The importance of an accessible home environment for occupational performance has been emphasized in occupational therapy, but knowledge about how accessibility can affect a person's activity patterns is limited. The purpose of this study was to describe the activity patterns of five elderly persons aged between 70 and 84 years and their views about accessibility and usability of their homes before and after a housing adaptation. Two different questionnaires, ‘Accessibility in My Home’ and the ‘Occupational Questionnaire’ were used for data collection. Adaptations in the home included: removing thresholds, installing new taps in the bathroom and kitchen and broadening doorways. After the adaptations the five participants reported that they increased their outside activities, reduced naps during the day and slept better at night. The results showed that the participants performed more and new activities when their home environment had become accessible. Activities performed were also perceived as more important after the housing adaptation. There is a need to replicate the study with a larger sample. Further research is needed on the impact of home adaptations on the activity patterns of elderly people. Copyright © 2006 John Wiley & Sons. Ltd