Supporting Independence with Mobility and Home Modifications
Play • 45 min

Dannelle speaks with occupational therapist, Emilia Bourland. In this episode, Emilia shares how we can reframe our approach to using mobility aides as tools of support and independence and how care partners should communicate needs and concerns for our own health and safety. Dannelle and Emilia discuss the importance of acknowledging our loved one’s fear of loss of independence and why support systems are essential to gaining the most effective tools and information as a caregiver.  

“The way might not look like we think it should look or like it used to look, but when we open up our mind to the possibilities, when we stay open-minded as to how something can happen, it's limitless.” - Emilia Bourland 



  • 03:31 Emilia’s three core values and how they connect to occupational therapy and caregiving 
  • 07:43 Educating people on caregiving by explaining the “how” and the “why” 
  • 10:07 How occupational therapists help with safety 
  • 13:21 An example of how an adaptation can help with transfers 
  • 18:46 Affordable places to buy durable medical equipment 
  • 21:24 How home health assessments can help improve accessibility 
  • 24:26 Paying for home health assessments with an occupational therapist 
  • 28:02 How to help loved ones adjust to integrating mobility aides 
  • 32:28 Examples of simple, inexpensive home modifications that will make life easier 
  • 37:02 Amelia’s passions outside of caregiving 

Takeaway Learnings

1. Balancing safety with support for our care partner’s independence can be so challenging. Using mobility devices, adaptive equipment, and home modifications can help create a care environment that reduces risk of injury for both care partners, while also empowering more self-reliance in those we care for. 


2. When we have the right information, we’re empowered to make better decisions. The disconnect between educational resources and the people who need them most is frustrating, but most importantly know that they exist, and may require a little digging to find what works. It may also be helpful to enlist a professional, or provide additional information like the Home Modification Information Network, which has been developed with support from the Administration for Community Living. On their site, you can find educational materials, programs, policies, funding, and more resources by state. 


3. If the person we care for is in medical crisis or rehabilitation, that’s an optimal time to talk with an occupational therapist or other appropriate care specialist to do a home safety assessment. 


Actionable Tips

1. Emilia talks about the difference our approach can make to help reframe how loved ones can understandably feel about using mobility aides. The default feeling is often that using a device like a walker or lift aid represents a taking away or loss of independence. When we’re having these conversations, taking time to first think about how we present choices and their benefits can be helpful – like, “I want to support you in doing what you can for yourself for as long as possible”. So, we’re addressing the fear and grief around loss of independence along with a potential help.  


2. For those of us who provide educational support, training, or instruction, as care professionals, it’s important we’re clear about our role – which is not about trying to fix a single specific problem or situation, but rather asking ourselves, “What information can I share to help care partners make more informed decisions now and in future?” This is empowerment. 


3. We need to take our physical strain and limitations seriously. Ask yourself, your support group, or consult with a professional about what kind of device aids, tools, or other assistance can help ease the strain of transfers or other daily caregiving activities. 

About Emilia Bourland

Emilia Bourland, OTR, ECHM is the president and founder of Higher Standards Caregiver Training, as well as co-founder of The Purpose Project. She has been an occupational therapist for over 10 years, working in adult settings ranging from home health to the ICU, and everywhere in between. Emilia has worked as adjunct faculty at Texas Woman's University, teaching masters level occupational therapy students both hands on clinical skills and advanced professional reasoning. She has taught safe handling and care skills to nurses, caregivers, and clients/patients since the start of her career as an occupational therapist, providing direct training to thousands of people, in addition to logging tens of thousands of hours in her own clinical practice. Emilia holds her master's degree in occupational therapy from Texas Woman's University and her Executive Certificate in Home Modification from the Leonard Davis School of Gerontology at the University of Southern California. She is nationally registered with the National Board of Certification of Occupational Therapists and is licensed as an occupational therapist in the state of Texas. Emilia has been academically published in "Topics In Stroke Rehabilitation," and is the creator of "The Guide to Successful Aging" Planning Tool. 

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