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). As the name implies, it is used by individuals with disabilities to cover the cost of home modifications needed in order for them to be able to work. If the person works outside their home, IRWE will cover the cost of modifications done to the outside of the house. If the person works from their home, IRWE will cover the cost of modifications done to the inside of the house. In most cases, the out of pocket cost of these services can be deducted from the amount of earnings used to determine SSI benefits. For more information, click on the link below:

Plan for Achieving Self Support (PASS)
PASS is a Supplemental Security Income (SSI) work incentive program that allows individuals with disabilities to work. It is a written plan of action in order to obtain a particular type of employment or open up a business. The money obtained will not affect your SSI eligibility and if you are already eligible to obtain SSI, your benefits will be increased to reimburse you for the money that you spent on your PASS. For more information about eligibility and/or requirements, click on the link below:

Overall, I think that it is important to understand that obtaining access to some of these programs and services is not clear cut; therefore, it is important to seek the advice of legal and social services professionals who can guide you in the process. Also, it is important that you talk to your doctor about your need for home modifications since many of them are not aware of this option. It is imperative that your doctor collaborates with this process since he/she will ultimately be providing the justification letter for you to get approved for home modifications. On the other hand, some Workers’ compensation administrators may not be too eager to pay for home modifications; however, if you are rightfully entitled to these benefits, home modifications and anything that you need to make you more comfortable and independent should be covered. Next week, we will be talking about tax benefits, reverse mortgages and other sources of funding for home modifications, so stay connected.


Miller Calberto, MS, OTR/L, CAPS
Senior partner
Adapting Spaces, LLC