Housing Adaptations Research Articles

Estimating the Influence of Housing Energy Efficiency and Overheating Adaptations on Heat-Related Mortality in the West Midlands, UK

Mortality rates rise during hot weather in England, and projected future increases in heatwave frequency and intensity require the development of heat protection measures such as the adaptation of housing to reduce indoor overheating. We apply a combined building physics and health model to dwellings in the West Midlands, UK, using an English Housing Survey (EHS)-derived stock model. Regional temperature exposures, heat-related mortality risk, and space heating energy consumption were estimated for 2030s, 2050s, and 2080s medium emissions climates prior to and following heat mitigating, energy-efficiency, and occupant behaviour adaptations. Risk variation across adaptations, dwellings, and occupant types were assessed. Indoor temperatures were greatest in converted flats, while heat mortality rates were highest in bungalows due to the occupant age profiles. Full energy efficiency retrofit reduced regional domestic space heating energy use by 26% but increased summertime heat mortality 3–4%, while reduced façade absorptance decreased heat mortality 12–15% but increased energy consumption by 4%. External shutters provided the largest reduction in heat mortality (37–43%), while closed windows caused a large increase in risk (29–64%). Ensuring adequate post-retrofit ventilation, targeted installation of shutters, and ensuring operable windows in dwellings with heat-vulnerable occupants may save energy and significantly reduce heat-related mortality.

障害を持つ児童生徒の個別教育計画とハウスアダプテーションに関する研究 建築・教育・医療によるサポートシステム

障害を持つ児童生徒の個別教育計画とハウスアダプテーションに関する研究 建築・教育・医療によるサポートシステム

Participation in Everyday Life Before and After a Housing Adaptation

ABSTRACTHousing adaptation aims to enable clients to live independently in their own homes. Studies focusing on participation in everyday life following a housing adaptation are lacking and needed. This study aimed to explore housing adaptation clients' experiences of participation in everyday life before and after a housing adaptation, through the lens of a housing adaptation, using a qualitative follow-up design, with 11 participants. It was found that when the housing adaptation met the participants' needs, performance of activities improved and the housing adaptation opened doors to engagement and participation in everyday life. Thus, focus on performance and engagement in everyday life at the onset of the housing adaptation process, combined with regular follow-ups, may enhance participation.

Accessibility problems in home environment for seniors in Latvia: Experience from the research project innovAge (WP2)

Studies on relations between health and environment indicate that accessibility positively influence healthy life expectancy, as accessible home environment and neighbourhood support mobility, daily activities and social participation in old age. One of the tasks in the EC 7th framework research project innovAge (2012-2015) aimed to develop an IT tool to support seniors’ involvement in decisions about their housing options and help them to become active partners in choice and supply of housing. This study aims to explore seniors’ opinions about accessibility in their physical home environment based on analysis of data - interview records and notes - from two study stages in the research project innovAge (WP2). Participants, at the first stage - 8 seniors and at the second stage - 10 seniors, represented variety of living conditions, family situations and functional abilities. Participation in the study was voluntary and the participants had right to withdraw from the study at any stage. Usually, barriers in home environment seniors consider late, when functional abilities decreases substantially. The most common places where environmental barriers appear are sanitary spaces, kitchen and entrance of the home. Despite the environmental barriers and functional limitations, seniors remain in their homes, mainly because in Latvia do not exist traditions to seek options for relocation, as well as there are no policies and services to support this. In few municipalities options exist to adapt home environment, but it refers only to cases of severe disability for persons using wheelchair. Usually, the need for environment adaptations for seniors is replaced by care services, thus meeting also the needs for seniors’ socialization. Regarding possibilities to adapt home environment, strong prejudices exist (bath vs. shower, disadvantages of living on the first floor, etc.). Seniors admitted that they lack knowledge and experience on housing adaptations, but emphasized that the environmental accessibility in a wider context, including the neighbourhood and services, is essential. The close cooperation with participants facilitated the researchers’ understanding of the seniors’ complex views and needs regarding their home environment and related issues, which are important for developing housing policies for senior citizens in Latvia. Despite the specified accessibility problems in home environment, the seniors evaluated usability of their homes generally high.

Experience of people with physical disability: Mobility needs during earthquakes.

BACKGROUND:People with physical disability are vulnerable in disasters because of their mobility limitations. They are unable to escape from hazards and their needs have been somewhat neglected in planning and relief measures.AIM:This study aimed to identify the mobility needs of people with physical disability during earthquakes across different provinces of Iran.MATERIALS AND METHODS:A qualitative study was conducted using 18 semi-structured interviews with participants who had a kind of mobility disability. The participants, across six provinces of Iran who had experienced an earthquake, were selected by purposive sampling in two ways of snowballing and maximum variation in 2017. Data were analyzed thematically assisted by MAXQDA 10 software.RESULTS:The mobility needs included house and workplace adaptation, spare assistive devices, easy access to vehicles, special facilities for emergency evacuation, adaptation and accessibility of shelters, adapted bathroom and toilet, and transferring by others.CONCLUSION:By considering needs and experiences of people with physical disability in disaster planning, appropriate interventions can be arranged to promote the level of response in disasters. Such measures can have a significant role in maintaining the lives and health of such people.

Resident’s satisfaction to relocated Houses after 2004 Indian Ocean Tsunami, Thailand

Abstract After Indian Ocean tsunami of 26 December 2004, Government, NGO and private organizations provided various types of post-disaster permanent housing. This study focuses on Relocate houses in Namkem community, Phangnga after residents live long-term in this post-disaster house. Aims to analyze resident’s satisfaction to Housing after lived more than a decade in the post-tsunami houses and analyze the development to physical of house regard to reconstruction, functions, or size. The relocation effect to the house adaptation and residents life style as a result shown that even self-built house that residents have participate in design and construction process themselves also need the individual renovation, according to that many of residents have change their job or need to travel in longer distance for work, The car park was one of the popular choice for space extension follow after the adding more bedrooms as number of family member increase. Residents who individually renovated and extend the house have gain more satisfy with their house so provided land-plot for self-extension may important more for recovery housing.

Service planning and delivery outcomes of home adaptations for ageing in the UK

In response to the impact of demographic change on the healthcare system, ‘ageing in place’ was introduced as a national policy to support elderly people living independently in their homes. Housing adaptation is essential for successful independent living and has been given increased political priority. However, adaptation policies and practice vary regionally, reflecting statutory limits, policy choices and local planning. This study investigated the current status of adaptation provision in different regions in the UK and assessed the effectiveness of local service planning and management. A mixed-methods sequential explanatory research strategy was employed. In the first quantitative phase, a questionnaire survey was carried out involving all 378 local authorities in England, Scotland and Wales. This was followed by a second qualitative phase involving individual interviews with five professionals and two clients and a focus group meeting with six key stakeholders. The study found that the current number of adaptations was relatively small compared with potential demands in most local areas, as was funding for adaptations. On the operational side, the adaptation process was fragmented, involving different service groups in many local authorities. There were disconnections between these groups, which often caused inefficiencies and poor effectiveness. Moving forward, local authorities need to have a clear vision of the overall need for adaptations and allocate sufficient resources. Practical guidelines are also needed for better integrated working and performance management.

Design an educational intervention to prevent falls of older people in social housing: description of a research method

In a social environment in which prevention of falls in older people has become a public health issue, adaptation of housing for older people is particularly important. Based on the home-identity concept, the objective of this research was to design an educational model specifically adapted to the context of a Social Housing Company (SHC), focussing on elderly tenants who have experienced a fall in order to allow them to adapt their lodgings and avoid subsequent falls. This article describes design-based research (DBR), which enabled the research committee (composed of professionals, tenants, and researchers) to construct the educational intervention based on analysis of the SHC context. The creation of a common approach within the research committee and the production of design-linked intentions enabled the creation of a formal intervention composed of four educational sessions, involving a private occupational therapist, an SHC social worker and a caretaker. The use of DBR can be justified by the research goal, i.e. validation of an educational model (based on the theoretical home-identity model) that can be transposed to a SHC. As this research is still underway, its quality criteria will only be partially described and will be completed by field experimentation. This exploratory study could eventually result in interventional research designed to assess this model in a multifactorial therapeutic patient education programme for older people at high risk of falls (e.g.: Personnes Âgées En Risque de Perte d'Autonomie device).

Transforming Home: parents’ experiences of caring for children on the autism spectrum in Tasmania, Australia

As the private dwelling becomes the preferred site of care for individuals with a variety of complex needs, there has been a burgeoning interest in housing adaptations and the impact on experiences of home. The majority of studies are situated within the contexts of ageing, the disabled body and chronic medical conditions. In this paper, we present the results of a self-directed photography pilot study exploring the experience of carers of children on the autism spectrum in Tasmania, Australia. The findings highlight the multifarious and exacting negotiations required to meet the complex and idiosyncratic needs of children with autism and those of other family members. A key theme is a heightened need for containment enacted through micro-scale modifications to the physical fabric and spatial organization of the dwelling and through less tangible but pervasive practices and routines. The multiple constraints and extensive impact on families emphasize an urgent need for targeted research, policy development and support for this population.

Falls and Fear of Falling among Persons Who Receive Housing Adaptations-Results from a Quasi-Experimental Study in Sweden.

While health might deteriorate through the ageing and disablement process, the impacts of disability can be reduced by adapting the environment. This study aimed to investigate the effects of applying a standardized research-based strategy to housing adaptation as compared to ordinary practice with respect to falls and fear of falling. Another aim was to investigate the overall effects of housing adaptations on fall-related outcomes over time. In total, 196 clients were included at baseline, with follow-up at 3 and 6 months after the housing adaptation was implemented. The only significant difference between the two approaches was identified with respect to fear of falling at 3 months after the housing adaptation, but not after 6 months. The number of clients reporting actual falls increased over time in both sites, whereas the number of reported near-falls decreased most in the intervention site, but without significant differences. Thus, the patterns of differences between the sites are inconsistent, as are the patterns of change in fall-related outcomes. An overall conclusion is that if the goal is to improve fall-related outcomes, housing adaptation should be complemented with other interventions preventing falls and explicitly address the clients’ activity limitations. In addition, longer follow-up times are necessary.

Off the Radar? Addressing housing disrepair to improve health in later life

Purpose The purpose of this paper is to highlight the pivotal role of initiatives that address housing disrepair, home improvements and adaptations as a way of improving health, independence and quality of life in older age. Design/methodology/approach The author uses data from housing and health, combined with the author’s experience of policy formulation as well as working with older people and developing practical services, particularly those which address private sector housing stock condition. Findings As well as its massive economic impact, housing greatly affects people’s health and wellbeing, not only in later life but across the life course. In England, there is a long history of systematic, government backed action to improve and maintain housing stock condition. There are significant economic and social gains from a coherent national response to addressing private sector housing disrepair, including creation of employment opportunities, economic stimulus through enabling best use of assets, as well as health and social care gains. In addition to increasing housing supply through building much needed new homes, existing housing stock disrepair needs once again to be “on the radar” of policy makers operating across health, social care and housing. Concerted action to make homes safe, healthy places to live in later life, whatever an older person’s tenure, requires vision and innovation and is an essential element in the integration of health, social care – and housing. With significant funding constraints in local authorities, especially for adult social care, and in the context of growing pressures on the NHS, sustaining good health in later life is more important than ever. There is a compelling case for cross-sector action to reduce health hazards in ordinary, private housing, given that 79 per cent of older people who live in non-decent homes are owner occupiers. This is an opportune moment for Health and Wellbeing Boards to take a lead on this issue at a local level, as well as time to put housing stock condition back “On the Radar” of national government policy. Social implications There is a need to embed practical housing services in the emerging integrated health and care systems in order to extend healthy later life for the majority of older people who live in mainstream housing. Originality/value The author draws on over 30 years’ experience of innovation, development and evaluation of older people’s housing, services and policy development to provide a vision for greater integration across health, care and housing.

HOUSING ADAPTATIONS IN THE UK: SCOPING THE EVIDENCE TO SUPPORT POLICY AND PRACTICE

In the UK there is a paucity of research evidence to underpin the implementation of housing adaptations’ policy and practice with little knowledge of what works for whom, in what circumstances, and to what effect. While the UK Government has significantly increased financial support for adaptations, money may be wasted due to under-utilisation. A scoping review is presented outlining firstly, central government funding and secondly, the quality of research evidence. Findings indicate that housing design to meet the needs of older and disabled people requiring adaptations is under-researched; a lack of evidence for design recommendations, and whether they have been tested in-situ. The implications suggest the need for a rigorous testing of design guidance regarding housing adaptations such that installations are appropriate for the user and other family members to enable successful ageing in place. The findings provide important comparative information contributing to a body of international literature.

USING EVIDENCE TO TRANSLATE NATIONAL POLICY INTO LOCAL ACTION

The challenge of turning national policy into actions, implemented at a local level, is one faced by policy-makers world-wide. Ireland’s national policy for promoting Positive Ageing explicitly acknowledges the role that the Age Friendly Cities and Counties (AFCC) programme plays in improving the lives of older people. Through a collaborative study jointly funded by national and local governments, the Healthy and Positive Ageing Initiative uses links established with the WHO’s Age Friendly Cities Programme to translate knowledge into action. Data from a random sample survey of people 55 and older in 20 AFCC programme areas during 2015/2016 (n=10,000) was disseminated to local AFCC alliances. Reflecting the priorities of the National Positive Ageing Strategy and the AFCC program, the survey covered areas such as deprivation and neighbourhood social capital, preferences for housing adaptation and local area walkability. Results link the social and built environment to the health and wellbeing of older people and identify barriers to participation and essential health and social services. As the AFCC program expanded to 10 new local authority areas, results are used to develop a common understanding of age friendly priorities, to optimise and sustain political and social commitment and to identify areas for action in new AFCC programs. The efficacy of the dissemination practices is explored through a qualitative study using thematic content analysis of the locally produced strategies and semi-structured interviews with the key stakeholders responsible for the implementation of strategies.

Housing accessibility problems for people with Parkinson's disease.

Promoting accessible housing for all citizens is high on the political agenda. Knowledge is, however, limited regarding housing accessibility problems for people with Parkinson's disease (PD). The objectives were to investigate housing accessibility problems among people with PD at different stages of disease severity and to analyze the potential impact of improved functional ability on accessibility problems. The study included 253 participants with PD (61% men; mean age 70years). Disease severity was assessed by the Hoehn and Yahr (HY) I-V stages: HY I, n=50; II, n=73, III, n=66; IV-V, n=64. Using the Housing Enabler (HE) instrument, accessibility problems were investigated by combining assessments of the person's functional capacity with assessments of physical barriers in the housing environment into a person-environment fit measure (HE-score). To analyze potential impact of improved functional ability on housing accessibility problems, data simulation was applied. HE-scores differed significantly (P<.001) in relation to HY stages. Overall balance problems explained 22% and walking devices 17% of the HE-scores, whereas environmental barriers contributed to a lesser extent. The environmental barriers generating the most HE-scores were "no grab bar at shower/bath/toilet" and "wall-mounted cupboards and shelves placed high". A simulation of improved balance significantly (P<.001) lowered the HE-scores in all HY stages. The results suggest that actions targeting balance problems and dependence on walking devices have the greatest potential for reducing housing accessibility problems for people with PD. The study also details environmental barriers that need specific attention when providing housing adaptation services.

Cohabitants' perspective on housing adaptations: a piece of the puzzle.

As part of the Swedish state-funded healthcare system, housing adaptations are used to promote safe and independent living for disabled people in ordinary housing through the elimination of physical environmental barriers in the home. The aim of this study was to describe the cohabitants' expectations and experiences of how a housing adaptation, intended for the partner, would impact their everyday life. In-depth interviews were conducted with cohabitants of nine people applying for a housing adaptation, initially at the time of the application and then again 3 months after the housing adaptation was installed. A longitudinal analysis was performed including analysis procedures from Grounded Theory. The findings revealed the expectations and experiences in four categories: partners' activities and independence; cohabitants' everyday activities and caregiving; couples' shared recreational/leisure activities; and housing decisions. A core category putting the intervention into perspective was called 'Housing adaptations - A piece of the puzzle'. From the cohabitants' perspective, new insights on housing adaptations emerged, which are important to consider when planning and carrying out successful housing adaptations.

Housing accessibility for senior citizens in Sweden: Estimation of the effects of targeted elimination of environmental barriers

Aim: To estimate the effects of targeted elimination of environmental barriers (EB) in the ordinary housing stock in Sweden, and to explore the estimated effects on accessibility at a population level in relation to (a) residents with different functional profiles, (b) different housing types and (c) building periods.Method: Data on dwellings from existing Swedish research databases were utilized. EB and accessibility were assessed by means of the Housing Enabler instrument. In simulations of EB removal, five items that correspond to the most common housing adaptations were selected. The simulations were applied to four functional profiles of different complexity.Result: EB known to be commonly removed by housing adaptations exist in large proportions of the existing ordinary housing stock. Estimated targeted elimination of selected barriers would have the largest accessibility effects for the more complex functional profiles. The effects would be consistently larger for one-family houses, and for all types of dwellings built before 1960.Conclusions: The elimination of the EB most commonly addressed by housing adaptations could result in a reduction of the housing accessibility problems that community-living older people are facing. For society to solve the housing situation for the ageing population well-informed and efficient upgrading of ordinary housing is imperative.

New public housing: a selective model disguised as universal? Implications of the market adaptation of Swedish public housing

Building upon the universal characteristics of the social democratic welfare regime, public housing in Sweden has traditionally been a central instrument in contributing to socially inclusive cities; however, changes in policy have gradually changed the landscape. This paper presents concerns for public housing's endeavour for social inclusion and suggests that the universal approach, of which Swedish public housing is a standing role model, is diminishing in favour of an ambiguous model of universal discourse and selective output. A ‘New Public Housing’ is emerging with higher thresholds, making it harder for economically disadvantaged groups to gain access to housing; at the same time, this is compensated by the increase of ‘social contracts’, which provides the financially vulnerable with an entrance to the housing market, however on very uncertain conditions. Increasingly catering for the most well off and the most vulnerable in society, this New Public Housing appears to exist in a contradictory state between its claims of universalism and the practice of excluding certain groups.

Transforming paper-based assessment forms to a digital format: Exemplified by the Housing Enabler prototype app

Background: The aim of this paper is to provide the reader with an overall impression of the stepwise user-centred design approach including the specific methods used and lessons learned when transforming paper-based assessment forms into a prototype app, taking the Housing Enabler as an example.Methods: Four design iterations were performed, building on a domain study, workshops, expert evaluation and controlled and realistic usability tests. The user-centred design process involved purposefully selected participants with different Housing Enabler knowledge and housing adaptation experience.Results: The design iterations resulted in the development of a Housing Enabler prototype app. The prototype app has several features and options that are new compared with the original paper-based Housing Enabler assessment form. These new features include a user friendly overview of the assessment form; easy navigation by swiping back and forth between items; onsite data analysis; and ranking of the accessibility score, photo documentation and a data export facility.Conclusion: Based on the presented stepwise approach, a high-fidelity Housing Enabler prototype app was successfully developed. The development process has emphasized the importance of combining design participants’ knowledge and experiences, and has shown that methods should seem relevant to participants to increase their engagement.

Identification of Spacial Pattern in Productive House of Pottery Craftsmen

The research goals were to identify a spacial pattern in craftsmen house and to see its relevance to the social-cultural life of the craftsmen. The existence of domestic and economic activity in craftsmen house creates a spacial pattern with particular characteristics. Data were collected through direct observation, interviews, and visual documentation to record productive house, settlement condition, and sequences of pottery production. The in-depth interview focused on the use of time, space, and house modification in craftsmen house. House in the craftsmen settlement was growing gradually by adjusting to the inhabitant's needs. This research was included in qualitative research that described observation results and then analyzed spacial pattern formed in craftsmen house. Research results show that in this settlement beside the mixed, balanced, and separated type of productive house, there is also pottery collectors house type. The changes in the productive house are related to housing adaptation or house adjustment to accommodate production process. The settlement orientation is along the streets, but the existence of open space in the form of pottery kiln and hay storage become the main orientation for productive spaces inside the craftsmen house. Pottery kiln and hay storage have become open cultural space that characterizes the pottery craftsmen settlement.

Negotiating Control: From Recognizing a Need to Making a Decision to Apply for a Housing Adaptation

ABSTRACTA housing adaptation (HA) can enable independent living in one's own home, but deciding to change the home environment can be a thought-provoking matter. The aim of this study was to explore the applicant's perspective and decision-making process when applying for an HA grant. Seventeen persons were interviewed about their application for such a grant, and the data were analyzed using a constant comparative approach. The findings illustrated how the participants negotiated control in their everyday lives as they went from recognizing a need to then deciding to apply for an HA grant. Before coming to a decision, alternative solutions were considered and their expectations on the effect of having an HA were explored. This knowledge is useful for professionals and caregivers to help support people during the HA decision-making process.