Abstract:

In this chapter, the Environmental Press Model is used to provide a perspective on the difficulties that many older people experience with routine household activities. Both ones' competence and the pressures of the home environment (environmental press) interact to produce the difficulties experienced. When demand exceeds capabilities, there are unmet housing needs. It is emphasised that aged and aging people should be treated as individuals - the type and degree of difficulties that they face vary significantly, and so, therefore, should the modifications recommended for their use - in order to acheive maximum benefit and to increase the likelyhood and willingness of individuals to make modifications on their homes. This chapter's focus is the development and application of a framework to identify housing needs, in order to make home modifications individualised for older people with a variety of disabling conditions. Routine activities (ADL's, IADL's, Ambient Temperature Control and common home activities) and design features (looking at functional capabilities relevant to home design features - access, use and exit of rooms, appliances and fixtures) are accounted for. This allows a distinction to be drawn between the different sorts of activities that may be impacted by disability, and in which ways this might be so. Products used in the home (ie: appliances), and their controls and hardware impact an individuals ability to operate them effectively. A study was conducted to assess individual performance of routine activities - with one's independence and the difficulty of the activities accounted for. It is thought that modifications designed to lessen the difficulty one has performing a task are likely to encourage independance in ADL's. Individuals were filmed completing activities of daily living in a home setting, with difficulties in task performance being observed, reported or inferred. Physical characteristics of home design were collected and collated. The chapter presents detailed case studies and findings related to background, housing needs, performance and home modifications. Findings suggest few problems in routine, daily activity performance - with difficulties being widespread across tasks. However, the tasks most challenging for those belonging to different disability categories were dependant upon type of disability, and required specific modifications. Inconsistancies were found in self reports of ability and what was observed, and recommendations for home modifications were provided based on the appropriate, individual needs. Peoples perceptions of the requirement or appropriateness of modifications heavily impact the likelyhood of modifications being undertaken.