Transforming Independence in a Care Home

She knew she needed to keep moving. With Parkinson’s disease, regular mobilisation is essential for maintaining strength and slowing decline. Her personal goal was simple: to get up from her chair, walk to her wardrobe, and return independently. But despite her motivation and understanding, she couldn’t do it. Every time she tried, something in her environment got in the way.

The Environment

When our occupational therapist visited, the first thing she assessed was not the resident herself but the room around her. One of the unique strengths of occupational therapy is this holistic approach — looking beyond a person’s diagnosis to understand how their physical environment, routine, and surroundings may be helping or hindering their independence.

In a care home setting, rooms are often arranged for the convenience of staff rather than the autonomy of residents. Furniture gets positioned for ease of access during care tasks, and over time, small decisions about where things are placed can quietly erode a resident’s ability to do things for herself.

What We Found

Three environmental barriers were identified within minutes. First, her chair was too low. For someone with Parkinson’s, where muscle stiffness and reduced power are already a challenge, a low seat makes standing almost impossible without help. Second, an over-bed table was positioned directly in front of her, blocking the path to her walking frame. She had weakness in one shoulder, which meant she could not easily push the table aside. Third, her Zimmer frame was routinely placed in front of the table rather than beside her chair — effectively out of reach at the very moment she needed it.

None of these barriers were intentional. Each one had simply gone unnoticed.

The Solution

The changes were straightforward. We worked with the care home team to source chair raisers already available on site and added an extra cushion, bringing the seat to a height from which she could stand independently. We repositioned the over-bed table to her stronger side so she could move it herself when needed. And we rearranged the furniture in her room so that her walking frame sat beside her chair, within easy reach, with a clear path to her wardrobe.

No new equipment was purchased. Nothing was ordered or requisitioned. The solution was entirely about rethinking the layout of what was already there.

“Just by rearranging furniture and looking at it through an OT lens, we were able to make her more independent.”

Within the same visit, she was able to stand from her chair, access her frame, and walk to her wardrobe and back — the goal she had set for herself. Staff were guided on the optimal positioning so that the arrangement would be maintained after each care visit.

Beyond the Room

Environmental reviews are only one part of what occupational therapy offers in a care home setting. Many residents experience social isolation that may not be immediately obvious. They spend time alone in their rooms and never join group activities — not because they choose not to, but because specific barriers prevent them. Those barriers are unique to each individual: it might be anxiety, sensory overload, difficulty with transfers, or simply not knowing what is available.

An OT can identify these barriers through individualised assessment and work with staff to remove them, helping residents engage in meaningful social participation.

There is also the often-overlooked challenge of transition into a care home. Moving from one’s own home involves significant losses — loss of independence, loss of choice, and loss of familiar surroundings. An occupational therapist can support this transition by ensuring the new environment feels personal, that routines are preserved where possible, and that the move is managed in a way that is truly individual and holistic.

What This Means for Care Homes

For care home managers, this case illustrates the tangible value of regular occupational therapy input. A single environmental review identified barriers that had gone unnoticed and restored a resident’s independence without any additional cost. Multiply that across an entire home, and the impact on resident wellbeing, falls risk, and staff workload can be substantial.

Regular OT involvement can support your home in three key areas: environmental reviews that identify and resolve barriers to independence room by room, social isolation identification that helps residents engage more fully in community life, and transition support that makes admission a more positive experience for new residents and their families.