Home adaptations and disability outcomes among older adults living in England

Guest blog by Tarani Chandola and Patrick Rouxel

The news that Care & Repair England closed in May this year was a shock to many researchers and practitioners in ageing. Despite their successful record as a charity since 1986, promoting the importance of decent housing for health and championing the need for more accessible housing for older adults, the lack of funding is sadly illustrative of the priorities not only in the policy sector, but also in research.

In our recently published study on the protective effect of home adaptations in preventing disability outcomes among older adults in England, we highlighted the lack of consideration of the role of housing conditions by many researchers on healthy ageing and disability. Housing adaptations are not even mentioned as a possible intervention in reviews on interventions for disability or healthy ageing. Moreover, in most of the leading longitudinal studies on ageing from across the world, data on housing adaptations are not collected. It is almost as though many researchers and policy makers believe that solutions to the problems of healthy ageing do not lie in funding for improving people’s home living conditions, where older adults spend most of the lives.

Adaptations to the built and home environment can reduce disability outcomes for people with mobility impairments.

It shouldn’t be a surprise to many practitioners in the field of ageing and gerontology that adaptations at home like putting in ramps and widened doorways can reduce disability outcomes for people with mobility impairments. Mobility impairments is by far the most common form of disability among older adults. In this study, we followed up 10,459 older adults in the English Longitudinal Study of Ageing for an average of 11 years. We found strong and consistent evidence that housing adaptations can prevent a deterioration in the health, wellbeing, and quality of life of disabled older adults. Among those with severe mobility impairments, home adaptions reduced the probability of falls by 3%, pain by 6%, and poor health by 4% compared to disabled adults living without any adaptations. These adaptations, which included widened doorways, access ramps, automatic doors, accessible parking, handrails and bathroom or kitchen modifications, also increased the chances that people with severe mobility impairments could go out of their home and participate in social activities by 6% and enabled them to remain in their own home for at least the next two years by 4%.

Housing adaptations can prevent deterioration across a range of health outcomes.

Tarani Chandola and Patrick Rouxel are based at the Faculty of Social Sciences at the University of Hong Kong, and were formerly at the University of Manchester.