Abstract:

Explores environmental adaptations to the home as part of a comprehensive and flexible approach to care management in Australia and addresses potential impediments to empowerment. Lack of environmental adaptations in care management can: 1) limit choices and flexibility in support, and thus limit power; 2) fail to minimize the use of visiting human service providers for frail seniors who prefer to maximize privacy and independence; 3) fail to achieve maximum integration and coordination of the support options most desired by frail elderly clients. When environmental adaptations are not part of a care management package, at least 3 types of impediments to empowerment can result: (1) physical barriers within the home limit mobility, control, safety, and full use of the environment; (2) inappropriate layout and design of the living space may compromise full control and use of the house; and (3) maintenance and management of the house becomes complicated and costly and, in some cases, they are totally neglected, causing faster deterioration of the environment. These may interfere with the enjoyment of aging in place, can shorten the time in which frail elderly can live independently in their housing of choice, and may cause premature and inappropriate transfer to institutional care.