A Model for Aging in Place in Apartment Communities

The purpose of this article is to introduce a theoretical model for an aging-in-place housing specialist for those living in congregate housing facilities. A “needs assessment” tool is outlined to help facilitate the successful implementation of a Health and Aging Residential Service Coordinator (HARSC), both from a research perspective and from implementation of training curriculum for this specialized population. A model that provides both on- and off-site services is hypothesized to be most effective.     

Environmental Evaluations and Modifications to Support Aging at Home With a Developmental Disability

ABSTRACT

Increasing numbers of people with developmental disabilities are living into old age and are now residing in community-based housing, largely due to the deinstitutionalization movement. The overlay of age-related impairments onto pre-existing, lifelong disabilities puts this population at a magnified risk for premature behavioral limitations and loss of independence. This article describes a demonstration project designed to enable people with developmental disabilities to age in place. Interviews and observational assessments with 45 older adults with developmental disabilities were conducted in their community-based homes to identify potential barriers to aging in place. An Individualized Environmental Intervention Plan was developed for each study participant, recommending ways to solve problems and eliminate potential barriers. Individualized Environmental Intervention Plans were implemented to the extent possible through home modifications and assistive technology. Pre- and post-modification task performance and self-report revealed the positive impact that home modifications and assistive technology can have. The study demonstrates the need for ongoing evaluation and assessment sensitive to the needs of people with developmental disabilities and the unique characteristics of supported living settings.     

Challenges to Aging in Place: Understanding Home Maintenance Difficulties

Age-related declines in capabilities may compromise older adults’ ability to maintain their homes, threatening successful aging in place. Structured interviews were conducted with 44 independently living older adults (mean age = 76.1, standard deviation = 4.7) to discuss difficult home maintenance tasks and how they managed those tasks. Solutions to managing difficulties were categorized as person-related or environment-related. The majority (85%) of responses were person-related solutions. An understanding of the specific challenges that older adults face in maintaining their homes can guide redesign efforts and interventions to effectively support older adults’ desire to age in place.     

Impacts of Home Modifications on Aging-in-Place

The purpose of this study is to analyze the relationship between home modifications and aging-in-place. Using the ENABLE-AGE United Kingdom sample (N = 376), the authors hypothesize that seniors who have modified their housing are likely to have stayed longer in their current housing. There is a positive relationship between home modifications and aging-in-place. The results underscore the importance of supportive environment to prolong living in housing settings.     

On Home Equity Conversion Mortgages for Elderly Homeowners

Analysis of reverse mortgage plans for elderly homeowners indicates that the compound interest charged by the lenders would capture more than half of the equity of the homeowners. The lenders further ask that the Federal Housing Administration (FHA) insure them against risks of unexpected longevity of the borrowers, creating an inderterminate risk to FHA.     

Aging in Place at Home Through Environmental Support of Physical Activity: An Interdisciplinary Conceptual Framework and Analysis

This article presents a conceptual framework to link issues of health, services, physical activity, and environment to help older adults age in place in their own homes, which may reduce the demands on society to provide institutional long-term care. Using environments to promote physical activity has received attention by researchers, but its impact on aging-in-place at home has been largely ignored. This article interprets and synthesizes existing studies on aging-in-place in relation to health and services, contributions of physical activity to health and service accessibility, and environmental support of physical activity. The conceptual framework can serve as the core construct to address gaps in previous research and as a tool to refine practical targets for policies and interventions aimed at promoting healthy aging.     

In Search of a Future for Large-Scale Care Homes in Flanders

Housing for older people in Flanders evolves toward small-scale facilities and better quality of life. Ageing population strains the means to achieve this to the limit. The authors investigate whether and how Flemish large-scale facilities can adapt to meet contemporary and future requirements of housing for older people. By analyzing current tendencies, they depict what this housing should look like, both now and in the future. They then investigate how an existing large-scale care home could fit this picture by using design as a mode of knowledge production. They propose to redesign the site such that its actual evolution would be thoroughly redirected. Beyond the facility at issue, the study shows how Flemish large-scale facilities could develop to keep playing a role in the future. They should timely adapt their size with qualities of small-scale housing schemes, and integrate in the neighborhood.     

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.     

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 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.     

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.     

Perceptions and Use of Gerotechnology: Implications for Aging in Place

ABSTRACT

Understanding perceptions and use of gerotechnology is crucial to optimize design, application, and education strategies that may reduce caregiver burden, extend healthy aging in place, and minimize demands on the health care system. A pilot project was conducted to explore attitudes, opinions, and preferences of older adults concerning the use of technology to support and extend their ability to “aging in place.” Four major themes emerged as important for older adults to age in place: safety and independence, social interaction, use of technology in the past, and the desire for support. Based on the literature in gerotechnology and the pilot study findings, we present a conceptual model that integrates gerotechnology into the life span theory of control (Heckhausen & Schulz, 1995 Heckhausen, J. and Schulz, R. 1995. A life-span theory of control. Psychological Review, 102(2): 284–304. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Schulz & Heckhausen, 1996 Schulz, R. and Heckhausen, J. 1996. A life span model of successful aging. American Psychologist, 51(7): 702–714. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) and the concept of aging in place.     

High-Tech Amenities for the Elderly: The Technological Assistance Needs of Elderly Koreans Aging at Home

This study builds on existing literature regarding residential technological systems and the elderly. This study investigates elderly Koreans’ needs for technological systems in their residential environments and makes appropriate suggestions for creating high-tech amenities to support their aging at home. This study surveyed 60 elderly Koreans and presented them with 5 categories of 24 technological systems to evaluate. Results of this study show that participants were willing to adapt technological systems in their residential environment without any technophobia. In terms of their needs, the participants ranked the safety and security system category first, the indoor environment control system category second, and the health-related system category third. The results of this study suggest that residential environments, including individual housing and apartment properties, should incorporate technological systems to extend elderly residents’ independent living at home.     

The Impact of the Physical Home Environment for Family Carers of People with Dementia: A Qualitative Study

Background: The majority of people with dementia are cared for by their families at home. This study aimed to elicit family carers' perceptions on home environmental aspects and strategies with the view to identify barriers and facilitators when caring for a person with dementia at home.

Design and methods: Thirteen co-resident family carers were engaged in semi-structured in-depth walking interviews. Interviews were recorded, transcribed and analysed using thematic analysis.

Results: Home environments can pose a number of challenges and opportunities. Aspects of the architectural and interior environment (e.g. size, condition, layout and accessibility, familiarity) are perceived as important (Theme 1) as well as a plethora of environmental strategies that encourage independence and comfort at home (Theme 2). Carers' scepticism, timing, costs, property characteristics and mistrust to services are some barriers to implementing environmental strategies (Theme 3).

Conclusions: Carers improvised solutions via trial and error and need further education on strategies to create an enabling and comfortable home environment.     

The Role of the Environment in Sedentary Behavior in Community-Dwelling Older Adults

To compare amounts of sedentary behavior and physical activity in adults residing in planned group residential settings to those residing in private homes, this study recruited 31 older adults who resided in planned group residential settings (n = 13) and in private homes (n = 18). Daily activities were measured using the SenseWear Armband for 7 days. Estimates of the duration of daily activities performed across sedentary, light, and moderate-to-vigorous intensities were captured. It was found that participants in planned group residential settings were older (age 85.9 ± 3.5 vs. 78.3 ± 7.2; p = 0.001) and spent more time in sedentary behaviors (12.7 ± 1.5 vs. 11.3 ± 1.6; p = 0.02) than participants in private homes. The difference was attenuated slightly after controlling for age and wear time (adjusted difference 1.2 ± 0.6 hours, p = 0.06). Thus, adults residing in planned group residential settings, which provide supportive services, were more sedentary than adults residing in private homes. The environment in which older adults live may contribute to sedentary behavior.     

The Presence of Memory-Enriched Environments for Cognitively Impaired Nursing Home Residents

Abstract

Enriched living environments that contain a wide array of personal memorabilia and memory-stimulating cues have the potential to support cognitive functioning. The purpose of this ethnographic research was to describe the care environments of older adults with cognitive impairment living in nursing homes (n?=?42), to evaluate the degree to which these environments contained memory-stimulating cues, and to understand the extent to which these environments were cognitively stimulating for older adults with dementia. Results indicated varying levels of enrichment both within and between homes, with nearly a quarter of the residents living in environments that contained no memory-enhancing stimuli.     

Housing Conditions and Risk: Reporting on a European Study of Housing Quality and Risk of Accidents for Older People

The declining capacities in older people often lead to limitations in activities of daily living and a simultaneous rising demand for care services. Many of these limitations in daily activities are to a varying degree caused, enhanced or facilitated by disadvantageous housing and environmental conditions. Home modifications have been credited as an important part of the solution, allowing for an extended and safer use of the home. In order to examine this issue in more detail, this paper provides empirical evidence on the type and extent of risks associated with accidents around the home. It reports on findings from a European case study on the difficulties using the home and risks of accidents which may lead to injury. It is argued that healthy housing conditions for older persons are important to maximize the supportive capacity of one's home, to stimulate an active and healthy lifestyle, and to avoid unnecessary institutionalization.     

The Importance of Personal Possessions for the Development of a Sense of Home of Nursing Home Residents

ABSTRACT

Personal possessions of nursing home residents can contribute to their sense of home. This study investigated which of the personal belongings were considered most important, and if these items indeed contributed to a sense of home. A qualitative research was conducted with 27 nursing home residents. Photographs, paintings, and pieces of furniture are objects with sentimental value. The television set is valued for its practical function. Residents of larger rooms have more flexibility in bringing along personal items, including pieces of furniture. The results of this study can be used for the design of nursing homes or for making informed choices during the process of institutionalization.     

Women Caring for Our Aging in Place Seniors Will Lose Out because of U.S. Immigration Policies

Most older people experiencing chronic health problems, physical disabilities, and memory losses are still able to age in place in their own homes. However, they often need help from others to enjoy healthy, active, and independent lives. They turn mostly to family members, mainly women and usually their daughters, daughters-in-law or wives. But caring for frail elders has become more demanding and complex, and these family members often feel physically and emotionally overwhelmed and burnt out. They concede that they cannot do it alone. Others find it more difficult to hold full-or even part-time jobs. Hiring home (direct) care workers to assist their loved ones can be an effective solution to ease their caregiving responsibilities. However, these personal care aides, home health aides, and nursing assistants are already in short supply. Moreover, going forward the aging of the baby boomer population will result in an even greater demand for their services even as these jobs are often unattractive to American-born workers and turnover is high. This country’s immigration policies will make it even more difficult for women caring for older persons to hire these workers. Over 25 percent of home care workers are low-skilled immigrants or foreign-born. However, the Trump administration’s policies reduce the number of immigrants entering the U.S. and specifically choke off the various pathways that enable low-skilled persons to be hirable in the home care sector. Female caregivers seeking relief from their caregiving responsibilities will lose out unless we remove these immigration barriers.     

Altering the Curriculum of the Home: Learning Environments for Korean and U.S. Students

ABSTRACT

The family and home environment are considered the most significant influences on children's development and learning. These factors directly influence student ability, motivation, and interest in learning. This study focuses on alterable factors in the home environment (i.e., homework time, attitudes, expectations, reading). A multiple-factor model provides a framework to discuss the family influences that appear to explain achievement differences. To gain perspective from international comparative studies, statistical findings highlight family practices in Korea and the United States. The implications from this article discuss altering the curriculum of the home, providing supportive family conditions, early intervention, and family–school collaborations. Altering constructive factors in the home environment in any culture may strongly influence children's learning and development.