Housing Design and Community Care: How Home Modifications Reduce Care Needs of Older People and People with Disability

Abstract

The extent to which housing design can minimise levels of community caregiving has remained largely unmeasured. This paper reports the potential for home modifications to reduce caregiving in the peoples’ homes, particularly older people and people with a disability. It contributes to new knowledge in understanding how housing can play a role in community caregiving and acknowledges the role of the built environment in managing care levels in ageing societies. This paper analyses self-reported care data from 157 Australian community care recipients (average age: 72 years) who had received home modifications within the past 6 months. A before/after comparison of care provided revealed that home modifications reduced hours of care provided by 42% per week. More detailed analysis revealed that the positive association of home modifications with care reduction is stronger with informal care (46% reduction) followed by formal care (16% reduction). These results suggest the role that home modifications, and housing design in general, play in reducing care needs in a community setting.

A Social-Ecological Approach to Identify Facilitators and Barriers of Home Modifications

“…Home modifications may also potentially prolong independence at home, or in some cases, delay institutionalization of older adults [11]. Additionally, people living with a disability at any age may benefit from home modifications [12]. Thus, home modifications may act as a bridge to emphasize active aging through a life course perspective [4].…”

Measuring Age-Friendly Housing: A Framework

“…Even if benefits can be achieved by adopting either standard or personalized modifications [97], the types of interventions and their impact on wellbeing are highly individual [104]. There is a consensus in the literature on the several benefits arising from home modifications: Improving accessibility, preventing falls, promoting safety, reducing difficulty in performing everyday life tasks, and reducing the need for health care [38,67,69,97,104,[109][110][111]. However, to be fully effective, interventions on dwellings must be combined with other strategies such as fall-prevention programs [85,110].…”

Older Clients’ Pathway through the Adaptation System for Independent Living in the UK

“…A number of studies [35][36][37] have reported that housing adaptations have improved health, independence and quality of life in later life. Beyond health and independence, several other studies [38][39][40] have further found that environmental adaptations have reduced older people's need for support from family caregivers and have lessened the strain on family relationships. Because of their key role in preventing falls, avoiding hospital admission and reducing domiciliary care, housing adaptations have brought significant savings to the National Health Service (NHS) services, home care costs and social services budgets [41][42][43].…”