Improved Housing Accessibility for Older People in Sweden and Germany: Short Term Costs and Long-Term Gains.

Björn Slaug,Roman Kaspar,Carlos Chiatti,Frank Oswald,Steven Schmidt

doi:10.3390/ijerph14090964

Abstract

The physical housing environment is important to facilitate activities of daily living (ADL) for older people. A hindering environment may lead to ADL dependence and thus increase the need for home services, which is individually restricting and a growing societal burden. This study presents simulations of policy changes with regard to housing accessibility that estimates the potential impact specifically on instrumental activities of daily living (I-ADL), usage of home services, and related costs. The models integrate empirical data to test the hypothesis that a policy providing funding to remove the five most severe environmental barriers in the homes of older people who are at risk of developing dependence in I-ADL, can maintain independence and reduce the need for home services. In addition to official statistics from state agencies in Sweden and Germany, we utilized published results from the ENABLE-AGE and other scientific studies to generate the simulations. The simulations predicted that new policies that remove potentially hindering housing features would improve I-ADL performance among older people and reduce the need for home services. Our findings suggest that a policy change can contribute to positive effects with regard to I-ADL independence among older people and to a reduction of societal burden.

Highlights

The acceleration of demographic ageing is one of the main challenges for European policy-making.As the baby-boom generation retires, the EU’s employed population will keep shrinking while the number of people aged over 60 will increase by about two million every year [1]
This study simulated the impact of policy changes in the area of housing accessibility, in terms of I-activities of daily living (ADL) dependency level, usage of home services and related costs
Our calculations integrated empirical data from the EU-funded ENABLE-AGE project in Sweden and Germany with publicly available statistics, testing the hypothesis that new policies to reduce potentially hindering housing features can help to maintain independence in instrumental activities of daily living (I-ADL) performance among older people who age in place

Summary

Introduction

As the baby-boom generation retires, the EU’s employed population will keep shrinking while the number of people aged over 60 will increase by about two million every year [1]. The policy responses identified to tackle this challenge are raising the efficiency and effectiveness of care delivery; reducing the incidence and prevalence of frailty and disability; and enabling older people to continue to manage independent living with functional limitations (e.g., within adaptable private homes). In this regard, the physical housing environment represents a key factor to facilitate activities of daily living (ADL) for older people [2,3]. A hindering environment may lead to ADL dependence and increase the need for home services, which is individually restricting and a growing

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Conclusion