Abstract:

This chapter queries why there is so little progress toward making residential environments more accessible. Awareness, affordability and adequacy of service provision are all considered to play a role in this slow progress - as are stereotyped beliefs regarding elderly people's competencies, a medical perspective of the issues facing elderly people (rather than environmental perspectives), need for extreme adaptations, and the need for repairs and maintenance. The chapter focuses on the required steps - in terms of research, practice and public policy - that will allow us to move forward to more life-long accessible housing by understanding how to individualise, assess, implement and pay for required home adaptations. The chapter presents an overview of the preceeding book chapters and their scope of research, with more individuals thought likely to develop an interest in home adaptations. More research is thought needed as to how disabled individuals use adaptations, and how such adaptations impact levels of independence, QOL, need for informal assistance, safety and medical costs. Also needing to be accounted for and considered are home and real-estate values. It is recommended that case managers, visiting nurses and other in the community long term care network should be trained to assess adaptation needs - thus increasing the possibility for service provision. Public education, product knowledge and awareness campaigns may help to increase the desire to modify. Funding for those in the lower income brackets is necessary to pay for adaptations, and is currently inadequate. Similar disabilities may require different approaches in order to maximise independence - depending upon context. A public policy response is encouraged, and possible programs are suggested - including a loans program for low income individuals. Increased research funding is also encouraged. Co-ordination of service delivery is an important area to note, with a need for public policy that supports comprehensive co-ordination of services and research material production. Overall, it is concluded that the home modification field is, at the moment, a growing and important field for research and development - with future development requiring a high degree of consumer input and targeted education.