An overwhelming majority of seniors prefer to “age in place” – that is, to live out their lives in their own homes or in non-nursing facilities that let residents retain much of their independence.
However, many seniors have some functional limitations that must be accommodated by their housing.
Access to housing that supports healthy aging isn’t universal; there are substantial accessibility issues to housing for seniors with functional limitations, according to a recent study published in BMC Public Health.
What are the barriers to access, and how can they be addressed?
In the study, researchers dove into that question. They examined senior housing in Sweden, but its conclusions apply broadly to all Western countries.
A bit of background, from the study:
In many countries different housing options for senior citizens are developing and transforming in both content and design. Due to a strong ageing-in-place policy in many Western countries and in Sweden in particular, an increasing share of the ageing population can be expected to live in dwellings in the ordinary housing stock despite health problems and need of health- and social care services that often come with age.
[…]
Housing accessibility problems are commonly dealt with on an individual level providing housing adaptations. However, aiming for accessible housing that supports ageing-in place, measures must be taken also on a group or population level. Foresighted housing provision with potential to accommodate the ageing population requires knowledge on the occurrence of environmental barriers in the ordinary housing stock. However, valid information on the detailed level required is lacking and the consequences environmental barriers generate in terms of accessibility problems for those senior citizens having different combinations of functional limitations are unknown.
The objective of the present study was to make an inventory of environmental barriers and investigate accessibility problems in the ordinary housing stock in Sweden as related to the functional capacity of senior citizens.
The authors found that the same elements that make for an independent life in old age – kitchens, bathrooms, etc. – also pose significant barriers for seniors with functional limitations.
These barriers can be improved through renovation – bathtubs instead of showers, low shelves, grab bars – but governments would likely need to bear some of the cost. From the study:
In line with previous research the results show that entrances, kitchens and bathrooms often have several environmental barriers that generate accessibility problems for people with functional limitations.
Kitchens and bathrooms are crucial for many activities of daily living such as being able to cook or shower independently. Thus, these results can be used to develop targeted actions for improving accessibility and independence in ADL and thereby influence health positively. In Sweden, the individual housing adaptation grant is a well-established intervention to eliminate problematic environmental barriers in the home. While this type of intervention is person-centred and target individual needs, our results reveal that the high number of environmental barriers and magnitude of accessibility problems could not possibly be eliminated by housing adaptation grants. Thus, large scale and systematic actions are needed if society wants to support active and healthy ageing for senior citizens.
The possibilities to finance large scale upgrading of the existing ordinary housing stock might be questioned, and unfortunately research on cost-effectiveness for housing interventions is rare. A financial evaluation of renovations in multi-dwellings in Sweden showed that, when accomplished simultaneously with pipe replacement, making the bathroom accessible did not cost more than a regular renovation. In fact, it was suggested that effects in terms of postponed or reduced need for home help services, informal care and special housing would make these actions profitable for the municipalities. The result showing how common the environmental barrier Stairs the only route (no lift/ramp) at entrances are, underlines the relevance for adopting a societal planning perspective to support active and healthy ageing. Thus, in the most recent governmental commission on housing for the ageing population in Sweden a main recommendation was to provide multi-dwelling estate owners governmental financial support up to 50 % of the cost for the installation of lifts in existing multi-dwellings.
The study concludes:
Despite high housing standard in the Swedish ordinary housing stock the results show a high prevalence of environmental barriers and substantial accessibility problems for senior citizens with functional limitations.
Considering there are many countries with a similar demographic situation and with comparable standard and conditions of the ordinary housing stock, our findings highlight a large-scale problem for the Western world at large. Accessible housing is the basis for active and healthy ageing and a necessity in countries with a strong ageing-in-place policy. To make housing accessible for senior citizens large-scale and systematic efforts involving many actors are required. The results of the present study provide additional impetus to such efforts.
