Heterogeneity of Characteristics among Housing Adaptation Clients in Sweden—Relationship to Participation and Self-Rated Health

Abstract

The aim of the paper was to explore the heterogeneity among housing adaptation clients. Cluster analysis was performed using baseline data from applicants in three Swedish municipalities. The analysis identified six main groups: “adults at risk of disability”, “young old with disabilities”, “well-functioning older adults”, “frail older adults”, “frail older with moderate cognitive impairments” and “resilient oldest old”. The clusters differed significantly in terms of participation frequency and satisfaction in and outside the home as well as in terms of self-rated health. The identification of clusters in a heterogeneous sample served the purpose of finding groups with different characteristics, including participation and self-rated health which could be used to facilitate targeted home-based interventions. The findings indicate that housing adaptions should take person/environment/activity specific characteristics into consideration so that they may fully serve the purpose of facilitating independent living, as well as enhancing participation and health.

Health-Related Quality of Life among People Applying for Housing Adaptations: Associated Factors

“…A potential explanation might be that their expectations on life in general are similar to others in the same age, but when comparing their own life with others they feel much more restricted and impacted by their activity restrictions, in this study demonstrated by their higher level of ADL dependence, and thus perceive their health as lower. When it comes to the older age group, they might perceive their activity limitations and dependence as a natural consequence of ageing, and thus it has less impact on their self-rated health compared to those that are younger [ 20 ].…”

“…UIMH has been tested for validity and reliability [ 27 ], and a further validation is currently ongoing [ 28 ]. Three aspects of usability have been identified; “Self-care aspects” (compromising 5 items: going to the toilet, personal hygiene, preparing meals, preparing snacks, and moving around the home with/without a mobility device, score 5–25 points), “Social aspects” (compromising 3 items: socializing with family and friends in the home, contacting others via telephone/Skype, and watching TV/listening to radio, score 3–15 points) and “Leisure/outdoor aspects” (compromising 3 items: entering the house, picking up the mail, and engaging in hobbies and leisure activities in the home, 3–15 points) [ 20 ].…”

“…People applying for HA are a heterogeneous group, in terms of e.g., age, independence in activities of daily living, participation in social activities and living conditions [ 19 , 20 ]. Most of them are 70 years or older [ 18 ] with declining physical and cognitive capacity due to normal ageing, or diseases such as stroke and dementia.…”

“…Most of them are 70 years or older [ 18 ] with declining physical and cognitive capacity due to normal ageing, or diseases such as stroke and dementia. However, younger people with injuries or diseases belong to this population [ 20 , 21 ]. Though different in terms of sociodemographic, clinical, and functional characteristics, they share the common need for having their physical home environment adapted to live independently.…”

Participation in Everyday Life Before and After a Housing Adaptation

“…People applying for an HA have different ages and levels of cognitive and physical function (Kim, Ahn, Steinhoff, & Lee, 2014;Thordardottir, Chiatti, Ekstam, & Malmgren F€ ange, 2016). They often have a reduced ability to perform activities (Johansson, Lilja, Petersson, & Borell, 2007;Petersson, Kottorp, Bergstrom, & Lilja, 2009;Petersson, Lilja, & Borell, 2012;Petersson, Lilja, Hammel, & Kottorp, 2008); their functional capacity is too low to overcome the environmental barriers in their own home, and thus they become dependent on others.…”