Restoring and Sustaining Home: The Impact of Home Modifications on the Meaning of Home for Older People

ABSTRACT

The importance of a supportive home environment to successful aging has been well-established in the literature, with home modifications increasingly acknowledged as ways of removing barriers to function and increasing independence for older people. Home modification literature and practice primarily focus on the home environment as a physical space in which to perform tasks and on the impact of modification on competencies and function. Home, however, is much more than a physical environment. Within a transactive framework, people and places are seen as engaged in a dynamic, reciprocal relationship through which home becomes a place of significant personal meaning. Through a qualitative framework, this study examines the experience of older people living in the community who are recipients of a home modification service. It explores the impact modifying the physical environment has on their experience of home as a place of meaning and provides insight into how home modifications can strengthen the home as a place of personal and social meaning as well as improve safety and comfort for the older person at home.     

Home Environment and Its Relation with Quality of Life of Older People

In this cross-sectional study, we tested the relationship between sociophysical environment, quality of life (QOL), and perceived social support among elderly in Iran. The sample includes 128 participants recruited in the city of Shahrekord, Iran. We measured Evaluation of Older People Living Environment (EVOLVE); Control, Autonomy, Self-realization and Pleasure scale (CASP-19) and Multidimensional Scale of Perceived Social Support (MSPSS) tools respectively, through home-based observation and interview. A significant relationship was found between several domains of home environment, QOL, and perceived social support. The interaction effect of the home environment and gender in relation to QOL and perceived social support was statistically significant. Our results support that the home physical environment may not be considered a strong predictor of QOL among the Iranian elderly.     

A Descriptive Study of Home Modifications for People with Dementia and Barriers to Implementation

This study describes home environmental features, safety issues, and health-related modifications in a community dwelling sample of 82 elderly people with dementia. Main barriers to the accessibility of the homes were steps both inside and outside the home. The majority of the caregivers had made home modifications that pertained mainly to physical limitations. Home modifications to support cognitive deficits were made to a lesser extent. The main barrier to the implementation of home modifications to accommodate the care recipient's memory loss was skepticism about their usefulness. Regarding the removal of physical barriers, financial constraints were most frequently mentioned.     

Housing Governance and Senses of Home in Older Age: The Provider Scale

Extensive research examines senses of home in aging, focusing on built and care environments. In parallel, a body of work examines housing governance, reviewing degrees of resident satisfaction. However, there is little crossover between this work, with governance research only rarely considering senses of home. This article argues for attention to the interconnections between provider-scale housing governance and senses of home in older age, arguing that governance mechanisms structure the housing context and provide the framework through which home is experienced and lived. Through a case study of a small, affordable housing community in Sydney, Australia, it shows that housing governance can profoundly shape senses of home in aging, both contributing to and diminishing senses of home. Further, it points to a connection between housing governance and housing design with different housing typologies associated with different aging bodies and forms of management practice, with profound implications for residents' senses of home.     

Integrating Services for Older People in Aging Communities in The Netherlands: A Comparison of Urban and Rural Approaches

ABSTRACT

The aim of this article is to discuss approaches to services integration for older people in urban and rural aging environments in The Netherlands, and the preliminary effects of these approaches on local aging conditions. In urban areas, services integration revolves around the creation of functional spatial hierarchy. In rural areas, the emphasis is on forging links between service providers. Outcomes for health and use of professional care services are similar. Out-comes for housing, informal care, and accessibility of services differ between urban and rural areas in ways that can be traced back to local aging conditions and elements of the specific approach to services integration used. In both urban and rural areas, much more could be done to connect formal programs to the lifeworlds of older dwellers.     

Protecting Older People From Burglary: Prevalence of Security Devices in the Homes of Older Adults in Perth,Western Australia

ABSTRACT

Fear restricts the activity of older adults, potentially leading to social isolation and unhealthy life styles. Consequently, this population remains a priority for home security research and intervention. One option is to increase home security by installing security devices. However, little is known about how older adults protect their homes. In this study, 5,582 community-dwelling older people completed a cross-sectional survey. The survey was able to document the prevalence of security measures taken by older adults. More than 70% of the respondents had security screens and key-operated deadlocks and 148 (2.7%) respondents reported no security features. Respondents living alone had the lowest prevalence of home security devices. Female living alone protected their home differently from male living alone by installing different security devices. Logistic regression analysis indicated that older adults living in detached houses feel particularly vulnerable to burglary (p < .001). These survey findings have practical implication for burglary prevention.     

Happy Living in Darkness! Indoor Lighting in Relation to Activities of Daily Living,Visual and General Health in 75-Year-Olds Living at Home

ABSTRACT

Lighting has been identified as a significant environmental attribute for promoting vision and general health among older people, enabling successful aging at home, but it has received little attention in the literature. Indoor lighting levels, self-reported vision and general health, and activities of daily life were measured in 114 healthy 75-year-old Norwegians. Despite very low levels of indoor lighting, the subjects were happy and healthy. There is a large discrepancy between self-assessed health and recommended lighting levels, and low awareness of the effect of lighting on age-related vision loss or daily living in the future. Knowledge of how to utilize indoor lighting to ensure healthy and safe aging in the home is needed.     

The Role of Perceived Racial Discrimination in the Marriage Gap Between Black and White People

Abstract

Many explanations offered for the gap in marriage rates between Black and White people are economic and cultural. Less often considered are how racial social psychological factors influence marriage rates. In this study, we use critical race theory and the life course perspective to investigate how perceived racial discrimination impacts the likelihood of marriage for Black and White people. Data for the study are taken from the Portraits of American Life Study (N?=?678). The results of logistic regression analyses show that among people who report perceived racial discrimination, White people generally have a higher probability of being married compared to Black people. Analyses by age demonstrate that among younger adults, Black people who perceive racial discrimination are equally likely to be married as White people and have a higher probability of being married than Black people who do not report perceptions of racial discrimination. A negative influence on the odds of marriage related to perceived racial discrimination for Black people becomes clearer as respondents age. The findings highlight the importance of considering perceptions of racial discrimination to better understand the marriage gap between Black and White people across the life course.     

Autonomy and Control in Everyday Life in Care of Older People in Nursing Homes

Self-control and autonomy are not guaranteed when people age and are in need of help from others, especially in institution-based housing. This occurs despite the fact that it is a generally accepted belief that care should be delivered with the greatest possible degree of independence and autonomy. This article discusses older people's experiences with and the opportunities for autonomy in institution-based housing. Through focus group interviews and observations, the daily lives of residents at two nursing homes in Sweden were studied through a comparative approach using the theoretical framework of organizational culture. Three themes emerged showing how autonomy was not a reality for the residents. The first theme revealed an ambivalent mission, indicating ambiguity as to whether the nursing home was a place to live in or a place in which to be cared for. The second theme was symbolic power, which encompassed the staff's power embedded in the organization. The third theme was the ageist approach to care, which was noted in the way staff considered the residents to be old people who were unable and unwilling to strive for autonomy. The three themes were embedded in the organizational culture and were created and recreated in the interaction between residents and staff. A key question for further research is how to change the culture to strengthen the residents’ autonomy.     

Physical Home Environment as a Determinant of Aging in Place for Different Types of Elderly Households

The aim of this research was to investigate the relationship between physical housing features and home modifications to aging in place or precipitating a housing transition among elderly households. Data was taken from two waves (1998 and 2000) of the Health and Retirement Survey. Univariate, bivariate, and multivariate analyses were performed. Residing in a multi-family home without an elevator was a predictor for housing transition for couple households, while residing in a home with small interior modifications was a predictor for remaining in place for single households. Implications for policy makers, health care providers, housing industry and elderly are discussed.     

Sources of Double Disadvantage for People with Disabilities Living in Remote and Rural Areas of New South Wales, Australia

This study demonstrates how people with disabilities living in remote and rural areas experience double disadvantage in regard to receipt of services. They tend to experience similar disadvantages to other remote and rural dwellers (as compared with their urban counterparts), but these disadvantages are compounded by those associated with living in an environment which does not cater for the needs of people with disabilities. Findings display how geographical, physical, cultural, social and psychological factors within the external environment create disadvantages for the individual. The project involved data collection from people with disabilities, disability groups, service providers, families and carers through consultations and field trips. Major issues emerging from consultations were concerned with: transport and distance, isolation, the need for more consumer involvement, the nature of service provision (appropriateness, flexibility, co-ordination and location), the need for community and professional disability awareness education, protection of rights, carers and respite care, accommodation and housing, education, employment, information dissemination and access to specialised equipment. Comparison with overseas studies indicates that findings from this Australian study have applicability in other countries which have large remote and rural areas.     

Perceived Need for Home- and Community-Based Services: Experiences of Urban Chinese Older Adults With Functional Impairments

Guided by Cantor’s social care model, this study identified individual, family, and social support factors that influence urban older adults’ need for home- and community-based services, including medical and rehabilitation, instrumental care and support, and psychosocial services. The data were extracted from the Sample Survey on Aged Population in Urban/Rural China conducted by the China Research Center on Aging in 2006. Results from multiple logistic regression show that older adults’ need for medical and rehabilitation services is significantly related to instrumental activities of daily living, depression, not having filial children, friend support networks, and having a confidant. Older adults’ need for instrumental care and support is related to their educational attainment, financial strain, instrumental activities of daily living, not living with children, and friend support networks. Finally, older adults’ need for psychosocial services is significantly related to educational attainment, depression, not being married, friend support networks, and having a confidant. Implications for social service development are discussed.     

The Physical Housing Environment and Subjective Well-Being Among Older People Using Long-Term Care Services in Japan

Abstract

For older people using long-term care services, the conditions of their life-space may be critical. The relationships between the physical housing environment and aspects of health were examined among older people in Japan (aged 65+ years, N?=?1,928) by multivariable logistic regression analysis, adjusting for sociodemographic characteristics. Lack of safety, low access to emergency assistance, low or high indoor temperature, poor sanitary conditions, and state of home disrepair were significantly associated with negative aspects of health among people with low activities of daily living (ADL) independence. Home care service providers and policymakers need to consider the importance of appropriate environmental conditions for the most vulnerable groups.     

Longitudinal Prevalence and Correlates of Elder Mistreatment Among Older Adults Receiving Home Visiting Nursing

The objectives of this study were to identify elder mistreatment (EM) prevalence among a cohort of older adults receiving visiting nurse care in their homes, determine EM subtypes, and identify factors associated with EM. EM data were collected by nurses during monthly home visits for up to 24 months. It took the nurses a mean of 10.5 visits to discern EM. Fifty-four (7.4%) of 724 patients were identified as mistreated, of which 33 had enough information to subtype the EM. Of these 33, 27 were victims of neglect, 16 of psychological abuse, and 10 of financial exploitation, and 17 suffered more than one type. Among the entire sample, 11 variables were positively correlated with EM presence. Nurses visiting older adults in their homes should be aware that their patients are, as a group, vulnerable to EM, and that the factors identified here may be specific markers of greater risk.     

当代城乡青少年科学素质的比较研究

科学素质“一般指了解必要的科学技术知识,掌握基本的科学方法,树立科学精神,并具有一定的应用它们处理实际问题、参与公共事务的能力”④,2007年,我们对安徽省10城市（含农村）的3045名青少年进行价值观调查,对城乡青少年的科学素质进行了比较．勾勒出城市青少年科学素质的平均水平高于农村青少年、城市青少年科学素质的发展性强于农村青少年、农村青少年具备的创新潜能与城市青少年差距不大、具有较好的科学素质是城乡青少年的共同追求等四个主要结论,分析了青少年科学素质对社会、个人的影响。研究认为,当代城乡青少年的科学素质有一定差异,平均水平有待提高．并针对现状提出教育引导的相关建议。     

Building Social Inclusion for Rural Older People Using Information and Communication Technologies: Perspectives of Rural Practitioners

Abstract

The literature identifies rural, older people as at risk of social exclusion, as a result of rural disadvantage. In this context, improved access to information and communication technologies (ICTs) has potential to build social inclusion, yet current evidence shows that rural, older people are the lowest current users of technology. This paper draws on the practice and local knowledge of rural practitioners from one Victorian region in order to explore: (a) the practice issues associated with ICT use among rural, older people; and (b) the characteristics of effective practice models in the rural, social work context. An analysis of findings highlights the need to respond to the diverse skills, needs, and learning styles of older people, to demonstrate the benefits of ICTs, involve users, and build confidence. Major barriers include poor ICT usage by many rural agencies and low practitioner capacity, as well as access and resources.     

The Influence of Self-Selection on Older Adults' Active Living in a Naturally Occurring Retirement Community

A cross-sectional, single-case study of older adults (N = 197) in a Midwestern rural naturally occurring retirement community compared the active living behavior and salience of socio-physical characteristics for three subsets of older residents: (1) in-migrants who moved based on recreational opportunities; (2) in-migrants who moved for other reasons; and (3) long-time residents. Some older adults with preferences for outdoor recreation self-selected into the naturally occurring retirement community due to opportunities for water-based activities. Self-selectors engaged in light recreation activities more frequently and for longer durations, received more frequent spousal encouragement to be active, and identified more types of activity companions than in-migrants who had moved for other reasons.     

以城镇基本公共服务均等化促进农业转移人口市民化

新型城镇化的核心是人的城镇化,人的城镇化主要是解决进城的农业转移人口能否顺利转变为城镇居民的问题,而实现这种转变的关键是能否享受均等化的基本公共服务。城镇基本公共服务不均等既表现在城镇社会的不同群体间,也表现在区域间。两者都会影响到农业转移人口的市民化过程。本文首先界定了城镇基本公共服务的内涵,并对其在群体间和区域间不均等的表现进行了考察,进而深入分析了不平等产生的原因,在此基础上提出了城镇基本公共服务均等化的实现路径。