Case Study • Care Transition
Home or Assisted Living?
After two rehab admissions in a row, a rehab-led home plan kept a couple in the home they built their lives in.
The Result
What Came Out of It
The family, the care manager, and Opt2Restore agreed unanimously on staying home. A stair lift was installed, the bedroom was modified, and 24-hour home health aide coverage was put in place right away, meeting the same goals that had made assisted living an option.
- 2back-to-back rehab admissions before the referral
- 2 weeksfrom first home visit to the family decision
- 24-houraide coverage in place at home
The Situation
A Decision Being Made Between Two Admissions
A woman with a progressive neurologic condition had two back-to-back rehab admissions after multiple falls and a fracture. Her husband, her primary caregiver, was under strain. The family was considering assisted living to cover her aide needs and give him relief.
A geriatric care manager brought Opt2Restore in. Within two weeks, we made two home visits between admissions, then joined the care manager’s family meeting at the rehab facility during her second stay. We presented a home plan side by side with assisted living, compared on safety, caregiver load, and the needs of the whole family.
What We Found
Four Areas Standing Between Her and Home
Entry
No railing on the exterior steps, including a step at the front walk.
Stairs
Rail on one side only, none at the bottom, and loose runners.
Bathroom
No full bath on the entry level, and an unsafe tub transfer with only a towel bar within reach. A shower door swung into the path beside an uncovered radiator, and a raised toilet seat had no grab bars.
Bedroom
A narrow walking path between the bed and furniture, over a worn rug, with limited transfer space.
The Plan
Safety Now, Function Next, Planning Later
- 1
Now: safety
Railings on both sides of the stairs, runners removed, grab supports in both bathrooms, motion lighting, and furniture moved for safe transfers.
- 2
Next: function
Stair lift for safe access between floors, and the primary bath converted to a low-threshold shower with rated supports.
- 3
Later: planning
First-floor bath expansion evaluated, laundry relocation priced, and equipment specified for future caregiving needs.
Facing a discharge decision? Find out whether home can work, and what it will take. Schedule an assessment, or call (516) 810-0330.
What Happened
The Couple Stayed Home
The couple stayed home, close to friends and the husband’s community. Specification sheets were issued, contractor bids were reviewed, and the couple hired a licensed contractor from the Opt2Restore vetted network under an uncompensated referral.
Completed work was verified against the specifications, and a twelve-month reassessment was scheduled as her condition progresses.
Why It Matters
A Clear Comparison Before a Crisis Forces the Choice
For Families
- Stay in the home you love, with a plan that works for the caregiver too.
- A clear comparison of home and assisted living, before a crisis forces the choice.
- Fall risks fixed first, and future needs planned and priced ahead.
For Care Managers and Discharge Teams
- A clinical home assessment delivered between admissions, in time for discharge planning.
- Physical therapy input on safety and caregiver load at the family meeting.
- Specifications, bid review, and verification of completed work.
Published with client permission. Identifying details have been removed and content condensed. Recommendations are specific to this client and home and are not a substitute for an individual assessment. Construction, permitting, and code compliance remain the responsibility of the licensed contractor and design professionals. Download the full case study (PDF)
Facing a Discharge Decision?
Find Out Whether Home Can Work
Families can schedule an assessment. Care managers and discharge planners can refer a client for a rehab-led home assessment before the discharge decision.