Translating high quality research specific to better design and building practice

Occasional Research Papers

HMinfo Occasional Research Papers are individually commissioned research papers on existing or emerging issues in home design and home modifications for older people, for people with disability, or for carers. Read more

Occasional Research Paper Search


Home Modifications and Their Impact on Waged Care Substitution

Authors: Bridge, C., Carnemolla, P.
Published: 11th July 2014
Audience: Government/NGOs/Peaks, Industry, Librarians/Researchers/Students
ISBN: 978-0-7334-28


There is a relationship between home modifications and community care provision. This research seeks to better understand the potential of home modification services to substitute for waged community care services. This is an important investigation for the purposes of exploring innovative and cost effective care solutions. The need for such research is high given the demands on care labour markets within the context of the challenges presented by Australia's ageing population, of whom a majority are living in older, inaccessible housing. However the potential for home modification substitution has been under explored.

This paper reviews current literature on home modifications and care substitution and is followed by case study examples which examine the relationship between care requirements and home modifications. Each case study demonstrates cost impacts and illustrates the variables affecting home modification and waged care costs. The case-studies utilise data from publicly available Australian data reported by Ageing, Disability and Home Care, Department of Human Services NSW (ADHC), as well as details obtained from actual case files which were supplied by Home Maintenance and Modification Service providers , a sector of the Australian Home and Community Care Program. Initial values derived from the case studies suggest that Home Modifications have the potential to be a cost effective component of a consumer directed community care approach. The case studies in this report introduce the concept of comparisons horizontally across the care stream networks. They serve to illustrate the potential of substituting waged care with self-care supported by home modifications however definitive values in the case studies were constrained by a lack of available data spanning the care streams.

In conclusion, the research suggests that home modifications are an under explored opportunity for substituting waged care through self care. However more longitudinal data collection between health profiles, care costs and home modification is required for further study in order to paint a more detailed picture of the interaction between home modifications and care provision.

Publication History

1st edition Home Modifications and their impact on waged care substitution by Phillippa Carnemolla and Catherine Bridge, April 2011.  Reprinted July 2014

Table of Contents


Publication History 


Executive Summary 


Project Aims 

Overview of results 


1. Introduction 

Why investigate the substitution of care? 

Background to the research 

Scope of work 

Care Terminology 

2. Research Methodology 

Literature Review  

Case Study Approach 

Cost Analysis 

How care costs were calculated 

How care hours were calculated 

Home modification cost data 

3. Literature Review  

General Structure of the Review  

Community Care 

Community Care Models 

Consumer Directed Care 

Australian Community Care Services 

Demand for community care 

Home Modifications and Maintenance Services (HMMS)

Who is currently using Australian home modification services? 

Demand for home modifications 

Significance of the home environment

Home modifications and accessible environment

How home modifications improve accessibility 

Person Environment Fit

Home modifications and safety 

Are there situations where home modifications do not benefit? 

Home modifications and their impact on care needs 


Self-care: The added value of independence 

Self-care and Bathing 

Is self-care always the ultimate goal? 

Self-care and learned helplessness 


Reads: 3038
Downloads: 583

Feedback Form

You may use the following form to send us anonymous feedback on this publication.

* Denotes required fields


To confirm that you are not an automated application, we ask that you answer the following simple question.

True or False: Tea and Coffee are drinks