The significance of the physical housing environment for dependence in activities of daily living - The Hässleholm Home & Health Study

A selection of old people in ordinary housing in the municipality of Hässleholm was followed for ten years (1994/95-2004/5), with the overall aim of investigating the association between different aspects of housing and health. At baseline the 133 subjects were aged 75-84. Those who could be reached for follow-up have been interviewed/assessed using quantitative methods on a further two occasions, after six (n=72) and ten years (n=34). After ten years, 14 people moreover took part in a qualitative in-depth interview study. The data collection for the project is thereby completed, but data from the ten-year follow-up have not yet been analysed. The results show that there are environmental obstacles in all dwellings. Among the most common, for example, the washbasin was placed at a height for standing, with an S-bend, cabinet or other obstacle underneath, and kitchens lacking a place to sit while doing kitchen work. The environmental obstacles that caused most accessibility problems included: lack of support handles in rooms for hygienic functions, high-placed wall cabinets and deep floor cabinets in kitchens, and steps and high thresholds in the entrance hall. At the six-year follow-up almost all reported that they were satisfied with their housing, and few people had plans to move. The occurrence of environmental obstacles was fairly unchanged over time, while increased occurrence of functional limitations and use of mobility aids meant that accessibility problems increased in scope. Already at baseline, statistically certain associations were found between accessibility problems in the home and dependence on help in activities of daily living (ADL) and between subjective well-being and accessibility problems. The follow-up after six years showed that both ADL dependence and accessibility problems had increased and that associations between these variables were found, as at baseline, in the subgroup of people living in homes with the most accessibility problems. The results can be used for planning housing and supportive measures for the elderly, for example, in the form of housing adaptation, providing assistive devices, home rehabilitation, home health care and home help.