Cohabitants’ perspective on housing adaptations: a piece of the puzzle

Accessible independent housing for people with disabilities: A scoping review of promising practices, policies and interventions

BACKGROUND

Accessible housing is imperative to enabling independent living for many people with disabilities; yet, research consistently shows how people with disabilities often lack appropriate accessible housing and are more likely to experience unaffordable, insecure, and/or poor quality housing. Therefore, the aim of this study was to understand promising practices, policies and interventions regarding accessible independent housing for people with disabilities.

METHODS

We conducted a scoping review that involved searching seven international literature databases that identified 4831 studies, 60 of which met our inclusion criteria.

RESULTS

The reviewed studies involved 18 countries over a 20-year period. Our review highlighted the following key trends: (1) removing barriers to obtaining accessible housing (e.g., advocacy, builders enhancing housing supply, subsidies and financial incentives); (2) policies influencing accessible housing; (3) interventions to enhance accessible housing (i.e., home modifications, smart homes, mobile applications and other experimental devices); and (4) the impact of accessible independent housing on health and wellbeing.

CONCLUSIONS

Our findings emphasize the importance of accessible housing for people with disabilities and the urgent need to advance accessible housing options.

Understanding home modification outcomes from the perspective of older people and people with a disability: informing home modification evaluation

PURPOSE

There is limited evidence to guide therapists in home modification outcome evaluation. Involving consumers in evaluating home modifications is critical to progressing practice. This study investigated the home modification experience and outcomes most valued by older adults and individuals with a disability in Australia.

MATERIALS AND METHODS

An interpretive description approach was used. Twenty participants aged 24-93 who had received major home modifications were interviewed and transcripts were analysed thematically.

RESULTS

Two major themes emerged: life before and during modifications - "it was all hard," and life after modifications - "to have a life." People's prior experience of home, the circumstance of and time to plan modifications, the perceived value of the modifications, and the home modification process and funding influenced perceptions of outcomes. Valued home modification outcomes included those that enable people to experience emotional and physical health, and safety; do what they want; maintain the image of the home; and plan for the future. Experiences and perceptions of modifications ranged from supportive to disruptive.

CONCLUSIONS

These findings point to the need for therapists to deeply understand and evaluate their clients' experiences of home and life as an initial and critical step in the home modification process.Implications for rehabilitationMajor home modifications result in broad and meaningful outcomes of importance to clients.Occupational therapists need to partner with clients to understand their life before and during modifications to achieve positive outcomes.Evaluation of major home modifications needs to be integrated and prioritised in daily practice.

Home modifications and repurposing: perspectives on the accessibility, affordability, and attractiveness

PURPOSE

Society has progressed in universal design guidelines and assistive devices for individuals with disabilities yet challenges due to affordability and attractiveness concerns remain to incorporate them into existing residences. Repurposing (i.e., replacing or adapting problematic fixtures or spaces, with others not originally intended for that purpose) may be the action to address the concerns of consumers. The purpose of this study was to elicit information on problems and solutions regarding home modifications and identify ways that consumers and professionals implement repurposing, that residents deemed accessible, affordable, and attractive.

METHODS

This convergent parallel design study consisted of focus groups who rated images of repurposed spaces. The focus groups included consumers with functional mobility and visual limitations (n = 8); and professionals who devised or recommended home modifications (n = 8). Participants reviewed three images of home modification solutions and completed a Likert-scale rating based on accessibility and attractiveness.

RESULTS

Focus group data indicated that high contrast, heights of fixtures, doors, and flooring - all pose threats to accessibility in the home. Consumers placed more value on attractiveness than professionals. Participants were aware and receptive to repurposing as a home modification technique but focused their discussion on adaptations.

CONCLUSION

Overall, adoption and implementation of home modifications promote accessibility, but professionals need to consider individualized needs and preferences, before suggesting modifications.IMPLICATIONS FOR REHABILITATIONRepurposing existing spaces, features, and fixtures can serve as a method of home modification.Consumer home modification recommendations are perceived to be more effective when collaboratively and individually developed with professionals.Data gathered through focus groups can be valuable for informing practice and research in home modifications.