Aussie Study Shows Worldwide Need for Home Modifications

Image by Marco Massimo, Pixabay

 A 2019 Australian study provides not only a look at the need for “aging in place” strategies across the world, but also measures the effectiveness of home modifications in boosting function, health, quality of life, and possibly even longevity. 

The study, “Housing Design and Community Care: How Home Modifications Reduce Care Needs of Older People and People with Disability,” was written by Phillippa Carnemolla and Catherine Bridge, professors of design and the “built environment” at two Australian universities. It is one of the first to attempt to “directly measure how housing practices impact health and care,” the authors wrote. Specifically, the study examined whether investing in “the built environment” of an aging or disabled person can effectively substitute, at least in part, for the ongoing demand for at-home care.

We will discuss the study’s actual findings in our next post. This week, we’ll look at some of the authors’ preliminary and background findings, because their summary of previous studies and some of the statistics they share are a great foundation for understanding the study’s approach, as well as a fascinating glimpse into the worldwide demand for strategies to help elderly people “age in place.”

The paper notes that, as in the United States, many countries worldwide are experiencing a “shift away from institutional care towards a reliance on home-based or community care” and notes that “capital investment in housing might reduce the ongoing need for (and ongoing costs of) care.”

This “capital investment” takes the form of home modifications, a term that is continually expanding to cover everything from housing adaptation and “environmental intervention” to assistive technology.

The authors first looked at what existing research could tell them; here are some notable examples of what they found through a worldwide survey of research on home modifications:

Most existing studies on the relationship between home modifications and fall preventions found that home modifications can reduce the likelihood of a fall or injury.

A number of studies have found that home modifications reduce “difficulty regarding activities of daily living,” thereby improving function in the residents whose homes are modified, as well as their ability to provide self-care.

Two random controlled trials found that people who received home modifications reported an increased quality of life.

A Japanese study found that “home modifications slow the progression of frailty,” while a similarly focused U.S. study found that home modifications “contribute to the meaning of home for older people.”

Multiple studies have documented a positive association between home modifications and reduced need for care, institutionalization, and external caregiving.

However, Carnemolla and Bridge note that there remains a lack of research looking at home modifications as “a single intervention,” which means that other factors could have been present in study subjects’ lives and influenced their positive outcomes.

The authors specifically studied whether building construction, in the form of home modifications, supports self-care, maintains independence in the home, and is therefore a legitimate alternative solution to community care needs across the world.

The need for data on this subject is increasingly obvious: in Australia alone, the authors report, more than 40% of all households include a person who is providing informal (unpaid) care to an elderly or disabled family member. The Australian Bureau of Statistics also found that 94% of seniors needing at-home care received assistance from a network of informal caregivers. The obvious over-reliance on informal care not only increases stress among caregivers, but also takes them out of the workforce, sometimes involuntarily, and can also cause stress to the loved one who needs care.

Next time, we’ll look at how the study was structured and what its authors found. Their work has important implications for countries across the world, and, of course, for us at Evolve as we try to help as many people as possible enjoy the benefits of aging in place.