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Ageing in Place for People with Disabilities

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Disabilities".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 29989

Special Issue Editor

Special Issue Information

Dear Colleagues,

Globally, life expectancy is increasing [1], and among people with disabilities, life expectancy is approaching that of the general population in many regions of the world [2]. Along with greater longevity, there has been a rise in disabling conditions [3], such that after the age of 65, the presence of more than one long-term condition is likely, and individuals may have several functional limitations to manage [4]. On the health service side, many countries are in the process of shifting the emphasis from costly acute and hospital-based care to community-based healthcare. There is also a growing investment in telecare and telemedicine. Research has also demonstrated that integrated care and support pathways are urgently needed to assist older people in communities [5] through primary care, community pharmacists, community health nursing, home and social care, and specialist, hospital-based services. The concept”ageing in place” has been around for a few decades. It emphasises the choice of individuals to live independently in the environments they prefer [6]. Housing, community and service design focus on maximising individuals’ autonomy and social connections. With the increase in functional limitations, support and assistance services must be adapted accordingly. Successful ageing in place requires more than just integrating health and social care services. It also necessitates a good understanding of local community assets. This Special Issue aims to collate research on ageing in place for people with disabilities. The topic rests thematically at the intersection of complex systems involving health, social, and community policies and practices. We invite interdisciplinary systematic reviews, quantitative and qualitative studies, evaluation and implementation research and case reports. We will also consider evidence reports on innovative interventions as well as accounts of experiences of ageing in place approaches.

We invite contributions from all social science and health-related disciplines.

This Special Issue will provide readers with best practice examples for ageing in place for people with disabilities, highlight persistent access barriers, and remind policy makers and practitioners of the need for change.

  1. https://www.who.int/gho/mortality_burden_disease/life_tables/situation_trends_text/en/
  2. Crimmins, E.M.; Zhang, Y.; Saito, Y. (2016). Trends Over 4 Decades in Disability-Free Life Expectancy in the United States. American journal of public health, 2016, 106, 1287–1293.
  3. http://www.healthdata.org/news-release/life-expectancy-climbs-worldwide-people-spend-more-years-living-illness-and-disability
  4. Jindai K, Nielson CM, Vorderstrasse BA, Quiñones AR. Multimorbidity and Functional Limitations Among Adults 65 or Older, NHANES 2005–2012. Prev Chronic Dis 2016, 13, 160174. DOI:http://dx.doi.org/10.5888/pcd13.160174
  5. https://www.ijic.org/articles/abstract/10.5334/ijic.976/
  6. Janine L. Wiles, Annette Leibing, Nancy Guberman, Jeanne Reeve, Ruth E. S. Allen; The Meaning of “Aging in Place” to Older People, The Gerontologist, Volume 52, Issue 3, 1 June 2012, Pages 357–366, https://doi.org/10.1093/geront/gnr098

Prof. Dr. Thilo Kroll
Guest Editor

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Keywords

  • disability
  • ageing in place
  • health systems
  • United Nations convention on the rights of persons with disabilities

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Published Papers (6 papers)

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Research

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22 pages, 2801 KiB  
Article
Wheeled Mobility Use on Accessible Fixed-Route Transit: A Field Study in Environmental Docility
by Sol Lim and Clive D’Souza
Int. J. Environ. Res. Public Health 2021, 18(6), 2840; https://doi.org/10.3390/ijerph18062840 - 10 Mar 2021
Cited by 2 | Viewed by 3140
Abstract
Multiple field studies provide qualitative accounts of usability barriers experienced by users of wheeled mobility devices on public transit. This study aimed to examine these usability barriers from the theoretical perspective of Environmental Docility by quantifying the relationship between functional capabilities of wheeled [...] Read more.
Multiple field studies provide qualitative accounts of usability barriers experienced by users of wheeled mobility devices on public transit. This study aimed to examine these usability barriers from the theoretical perspective of Environmental Docility by quantifying the relationship between functional capabilities of wheeled mobility device users and ingress–egress performance on accessible fixed-route transit vehicles in an urban setting. Twenty-eight wheeled mobility users each completed three trips on a predetermined route through the local public transit system. Ingress and egress times, user-reported usability ratings and open-ended comments were analyzed. Regression analyses indicated significant interactions between age and minimum parallel-park length on ingress and egress times. Specifically, lower functional capability reflected in older age and less maneuvering ability predicted decreased performance (longer ingress–egress times), indicating less adaptability to environmental demands and agreement with the Environmental Docility Hypothesis. Usability ratings and comments revealed difficulty with negotiating access ramps and turning maneuvers in the vehicle interior and in proximity to other passengers. Despite compliance with accessibility standards, current design of transit vehicles present substantial usability barriers for wheeled mobility users. Environmental Docility provides a theoretical basis to identifying modifiable factors related to person and environment for improving usability of public transit for people aging and/or with mobility impairments. Full article
(This article belongs to the Special Issue Ageing in Place for People with Disabilities)
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20 pages, 5821 KiB  
Article
Life Experiences with Using Community Care among People with Severe Physical Disabilities: A Comparative Analysis between South Korea and Japan
by Minyoung Lee, Yeji Choi, Eun Young Lee, Dong-A Kim and Seung Hee Ho
Int. J. Environ. Res. Public Health 2020, 17(24), 9195; https://doi.org/10.3390/ijerph17249195 - 9 Dec 2020
Cited by 1 | Viewed by 2154
Abstract
This study identified the pathways chosen by people with severe physical disabilities (PWSPD) in South Korea and Japan in using community care throughout their life and compared their experiences while navigating these pathways from their perspective. A concurrent nested mixed-method design was adopted. [...] Read more.
This study identified the pathways chosen by people with severe physical disabilities (PWSPD) in South Korea and Japan in using community care throughout their life and compared their experiences while navigating these pathways from their perspective. A concurrent nested mixed-method design was adopted. Quantitative data analysis included pathway mapping of facilities and services used throughout their lives. For qualitative data, interpretative phenomenological analysis (IPA) was applied. Eleven South Korean (congenital 7, acquired 4) and nine Japanese (congenital 6, acquired 3) participants were surveyed and interviewed. Pathway mapping was conducted by classifying the participants into focus groups. South Korean participants took nine years more than the Japanese participants to reach independence and showed different pathway characteristics. Superordinate themes from the IPA provided insight into the differences in experiences between PWSPD of the two countries: (1) accessibility and continuity of medical services; (2) experience of vocational training; (3) way and degree of social support for independent living; (4) care planning for receiving comprehensive services. In developing a community care model for the PWSPD to accelerate their time to independence, the government should strive for accessibility and connectivity of medical services, strengthen vocational training, social support for independent living, and information provision for the PWSPD. Full article
(This article belongs to the Special Issue Ageing in Place for People with Disabilities)
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18 pages, 624 KiB  
Article
Urban–Rural Differences in Long-Term Care Service Status and Needs Among Home-Based Elderly People in China
by Liangwen Zhang, Yanbing Zeng, Lixia Wang and Ya Fang
Int. J. Environ. Res. Public Health 2020, 17(5), 1701; https://doi.org/10.3390/ijerph17051701 - 5 Mar 2020
Cited by 51 | Viewed by 5555
Abstract
Background: Long-term care (LTC) needs for the elderly have become increasingly crucial policy concerns in rapidly aging Asia, especially in China, the most populous nation. However, very few studies have examined the cohort differences in terms of their existing and expected utilization of [...] Read more.
Background: Long-term care (LTC) needs for the elderly have become increasingly crucial policy concerns in rapidly aging Asia, especially in China, the most populous nation. However, very few studies have examined the cohort differences in terms of their existing and expected utilization of LTC services, above all urban–rural differences. This study aims to evaluate the differences of LTC current status and needs between urban–rural areas and age groups, and to identify influencing factors causing the different LTC needs. Methods: The data come from the Chinese Longitudinal Health Longevity Survey in 2014. A total of 7192 home-based elderly aged ≥65 years by multistage sampling were enrolled. The Andersen Model was applied to categorize the influential factors into three components including predisposing, enabling and needs. Multivariate logistic regression analysis was used to analyze the influential factors of the three levels of LTC needs. Results: A total of 6909 valid sample sizes were included in this study. The overall LTC needs of the elderly showed a rapidly increasing trend among which older people had the highest needs for bathing (27.29%) and toileting (15.8%). It was also demonstrated the aged cohort between urban and rural exerted an impact on all aspects of LTC status and needs to varying degrees (p < 0.05). Compared with urban areas, the LTC needs for the elderly in rural areas was more vigorous, but the supply was seriously inadequate. The elderly who were older, living in rural areas, unmarried, non-farming, with low income, in poor health and having less autonomy had higher anticipated needs for LTC services (OR > 1, p < 0.01). Compared with the young-old in rural areas, the young-old in urban areas were prone to live alone (OR = 1.61, p < 0.01). The elderly who were older, living in rural areas, farming, with low income, lonely and depressed had higher anticipated needs for community-based services (1 < OR < 1.69, p < 0.05). Conclusions: The aged cohort in urban–rural distinction were facing an increasing need for immediate care due to the inadequate support being provided, especially among rural elderly. The oldest elderly in rural areas had higher LTC needs, and different levels of needs were affected by age, economic level, family support, health status and other related effects. This study provides evidence-based recommendation for further improving the construction and development of the LTC system in China. Full article
(This article belongs to the Special Issue Ageing in Place for People with Disabilities)
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15 pages, 2782 KiB  
Article
Controlling for Structural Changes in the Workforce Influenced Occupational Class Differences in Disability Retirement Trends
by Svetlana Solovieva, Taina Leinonen, Kirsti Husgafvel-Pursiainen, Antti Kauhanen, Pekka Vanhala, Rita Asplund and Eira Viikari-Juntura
Int. J. Environ. Res. Public Health 2019, 16(9), 1523; https://doi.org/10.3390/ijerph16091523 - 30 Apr 2019
Cited by 5 | Viewed by 2881
Abstract
We explored occupational class differences in disability retirement trends accounting for structural changes in the workforce induced by the recent economic crisis and the following economic stagnation. Using nationwide register data on the general Finnish population aged 30–59 years, we examined trends in [...] Read more.
We explored occupational class differences in disability retirement trends accounting for structural changes in the workforce induced by the recent economic crisis and the following economic stagnation. Using nationwide register data on the general Finnish population aged 30–59 years, we examined trends in disability retirement due to all causes, musculoskeletal diseases, and mental disorders in 2007, 2010, and 2013. Applying propensity score (PS) matching to control for bias induced by structural changes in the workforce over time, we obtained 885,807 matched triplets. In the original study population, all-cause and cause-specific disability retirement declined between 2007 and 2013 for most occupational classes. In the matched study population, the disability retirement among skilled and unskilled manual workers sharply increased in 2010 and then declined in 2013. PS matching considerably attenuated the decline in disability retirement, particularly between the years 2007 and 2010. In general, the differences in disability retirement between both skilled and unskilled manual workers and upper-level non-manual employees widened during the period of economic stagnation. In occupational epidemiology, structural changes in the workforce should be accounted for when analysing trends in ill-health. Controlling for these changes revealed widening occupational class differences in disability retirement during the period of economic stagnation. Full article
(This article belongs to the Special Issue Ageing in Place for People with Disabilities)
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16 pages, 1328 KiB  
Article
A Pilot Study to Test the Feasibility of a Home Mobility Monitoring System in Community-Dwelling Older Adults
by Heesook Son and Hyerang Kim
Int. J. Environ. Res. Public Health 2019, 16(9), 1512; https://doi.org/10.3390/ijerph16091512 - 29 Apr 2019
Cited by 12 | Viewed by 3355
Abstract
Technology enables home-based personalized care through continuous, automated, real-time monitoring of a participant’s health condition and remote communication between health care providers and participants. Technology has been implemented in a variety of nursing practices. However, little is known about the use of home [...] Read more.
Technology enables home-based personalized care through continuous, automated, real-time monitoring of a participant’s health condition and remote communication between health care providers and participants. Technology has been implemented in a variety of nursing practices. However, little is known about the use of home mobility monitoring systems in visiting nursing practice. Therefore, the current study tested the feasibility of a home mobility monitoring system as a supportive tool for monitoring daily activities in community-dwelling older adults. Daily mobility data were collected for 15 months via home-based mobility monitoring sensors among eight older adults living alone. Indoor sensor outputs were categorized into sleeping, indoor activities, and going out. Atypical patterns were identified with reference to baseline activity. Daily indoor activities were clearly differentiated by sensor outputs and discriminated atypical activity patterns. During the year of monitoring, a health-related issue was identified in a participant. Our findings indicate the feasibility of a home mobility monitoring system for remote, continuous, and automated assessment of a participant’s health-related mobility patterns. Such a system could be used as a supportive tool to detect and intervene in the case of problematic health issues. Full article
(This article belongs to the Special Issue Ageing in Place for People with Disabilities)
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Review

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18 pages, 599 KiB  
Review
Occupational Therapy and the Use of Technology on Older Adult Fall Prevention: A Scoping Review
by María del Carmen Miranda-Duro, Laura Nieto-Riveiro, Patricia Concheiro-Moscoso, Betania Groba, Thais Pousada, Nereida Canosa and Javier Pereira
Int. J. Environ. Res. Public Health 2021, 18(2), 702; https://doi.org/10.3390/ijerph18020702 - 15 Jan 2021
Cited by 11 | Viewed by 12181
Abstract
Introduction: Falls are the second leading cause of accidental or non-intentional deaths worldwide and are the most common problem as people age. The primary purpose of addressing falls is to detect, prevent, treat, and reduce their incidence and consequences. Previous studies identified [...] Read more.
Introduction: Falls are the second leading cause of accidental or non-intentional deaths worldwide and are the most common problem as people age. The primary purpose of addressing falls is to detect, prevent, treat, and reduce their incidence and consequences. Previous studies identified that multifactorial programs, an interprofessional team, and assistive technology are required to address falls in older adults effectively. Accordingly, the research question is as follows: what are the scope, type of studies, and approaches and strategies to fall risk using technology in the existing occupational therapy literature regarding interventions to address the effects of falls in older adults on daily living? Methods: This scoping review was carried out in January 2020 through Biblioteca Virtual de Salud España, C.I.N.A.H.L., Cochrane Plus, OTSeeker, PubMed, Scopus, and Web of Science. Results: Twelve papers were included. We analyzed the year and journal of publication, authors’ affiliation, and design of the study, and thematic categories. There were three themes: participants’ characteristics, type of intervention, and fall approach and type of technology used. Discussion and Conclusions: The literature obtained is scarce. It is considered to still be an emerging theme, especially when considering the use of technology for occupational therapy. Full article
(This article belongs to the Special Issue Ageing in Place for People with Disabilities)
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