Project: Research


The overall aim of the project was to study how objective and subjective aspects of the domestic environment interact with the way very old people perceive their health, expressed as autonomy, participation and well-being. ENABLE-AGE was financed during 2002–2004 mainly by the European Commission and was coordinated by Lund University, with Iwarsson as coordinator. The project involved a total of 1,918 old people in Sweden, Germany, the United Kingdom (UK), Hungary and Latvia and consisted of a survey, a qualitative interview study and a review of legislation on service, care and housing for older people. The survey generated a database containing 1,600 variables concerning objective and subjective aspects of the housing environment and health. The degree of detail in the housing variables is unique. The first interview in Sweden included 397 people living on their own in Lund, Helsingborg and Halmstad, aged 80–89 years. The survey was based on a questionnaire consisting of both well-tested and more recent assessment and self-rating instruments and project-specific questions, while the in-depth interview study (N=189, of whom 40 in Sweden) was inspired by grounded theory. Apart from the in-depth interview study planned for ENABLE-AGE as a whole, a doctoral student in Iwarsson’s research group also did in-depth interviews with a further 21 people. The review of legislation on service, care and housing for older people was based on an examination of literature, reports and laws in each country, followed by a structured comparison between the countries. We have hitherto published summary descriptions of the project and an article in which we describe experiences and challenges in research on old people’s housing and health which involves more than one country. In addition, we have written a couple of methodological articles describing basic scientific qualities and also illuminating challenges in the research process.

The results of the first empirical articles demonstrated associations between the scope of accessibility problems and activity-related aspects of usability. People who lived in more accessible homes rated them as more useable and meaningful in relation to their daily activities, and they stated a lower degree of external control mechanisms in they way they coped with their housing situation. The next step was to study the associations between subjective and objective housing factors on the one hand and health aspects on the other. The results show that people who lived in more accessible housing and found the home meaningful and usable, and who invoked external control mechanisms to a lower extent, were more independent in ADL and reported higher well-being. Although there are differences in detail, the results show that the patterns in the interaction between the different housing and health variables are similar in the five countries. When it comes to housing standards, the occurrence of physical environmental obstacles and accessibility problems in the home and its immediate surroundings, results based on 1,150 people and their homes in Sweden, Germany, and Latvia show that different kinds of controls/handles requiring good hand function (in kitchen and bathroom) were the most common environmental obstacles. The scope of accessibility problems did not differ between the three countries, nor did it change during the one-year follow-up period. A significant proportion of the individual environmental obstacles that caused most accessibility problems were the same in the three countries.

The results of the Swedish qualitative interviews show that the home is an important place for very old people and increases in significance as functional ability declines. The home is very meaningful for the sense of participation, both in society and in close social relations and everyday activities. We have also published a study describing reported needs, the possession and use of assistive devices in the five countries. The results reveal differences between Western and Eastern Europe, as very old people, above all in Sweden, report higher satisfaction of needs and use of assistive devices than very old people in Latvia and Hungary. The rollator in particular is a much more common device in Sweden than in other countries. Both nationally and internationally, the project ENABLE-AGE is unique of its kind, producing knowledge than can serve as a basis for developing housing that promotes the autonomy, participation and well-being among older people. Moreover, the project generates knowledge about methods of assessment and analysis for direct application in geriatric care, especially in rehabilitation.
Effective start/end date2002/01/022004/12/31