A Novel Adaptation of the HOME Inventory for Elders: The Importance of the Home Environment Across the Life Course

Abstract

The context in which dependents, regardless of age, receive care affects their health. This study adapted the Home Observation for Measurement of the Environment (HOME) Inventory, originally designed for child development research, to assess the quality of stimulation and support available to elders in their habitual households in Sri Lanka. Whether the adapted domains correlated with indicators of health and well-being in ways consistent with the child development literature was then examined. Through mixed-methods research based on 248 household surveys, four focus groups, and 15 interviews, three domains emerged: Physical Environment, Variety of Stimulation, and Emotional and Verbal Responsiveness. Regression modeling revealed that a higher quality physical home environment correlated with two measures of cognitive function after adjusting for covariates, but no consistent association with two psychological well-being scales. In contrast, higher Variety of Stimulation scores correlated with better cognitive function and lower psychological distress. There was no consistent correlation between Responsiveness and selected health outcomes. Qualitative data indicate that elders are active household contributors who strive to achieve harmonious relations with coresident kin. These findings reveal notable synergies between early and late life efforts to improve cognitive and psychological health, and highlight household considerations for future healthy aging research.

Single Time-Point Study of the Home Environment and Functionality of Older Adults in Spain

“…Table 4 shows the items of the different domains of the HOME inventory [ 8 ] based on cognitive level. The means of items detailing optimal cognitive level fluctuate between 26 and 78 points.…”

“…In addition to physical resources, sociability predicts the cognitive level of older people living in the community [ 8 ]. The home-socio-affection environment is created through the interactions of the individual with other people in their physical environment.…”

“…Finally, the domain “emotional and verbal sensitivity” is made up of 10 items that ask about interactions between the participant and their caregiver, in terms of the quality of their communication and affection (10 items). As pointed out by Hale et al [ 8 ], scores ≤ 7 points in the home-physical, home-stimulation and home-socio-affection domains of the HOME inventory indicate an adequate environment.…”

“…The measure used was the Home Observation for Measurement of the Environment (HOME) inventory [ 8 ], which assesses the physical, social and personal characteristics available in the home environment of older people. The assessment takes between 45 and 90 min.…”

“…The characteristics of the environment are not neutral; in fact, an environment that has places to walk or bio-healthy parks has numerous health benefits for a person of any age, but especially for an older person with fragile health [ 8 ]. Furthermore, access to health services and community activities influences the preservation of one’s autonomy, personal development and one’s ability to achieve their goals [ 9 ].…”