Catherine Bridge

Home modification guidelines as recommended by visually impaired people

Purpose – The purpose of this paper is to provide an evidence-base for home modification guidelines for people with visual impairment due to age-related macular degeneration (AMD), from the perspective of people with AMD, by exploring the home modifications they find useful and would recommend to other people with visual impairment due to AMD as being effective. Design/methodology/approach – People with impairments may not be aware of their own coping with inability strategies until they are asked to express their strategies. A qualitative approach using semi-structured individual interviews was used to elicit the perspectives of people with AMD with regards to their preferred home modification interventions. Interviews were recorded and then transcribed verbatim into text for thematical analysis using Nvivo 8. Findings – In total, 31 individuals (aged 79.1 ^ 5.6 years) with AMD and no other ocular diseases were recruited from a low vision clinic or the Macular Degeneration Foundation database in a metropolitan city. Interviewees had not received any formal home modification assessment from a government provider. Nevertheless, 70 per cent of participants stated that they undertook home modifications themselves or with the assistance of family and friends. The most important functional modifications as perceived by the participants concerned the installation of hand rails, non-slip matting, colour contrasting safety stair nosing, single lever taps, slip resistant flooring, lift chairs and motion sensors that activated pathway lighting. Kitchens, steps and bathrooms were perceived as hazardous locations. Most participants had difficulties with reading fine-print material on kitchen appliances, washing machines, microwave ovens and remote controls for electronic devices in the home. Originality/value – An evidence-base for useful home modifications as suggested by people with visual impairment was perceived to be a valuable resource for other people with visual impairment who may not yet have developed adaptive strategies. Industrial and interior designers and low vision rehabilitation services who aim to improve functionality of the home environment will also find these suggestions useful.

Mobile crowdsourcing older people's opinions to enhance liveability in regional city centres

With larger numbers of older people living longer, an increasing proportion of the population will require a more supportive and responsive regional city environment. However, regional local governments have neither the resources nor the appropriate tools needed to understand and respond to the infrastructure needs of older persons. As mobile devices such as tablets and phones proliferate, there is an opportunity to use mobile apps to engage older people more effectively with their local government associations in planning the future of their regional city centres. In this paper we discuss the potential of this application for crowdsourcing older peoples opinions as a form of community engagement. The application was developed in partnership with the Local Government Association and the partnership of the two regional local governments who participated in our pilot. We begin by describing the architecture of our platform, addressing choices regarding user interface design, modes and models for data capture, and standards guidelines. We then discuss methods we use for analyzing and visualizing the collected data to facilitate better decision making by governments. Lastly, we discuss the results of the field trials of our platform with mobile focus groups comprising senior citizens in two coastal regional cities in New South Wales, and interpret how our findings relate with the planning and development of these towns. Our work is the first step towards the use of mobile technologies to enable large scale data collection that can lead to smarter and more liveable cities for senior citizens.

Innovative strategies for adaptation to loss of vision

Age-related macular degeneration (AMD) is a major cause of visual impairment and blindness among people aged over 60 years in developed countries and it is forecast that the prevalence of AMD will increase. AMD is characterised by progressive loss of central vision leading to loss of functional vision (the ability to undertake visually guided activities). Functional vision may be assessed using ‘activity of daily living (ADL) instruments, which assess independent living skills, such as ability to read, write, recognise faces and objects and other daily living activities. AMD also affects the quality of life and impedes healthy independent ageing. Individuals confronted with disability may create novel strategies to cope. This case study will highlight how the ability to function may be greater than expected, based on the level of visual function and ADL instrument measures. This study shows how appropriate devices and the exercise of creativity can aid in the development of novel coping strategies. For example, threading a needle is often regarded as a highly-visually demanding task requiring fine visual resolution and is used by some ADL instruments to measure functional visual ability in people with visual impairment. This clinical communication highlights strategies that do not rely heavily on vision and may be used for threading needles and other related tasks.

Perceptions of older people regarding their vision and incident causation

Purpose It is widely known that visual impairment (VI) is a risk factor for falls, but patients or their eye care practitioners may not recognize other kinds of incidents as being problematic because of their vision. Consequently, older people with VI may have unmet needs for advice on how to carry out activities of daily living safely. Therefore, the purpose of this study was to understand whether older people with VI consider their vision as a causative factor of incidents they experience and their perceptions regarding the prevention of future incidents. If sample size permitted, a secondary aim was to evaluate whether quantitative findings supported their perceptions. Methods The study design was a prospective cohort study evaluating injurious and damaging incidents and related near misses using open questions in a written 2-weekly large-print diary with active follow-up over 8 weeks in older people (>60 years, n = 80) with and without VI. Baseline measures included habitual binocular visual acuity, contrast sensitivity, visual fields, 3-m walk test, and Short Form 12 physical and mental component scores. Participants’ diary entries were coded. Factor analysis and binary logistic analysis were used to investigate whether baseline measures were predictive of incident occurrence. Risk and preventative factors identified were compared. Results Participants perceived that their vision was implicated in bump and fall incidents. Quantitative analysis indicated that contrast sensitivity and fitness were significant predictors of incident occurrence. Six vision-related and five non–vision-related causative factors were identified by participants as contributing factors. Participants frequently stated “don’t know” when asked to identify solutions to prevent incident recurrence. Conclusions Participants had unmet needs for advice in relation to incident prevention. It would be prudent for eye care practitioners to raise incident prevention in eye care consultations regardless of voiced patient concerns.

An enabling BIM block library: an online repository to facilitate social inclusion in Australia

Purpose – The purpose of this paper is to explore the implications of socially inclusive Building Information Modelling (BIM) library components. BIM requires and integrates many sets of predefined blocks or collection of attributes. Any one of the individual blocks can be replicated and/or stored in a block library for later reuse. However, few if any current block libraries contain or have access to the blocks that enable social inclusion. Design/methodology/approach – An action-based research methodology was used to design, develop and deploy three enabling blocks as part of a plan to develop a larger library of tools for BIM practitioners. The Enabling Block Library is an open access library of Australian code-compliant mobility elements published online. This paper discusses the design and development of the library components in detail, explaining how each of the three blocks was selected in our pilot evaluation and how each was identified; fact-checked; planned (designed); deployed (action); and th...

Cities, environmental stressors, ageing and chronic disease

Clearly, in order to plan, design and develop a more liveable city for older people that can reduce the chronic disease burden, a wide range of social, economic and environmental needs must be satisfied. The publication of articles regarding environmental stressors and ageing is important as many nations have launched projects seeking to monitor and disseminate better information regarding risks posed to older adults by environmental exposures. Older adults are more vulnerable than younger ones, both because of biological issues associated with impaired healing responses and as a result of accumulating toxins via exposure across large blocks of time if not the entire life course [1]. So the empirical finding by Black et al. [2], which identified ‘that older long-term Australian urban residents are more likely to have a noninfectious chronic disease, which may be associated with environmental exposure, than those living in rural locations’, is timely if not a little alarming.

Participatory Design Resulting in a ‘Do-It-Yourself Home Modification’ Smartphone App

While the numbers of Do-It-Yourself (DIY) home modifications have increased, there is little available information that assists people to do their own home modifications. This is in the context that the traditional Australian home has generally been built with little consideration for anyone who may be less agile or who may have any other ability issues. For instance, someone may find themselves no longer able to step into a bath or have difficulty standing up from the toilet and need to make changes to their home to remain independent and safe. Home modifications describe these types of changes in the home typically made in response to loss of ability and are designed to help people to remain independent and safe whilst reducing any risk of injury to their carers and care workers. This paper outlines the participatory design process used to create the smartphone App and reports on its beta testing and final launch.

DIY home modifications: an Australian case-study of choice and control

Recent disability and aged care reforms in Australia have shifted emphasis from ongoing support and care toward prevention and early intervention, complementing universal design values of equity and flexibility. The reforms encourage the active engagement of individuals in the choices they make about housing and the support and care they receive, and will drive a preference to age in place. Approximately 2% of Australia’s housing stock is new built each year, with a small proportion incorporating universal design principles. Consequently, existing premises will need to be modified to enable people who are ageing and people with disability to live in the community and receive support at home. This paper considers how, in a person-centred support environment, do-it-yourself (DIY) home modifications expand our understanding of universal design, as DIY can empower individuals to exercise autonomy and control over their lives and the choices they make. This paper uses preliminary findings from research undertaken at the Home Modification Information Clearinghouse (Australia) into DIY home modifications to illustrate how the DIY process reaffirms the role of the individual in universal design. First, the paper provides an overview of the Australian reforms and universal housing design in Australia to highlight the potential of modifications to enable aging in place. The paper then provides an overview of the project and research methods, followed by a discussion of preliminary findings. The paper concludes that DIY highlights the importance of individual choice and control over changes made to a person’s home. DIY home modification practices should inform the way that universal design policies accommodate and facilitate the views and preferences of the individuals they are designed to serve.

Home modification case-based application for online case capture and reuse

Home modification practice for people with impairments of ability involves redesigning existing residential environments as distinct from the creation of a new dwelling. While research on case-based design reasoning and healthcare informatics are well documented, the reasoning and process of redesign and its integration with individual human functional abilities remains poorly understood. Developing a means of capturing redesign knowledge in the form of case documentation online provides a means for integrating and learning from individual case-based redesign episodes where assessment and interventions are naturally linked

Applying a theory of online community development as a basis for reform of home modification service information in Australia

An innovative whole of government strategy laid the foundations for both the home modification information clearinghouse project and its subsequent integration with the human-services network (HS-NET). Integration with the HS-NET has facilitated a one stop information gathering and decision action environment by enabling e-referral and e-service lookup. First, the context for the need and fit of the theoretical approach selected is overviewed. Second, the resultant Web based information delivery strategy is discussed. Last, usability data from a range of users from across government and non-government organisations provides pointers about perceived value and limitations