be an initial barrier. Unfortunately, living conditions have not been designed to meet the needs of an aging adult completely, despite the intention of older adults to remain in their homes as long as possible (Wiles, Liebing, Guberman, Reeve, & Allen, 2012). While the majority of older adults wish to age in place, people may also be forced to do so as a result of their socioeconomic status. Older adult communities can be very expensive. Because Establishment of aging in place as an emerging niche The American Physical Therapy Association recognizes the role that physical therapists hold in providing care for individuals aging in place. Geriatric and home health specialists are uniquely trained to help patients and their caregivers in creating a safe environment. It also stresses prevention of potential disorders and deficits, such as falls and cognitive decline, through adaptation of the physical environment (Hayhurst, 2017).Aging in place and home modifications are growing to become a niche area, in response to the increasing number of Baby Boomers Home is a multifaceted concept, comprised of the physical building and the contexts that turn the house into “home.” People have strong attachments to their homes through memories, objects, and emotions that must be acknowledged Housing stock Different types of buildings make up the housing stock in the United States. Most homes are built of wood, completed piece by piece, though some are partially built and constructed on site. The majority of homes are single-family detached homes: a single building on a single lot, not attached to another structure. In some parts of the country, especially in cities, row homes are more common. Entire blocks are filled with houses that share the side walls. Duplexes and triplexes are two or three units in one building. People may also live in large apartment or condominium buildings. Homes may be single or multistory. Ranch homes are typically single story with low ceilings and attached garages. Split-level homes will have an upstairs, downstairs, and a sunken living or dining room, which requires more navigation of stairways than some other housing types. In some parts of the country, especially the Northeast and Midwest, basements are standard features. Just like split-level homes, basements cause extra areas of the home and stairs to be maneuvered, especially when important appliances, such as the laundry machines, are located in that area. Basements also have a tendency to raise the rest of the home, making no-step entries harder to obtain. Unfortunately, the majority of these homes were built without consideration that people will age and have different needs over time. Accessibility, design, and even location of the housing Meaning of home during the aging process Many older adults have remained in their homes across a long number of years, often raising their families and cultivating decades of memories. These memories and strong emotions, both positive and negative, play a role in the desire of an older adult to leave that environment. The familiarity alone creates structure for their daily lives through the physical environment. Humans create stronger memories through the attachment of emotions to that memory. In that way, the experiences of the past within the home support people’s cognition as they age. They also experience strong emotional attachment to the objects within their space, making it more difficult to relocate. In addition, the familiarity of the environment allows for increased self-efficacy and feelings of control over their lives (Golant, 2011; Rioux, 2005). This sense of independence is created by the symbolism of being able to reside in their home, resisting Impact of home on the aging process Remaining at home has positive effects on the health and well- being of older adults. The environment can be an organizing force for older adults who use its familiarity to structure their
insurance typically does not cover rent, the cost of the facility and the move itself can be prohibitory for some people. People of lower socioeconomic status and means can be forced to age in place, simply out of necessity (Lehing, Smith, & Dunkle, 2015). The ideal situation is for people to have the autonomy to choose their living situation, be it to age in place or move to a different location, rather than to be forced out or forced to stay. growing older and the increased desire to remain at home as long as possible. Accordingly, physical therapists are encouraged not only to perform home safety assessments and home modification recommendations, but to become involved as consultants to architects, interior designers, builders, contractors, and other design professionals. Physical therapists are positioned to play a larger role in this area; it is part of our scope of practice and indicative of the desires of an entire population.
HOME
when considering the desire to age in place and during the creation of home modification recommendations and completion.
stock is not supportive of aging in place worldwide (Tanner, Tilse, & de Jonge, 2008). The community should also be examined when considering aging in place. The suburb movement has caused issues with the isolation of older adults, which leads to increased rates of depression and loneliness. It is not uncommon to meet women of the Greatest Generation who never learned to drive, because societal norms of the time allowed only their husbands to drive. Additionally, older adults may no longer drive, a decision made either of their volition or due to implications of a medical condition. Research has shown that a lack of public transportation in a community correlates to decreased health and increased mortality of residents because people may be unable to attend needed physician appointments and complete activities such as grocery shopping (Clarke, Ailshire, & Lantz, 2009; Crabtree & Mushi-Brunt, 2013). The community is a great support to older adults. Older adults may choose to move into different housing situations to be closer to stores, physicians, and family. As mentioned earlier, people can be forced to remain in their communities for familial or economic reasons. Therefore, as physical therapists, we must also consider the outside community when assisting our clients in aging in place. Aging in place is more than just the physical building in which the person resides. possible outside pressures of relocation, and continuing to care for oneself. In addition to memories, the home provides safety and security. Older adults spend increasing amounts of time in their home as they grow older and often will make adaptations to the home or their routine to compensate for decreasing physical and cognitive abilities (Tanner et al., 2008). The home also is perceived by those residing within as a shelter from the outside world. Some older adults can feel pressured by family and friends to change their living situation, or have watched their neighborhoods change over the years; their home provides a sense of safety, comfort, and protection from outside forces. Being at home also promotes positive daily feelings and contributes to a sense of resilience (Rioux, 2005).
day and thoughts. Physical therapists are already aware of the important role that context and the physical environment can play in performance of ADLs. Naturally, the qualitative research
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