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  • Close to Home: Occupational Therapist, Kate Sheehan from The OT Service, explores with us the importance of putting the client at the heart of the home design process.
Close to Home: Occupational Therapist, Kate Sheehan from The OT Service, explores with us the importance of putting the client at the heart of the home design process.

When it comes to our homes, there really is no place like it. The global pandemic and long stretches of lockdown has brought into sharp focus just how important the space and functionality of a home is to all our lives. But for those living with severe disabilities, good home design and architecture is so much more. It’s about independence and control; the ability to engage in family life and the ability to create a home environment that can help give them a sense of purpose.

Kate Sheehan is an experienced Occupational therapist and Director of The OT Service. She works with catastrophically injured clients to help them achieve exactly what they want and need from the design of their adapted home.

Getting the design of an accessible home right takes time.

Getting the design right takes time” says Kate. “Whist time constraints can be a factor, by allowing OT’s the time to fully assess and work with the client to properly understand their goals and needs, it’s more likely that the design of their new home will be exactly right for them”.

Kate advocates early client conversations to help with this process. “There is a grieving process as clients come to terms with their injuries, and holding on to what’s important to them – usually their home and family life – is something that has to be handled sensitively”.

The process of adapting a home or building a new one can be an area where clients can feel more in control of their lives, when in other areas they may feel powerless. Involving clients in the design process includes talking to them about how the design of the home can:

  • make them more independent and therefore less reliant on carers
  • facilitate them in engaging fully with family life
  • allow them to continue with or take up new hobbies
  • help to express themselves


When someone suffers a catastrophic injury, it can feel like they have had their identity stripped away from them. Having a hand in the design of their new home can be incredibly empowering. If a client wants to express themselves by having orange walls emblazoned with cartoon figures, or have a space created where they can paint on large canvas, then we must do everything we can to help clients achieve their goal”.

By understanding what brings purpose to an individual’s life, homes can be designed around this. For example, a client might want to be able to look after their grandchildren, chair committee meetings or have a storage area for their off-road wheelchair. These are all activities that give their life meaning but where good design can support them.

Space, space and space!

One thing I have learnt about working with architects and clients when designing their homes is that it’s crucial to create enough space to allow the client to move and store their equipment. It’s not uncommon for me to return to a client’s house to find they have had to create additional storage space in the garden!”

When it comes to moving around their home, its important that the design of kitchens, bedroom and outside spaces accommodates any restrictions of movement that a client may have. For example with  spinal cord injury clients, an individual with good upper limb strength and movement may be able to navigate easily around tight corners, others may require a larger turning space to get about their home. It is this attention to detail in the design that can make a huge difference.

No two clients are the same, and as such every building must be carefully designed around the needs and circumstances of an individual. “A home is an expression of ourselves, therefore OT, disability architects and other professionals must all work collaboratively to achieve the very best for clients.”


Kate Sheehan recently featured on 'Finding Derek', the ITV Documentary where Journalist and Presenter Kate Garraway allowed cameras into her home to document her story as her husband battles Covid-19.

Kate worked with Kate Garraway and Derek to design and adapt their home to meet his needs.

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