Home modifications for older people: what they are and how to get them

Home modifications are physical changes to a house that make it safer and easier to use as someone's abilities change. They range from a grab rail beside the toilet to rebuilding a bathroom as a level-access shower. The purpose is straightforward: to let a person keep living in their own home, doing things for themselves, rather than moving somewhere else because the building has become the obstacle.

They are worth understanding as their own category, separate from equipment. A shower chair is equipment, something you place in the room. A modification changes the building itself, such as removing the step into the shower. Both can help, and an assessment will often recommend a combination.

Minor and major modifications

The distinction matters because it affects who assesses it, how it is funded and how long it takes.

Minor modifications are small, low-cost, and usually installed in a single visit. They include grab rails and handrails, lever taps that can be used without gripping, non-slip flooring or strips, a handheld shower, raised toilet seats, better lighting, removing trip hazards, and small ramps or threshold wedges.

Major modifications are structural, cost considerably more, take longer, and often need a builder and sometimes council approval. They include full bathroom conversions to level-access showers, widening doorways for a wheelchair, permanent ramps, stair lifts, and kitchen changes such as lowering benches.

Most people need only minor changes, and those are also where the greatest safety benefit per dollar usually sits.

Start with an occupational therapist

The right starting point is almost always an assessment by an occupational therapist, usually called an OT. This is not a bureaucratic hurdle; it is the step that makes the rest work.

An OT looks at the person and the house together. They watch how someone actually moves through their own home, getting out of bed, into the shower, on and off the toilet, in and out of the kitchen, and identify where the risk really is. That frequently differs from what the family assumed. They then recommend specific changes, in specific places, at specific heights, which matters more than it sounds: a grab rail fitted in the wrong position can be worse than none at all, because it invites a person to pull on something that does not support the movement they are making.

An OT report is also what funding bodies want to see, so the assessment is usually a practical requirement as well as a clinical one. Our guide to allied health for older people explains how to access an OT and what other therapists do.

How they get funded in Australia

Which pathway applies depends mainly on age and circumstances.

Through the aged care system. For people aged 65 and over, the aged care system is the usual route, and it starts with an assessment arranged through My Aged Care on 1800 200 422. Entry-level support can cover minor modifications, while an ongoing package at home can fund larger work, with the level of support depending on assessed need. Contribution arrangements apply and depend on your circumstances, so ask My Aged Care or the provider what you would be expected to pay before work is scheduled. Our guide to who is eligible for a Home Care Package covers how the assessment process works.

Through the NDIS. For people under 65 with permanent and significant disability, home modifications can be funded as part of an NDIS plan. Major modifications require an assessment by a suitably qualified OT and, for significant building work, quotes and NDIS approval before anything starts. Minor changes are usually more straightforward. The NDIS line is 1800 800 110, and our guide to what the NDIS covers sets out the support categories.

Through DVA. Veterans and some dependants may be able to access modifications through the Department of Veterans' Affairs, with its own assessment process.

Privately. Anyone can pay for the work themselves, and for a couple of grab rails this is often simpler and faster than waiting for an assessment. Even then, an OT's advice on placement is worth having.

Do not commit to major work before funding is confirmed. Approval is generally needed in advance, and work already completed is usually not reimbursed.

Practical points people often miss

If you rent, you need the owner's written permission. Most tenancy laws in Australia have provisions covering modifications for disability or safety, and a landlord's ability to refuse reasonable changes can be limited, but the process still starts with a written request. Ask early, because it can take time.

Use tradespeople who do this work regularly. A grab rail must be fixed into a structural stud or with proper fixings to take a person's full body weight; screwing one into plasterboard alone is genuinely dangerous. Ask whether the installer has done aged care or disability modifications before.

Think slightly ahead, not just about today. If a bathroom is being rebuilt anyway, building in a level-access shower now costs far less than doing it again in three years.

Do the cheap things immediately. Better lighting, especially between the bed and the toilet, removing loose mats, and clearing walkways cost almost nothing and can be done this weekend while an assessment is pending.

To find providers who can help, browse home care services near you on Our Mate.

Frequently asked questions

What are the most common home modifications for older people?

Grab rails in the bathroom and toilet, handrails on steps and in hallways, non-slip flooring, lever taps, raised toilet seats, better lighting, and removing trip hazards such as loose mats. Larger jobs most often involve converting a shower to level access or installing a permanent ramp.

Do I need an occupational therapist assessment?

For most funded work, yes, and it is strongly advisable in any case. An OT identifies where the actual risk is and specifies exactly where and how each item should be installed. Funding bodies generally require an OT report before approving anything beyond very minor items.

Will aged care or the NDIS pay for home modifications?

Both can. For people 65 and over, the aged care system is the usual route via an assessment arranged through My Aged Care on 1800 200 422. For people under 65 with permanent and significant disability, modifications can be funded through an NDIS plan. Contribution arrangements and approval requirements differ, so confirm what applies before work begins.

Can I make modifications to a rental property?

Usually, but you need the owner's written permission first. Tenancy laws across Australia include provisions covering changes needed for disability or safety, and there are limits on refusing reasonable requests. Put the request in writing early, as approval can take time.

How long do home modifications take?

Minor items such as grab rails can often be installed within days once approved. Major structural work takes considerably longer, because it involves an OT assessment, quotes, funding approval, sometimes council approval, and then the building work itself. Start the process well before the need becomes urgent.