Participation in Everyday Life Before and After a Housing Adaptation

The Relationship Between Physical Housing Characteristics, Housing Accessibility and Different Aspects of Health Among Community-Dwelling Older People: A Systematic Review

Objectives: To synthesize the evidence on the relationships between physical housing characteristics or housing accessibility and different aspects of health among community-dwelling people 60 years and older. Methods: A systematic review of recent evidence with a narrative synthesis was conducted. Results: We included 15 studies and found three themes covering physical housing characteristics or housing accessibility that are associated with aspects of health among community-dwelling older adults: (1) interventions by home modifications targeting housing features both at entrances and indoors; (2) non-interventions targeting indoor features; (3) non-interventions targeting entrance features, that is, the presence of an elevator or stairs at the entrance. The overall quality of evidence across studies was assessed as very low. Discussion: The findings highlight the need for studies with a stronger research design and higher methodological quality that address the physical housing environment in relation to health among older adults to strengthen the body of evidence.

Older adults' perspectives on physical activity and sedentary behaviour within their home using socio-ecological model

BACKGROUND

There are few studies that focus explicitly on the impact of the home environment on older adults' sedentary behaviour (SB) and physical activity (PA) using the socio-ecological model (SEM). This study aims to investigate older adults' PA and SB within the home environment integrating the SEM as a theoretical framework.

METHODS

A qualitative exploratory research design was employed to conduct 33 in-depth interviews (IDIs) and five focus group (FGs; n = 16) with multi-diverse ethnic older adults (mean age 72±5 years). Using reflexive thematic analysis themes were generated from the data set and were interpreted using the SEM.

RESULTS

The findings indicate that different levels of the SEM had an impact on older adults' PA and SB. These include the 1) Individual level: Attitude, perception and motivation 2) Interpersonal level: Family and Friends: a motive to remain active 3) Organisational level: healthcare institutes, 4) Community level factors: Significance of social groups, 5) Physical Environment: Microenvironment and 6) Policy level factors (lockdown restrictions and healthcare system). This model can be utilised to foster activity within the home by focusing on the facilitators and barriers identified at each of these levels of influence.

CONCLUSION

The study findings suggest that modifying PA and SB in the home environment is complex and is influenced across different levels of the SEM. Therefore, a holistic approach is required that integrates these multiple influences. This understanding can inform the design of interventions that seek to optimize PA and minimize SB within the home environment.

Development of a tool to assess environmental factors to support home care - a Delphi study

BACKGROUND

Living in an adequate environment suited to one's abilities and needs is an essential condition to function in daily life. However, no complete tool currently exists to provide a rapid overview of a person's environment, both material (accommodation and auxiliary means) and social (entourage and available services). Our aim was to develop a tool to identify potentially problematic environmental factors and to determine when an in-depth assessment is necessary.

METHODS

Health professionals experienced in home-based treatment participated in a three-round Delphi process. The first round aimed to define which items the tool should contain, the second to collect participants' opinions on a first version of the tool, and the third to collect the participants' opinions on the adapted version of the tool.

RESULTS

A total of 29 people participated in the first round, 21 in the second and 18 in the third. The final tool contains 205 items divided into four categories (basic information about the inhabitant and their home, inhabitant's level of independence and autonomy, home, tools and means at the inhabitant's disposition) and two annexes (stairs to access to the home, internal staircase to the dwelling).

CONCLUSIONS

A complete tool allowing professionals working in patients' homes to obtain an overview of the environmental factors that could represent obstacles to the independence of the inhabitant, or to the possibility of providing quality care could be developed. This tool is very complete but relatively long. To facilitate its usability, it would be relevant that a digital version to focus on individual relevant categories be elaborated.

Needs, benefits, and issues related to home adaptation: a user-centered case series applying a mixed-methods design

Introduction

Home adaptation can be a key contributor to successfully aging at home, allowing older adults to remain in a familiar environment while maintaining their quality of life and well-being despite progressing functional difficulties. Although several theoretical studies on home adaptations exist, the benefits of custom home adaptations remain poorly evaluated. The present study's primary aims were to explore older adults' expectations and needs regarding home adaptations and evaluate the impact of individualized home adaptations on quality of life, fear of falling, independence, and difficulties using adapted rooms. Its secondary aim was to describe the barriers and facilitators of home adaptation.

Method

The 15 homes in this case series were adapted using an inclusive, interdisciplinary approach. Adaptations' effects were assessed using a parallel mixed-methods design. Quantitative and qualitative data were collected using questionnaires and semi-structured interviews. An architect and a health professional visited each home twice to assess the older adult's expectations and needs, evaluate the home's technical aspects, and co-create an adaptation plan with that study participant. They assessed the older adult's perceived quality of life, fear of falling, independence, and difficulties using the rooms needing adaptations. Inhabitants received two more visits after the adaptations (one or two months and six months later) to assess their benefits.

Results

Most homes had their bathroom adapted. Participants reported improved safety, independence, ease of use, positive feelings, and comfort. They also reported lower perceived levels of difficulties during the activities of daily living in the adapted rooms (reductions of 93.4% [SD = 12.7] of bathrooms and 100% of kitchens), an improvement in quality of life of 9.8% (SD = 27.6), and a reduction in fear of falling of 12.5% (SD = 9.7).

Conclusion

Home adaptations are beneficial to older adults' activities of daily living and improve their quality of life; however, several factors hinder the implementation of those adaptations.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-03204-2.