The Home Environment & Disability in Older Adults
By Richard Shank
The home environment has become widely recognized as an important factor in influencing the daily functioning and physical abilities of older adults. In fact, the relationship between the home and disability has become an important public health problem, because the majority of older adults live in private households and those age 80 and over spend the majority of their time in the home.
Often, home modifications are made to reduce the risk and impact of falls. Interestingly, home modification research only finds limited support that this happens. Rather, the research literature suggests that the benefits of home modification lie in its ability to reduce disability, not falls. A recent review of the home modification literature found that most research on the home environment concludes that a consensus has emerged suggesting that improvements to the home environment will increase physical functioning and delay the onset of disability. However, that this increased functioning did not reduce falls; only the long-term impact of them. Additionally, the research literature points out that the known gain in physical functioning can be increased when the design of home environments is matched to the needs of individual residents.
Questions remain as to why home modifications can reduce disability but not necessarily falls. One explanation is that falls are seldom and seemingly random events, whereas physical functioning and disability entails everyday interaction with the home environment.
Source: Wahl, H., Fange, A., Oswald, F., Gitlin, L., Iwarsson, S. 2009. The home environment and disability-related outcomes in aging individuals: What is the empirical evidence? The Gerontologist 49(3): 355-367.
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