Abstract
Aging in place (AIP) is one’s ability to live at home without relocation to long-term care. The purpose of this study was to highlight the facilitators and barriers in one’s AIP implementation. OTs can apply these themes to increase the quality of life and potential of older adults to age in place.
Primary Author and Speaker: Mackenzie Macuch
Contributing Authors: Sajay Arthanat, John Wilcox
The purpose of this study was to highlight the barriers and facilitators to an older adult's implementation for aging-in-place (AIP) solutions. AIP is one’s ability and potential to live and age in their own home and community (Stones & Gullifer, 2014). Current research indicates that the majority of older adults desire to age-in-place (Vanlerberghe et al., 2017). An individual's loss of independence and sense of security within their home and community typically results in the individual moving to an assisted living facility or nursing home. This often creates physical, emotional, and financial burdens for the individual (Wiles et al., 2011). We implemented a qualitative grounded theory research to understand the perspective of older adults towards AIP, to determine the factors that leads to successful AIP, and to identify the concerns and barriers associated with this concept. The participants for the study consisted of ten older adults living in Cape Cod and Plymouth County, MA who were sampled using inclusion criteria of age, income, housing arrangement, and health status. Following Institutional Review Board approval, participants were screened and recruited through rehabilitation facilities, local senior centers, and senior residential communities. Data was collected through 60-120 minutes semi-structured interviews, conducted throughout a ten-week period. Each interview was audio recorded and transcribed verbatim.
The data was analyzed by three independent reviewers using an open coding system. The data was triangulated using a constant comparison method. Summaries from each interview categories and themes were drafted and distributed to respective participants for verification and member check. Results highlighted four common themes across all ten interviews; sense of autonomy, sense of engagement, sense of community, and a sense of safety. Each of these themes was viewed as both a barrier and facilitator by the participants in the study. All of the participants recognized the impact of AIP in their ability to grow old in their homes. Autonomy was highly valued across all participants. Activity engagement also influenced the participants ability to AIP as it created opportunities for social participation and leisure activities outside of their home. The participants’ perceptions on relocating to a long-term care facility were influenced by a variety of concerns regarding participation in their meaningful activities and a loss of dignity. 9/10 participants valued the implementation of technology and participation in virtual community. The ability to balance autonomy and safety was identified as a challenge for the participants in their ability to AIP. As a barrier to overcome, the acceptance of smart home technology varies greatly among all participants.
The research aligns with AOTA’s vision of promoting quality of life and community living potential of the aging population (AOTA, 2018), as well as the WHO global strategy related to age-friendly environments and enablement of autonomy with the aging population (WHO, 2016). This research highlights the older adults’ valued participation in activities within their home and community as well as the considerations for home modifications and technology to promote safety and independence. The findings have implications for home-based OT practice. Home health professionals and AIP specialists should closely examine their clients’ individual definition of autonomy, home access and safety issues, competence with technology, and community resources. Indicators gathered from this research and a subsequent focus group were used to develop and conduct a comprehensive survey on AIP in New England.
American Occupational Therapy Association [AOTA]. (2018). Aging in place and home modifications. Retrieved from https://www.aota.org/Practice/Productive- Aging/Emerging-Niche/Home-Mod.aspx
Stones, D., & Gullifer, J. (2014). ‘At home it’s just so much easier to be yourself: older adults’ perceptions of ageing in place’. Ageing & Society, 36, 449-481. doi:10.1017/So144686X14000214
Vanleerberghe, P., Witte, N. D., Claes, C., Schalock, R. L., & Verte, D. (2017). The quality of life of older people again in place: a literature review. Quality of Life Res, 26, 2899-2907. doi:10.1007/s11136-017-1651-0
Wiles, J. L., Leibing, A., Guberman, N., Reeve, J., & Allen, R. E. (2011). The meaning of “ageing in place” to older people. The gerontologist, gnr098.