Abstract: We present an approach to exploring the role of environmental supportiveness in contributing to older people's quality of life (QoL), based on Little's ecological model (2010) in which individual and situational factors influence the personal projects of salience to individuals. Personal projects are self-generated and purpose-oriented activities or goals in which an individual is engaged (Little, 1983). The efficacy with which the pursuit of these activities is achieved depends on the nature of the project and the degree to which it is supported by external factors such as the environment. We explore the relationship between the outdoor environment and QoL, drawing on the concept of “environmental support” as presented by Sugiyama and Ward Thompson (2007a). There is a positive relationship between the number of outdoor personal projects older people participated in and measures indicative of their QoL. The relationship between perceived environmental support and QoL measures was significant in pr...

Abstract: As the quest for knowledge translation from research to practice and policy contexts is growing stronger, researchers need to develop strategies for synthesizing research findings. Since home environments constitute an important context for the delivery of health care and social services to older adults and people aging with disabilities, research in this field can serve as an example for such endeavors. Using 35 original publications and one unpublished doctoral dissertation based on the European ENABLE-AGE Project, we aimed to demonstrate a systematic approach to synthesize research findings generated by large research projects as the basis for evidence-based interventions. The synthesized findings highlighted the complex interactions between objective and perceived aspects of housing and aspects of health in very old age, impacting on, for example, residential decision making. Independence in daily activity is influenced by the sociocultural care and service context. A familiar and safe neighbo...

Abstract: While there is growing interest in inclusion of gardens and outdoor spaces in residential care facilities for older adults, these spaces are often underutilized despite many identified, evidence-based benefits. A qualitative study of participant observations with behavior mapping, and individual and focus-group interviews, using a grounded theory methodology was used to understand value versus use of outdoor garden spaces. Individual and focus-group interviews were conducted with 32 residents from two facilities. Results revealed that views of nature are fundamentally important to resident well-being, that access to nature influences facility choice, and use of garden spaces is influenced by the way in which individuals prefer to enjoy nature.

Abstract: Lighting has been identified as a significant environmental attribute for promoting vision and general health among older people, enabling successful aging at home, but it has received little attention in the literature. Indoor lighting levels, self-reported vision and general health, and activities of daily life were measured in 114 healthy 75-year-old Norwegians. Despite very low levels of indoor lighting, the subjects were happy and healthy. There is a large discrepancy between self-assessed health and recommended lighting levels, and low awareness of the effect of lighting on age-related vision loss or daily living in the future. Knowledge of how to utilize indoor lighting to ensure healthy and safe aging in the home is needed.

Abstract: An unknown number of mentally ill elders in the United States receive care in assisted living, along with persons facing physical or cognitive challenges. While dementia is familiar in assisted living, our data indicate that neither staff nor residents are prepared to work or live with the mentally ill. Challenges are created for professionals, since these residents bring diverse needs. Daily interresident interactions are also disrupted or stressful. Qualitative data describe the impacts on quality of resident life as well as care and management dilemmas identified within five assisted-living settings having varying presence of mental illness among residents.

Abstract: Sensory gardens are increasingly popular in Norwegian nursing homes. This study examined the design characteristics of Norwegian sensory gardens using a cross-sectional web survey design addressing nursing home leaders (n = 121). The findings revealed that Norwegian sensory gardens were generally compliant with recommended design guidelines involving sensory experiences, stable walkways, landmarks, accessibility, visibility from indoors, seating features, and prosthetic supports. There is, however, a potential for further improvements concerning walkways with rails, access to alarm systems, clear signposts to toilets from the outdoors, lighting in the evenings, greenhouses, increased awareness of edible and nontoxic plants, and maintenance of the gardens.

Abstract: A housing adaptation (HA) can enable independent living in one's own home, but deciding to change the home environment can be a thought-provoking matter. The aim of this study was to explore the applicant's perspective and decision-making process when applying for an HA grant. Seventeen persons were interviewed about their application for such a grant, and the data were analyzed using a constant comparative approach. The findings illustrated how the participants negotiated control in their everyday lives as they went from recognizing a need to then deciding to apply for an HA grant. Before coming to a decision, alternative solutions were considered and their expectations on the effect of having an HA were explored. This knowledge is useful for professionals and caregivers to help support people during the HA decision-making process.

Abstract: Creating active-living, age-friendly communities requires new methods to assess public spaces and to engage older citizens in healthy urban planning. This article presents the development and piloting of a participatory group tool to evaluate and rate the quality of streets for walking from the viewpoint of older adults, designed as a simple and practical perceived built-environment measure for action and research purposes. The pilot study took place in two cities (Lisbon and Odivelas) in Portugal, and involved 32 older residents and local partners.

Abstract: In the context of healthy aging, we explore newly constructed, unassisted affordable rental housing with respect to design, location, and the involvement of seniors in decision making. We do so from the perspectives of seniors and project sponsors. Overall, the themes that emerged from these two groups of participants diverge. Seniors spoke about the importance of shared space, design-related barriers to aging in place, and problems accessing transportation. They also expressed a range of views regarding participation in decision making, from conveying it was not necessary to requesting resident involvement. Project sponsors spoke about cost, feasibility, and, in certain cases, learning how to build housing; they also evinced disparate views about the nature of the housing they were providing and the importance of seniors' involvement. Recommendations include linking housing to health and social policy, implementing guidelines for sponsors related to design and location, and providing increased fu...

Abstract: An innovative housing model that provides integrated support services to a mixed community of adults with physical, developmental, and mental health needs demonstrates how the use of social and personal space intersects with social participation levels. Case study findings from the first two years of this five-year research project at Reena Community Residence will report on the lived experience of a diverse, multigenerational population as they transition from various residential settings and connect to a new “intentional community with supports.” It is important when considering housing for older adults who are aging in place to recognize that these tenants with special needs age much earlier than the rest of the population. Tenant responses define their personal space and environmental fit. Emerging levels of social participation are being recognized by the tenants as life-changing events.

Abstract: Elderly housing policies in Finland emphasize aging in place and preparing the existing housing stock for the predicted increase in the aged population. Timely home modifications that enhance mobile accessibility are a focal target for these policies. This article introduces the idea of mass-customizable architectural accessibility improvement models (AIMs) that have been developed for typical Finnish flats. The applicability and generalizability of an AIM designed for an archetypal two-room flat is tested by applying it to nine case buildings in the city of Tampere. The model was found to be beneficial for 42 of the 45 rooms in the research material.

Abstract: The environments in which people live contribute to their health. This evaluation of a new seniors assisted living facility studied the role of the built environment on healthy aging. An environmental design survey was used to examine resident satisfaction and place attachment as a way to increase awareness of person-environment fit. Surveyed residents reported high levels of satisfaction with the built environment, and satisfaction scores were positively correlated with measures of place attachment. The results of this evaluation increases our understanding of how the built environment impacts seniors in residential living facilities, and the value of measures examining person-environment fit.

Abstract: This article explores perceptions on the suitability and effectiveness of Lifetime Homes standards (LTHS) for those with visual impairment in Northern Ireland LTHS are a series of mandatory United Kingdom public-sector housing design interventions, providing a model for ensuring accessible and adaptable homes throughout an occupant's life span An aging demographic with increasing incidence of diabetes has led to rising numbers of elderly, visually impaired people wanting to remain in their homes for longer Qualitative semi-structured interviews were conducted with 13 key stakeholders and thematically analyzed Although findings show that employing LTHS offers benefits to visually impaired residents, shortcomings were also identified Evidence indicates a need for policy makers, health-care professionals, and housing associations to modify practices to better meet the housing needs of visually impaired people Findings may also be applicable to those with other impairments and disabilities in re

Abstract: The perception of elderly residents as a homogeneous group is challenged by the diversification of lifestyles and emphasis on individuality in housing. Recently, there has been a rise in Finland in housing projects initiated by groups of elderly people, where the seniors themselves are seeking to fill in qualitative gaps in the offering of housing. This article presents a comparative analysis of four senior housing concepts that represent both a producer-driven (“for the elderly”) and a resident-driven (“by the elderly”) approach. The study shows that elderly people can be a resource for residential development and that this necessitates a different “design logic” than in conventional senior housing.

Abstract: In the United Kingdom, the supply of new homes to the housing market tends to be focused either on “general-needs” housing on the one hand, or on special-needs housing for the elderly on the other, with relatively few people moving into homes that will support their independence as they age. Against the backdrop of the UK's chronic housing shortage and the UK government's recent Housing Standards Review, this case study of a mainstream housing development—which meets so-called “Lifetime Homes” in “Lifetime Neighborhoods” standards—identifies specific design and locational features that have attracted “downsizers” to buy into it, as well as those they subsequently found problematic.

Abstract: Although there is no generally agreed upon definition of the term age friendly, almost all definitions share the same health related goals. Menec et. al. offered a conceptual framework defining age friendly as efforts to increase connectivity. Our analysis was designed to test the hypothesis that targets of many age friendly efforts (food, housing, transportation and social capital) are associated with these health outcomes. We discovered that the two areas associated with increasing connectivity, transportation and social capital, were associated with the age-friendly health related goals. We conclude that Menec's framework provides a useful way of defining age friendly interventions.

Abstract: The aim of this article is to discuss approaches to services integration for older people in urban and rural aging environments in The Netherlands, and the preliminary effects of these approaches on local aging conditions. In urban areas, services integration revolves around the creation of functional spatial hierarchy. In rural areas, the emphasis is on forging links between service providers. Outcomes for health and use of professional care services are similar. Out-comes for housing, informal care, and accessibility of services differ between urban and rural areas in ways that can be traced back to local aging conditions and elements of the specific approach to services integration used. In both urban and rural areas, much more could be done to connect formal programs to the lifeworlds of older dwellers.

Abstract: The demographic statistics in developed countries suggest growth in the elderly segment of the population. At the same time, other studies forecast a shortage of nurses, increasing the pressure on hospitals to provide treatment for longer periods of time. These trends suggest a need for new ways of taking care of the elderly population that support safe, comfortable, and independent living. Meanwhile, prominent advances in information and communications technology (ICT) have enabled new systems that address various needs of the elderly. This article presents a case study of a rehabilitation facility located in Tampere, Finland, that uses an automation system in which ambient assisted living (AAL) and building automation (BA) system functionalities are combined. It details a field study summarizing the needs of the users, describes functional scenarios supported by the system, and reports the results of the first usability tests suggesting acceptance of a new technology by residents and caregivers....

Abstract: Moving into a retirement community may be precipitated by or bring about changes in health status. We hypothesized that moving into a retirement community would be associated with a decline in self-rated health (SRH), but that health-related factors would mitigate this association. We analyzed data from 58,272 participants in Cohort 3 of the Medicare Health Outcome Survey. Individuals answered questions regarding living status in 2000 and 2002. Those who moved into a retirement community were compared with those who did not. The primary outcome was change in SRH. We created adjusted and unadjusted models. A total of 2,520 participants (4.4%) moved into retirement communities between 2000 and 2002. There were no substantial differences in the mean change in SRH between those who moved and those who did not. In adjusted and unadjusted models, moving was not significantly associated with changes in SRH. In an analysis stratified by SRH, only those with the best SRH had a significant decline in SRH ...

Abstract: This article describes a framework for measuring activity demands and the psychometric properties of a related measurement tool, the Multidimensional Activities Demand Strength for Assisted Living (MADS-AL). Nine experts—three in physical, cognitive, and social domains, respectively—rated demands of 37 common assisted-living activities. Interrater reliability and internal consistency for physical, intraclass correlation coefficient (ICC)(2, 3) = .96, Cronbach's α = .97, cognitive, ICC(2, 3) = .71, α = .93, and social, ICC(2, 3) = .80, α = .86, scales give preliminary support for reliability of the MADS-AL tool. Overall, this article moves the field toward considering task demands as a relevant variable to inform future activities research and practice.

Abstract: Residential care facilities, known by a variety of names such as assisted living or group homes, offer assistance to people who find it difficult to live alone but who do not need or wish to enter a nursing home. There is substantial variation in the amount that residents are charged each month. Data from the 2010 National Survey of Residential Care Facilities were used to identify factors that affect the total monthly charges to residents. These findings can inform an individual's search for an appropriate, affordable option.

Abstract: Although the elderly as a while show relatively little geographic migration in the U.S., we were interested in the geographic migration patterns among a specific subset of elderly that we know have moved out of the traditional family home—those living in assisted living and independent living communities. We analyze data from the Residents Financial Survey, a survey of 2,617 residents in assisted living and independent living communities that asked about their previous living arrangement, where they lived before moving to their current community, and how their care needs were previously met. We find there is substantial migration among respondents. Using self-reported and community-reported location and zip code information, we calculated whether people moved across state lines and we computed the distance people moved between their previous location and their current community. While the median distance moved is less than 10 miles, 20% moved across state lines and 21% of the sample moved more tha...

Abstract: Although most older adults prefer to age in place, their homes often lack supporting features. Universal design (UD) modifications help promote independence and reduce the risk of accidents. This study investigated whether educating homeowners about UD following a home disaster influenced the repairs they made. Home insurance policyholders who submitted claims for damage to bathrooms or kitchens received an educational brochure introducing UD features. Homeowners completed follow-up surveys with questions about home modifications made, respondents' demographic characteristics, and householders' ability to perform activities of daily living (ADLs). Descriptive and bivariate analyses were conducted. Thirty-three of 37 respondents (89.2%) had implemented UD modifications, making an average of 9.1 UD modifications. Most respondents rated the brochure information positively and respondents' self-rated knowledge of UD improved after reading the brochure. The number of modifications made was positively a...

Abstract: Since 90% of older adults prefer aging in place (Wang, Shepley, & Rodiek, 2012), it is important that neighborhood design supports successful aging Beyond basic needs, research indicates quality interaction is associated with positive health and well-being benefits, particularly for older adults In this, design supporting social relationships plays an essential role This study's purpose was to identify New Urbanist neighborhood and social space design attributes supporting older residents' physiological and social needs This case study used keyword-in-context analysis with focus group interview data to identify domains supporting social interaction for residents aging in place including: location factors, social factors, design factors, and programmatic factors

Abstract: This study asserts that in order to enhance functionality of home modification, caregivers need specific training by professionals before environmental changes create confusion. The purpose of this study was to investigate the beliefs and attitudes of caregivers regarding the effects of environments on the independence of a family member with dementia living in the home. Using a phenomenological approach to gather narrative information about caregiving and the home environment, semi-structured interview questions were conducted with six caregivers in a rural Midwestern county. Two main themes emerged from the caregiver perceptions regarding attitudes about the physical environment: (a) change within the home creates confusion in the care recipient; and (b) there are few changes in the home that will increase the independence of a person with dementia. The findings of the study resulted in a deeper understanding of caregivers’ attitudes about the physical environment and their resistance to environ...