Summary
This episode is an audio version of our blog, “Reframing Hoarding as Occupation: What Occupational Therapists Bring That Nobody Else Can.” Sue Doyle, PhD, OTR/L walks through an occupation-based lens on hoarding disorder so you can move beyond overwhelm and judgment, use structured tools, and design person-centered interventions that truly support safety, function, and meaningful change.

In this episode, we cover:

• Why hoarding disorder is often misunderstood—even within OT—and how reframing hoarding behaviors (collecting, acquiring, arranging, saving) as occupations that meet real needs for safety, identity, continuity, and connection can transform your clinical perspective and therapeutic alliance.
• The unique multi-dimensional role of occupational therapy in hoarding work, including attending simultaneously to psychological factors (attachment, decision-making), environmental risks (clutter, fire risk, falls), functional impact (ADLs and access), and meaningful roles and routines.
• Practical OT tools and strategies you can start using now, such as the Hoarding Rating Scale, Clutter Image Rating, and ADL-H, plus occupation-focused goal setting and motivational interviewing approaches that align interventions with what the client most wants to be able to do—not just what others want them to discard.

Read the full blog and see visuals:

• Read the article: https://thehomeaccessibilitytherapist.blog/2026/06/24/reframing-hoarding-as-occupation-what-occupational-therapists-bring-that-nobody-else-can/
• View any photos, diagrams, or checklists mentioned in this episode on the blog.

Related trainings and courses:

• Certified Home Accessibility Therapist (CHAT): https://www.thehomeaccessibilitytherapist.com/CHAT
• Occupational Therapy for Persons with Hoarding Disorder: https://www.thehomeaccessibilitytherapist.com/HoardingCourse
• All Courses: https://www.thehomeaccessibilitytherapist.com/courses

Stay connected:

• Website: https://www.thehomeaccessibilitytherapist.com/
• Blog: https://thehomeaccessibilitytherapist.blog/
• Join the newsletter: https://www.thehomeaccessibilitytherapist.com/Newsletter
• Join our Facebook Group: https://www.facebook.com/groups/homeaccessibilitysafety
• Follow on LinkedIn: www.linkedin.com/in/susan-doyle-38bba3178

Summary

In this Therapist Thursday episode, Sue Doyle, PhD, OTR/L talks with Consuela Marshall, an occupational therapist with 30 years of experience—26 of those in home health—about shifting from traditional home health into mission-driven fall prevention, home safety coaching, and nonprofit work in the Baton Rouge area. Consuela shares how repeated fall-related home health episodes, insurance and PDGM constraints, and her passion for lower-resource communities led her to rethink “textbook” home modifications and build a foundation focused on practical, affordable fall prevention education for families and caregivers.

What you’ll learn in this episode:

How Consuela’s decades in home health, frustration with PDGM and Medicare Advantage visit limits, and seeing the same clients return after multiple falls pushed her to focus her OT career on proactive fall prevention and home safety instead of only post-fall rehab.

Practical, client-centered strategies she uses to make home safety both relevant and affordable—such as reframing “home modifications,” respecting cherished items, using creative low-cost solutions (like a screen-door handle in a difficult bathroom), and tailoring recommendations for families with very different financial and housing realities.

Business, advocacy, and nonprofit insights on moving beyond cash-pay and Part B, writing a falls book, founding a 501(c)(3) to serve under-resourced older adults, pursuing a master’s in nonprofit administration, building community partnerships and sponsorships, and encouraging other therapists to “start where you are” with home mods—even before you have every contractor or tool lined up

Guest details and links:

Consuela Marshall

• Website: https://www.findingafoothold.com/
• LinkedIn: linkedin.com/in/consuela-marshall-ot-chat-caps-cdp-3a136a1b9

Resources mentioned:

• Certified Home Accessibility Therapist (CHAT): https://www.thehomeaccessibilitytherapist.com/CHAT
• All Courses: https://www.thehomeaccessibilitytherapist.com/courses

Connect with The Home Accessibility Therapist:

• Website: https://www.thehomeaccessibilitytherapist.com/
• Blog: https://thehomeaccessibilitytherapist.blog/
• Join the newsletter: https://www.thehomeaccessibilitytherapist.com/Newsletter
• Join our Facebook Group: https://www.facebook.com/groups/homeaccessibilitysafety
• Follow on LinkedIn: www.linkedin.com/in/susan-doyle-38bba3178

Summary

In this office hours episode, Sue Doyle, PhD, OTR/L, focuses on how to actually find and connect with the people in your community who can send you ideal home modification clients. She walks through potential referral sources, how to frame your unique OT value, and simple, relationship-based steps to start building a steady stream of home mods referrals.

Questions answered in this episode:

Who are the key professionals, agencies, and organizations that are already seeing your ideal home mods clients before you, and how can you identify them in your own community?

How do you clearly communicate the unique value of OT-led home assessments—beyond ADA checklists and contractor recommendations—so referral partners understand why they should send clients to you?

What concrete steps can you take to nurture referral relationships over time (multiple “touches,” education, and follow-up) without feeling like a full-time salesperson?

Mentioned resources and links:

• Certified Home Accessibility Therapist (CHAT): https://www.thehomeaccessibilitytherapist.com/CHAT
• Courses & Memberships: https://www.thehomeaccessibilitytherapist.com/courses
• Any handouts, checklists, or blog posts referenced:

Submit a question for a future episode:

• Use the question form here: https://www.thehomeaccessibilitytherapist.com/SubmitQuestion
• Or email your question to: sue@thehomeaccessibilitytherapist.com

Connect with The Home Accessibility Therapist:

• Website: https://www.thehomeaccessibilitytherapist.com/
• Blog: https://thehomeaccessibilitytherapist.blog/
• Join the newsletter: https://www.thehomeaccessibilitytherapist.com/Newsletter
• Join our Facebook Group: https://www.facebook.com/groups/homeaccessibilitysafety
• Follow on LinkedIn: www.linkedin.com/in/susan-doyle-38bba3178

Summary

This episode is an audio version of our blog, “From One-Off CEUs to a Real Growth Plan: Professional Development for OTs in Home Safety and Home Modifications.” Sue Doyle, PhD, OTR/L unpacks why random CEUs leave you feeling no more confident in home safety and home mods, and shows you how to build an intentional 6–12 month learning plan that actually moves you toward mastery instead of just meeting licensure requirements.

In this episode, we cover:

• The problem with scattered, last-minute CEUs: how discount-driven or convenience-based course choices create fragmented knowledge, low retention, and ongoing uncertainty around complex areas like home accessibility, funding, documentation, and multi-factor home visits.
• A simple but powerful growth-plan framework with three pillars—a clear destination, a realistic 6–12 month timeline, and structured learning tracks (clinical foundations, environmental/design knowledge, and systems/advocacy) that build depth in home safety and home modifications instead of one-off exposure.
• Step-by-step guidance to map your own plan: self-assessing your current gaps, choosing a focused goal, selecting 3–5 aligned learning activities, intentionally applying what you learn with real clients, and using reflection and check-ins (illustrated through “Jordan,” an OT case example) to turn CEUs into real competence and confidence in the home.

Read the full blog and see visuals:

• Read the article: https://thehomeaccessibilitytherapist.blog/2026/05/19/from-one-off-ceus-to-a-real-growth-plan-professional-development-for-ots-in-home-safety-and-home-modifications/
• View any photos, diagrams, or checklists mentioned in this episode on the blog.

Related trainings and courses:

• Certified Home Accessibility Therapist (CHAT): https://www.thehomeaccessibilitytherapist.com/CHAT
• Disaster Preparedness, Response, and Recovery: A role for OT https://www.thehomeaccessibilitytherapist.com/Disastercourse
• All Courses: https://www.thehomeaccessibilitytherapist.com/courses

Stay connected:

• Website: https://www.thehomeaccessibilitytherapist.com/
• Blog: https://thehomeaccessibilitytherapist.blog/
• Join the newsletter: https://www.thehomeaccessibilitytherapist.com/Newsletter
• Join our Facebook Group: https://www.facebook.com/groups/homeaccessibilitysafety
• Follow on LinkedIn: www.linkedin.com/in/susan-doyle-38bba3178

Summary
This episode is an audio version of our blog on “seeing safely” with aging eyes. Sue Doyle, PhD, OTR/L walks through how age-related vision changes and cataracts interact with real-world home environments so you can incorporate lighting, contrast, and clutter-focused modifications into your assessments and reduce fall risk in a practical, low-cost way.

In this episode, we cover:

• What actually happens to vision with aging and cataracts—reduced contrast sensitivity, increased glare, slower light adaptation, and hazier vision—and why beige-on-beige environments, shiny floors, and inconsistent lighting can turn otherwise strong, balanced older adults into high fall-risk clients.
• Evidence-informed principles for “seeing safely,” including prioritizing even, glare-free lighting along key paths, using contrast strategically on stairs, grab bars, and switches, simplifying visual clutter, and making important safety features visually louder than background distractions.
• Room-by-room strategies for entries, hallways, stairs, bathrooms, bedrooms, and kitchens that you can plug directly into your next evaluation—plus a quick clinical vision-and-environment checklist to help you systematically capture vision-related risks rather than treating falls as only a strength or balance problem.

Read the full blog and see visuals:

• Read the article: https://thehomeaccessibilitytherapist.blog/2026/06/03/seeing-safely-at-home-aging-eyes-cataracts-and-evidence-informed-home-modifications/
• View any photos, diagrams, or checklists mentioned in this episode on the blog.

Related trainings and courses:

• Certified Home Accessibility Therapist (CHAT): https://www.thehomeaccessibilitytherapist.com/CHAT
• Disaster Preparedness, Response, and Recovery: A role for OT https://www.thehomeaccessibilitytherapist.com/Disastercourse
• All Courses: https://www.thehomeaccessibilitytherapist.com/courses

Stay connected:

• Website: https://www.thehomeaccessibilitytherapist.com/
• Blog: https://thehomeaccessibilitytherapist.blog/
• Join the newsletter: https://www.thehomeaccessibilitytherapist.com/Newsletter
• Join our Facebook Group: https://www.facebook.com/groups/homeaccessibilitysafety
• Follow on LinkedIn: www.linkedin.com/in/susan-doyle-38bba3178

Summary

In this Therapist Thursday episode, Sue Doyle, PhD, OTR/L talks with Martha Pack, an occupational therapist and CHAT trained home modifications specialist based in Knoxville, about building a business focused on aging in place and caregiver support. Martha shares how her years in nearly every OT setting, combined with home health experience during COVID, led her to create a dedicated home mods practice that tailors environments for older adults in private homes and senior living communities.

What you’ll learn in this episode:

How Martha’s journey through school systems, hospitals, outpatient rehab, skilled nursing, and finally home health sparked her passion for home modifications, including the “aha” moment of simply repositioning a suction grab bar and realizing the impact of placement, design, and true accessibility.

Practical strategies she uses now, from acting as the communication bridge between clients and contractors, to providing caregiver education, planning for the “journey of aging,” and using grant-funded programs to create affordable, customized aging-in-place solutions in both private homes and facilities.

Business and networking insights on moving from “side hustle” to full business, deepening her expertise through, CHAT, CAPS, ECHM, and leveraging in-person networking and senior resource groups, and partnering on county grants like OAHMP to grow a sustainable practice while retaining the autonomy she wouldn’t trade to return to traditional employment.

Guest details and links:

• Martha Pack
• Website: adaptandstay.com
• LinkedIn: linkedin.com/in/martha-pack-otr-l-cdp-caps-echm-chat-drs-5a4501123

Resources mentioned:

• Certified Home Accessibility Therapist (CHAT): https://www.thehomeaccessibilitytherapist.com/CHAT
• All Courses: https://www.thehomeaccessibilitytherapist.com/courses

Connect with The Home Accessibility Therapist:

• Website: https://www.thehomeaccessibilitytherapist.com/
• Blog: https://thehomeaccessibilitytherapist.blog/
• Join the newsletter: https://www.thehomeaccessibilitytherapist.com/Newsletter
• Join our Facebook Group: https://www.facebook.com/groups/homeaccessibilitysafety
• Follow on LinkedIn: www.linkedin.com/in/susan-doyle-38bba3178

Summary

In this office hours episode, Sue Doyle, PhD, OTR/L, unpacks how Medicare and reimbursement really work when you’re providing home safety and home modification services. She explains what counts as medical necessity, when you can and cannot bill, and how to protect both your clients and your practice while still offering valuable cash-based options.

Questions answered in this episode:

When is a home safety or home modification assessment considered medically necessary and covered, and when is it purely aging-in-place or preventative and not covered?

How do Medicare rules like mandatory claim submission, fall-risk guidelines, and quality measures (such as MIPS 154 and 155) affect what you can bill for and how you document your services?

What do therapists need to know to ethically offer cash-based home mods, set clear policies, and distinguish covered from non-covered services in day-to-day practice?

Mentioned resources and links:

• Certified Home Accessibility Therapist (CHAT): https://www.thehomeaccessibilitytherapist.com/CHAT
• Courses & Memberships: https://www.thehomeaccessibilitytherapist.com/courses
• Any handouts, checklists, or blog posts referenced:

Submit a question for a future episode:

• Use the question form here: https://www.thehomeaccessibilitytherapist.com/SubmitQuestion
• Or email your question to: sue@thehomeaccessibilitytherapist.com

Connect with The Home Accessibility Therapist:

• Website: https://www.thehomeaccessibilitytherapist.com/
• Blog: https://thehomeaccessibilitytherapist.blog/
• Join the newsletter: https://www.thehomeaccessibilitytherapist.com/Newsletter
• Join our Facebook Group: https://www.facebook.com/groups/homeaccessibilitysafety
• Follow on LinkedIn: www.linkedin.com/in/susan-doyle-38bba3178