Field Test of the Cougar Home Safety Assessment for Older Persons Version 1.0

Abstract

After reviewing the literature on environmental safety and existing home safety evaluation tools, the researchers developed the Cougar Home Safety Assessment Version 1.0 (Cougar 1.0). This assessment is a 56-item tool for identifying environmental safety hazards in the homes of older persons. The first purpose of this study was to develop and field test the Cougar 1.0 to determine its inter-rater reliability and validity. The second purpose was to identify specific environmental safety hazards in the residences of older persons during the field test. Three graduate occupational therapy students administered the Cougar 1.0 in the homes of 14 older persons within one county of northeastern Pennsylvania. The instrument was found to have a moderate level of inter-rater reliability, as Cohen’s Kappa for the ratings of the 3 raters was .506. Percent agreement between the three raters was 90 percent. The field test found that the most frequently unsafe aspects of the homes were: a lack of grab bars near toilets; no emergency numbers posted near phones; the presence of non-grip throw rugs; lack of fire extinguishers; and lack of step stools. Participating residents and occupational therapy home safety specialists provided positive feedback regarding the content validity of the Cougar 1.0. This research suggests that the use of this instrument by occupational therapists may prevent client injuries in the home.

Home Modification Assessments: Clinical Utility and Treatment Context

“…Basic home safety interventions are intended to increase the client's safety at home through strategies such as removing fall hazards, installing smoke detectors, adjusting water temperatures, and addressing electrical problems (Fisher, Civitella, & Perez, 2006). These interventions do not require professional design or installation, and many, if not all, of the recommended modifications may be implemented by the client or family members.…”

“…The assessment addresses the environment and not the client's ability or actual performance (Fisher, Civitella, & Perez, 2006). One weakness of the Cougar is that it does not address the physical or mental ability of the client .…”

“…The occupational therapist will be escorted through the resident's home or apartment to complete the assessment (Fisher, Coolbaugh, & Rhodes, 2006). The Cougar 4.0 is a comprehensive assessment that addresses fire hazards; emergency communication and preparation; medical supplies and medication management; electrical safety; water temperature; kitchen safety; and fall hazards in hallways, bathrooms, closets, and parking areas (Fisher, Civitella, & Perez, 2006). The assessment includes 78 criteria that can be measured by observation, testing of certain home items, and asking the resident.…”

A field test of the Cougar Home Safety Assessment (version 2.0) in the homes of older persons living alone

“…We felt that the Cougar 1.0 assessment was adequate, but was not optimal, in this regard. A strength of the Cougar 1.0 is that it possesses acceptable interrater reliability as demonstrated by Fisher, Coolbaugh, et al (2006). In their study, percent agreement of three raters was 90%.…”

“…In an effort to provide occupational therapists with such a tool, the purpose of this study was to develop the Cougar 2.0. Our plan was to revise the Cougar 1.0 — a home safety assessment developed for a prior study in which the interrater reliability of the Cougar 1.0 was established (Fisher, Coolbaugh, & Rhodes, 2006). Our revisions were guided by the literature, our own critique of the assessment, and feedback obtained from the residents and occupational therapy home care specialists involved in the prior study.…”