An Exploration of Adjustment Needs and Efforts of Persons with Dementia After Relocation to a Residential Care Facility

This study examined the adjustment needs and efforts of individuals with dementia after relocation to a residential care facility. This was a qualitative prospective study that involved in-depth face-to-face interviews with 16 individuals with dementia and their family caregivers at 2 and 6 months post-relocation. In their efforts to recreate a sense of home, individuals with dementia had to meet three major highly interrelated and overlapping categories of needs to settle in, fit in, and find meaning in this transition. The satisfactory fulfillment of these adjustment needs resulted in a sense of comfort, connection, and continuity associated with feeling at home. Participants’ efforts to place themselves in their new living environments created a simultaneous need to integrate relocation into their overall sense of self. The results support earlier research indicating that place making is a critical process in the overall psychosocial adjustment to old age. The findings inform supportive interventions to assist individuals with dementia to reconstruct home in a residential care environment.     

The Mobility of Elderly Residents Living in Suburban Territories

Abstract

Many authors have observed die elders' unanimous aspirations to age in place. Such residential aspirations echo theoretical concepts such as “environmental-fit.” Aging residents adapt to their residential environment according to their autonomy level, their financial and social resources, as well as the meanings they invest in both residential situations and lifestyle (Lord, 2004; Wagnild, 2001). Therefore, the suburbs constitute a challenge for aging residents' intentions to remain in their home for as long as possible. These low-density environments encourage car dependency for almost every daily activity. In that regard, many studies have investigated the daily mobility patterns of elders living in such areas. However, most of them have focused on aspects linked to transportation and driving security (Rosenbloom, 2003). In this context, with a socio-anthropological (in-depth interviews) method, the elders' daily mobility is explored in a complex layering of issues. Two interdisciplinary qualitative researches on the daily and residential mobility of elderly suburbanites have been used: a group living in Quebec City's Post-War suburbs in Canada (n = 56) and another in Marseille's periurban suburbs in France (n = 36). The results show that we must investigate beyond the elders' “emotional attachment”to their “home” in order to explain the everyday tensions underlying accessibility and daily mobility. Aging in a single-family house is more than a deliberate choice. Moving away from one's neighborhood is considered a last resort alternative by the majority. Instead, the elderly from both milieus will adapt their lifestyles to the environment by redesigning their daily activities and their mobility practices in order to age in place. Therefore, adapting daily mobility practices to social interactions and social representations all become a sine qua nonecondition.     

Housing Strategies for the Elderly:

Gerontologists often speak of a need to create a continuum of alternative housing environments to increase the number of housing options between those with no services and those with a high level of complementary services. By expanding the number of alternatives, it is expected that the elderly will select an environment consistent with their needs and at least implicitly maximize life satisfaction. This paper examines a set of assumptions and values implicit in calls for such a continuum. The analysis identifies a number of issues not generally recognized in the literature which may hinder or facilitate the development and implementation of housing programs for the elderly.     

Restorative home environments for family caregivers

Caregiver stress negatively affects caregiver health and the overall quality of in-home caregiving. While environmental interventions such as home modifications help caregivers manage stressful functional aspects, interventions for managing stressful emotional aspects are unexplored. Frequently, caregiving responsibilities restrict caregivers' spatial and temporal range of restorative activities to their familial residential environment. In a first attempt to explore the restorative potential of a house in which caregiving occurs, this paper reports experiential attributes of restorative environments from environmental psychology and healthcare design research. It discusses the relevance of restorative attributes to the socio–physical residential context of caregiving using three caregiver needs: need for a temporary escape, meaningful social support, and a sense of control. This conceptual exploration of the restorative potential of the residential caregiving environment offers a base for investigating targeted architectural and functional interventions that might complement current advances in home modifications and respite services.     

An ICT-Driven Hybrid Automation System for Elderly Care Support: A Rehabilitation Facility Study Case

Abstract

The demographic statistics in developed countries suggest growth in the elderly segment of the population. At the same time, other studies forecast a shortage of nurses, increasing the pressure on hospitals to provide treatment for longer periods of time. These trends suggest a need for new ways of taking care of the elderly population that support safe, comfortable, and independent living. Meanwhile, prominent advances in information and communications technology (ICT) have enabled new systems that address various needs of the elderly. This article presents a case study of a rehabilitation facility located in Tampere, Finland, that uses an automation system in which ambient assisted living (AAL) and building automation (BA) system functionalities are combined. It details a field study summarizing the needs of the users, describes functional scenarios supported by the system, and reports the results of the first usability tests suggesting acceptance of a new technology by residents and caregivers. The unique combination of ambient assisted living and building automation offers a safer and more comfortable environment for the elderly as well as helps caregivers on-site in managing their workloads.     

An Assessment,Using the Multiphasic Environmental Assessment Procedure (MEAP), of a Rural Life-Care Residential Center for the Elderly

This study reports the findings of an assessment of a life-care center for elderly persons in a rural area using the Multiphasic Environmental Assessment Procedure (Moos and Lemke, 1979a). The study assesses the physical and architectural features, the social climate, and the policies and programs of the home. The results are compared to previous assessments of sheltered-care facilities, and the findings of the study support similar research conducted by Moos and Lemke. The facility's selection process leads to a population with similar characteristics, tending to promote a harmonious environment. The residents have a positive perception of their personal environment which encompasses the physical and social environment and organizational structure. This type of environment offers a smooth transition from living in a private residence to a residential life-care center.     

Applying a Treatment Effects Model to Investigate Public Amenity Effect on Physical Activity of the Elderly

The increasing elderly population puts significant health, economic, and social burdens on society. Physical activity is one of the most cost-effective ways to maintain the health of the elderly. This study adopts a treatment effects model to investigate the causal relationship between environment attributes and physical activity among the elderly, while taking endogeneity into account. The data were collected from 274 participants by face-to-face interviews in Taichung, Taiwan. Performing physical activity regularly in parks is the most important measure of the amount of physical activity by the elderly. Providing sufficient and accessible parks in metropolitan residential neighborhoods could be one of the most cost-effective ways to promote physical activity for the elderly living in midsize Asian cities.     

Editorial

This study aims to analyze the environmental elements of residential facilities for elderly people by using Antonovsky's salutogenic concept. The relationship between the environment and health is clearly identified. This information facilitates the presentation and development of residential facilities with healthy living conditions for elderly people in South Korea. The concept includes providing a residential environment that is safe from a variety of dangers by applying a barrier-free concept to address the physical changes of elderly people. It also provides an environment equipped with a continuous protection system that considers both the physical and sociopsychological aspects of this particular treatment environment.     

A Mathematical Model of the Housing Decisions of Elderly Homeowners

This article presents a mathematical model that attempts to capture the factors that are most important in determining an elderly homeowner's housing decision. The factors considered include the homeowner's home equity, financial assets, income, housing cost, and psychological attachment to the home. The findings indicate that the various factors may have quite different effects across the varied housing actions that the elderly may take. This suggests that any empirical analysis regarding the home ownership decisions of the elderly needs to distinguish among the different actions that the elderly can take.     

Moving to and Living in a Retirement Home

Abstract

Bad health combined witii deteriorating physical functions force many elderly people to move to a retirement home. The primary focus of this study was to investigate the resident's experience of safety and security. From a sample of 57 residents, 12 persons volunteered to participate in the interview. Data were analyzed with qualitative content analysis. The standard and design of the participant's previous home made mobility difficult and this affected their sense of security. This motivated them to move into an environment where they felt more secure. The environment at the retirement home was predominantly described as secure and safe. The finding shows that the participants felt that safety and security were more important than independence.     

Influence of Income on Energy Beliefs and Behaviors of Urban Elderly

Although public attention toward residential energy costs has diminished in the past few years, meeting energy costs remains a concern for the elderly population. The impact of income on energy beliefs and behaviors of urban elderly indicate that lower income elderly may be adversely affected by residential energy costs. The results of this study indicate that urban elderly with lower incomes engage in more lifestyle cutbacks and curtailment behaviors than do those with higher incomes. This research emphasizes the need to investigate energy policies that target low income elderly.     

A Study of Residential Condition and Satisfaction of the Elderly in China

This article investigates the current housing reality and subjective appraisal of the elderly in China by presenting the latest empirical evidence. Based on a literature review, survey data of September 2009 were analyzed, which included 692 Chinese households with a focus on their elderly members. Major findings were the following: (1) affordability was an outstanding issue, with 56.6% of the elderly respondents feeling overburdened by housing costs; (2) facilities in the homes were less of an issue than their community facilities, which were inadequate especially for the handicapped; (3) the elderly respondents as a whole seemed to enjoy their housing property, though significant differences in homeownership and residential satisfaction were found among them; (4) differences were also found among the elderly in terms of access to healthcare (including emergency help), transportation, and housing environment; and (5) residential satisfaction of the elderly were related to their occupational status before retirement, income, health, distance to healthcare facilities, living arrangements, homeownership, housing conditions, social contacts/visits, and gender. Implications of the findings are discussed for research and policy considerations.     

Perceived Aspects of Home Environment and Home Modifications by Older People Living in Rural Areas

This study investigated the relationships between the “perceived aspects” of current home environment of elderly people living in rural areas and their home modification behavior. To investigate this perception, home satisfaction, perception of home capability, and home safety were used as perceived aspects of the home. Data were collected by a questionnaire. The response rate was 43.1%, with 317 eligible questionnaires. The results from this study indicate that there was no significant difference in perceived aspects of home environment between those who modified their homes and those who did not. Regardless of their current home conditions, most elderly respondents (75%) showed high home satisfaction. Results from this study suggest that a modified home environment does not necessarily contribute to an older person's perception of perceived aspects of their home environment.     

“Thanks to the Internet,We Remain a Family”: ICT Domestication by Elderly Immigrants and their Families in Israel

In addition to coping with intergenerational and spousal problems related to aging and/or immigration, elderly immigrants in Israel are also often burdened with domesticating information and communication technologies (ICTs). Thus, the goal of this study is to explore how relationships within the elderly immigrant’s family are manifested in a home computer context and to determine the roles that domestication of the relevant technologies plays in their family life. This qualitative study is based on in-depth interviews with 26 elderly users who immigrated from the Former Soviet Union (FSU) to Israel about 20 years ago. The findings show that ICT domestication and family dynamics are complex, interrelated processes: Technologies have dramatically changed the elderly immigrants’ family situations, yet immigrants have accorded these technologies unique meaning, adapting them to respond to their family needs and negotiating ICT domestication as a means of discussing and rebuilding family communication.     

Designing a “Think-Along Dwelling” for People With Dementia: A Co-Creation Project Between Health Care and the Building Services Sector

Ageing-in-place is the preferred way of living for older individuals in an ageing society. It can be facilitated through architectural and technological solutions in the home environment. Dementia poses additional challenges when designing, constructing, or retrofitting housing facilities that support ageing-in-place. Older adults with dementia and their partners ask for living environments that support independence, compensate for declining and vitality, and lower the burden of family care. This study reports the design process of a demonstration home for people with dementia through performing a literature review and focus group sessions. This design incorporates modifications in terms of architecture, interior design, the indoor environment, and technological solutions. Current design guidelines are frequently based on small-scale studies, and, therefore, more systematic field research should be performed to provide further evidence for the efficacy of solutions. The dwellings of people with dementia are used to investigate the many aspects of supportive living environments for older adults with dementia and as educational and training settings for professionals from the fields of nursing, construction, and building services engineering.     

Adoption of an Outdoor Residential Hall Smoking Policy in a California Public University: A Case Study

Abstract

Objective: Because secondhand smoke is a public health concern, many colleges have adopted bans to ensure healthier environments. This study demonstrates how outdoor smoking policy change can be accomplished at a large public university. Participants: The participants were 1,537 students housed in residential communities at the University of California, Berkeley, who completed an online survey. Methods: A proposal for smoke-free residential communities that included student resident survey data was prepared. Results: The survey data indicated that most students (77%) were bothered by secondhand smoke, and most (66%) favored smoke-free environments. The data were used to advocate for a change in the residential community smoking policy. Conclusion: The survey data and institutional comparisons played a key role in administrators’ decision-making about campus smoking policy. Despite administrators’ concerns about students’ safety and freedom of choice, student-led advocacy was able to influence policy change.     

Monitoring Quality of Care in Residential Care for the Elderly: The Information Challenge

This study assesses the administrative data compiled on residential care facilities for the elderly (RCFEs) by the state of California and considers the feasibility of their adaptation into a comprehensive information system. Required state RCFE reporting forms were reviewed for potential data elements. Recording and reporting variation was evaluated using a stratified probability sample of 340 facilities licensed in Northern and Central California. Stratification was by facility size and state district office. Data collection included a 5-year retrospective review of forms and documents in each facility's public file. Little of the information required from RCFEs is computerized. Most of it is maintained at the individual facility and not included in public files. Basic information, while included in the public file, is commonly either not available or not current. Resident characteristics and outcomes are not compiled, except indirectly in citations. The information required from RCFEs, if appropriately compiled and maintained, would produce a comprehensive quality assurance system and more effectively support consumer information and policy needs.     

Elderly-technology interaction: accessibility and acceptability of technological devices promoting motor and cognitive training

As the world population is ageing, studies on the socio-economic and health consequences are proliferating. Little has been done on the effectiveness and impact elderly may benefit from the use of technology in their everyday life. The pilot study, implemented within a funded project aimed at identifying sustainable actions to promote Seniors' quality of life, intended to investigate this kind of interaction in terms of accessibility and acceptability that senior citizen experience with technological devices promoting motor and cognitive training. In the hypothesis, interfaces and technological artifacts, that still take in little account the seniors' physical characteristics (e.g. physiological limitations in sight, hearing, movement) and cognitive processes (selective memory often driven by practical needs), can cause elderly to mistrust technology. Study participants were twenty over seventy-year-old people, who were observed and interviewed in context in a two-hour training session regarding the technological devices user experience. The results are presented with scenario-based techniques that help represent typologies of users in different use situations. Findings confirm the hypothesis, highlighting that elderly may accept technological artifacts when they perceive them as bringing benefits in terms of well-being and health.     

Stepping Down and Stepping In: Youth's Perspectives on Making the Transition from Residential Treatment to Treatment Foster Care

Older youth preparing to emancipate from the foster care system are often served in residential treatment settings where they have limited opportunities to practice skills for independent living in a community setting. Stepping these youth down to less restrictive environments such as treatment foster care is a growing trend, especially for youth with mental health issues. Yet, few studies have explored the youth's perspective on making this transition. This study utilized qualitative interviews with youths who were participating in a treatment foster care intervention study (n = 8) to gain their perspectives on the process of transitioning from residential care. Youths were interviewed right before they exited residential care and two months after placement in the new foster home. Youths reported hopes for gaining family in the new home as well as fears of placement disruption. Findings point to the need to enlist youths in discussion and problem solving about difficulties they anticipate in the new home and expectations for their relationship with the new foster parents. In addition, the struggles described after two months in the home point to the need for youths to build specific skills to better manage ongoing relationships with foster parents and for foster parent training on how to help build these skills.     

Toward a dimensional model of risk and protective factors influencing children's early cognitive,social, and emotional development during the COVID-19 pandemic

Variation in infants’ home environment is implicated in their cognitive and psycho-social development. The pandemic has intensified variations in home environments through exacerbating socioeconomic inequalities, and increasing psychological stressors for some families. This study investigates the effects of parental (predominantly maternal) mental health, enriching activities and screen use on 280 24- to 52-month-olds’ executive functions, internalising and externalising problems, and pro-social behaviour; with socioeconomic status and social support as contextual factors. Our results indicate that aspects of the home environment are differentially associated with children’s cognitive and psycho-social development. Parents who experienced sustained mental distress during the pandemic tended to report higher child externalising and internalising problems, and executive function difficulties at follow-up. Children who spent more time engaged in enriching activities with their parents showed stronger executive functions and social competence six months later. Screen use levels during the first year of the pandemic were not associated with outcomes. To mitigate the risk of persistent negative effects for this ‘pandemic generation’ of infants, our study highlights the importance of supporting parents’ mental health. As our results demonstrate the impact of social support on mental health, investing in support services and interventions promoting building support networks are likely to be beneficial.