How to Scope a Job With the User and a Family Member Present
Why this matters
On most accessibility jobs the person who calls is not the person who lives there. It is the son who lives two states away and saw his father fall on a video call, or the daughter who drives over every Sunday. They are worried, they are often paying, and they arrive with a solution already chosen. The parent, meanwhile, may want something different, or nothing at all. Scope the job with whoever talks loudest and you install the son's stairlift in a house where the father keeps taking the stairs, because nobody asked him how he wanted to get up them.
The rule this article works from: the decision belongs to the person who lives there, and the family's input is part of how they make it. Both halves matter. Shutting the family out loses the person who sees the bad days you never will. Letting them decide loses the job's whole reason to exist.
Whether the person can make the decision at all is not your call and is not covered here. That belongs to the Safeguarding group: see related, Capacity to Contract: The Signs and What to Do and Working With a Power of Attorney or Guardian.
Step 1: Find out before the visit who is who
The office does this at intake. Four questions, asked of whoever calls:
- Who lives in the home and will use the changes?
- Who owns the home? A parent, a couple, a trust, a landlord.
- Who will be at the visit?
- Who is paying?
Write the answers on the job. They are four different people more often than you would think, and the visit plays out differently for each mix. A son paying for work on his mother's house is common. A daughter who holds a power of attorney is a different situation, and the office should note it so the tech knows to ask for it rather than assume it; see related, The Accessibility Job Intake SOP.
What breaks if you skip it: the tech walks in, the son introduces himself as the customer, and the whole visit is pitched to the wrong person before anyone noticed.
Step 2: Set the conversation up so the person is in the middle of it
Sit where the person who lives there is the one you face, with the family member beside them, not between you. Introduce yourself to both, then say plainly how you will run it:
"I'll mostly be asking you how things work for you day to day, and then I want to hear from you too," turning to the family member, "because you'll see things I won't."
That sentence does two jobs. It tells the parent the visit is about them. It tells the family member they will get a turn, which is what stops most people talking over: they are not trying to take over, they are trying to make sure the worry they drove here with gets said.
Step 3: Ask the person first, then the family, as separate turns
Run the functional questions with the person: how they get in and out of the shower, which side they get out of bed on, what is harder at the end of the day. Watch them do it where you can. How to ask those questions is owned by a sibling: see related, The Accessibility Walkthrough With the Person Who Lives There.
Then turn to the family member and ask what they see. Give it its own turn, and ask about specifics, not opinions: "Have you seen him have trouble anywhere we haven't talked about?" Often this is where the fall that nobody mentioned comes out, or the shower he says is fine and has not used in a month.
When the family member jumps in during the person's turn, do not correct them. Acknowledge it, park it, and turn back:
SON: He can't do the stairs anymore. We need a
stairlift, that's why you're here.
TECH: That's helpful, and I want to come back to it.
(turning) Mr. Ortiz, how do the stairs go for
you right now?
FATHER: They're fine. I take them slow.
SON: Dad, you fell on them in March.
TECH: (to the father) Tell me about that.
FATHER: I missed the bottom step. There's no rail on
that side and I reached for nothing.
TECH: Which hand do you reach with going down?
FATHER: Left. My right shoulder's no good.
TECH: And the only rail is on the right going down.
FATHER: That's right.
TECH: (to both) So before we talk about a lift, the
fall was on a side with nothing to hold.
The son was right that something had to change and wrong about what, and the father was right that he could still do the stairs and wrong that they were fine. Neither would have got there alone. The tech did not take a side; he asked questions until the fact both of them needed was on the table.
Step 4: When they disagree, separate the safety fact from the preference
Disagreements on these jobs nearly always mix two things: something the shop can establish (a fall on the left, a 36-inch hallway a lift cannot turn in, a tub wall the person can no longer step over) and something that is genuinely a preference (keep walking the stairs, or not; a grab bar that looks clinical, or not).
Put the facts on the table neutrally, as observations, and leave the preference to the person:
- State what you observed, in the same words to both: "He reaches with his left hand and there is no rail on the left."
- Lay out the options with what each does and does not solve, not which one you would pick. "A rail on the left gives him something to hold on every step he takes now. A stairlift means he does not walk the stairs at all. A rail is a day's work; a lift is a larger job and changes how the stairway is used."
- Name what would change the answer. "If his balance gets worse, or if he starts needing to stop halfway, a lift is the next step, and nothing we put in now would get in its way." See related, Designing for a Progressive Condition.
- Bring in the occupational therapist when the fact itself is disputed: whether he is safe on the stairs with two rails is a clinical judgment, and an OT's assessment settles it better than you or the son can. See related, Working With the Occupational Therapist.
Then ask the person what they want to do. If the family member still disagrees, say so honestly: "I'd want this to be your dad's decision. If you're worried it isn't safe enough, the OT is the right person to tell us that."
What not to do: split the difference to keep everyone happy, quote both, or agree privately with the family member at the truck afterward. All three put the decision back with whoever caught you last.
Step 5: Write the decision in the person's words, and get the right signature
The scope records who was present, what was discussed, the options offered, and what the person chose, in their own words where you can: "Mr. Ortiz wants a second handrail now and does not want a stairlift at this time." Note the family member's concern too, without editorializing: "Son concerned about stair safety; OT referral offered."
Who signs is set by who owns the home and who is contracting for the work, and it is not always the person paying. A family member paying for work on a parent's house is common; the owner's authorization for work on their own home is the one that matters. Where the person paying, the person signing and the person who owns the house are three different people, or someone presents a power of attorney, the shop's standard contract language is a question for your own attorney. This is not legal advice. What the shop can bank is the record: who was present, what each was told, and what the homeowner decided.
If the person signing seems to be pressured, or a family member's interest in the decision looks financial rather than protective, stop the sale and follow the Safeguarding guidance rather than handling it yourself: see related, Capacity to Contract: The Signs and What to Do.
Two versions of this that run differently
The family member is on the phone, not in the room. Common when the payer lives far away. Put them on speaker only after you have run the person's turn in the room; otherwise the voice on the phone drives the visit and the person in the chair beside you listens. Then give the caller their turn with the same specific question, and send both of them the same written scope, not a separate version to the payer.
The person wants more than the family wants to fund. The reverse disagreement, and it gets the same handling: the facts stated neutrally, the options with what each solves, the choice the person's. The shop does not decide whose money is right. It can phase the scope, so the item that addresses the observed risk goes first and the rest is quoted separately for whoever pays to decide on later.
Worked example: the scope the visit produced
The Ortiz visit, continued. Intake had recorded: father, 81, lives alone and owns the house; son visits monthly and is paying; son booked the visit and asked for a stairlift quote.
The visit found:
- Stairs: 12 risers, rail on the right going down only. The father reaches with his left. The March fall was at the bottom step.
- Bathroom: tub with a sliding door; he steps in holding the door frame, which flexes. He did not raise it; the son did, during his turn.
- Bedroom: fine. He gets out of bed on the right with no trouble.
Options offered for the stairs: a second rail on the left, continuous to the bottom step with an extension past it, or a stairlift. The father chose the rail. The son asked whether that was enough; the tech said the OT was the person to answer it and offered to send her the scope.
The bathroom was the son's find, and it changed the job. The father had not mentioned the tub at all. A grab bar on the tub's back wall gives him something solid where he now grabs a flexing door frame. He agreed to it once he saw where it would go.
The scope listed two items, the left rail and the tub grab bar, with the father's choice recorded, the son's concern noted, and the stairlift listed as considered and declined at this time. The father signed as owner; the son paid. The OT reviewed the scope and agreed with both items, adding that the rail should extend at the bottom, which the scope already had.
Two months later the son called back, this time to book the grab bar's twin by the toilet. The father had asked for it.
References
- See related: Capacity to Contract: The Signs and What to Do; Working With a Power of Attorney or Guardian.
- See related: The Accessibility Walkthrough With the Person Who Lives There; Working With the Occupational Therapist; The Accessibility Job Intake SOP.
- See related: How to Talk With a Customer Who Uses a Wheelchair; Designing for a Progressive Condition; How to Add a Handrail That Actually Holds.