This paper describes an instrument — the Housing Enabler — used in the assessment of housing accessibility. The tool was developed from the original Enabler idea by Steinfeld et al (1979), resulting in an instrument for reliable assessment of the accessibility of the housing environment and the immediate outdoor environment in terms of occupational therapy. Apart from a description of the instrument itself, this paper presents theoretical bases, studies completed, and current, and future considerations of importance for occupational therapy practice and research. The outcome of a Housing Enabler assessment makes the concept of accessibility concrete and allows for individual as well as group analyses. In conclusion, the Housing Enabler is a useful and reliable instrument for research, practice and education. It offers a wide range of applications and is well suited for the current development of community-based occupational therapy.
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References
1.
BadleyEM (1993) An introduction to the concepts and classifications of the International Classification of Impairments, Disabilities and Handicaps. Disability and Rehabilitation, 15(4), 161–78.
2.
BaumCLawM (1998) Community health: a responsibility, an opportunity, and a fit for occupational therapy. American Journal of Occupational Therapy, 52(1), 7–10.
3.
Boverket (1991) Kartläggning av användningen av bostadsanpassningsbidrag. [A survey on the use of grants for housing adaptations. In Swedish.]Karlskrona, Sweden: Boverket.
4.
Boverket (1994) Bostadsanpassningsbidrag. En uppföljning av kommunernas verksamhet. [Housing Adaptation Grants. A follow-up of the local authorities' activities. In Swedish.] Rapport 1994:11. Karlskrona, Sweden: Boverket.
5.
Boverket (1996) Bostadsanpassningsbidrag 1994–95 — Omfattning, kostnadsutveckling och tillämpning. [Housing Adaptation Grants 1994–95 — scope, cost development and application. In Swedish.] Rapport 1996:5. Karlskrona, Sweden: Boverket.
6.
Canadian Association of Occupational Therapists (1997) Enabling occupation: an occupational therapy perspective. Ottawa: CAOT Publications ACE.
7.
ChristiansenC (1991) Occupational therapy: intervention for life performance. In: ChristiansenCBaumC, eds. Occupational therapy: overcoming human performance deficits. Thorofare, NJ: Slack.
8.
ClemsonLRolandMCummingR (1992) Occupational therapy assessment of hazards in the homes of elderly people: an inter-rater reliability study. Australian Occupational Therapy Journal, 39(3), 23–26.
9.
CooperBCohenUHasselkusBR (1991) Barrier-free design: a review and critique of the occupational therapy perspective. American Journal of Occupational Therapy, 45(4), 344–50.
10.
FängeAIwarssonS (1999) Physical housing environment - development of a self-assessment instrument. Canadian Journal of Occupational Therapy, in press.
11.
IwarssonS (1997a) Functional capacity and physical environmental demand: exploration of factors influencing everyday activity and health in the elderly population. Unpublished Doctoral dissertation. Lund, Sweden: Department of Community Health Sciences Dalby/Lund, Lund University.
12.
IwarssonS (1997b) ENABLER - en metod för analys av tillgänglighetsproblem i boendet. Manual och bedömningsblanketter. [The Enabler - a method for analysing accessibility problems in housing. Manual and rating forms. In Swedish. Upon request, the book manuscript is available in English.] Society, Individual, Health. Report no. 15. Lund, Sweden: Department of Community Health Sciences Dalby/Lund, Lund University.
13.
IwarssonSIsacssonÅ (1993) Basic accessibility in modern housing - a key to the problems of care in the domestic setting. Scandinavian Journal of Caring Sciences, 7(3), 155–59.
14.
IwarssonSIsacssonÅ (1996a) Development of a novel instrument for occupational therapy assessment of the physical environment in the home - a methodologic study on ‘The Enabler’. Occupational Therapy Journal of Research, 16(4), 227–44.
15.
IwarssonSIsacssonÅ (1996b) Housing standards, environmental barriers in the home, and subjective general apprehension of housing situation among the rural elderly. Scandinavian Journal of Occupational Therapy, 3, 52–61.
16.
IwarssonSIsacssonÅ (1997a) On scaling methodology and environmental influences in disability assessments: the cumulative structure of personal and instrumental ADL among older adults in a Swedish rural district. Canadian Journal of Occupational Therapy, 64(5), 240–51.
17.
IwarssonSIsacssonÅ (1997b) Quality of life in the elderly population: an example exploring interrelationships among subjective well-being, ADL dependence, and housing accessibility. Archives of Gerontology and Geriatrics, 26(1), 71–83.
18.
IwarssonSIsacssonÅLankeJ (1998) ADL dependence in the elderly: the influence of functional limitations and physical environmental demand. Occupational Therapy International, 5(3), 173–93.
19.
IwarssonSStåhlA (1999) Traffic engineering and occupational therapy: a collaborative approach for future directions. Scandinavian Journal of Occupational Therapy, 6(1), 21–28.
20.
KaplanS (1996) Critical evaluation of standardised tests. Occupational Therapy in Health Care, 10(3), 3–14.
21.
KielhofnerG, ed (1995) A model of human occupation: theory and application. 2nd ed.Baltimore: Williams and Wilkins.
22.
LettsLLawMRigbyPCooperBStewartDStrongS (1994) Person-environment assessments in occupational therapy. American Journal of Occupational Therapy, 48(7), 608–18.
23.
LawtonMP (1980) Environment and ageing. Los Angeles: Brooks/Cole Publishing.
24.
LawtonMPNahemowL (1973) Ecology and the ageing process. In: EisdorferCLawtonMP, eds. The psychology of adult development and ageing. Washington, DC: American Psychological Association.
25.
McClainLToddC (1990) Food store accessibility. American Journal of Occupational Therapy, 44(6), 487–91.
26.
McCollMA (1998) What do we need to know to practise occupational therapy in the community?American Journal of Occupational Therapy, 52(1), 11–18.
27.
McGrathJRDavisAM (1992) Rehabilitation: where are we going and how do we get there?Clinical Rehabilitation, 6, 225–35.
28.
McKinnonALTownsendEMaconachieR (1990) Position paper on occupational therapy in home care. Canadian Journal of Occupational Therapy, 57(1), 2–4.
29.
MillerBRJSiegKWLudwigFMShortridgeSDVan DeusenJ (1988) Six perspectives on theory for the practice of occupational therapy. Rockville, MD: Aspen.
30.
NagiSZ (1991) Disability concepts revisited: implications for prevention. In: PopeAMTarlovAR, eds. Disability in America: toward a national agenda for prevention. Washington, DC: National Academy Press.
31.
SonnUHulter-ÅsbergK (1991) Assessment of activities of daily living in the elderly. A study of a population of 76-year-olds in Gothenburg, Sweden. Scandinavian Journal of Rehabilitation Medicine, 23, 193–202.
32.
SteinfeldESchroederSDuncanJFasteRCholletDBishopMWirthPCardellP (1979) Access to the built environments: a review of the literature. Washington, DC: US Government Printing Office.
33.
Swedish Handicap Institute (1989, 1995) Bygg ikapp handikapp. [Building to overcome handicap. In Swedish.]Stockholm: SHI.
34.
TibblinGTibblinBPecivaSKullmanSSvärdsuddK (1990) The Göteborg Quality of Life Instrument - An assessment of well-being and symptoms among men born 1913 and 1923. Scandinavian Journal of Primary Health Care, 8 (Suppl 1), 33–38.
35.
TranterRTSlaterRVaughanN (1991) Barriers to mobility: physically-disabled and frail elderly people in their local outdoor environment. International Journal of Rehabilitation Research, 14, 303–12.
36.
TrickeyFMaltaisDGosselinCRobitailleY (1993) Adapting older persons' homes to promote independence. Physical and Occupational Therapy in Geriatrics, 12, 1–14.
37.
VerbruggeLMJetteAM (1994) The disablement process. Social Science and Medicine, 38(1), 1–14.
38.
WadeDT (1994) Measurement in neurological rehabilitation. Oxford: Oxford University Press.
39.
World Health Organisation (1980, reprinted with preface 1993) International Classification of Impairments, Disabilities and Handicaps, ICIDH. A manual of classification relating to the consequences of disease. Geneva: WHO.
40.
World Health Organisation (1997) ICIDH-2: International Classification of Impairments, Activities and Participation. A manual of dimensions of disablement and functioning. Beta-1 draft for field trials. Geneva: WHO.
41.
ZemkeRClarkFA, eds (1996) Occupational science: the evolving discipline. Philadelphia: FA Davis.
