Aims: This analysis aims to identify what older adults self-report about engagement in home activities (EHA), if there is a difference between perceived and observed activity performance in the home, and what predicts EHA. Methods: Baseline data were analyzed from a randomized controlled trial of an occupational therapy fall prevention intervention with older adults age 65 and older with a fall within 6 months. A multiple linear regression model was used to compare perceived and observed activity performance. Results: Ninety-two participants (mean age 77.7 ± 7.4) were included. EHA can be predicted (F(6, 85) = 13.86, p < 0.001, R = 0.70, R2 = 0.50) by perceived activity performance (p = 0.02), fear of falling (FOF) (p < 0.001), and depression (p = 0.05). Conclusions: Perceived activity performance predicts EHA but observed activity performance does not, indicating clinicians should consider older adults' perceptions. Self-efficacy and awareness may be reasons for differences between perceived and observed activity performance in the home. FOF and depression are also predictors of EHA.