Marianne Granbom

A public health perspective to environmental barriers and accessibility problems for senior citizens living in ordinary housing

BackgroundHousing environments that hinder performance of daily activities and impede participation in social life have negative health consequences particularly for the older segment of the population. From a public health perspective accessible housing that supports active and healthy ageing is therefore crucial. The objective of the present study was to make an inventory of environmental barriers and investigate accessibility problems in the ordinary housing stock in Sweden as related to the functional capacity of senior citizens. Particular attention was paid to differences between housing types and building periods and to identify environmental barriers generating the most accessibility problems for sub-groups of senior citizens.MethodsData on environmental barriers in dwellings from three databases on housing and health in old age was analysed (N = 1021). Four functional profiles representing large groups of senior citizens were used in analyses of the magnitude and severity of potential accessibility problems. Differences in terms of type of housing and building period were examined.ResultsHigh proportions of one-family houses as well as multi-dwellings had substantial numbers of environmental barriers, with significantly lower numbers in later building periods. Accessibility problems occurred already for senior citizens with few functional limitations, but more profound for those dependent on mobility devices. The most problematic housing sections were entrances in one-family houses and kitchens of multi-dwellings.ConclusionsDespite a high housing standard in the Swedish ordinary housing stock the results show substantial accessibility problems for senior citizens with functional limitations. To make housing accessible large-scale and systematic efforts are required.

Voices on Relocation and Aging in Place in Very Old Age—A Complex and Ambivalent Matter

PURPOSE This cross-national qualitative study explores how very old people reflect upon relocation and aging in place. DESIGN AND METHODS Swedish and German data are utilized in this study. About 80 community-living participants, 80-89 years of age, were interviewed with open-ended questions at home by trained interviewers. The interviews were analyzed by using conventional qualitative content analyses. RESULTS Reasoning about relocation or aging in place in very old age is a complex and ambivalent matter. A variety of reflections, emotions, and behaviors for and against a move are revealed. Reasons to move reflect the urge to maintain independence, to stay in control, and to avoid loneliness. This is mainly expressed reactively. Reasons not to move reflect a strong attachment to the home and neighborhood. Moreover, reasons not to move reflect practical aspect such as economy and strain, as well as fear of losing continuity of habits and routines. IMPLICATIONS There is a need for society to develop counseling systems to meet very old peoples ambivalence and practical considerations to move or not to move. Thus, the ambivalence to stay put or to relocate needs to be further explored from an applied perspective by also taking nonmovers into account.

Community Relocation in Very Old Age: Changes in Housing Accessibility.

OBJECTIVE The objective of this study was to compare environmental barriers, housing accessibility, and usability before and after relocation of very old, single-living people in the community. It also examined whether accessibility improved after relocation compared with a simulated scenario in which participants would have remained in their former dwellings. METHOD Data from the Swedish part of the longitudinal Enabling Autonomy, Participation, and Well-Being in Old Age: The Home Environment as a Determinant for Healthy Ageing database were analyzed with a before-and-after design (N = 29). Mean time from before to after data collection was 2.6 yr. RESULTS The number of environmental barriers was significantly reduced after relocation, especially barriers at entrances and in bathrooms. In addition, usability was stable and accessibility improved compared with the simulated scenario of remaining in the former dwelling. CONCLUSION Community-based moves to new dwellings may lead to fewer environmental barriers and stable levels of usability and accessibility. This relocation is a positive outcome, considering the expected functional decline in old age.

Cross-national and multi-language qualitative research: challenges and recommendations

Interest in cross-national partnership is increasing in Europe, a situation very much reflected in calls for funding. Multi-language qualitative research methodologies need to be strengthened in order to support this growing trend toward the promotion of cross-national collaboration. This practice analysis reports on our experience of carrying out cross-national and multi-language based qualitative research. Based on this, we recommend taking into account the potential challenges of language and national culture from the planning phase onwards, handling them in a structured, predefined way throughout the research process and using software to assist with the challenges brought about in a multi-language environment.

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

Abstract 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.

Residential choices in very old age: a synthesis of quantitative and qualitative findings

The objective of the EVIDEM-EXERCISE study was to evaluatethe effectiveness of an exercise regime as a therapy for the behaviouraland psychological symptoms of dementia (BPSD). A pragmatic, ran-domized, controlled, single-blind, parallel-group trial of a dyadic exer-cise regime (tailored walking) for community-dwelling individuals withBPSD and their carers was undertaken. The primary outcome wasBehavioural and Psychological Symptoms as measured by the Neuro-Psychiatric Inventory at week 12. Results show no significant differ-ence of NPI score at week 12 between the group receiving the dyadicexercise regime and those that did not. Secondary outcome measure ofcaregiver’s burden was significantly improved; caregiver burden dou-bled by week 12 for the control group participants, but decreased forthose receiving the exercise intervention. In conclusion, this study foundthat regular simple exercise does not improve BPSD but did seem toattenuate changes of caregiver burden.Studies about intimacy in old age have mostly focused on institutionalized life-long marriages. Little research has focused on re-partnering in later life and the impact these relationships have on life satisfaction. Framed by Giddens’ Transformation of intimacy and Laslett’s Third age, as well as changing social and demographical conditions, this paper focuses on how different forms of new intimate relationships impact on life satisfaction in later life. Qualitative interviews were conducted with a strategic sample of 28 Swedes, 63–91 years, who were married, cohabiting and living apart together in new intimate heterosexual relationships initiated after the age of 60 or who were currently dating. The results showed the significance of new intimate relations the experience of life satisfaction in later life: The importance of being needed and confirmed by one’s partner, for intimacy and sexuality, for unloading children’s care responsibility, for sharing experiences in everyday life and for safety. The results also showed the importance of the partner as a resource for new experiences and a healthier life style. In conclusion, the results will be theorized in a time frame: First, in the light of new post (re)productive free time in the third age. Second, in the light of the finite remaining life-time. The results from the qualitative study will be contextualized by results from a representative survey on intimate relations among 3 000 60-90 year old Swedes (data collection has just finished).It is often argued that in late modernity sex has escaped its reproductive cage and people form pure relationships, based on mutual satisfaction. Ironically, although older people are per definitio ...