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Friendly Residential Environments for Ageing in Place with Autonomy and Independence

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

Deadline for manuscript submissions: closed (28 October 2022) | Viewed by 71430

Special Issue Editors


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Guest Editor
Spanish National Research Council (CSIC), Research Group on Ageing (GIE-CSIC), 28037 Madrid, Spain
Interests: ageing; age-friendly settings; active/healthy ageing; quality of life; wellbeing; residential environments; health emergencies.

E-Mail Website
Guest Editor
Spanish National Research Council (CSIC), Research Group on Ageing (GIE-CSIC), 28037 Madrid, Spain
Interests: ageing; active/healthy ageing; health conditions; physical and social environments; gender roles and intersectionality; quality of life; wellbeing

E-Mail Website
Co-Guest Editor
Department of Geography, National Distance Education University (UNED), 28040 Madrid, Spain
Interests: ageing; environmental gerontology; age-friendly environments; residential environments; active and healthy ageing; quality of life; dependence; disability; social services; health emergencies; social vulnerability; climate change

Special Issue Information

Dear Colleagues,

The issue will focus on theoretical and applied subjects about residential environments and their connections with personal and contextual factors, quality of life, and wellbeing as people age. Conceptual approaches, literature reviews, and methodological studies deserve a special mention, as well as the incorporation of new technologies, the management of health emergencies (COVID-19 pandemic), and climatic risks, which are of valuable interest to better understand the environmental dimensions of aging at home/in place. From multidisciplinary epigenetic approaches and environmental gerontology, studies on implications of the aging environments on therapeutic strategies will be accepted.

We have been invited to organize a Special Issue on Friendly Residential Environments for Aging in Place with Autonomy and Independence in the International Journal of Environmental Research and Public Health (Impact Factor: 2.849 in 2019). More detailed information can be found in the journal site https://www.mdpi.com/journal/ijerph.

Under the Aging in Place (AIP) paradigm, older people report their preference for aging in their usual environments, distinguishing between various geographic scales: micro (dwelling), meso (community and neighborhood of residence) and macro (support services). However, the unadaptability of environments to the changing needs of older residents could have adverse effects on their health and living conditions. In this sense, the Age-Friendly Cities and Communities program is designed to engage communities to be adapted to address the environmental and social factors that contribute, from a theoretical or applied perspective, to active and healthy aging and, consequently, to well-being and quality of life as people age.

This Special Issue will welcome contributions related to the residential environment of older people, their characteristics, and its influence on autonomy, independence, and quality of life in the aging process, such as studies connected with aging in place, age-friendly cities and communities, active and healthy aging, residential contexts (housing, long-term care settings, cohousing), residential social networks, residential services, and related topics, for older adults both with and without dementia. Theoretical approaches, literature reviews, and methodological studies deserve a special mention, as well as the application of quantitative, qualitative or mixed methods, or the incorporation of new technologies to better understand the environmental dimensions of aging at home. In addition, new studies on the therapeutic importance of environments in aging are accepted, from the multidisciplinary approaches of epigenetic and environmental gerontology. Precisely, some of the responses to health emergencies (COVID-19 pandemic) and climate hazards (floods, heat waves) will come from a better understanding within aging environments.

Dr. Fermina Rojo-Pérez
Dr. Gloria Fernández-Mayoralas
Dr. Diego Sánchez-González
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

  • age-friendly communities
  • residential environments
  • built environment
  • aging in place
  • active aging
  • healthy aging
  • housing
  • long-term care settings
  • cohousing
  • quality of life
  • therapeutic environments
  • health emergencies
  • climate change
  • public health
  • epigenetic
  • environmental gerontology

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Published Papers (23 papers)

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14 pages, 680 KiB  
Article
Factors Associated with Aging in Place among Community-Dwelling Older Adults in Korea: Findings from a National Survey
by Myong Sun Cho and Mi Young Kwon
Int. J. Environ. Res. Public Health 2023, 20(3), 2740; https://doi.org/10.3390/ijerph20032740 - 3 Feb 2023
Cited by 8 | Viewed by 3350
Abstract
Ever since baby boomers started turning 65 years old in 2020, Korea is set to become a super-aged society by 2025. This makes it the world’s fastest-aging society. Aging in place (AIP) has become a policy direction to prepare for an aging society [...] Read more.
Ever since baby boomers started turning 65 years old in 2020, Korea is set to become a super-aged society by 2025. This makes it the world’s fastest-aging society. Aging in place (AIP) has become a policy direction to prepare for an aging society and improve older adults’ quality of life. It refers to the ability of older adults to remain in their homes and communities as they age, allowing them to reside in their place of preference and access the services they require to promote their quality of life. A cross-sectional study design was employed using data sampled from the 2020 National Survey of Older Koreans. In total, 9930 older adults (aged between 65 and 99 years old) participated. The results confirmed that the intention to pursue AIP is related to personal factors (education, income, house ownership, smoking, exercise, depression), interpersonal and communal factors (unmet healthcare needs, need for home care services, family contact), and policy level factors (basic pension beneficiary, long-term care services) using an ecological model. The findings may promote individual health behaviors and help fill the gap between unmet healthcare needs and community care services that positively influence older adults’ AIP. Full article
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21 pages, 4556 KiB  
Article
Living in an Age-Friendly Community: Evidence from a Masterplanned Development in Southwest Sydney
by Alasdair Jones and Susan Parham
Int. J. Environ. Res. Public Health 2023, 20(2), 1312; https://doi.org/10.3390/ijerph20021312 - 11 Jan 2023
Cited by 1 | Viewed by 2435
Abstract
This paper is situated at the interface of a growing urban studies literature concerned with ‘masterplanning’ practices in urban planning and another, hitherto relatively discrete, body of research concerned with age-friendly cities and communities. The authors are interested in exploring a gap in [...] Read more.
This paper is situated at the interface of a growing urban studies literature concerned with ‘masterplanning’ practices in urban planning and another, hitherto relatively discrete, body of research concerned with age-friendly cities and communities. The authors are interested in exploring a gap in aging in place literature around how neighbourhoods and residential settings developed with aging in place principles in mind are experienced and perceived by residents. To explore this research gap, the authors analyse qualitative (primarily interview and focus group) data collected in Park Central, a masterplanned development located in the Campbelltown suburb in the southwest region of the Sydney metropolitan area, Australia. This development was delivered in response to a need identified by the state’s land and property development agency, Landcom, for more diverse and affordable medium-density housing in Campbelltown. In particular, a need was identified for housing developments that would be able to sustainably accommodate the changing lifestyle needs of a maturing population in the region. Drawing on our thematic analysis of our data, we discern three key themes in research participants’ experiences of Park Central as a place for aging. These themes are elaborated via recourse to excerpts from our data and discussed with a view to informing how the conception, development and practice of further age-friendly communities is approached. Full article
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15 pages, 410 KiB  
Article
Friendly Residential Environments That Generate Autonomy in Older Persons
by Alejandra Segura Cardona, Doris Cardona Arango, Angela Segura Cardona, Carlos Robledo Marín and Diana Muñoz Rodríguez
Int. J. Environ. Res. Public Health 2023, 20(1), 409; https://doi.org/10.3390/ijerph20010409 - 27 Dec 2022
Cited by 3 | Viewed by 2375
Abstract
Objective: This study aimed to explore the housing and residential environment conditions associated with functional autonomy in older persons. Methods: A quantitative cross-sectional study was conducted, including 175 individuals over the age of 60. Participants were non-institutionalized urban residents of Medellín, Colombia, selected [...] Read more.
Objective: This study aimed to explore the housing and residential environment conditions associated with functional autonomy in older persons. Methods: A quantitative cross-sectional study was conducted, including 175 individuals over the age of 60. Participants were non-institutionalized urban residents of Medellín, Colombia, selected by random two-stage sampling (neighborhoods and blocks). Analysis was done according to functional autonomy of action (dependent variable); and demographic conditions, housing, and the physical and social environment suggested by the World Health Organization (WHO) in the strategy of age-friendly cities (independent variables). Univariate, bivariate, and multivariate analyses were performed with these variables, where the odds ratio (OR), association hypothesis test, and confidence intervals were estimated, using logistic regression models. Results: 89.7% of older persons had moderate physical performance. The performance of intergenerational activities (OR = 5.28) and community actions (OR = 11.28) were part of social environments. The adaptations in public transport (OR = 90.33), sanitary services (OR = 4.1), and lighting in parks (OR = 19.9) of the physical environment were the associations found with functional autonomy. Conclusions: Exploring how the physical and social environments surrounding housing are associated with the functional performance of older persons can generate useful information to support public health and city infrastructure strategies that improve their physical performance and maintain autonomy. Full article
16 pages, 1281 KiB  
Article
The Impact of Retired Immigrants on Quality of Life for the Local Aging Population: Results from the Southeast Spanish Coast
by José Ramón Valero-Escandell, Xavier Amat-Montesinos and Carlos Cortés-Samper
Int. J. Environ. Res. Public Health 2023, 20(1), 366; https://doi.org/10.3390/ijerph20010366 - 26 Dec 2022
Cited by 4 | Viewed by 1730
Abstract
The immigration of foreign retirees to Spain’s southeast coast is a tradition that stretches back decades. This phenomenon has modified the demographic structure of many towns and also transformed their social and economic features, as well as the number and diversity of services [...] Read more.
The immigration of foreign retirees to Spain’s southeast coast is a tradition that stretches back decades. This phenomenon has modified the demographic structure of many towns and also transformed their social and economic features, as well as the number and diversity of services available to the population. This study examines the effect of post-employment immigration on economic revitalisation, the increase in services and the arrival of new inhabitants. It demonstrates the transformative potential of the phenomenon for pre-coastal areas in the Spanish southeast and its influence on the configuration of friendly residential environments. The study analyses the evolution of basic demographic data and its spatial behaviour, establishing relationships between the quality of life of the local aging population and retired immigrants. The analysis focuses on the impact of residentialist areas on the configuration of friendly living environments. The results show how these communities, which were once somewhat stagnant and had a significantly aging population, either participated in the development or have improved their access to certain services and facilities, configuring new environments. The results reflect the improvement of the quality of life for the elderly in these settings, considering that they are often the majority age group. Full article
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21 pages, 825 KiB  
Article
The Importance of Place Attachment in the Understanding of Ageing in Place: “The Stones Know Me”
by Irene Lebrusán and M. Victoria Gómez
Int. J. Environ. Res. Public Health 2022, 19(24), 17052; https://doi.org/10.3390/ijerph192417052 - 19 Dec 2022
Cited by 14 | Viewed by 3888
Abstract
As academic literature has shown, there is a preference among older adults to experience old age independently, in their own homes, giving shape to what has been called ageing in place. This phenomenon links residence, life cycle, and the experience of old age. [...] Read more.
As academic literature has shown, there is a preference among older adults to experience old age independently, in their own homes, giving shape to what has been called ageing in place. This phenomenon links residence, life cycle, and the experience of old age. Although it depends on many factors (housing characteristics, the elderly’s economy, or their social support, among others) it is based on place attachment as a key aspect, which comprises two different but interwoven dimensions: the home (private space) and the neighbourhood (social space), understood as an extended sphere of the home. Despite its importance, and beyond the consensus that the time spent in a place increases attachment to it, the processes whereby place attachment is constructed by the elderly and the role of the experience of neighbourhood are little known. This article intended to delve into the meaning of place attachment, its importance, and how it is built by the elderly population in urban areas. For this purpose, a qualitative study was conducted in Spain, selecting Madrid (the biggest city in the country) as a case study of how place attachment is shaped in an urban setting. To obtain in-depth information, data were collected through ethnographic interviews with 37 people aged 65–95 and 1 focus group among elderly aged 65–71. The most relevant finding of the qualitative analysis is the emotional significance of attachment to the local space as an element that enables continuity—as opposed to the rupture to which we associate old age- in the experience of the life cycle of the elderly. It should be noted that some of the results are conditioned by the specificities of Spanish society, particularly with regard to family ties. Potential extrapolations to other realities should take this point into account. Full article
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26 pages, 476 KiB  
Article
Social Image of Old Age, Gendered Ageism and Inclusive Places: Older People in the Media
by María Sánchez-Román, Gadea Autric-Tamayo, Gloria Fernandez-Mayoralas, Fermina Rojo-Perez, María Silveria Agulló-Tomás, Diego Sánchez-González and Vicente Rodriguez-Rodriguez
Int. J. Environ. Res. Public Health 2022, 19(24), 17031; https://doi.org/10.3390/ijerph192417031 - 18 Dec 2022
Cited by 5 | Viewed by 4972
Abstract
Ageism promotes the exclusion of older people from society by generating a negative image that they also internalize. The aim of this article is to investigate older people’s social self-image, through statements broadcast on a national Spanish radio program aimed at this group. [...] Read more.
Ageism promotes the exclusion of older people from society by generating a negative image that they also internalize. The aim of this article is to investigate older people’s social self-image, through statements broadcast on a national Spanish radio program aimed at this group. A qualitative analysis was conducted for a random sample from the sound archive for the Radio Nacional de España program Juntos Paso a Paso (Together, Step by Step) (2008–2021), using codes based on the pillars and determinants of active ageing and the three dimensions of ageism. Intercoder agreement was calculated. There were significant findings regarding ageism, gendered ageism and ageing in place, with differences according to size of municipal area. The program in question can be considered a viable secondary source for the research aim. Ageism is most commonly manifested through implicit opinions and invisibilization in family and social contexts. Care activities play a notably central role in responses related to gendered ageism. In relation to ageing in place, older people prefer their habitual environment when they have moderate care needs and accept moves to nursing homes when their needs increase. Full article
14 pages, 699 KiB  
Article
Aging in Place: Connections, Relationships, Social Participation and Social Support in the Face of Crisis Situations
by Sacramento Pinazo-Hernandis, Mauricio Blanco-Molina and Raúl Ortega-Moreno
Int. J. Environ. Res. Public Health 2022, 19(24), 16623; https://doi.org/10.3390/ijerph192416623 - 10 Dec 2022
Cited by 5 | Viewed by 2506
Abstract
Objectives: We seek to identify active coping strategies used by older adults to face the pandemic and to deal with daily stressors, and to clarify which factors had an effect on stress, positive emotions and depression in active and healthy community-dwelling older adults [...] Read more.
Objectives: We seek to identify active coping strategies used by older adults to face the pandemic and to deal with daily stressors, and to clarify which factors had an effect on stress, positive emotions and depression in active and healthy community-dwelling older adults in the first and second year of the pandemic in Costa Rica. Methods: Participants were living in their own homes in Costa Rica (n = 218, mean age 69.96, 82.1% women). Participants were interviewed by phone and answered an online survey, which included socio-demographic information, mental health variables such as stressors (perceived health and fear of COVID-19, illness, perception of pandemic gravity), loneliness (whether they felt lonely and how often they felt lonely), access to Information and Communication Technologies, socio-emotional coping variables, social participation and physical activity level during the pandemic. Results: Positive socio-emotional indicators related to well-being such as self-efficacy, social support, perceived health and proactive behavior were high. Negative well-being indicators such as perceived stress, emotional COVID-19 fear and loneliness showed low values in the sample studied during both years. We found significant relations across the dependent variables (perceived stress, positive emotions and depression) by studying the psychological well-being coping strategies. Conclusions: Findings highlight the importance of coping strategies and social participation in the capacity of older adults to mitigate the negative psychological consequences of crisis situations and provide evidence of “aging in place”. Full article
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19 pages, 852 KiB  
Article
Residential Environment Assessment by Older Adults in Nursing Homes during COVID-19 Outbreak
by Fermina Rojo-Perez, Vicente Rodriguez-Rodriguez, Gloria Fernandez-Mayoralas, Diego Sánchez-González, Carmen Perez de Arenaza Escribano, Jose-Manuel Rojo-Abuin, Maria João Forjaz, María-Ángeles Molina-Martínez and Carmen Rodriguez-Blazquez
Int. J. Environ. Res. Public Health 2022, 19(23), 16354; https://doi.org/10.3390/ijerph192316354 - 6 Dec 2022
Cited by 4 | Viewed by 2940
Abstract
The most vulnerable residential settings during the COVID-19 pandemic were older adult’s nursing homes, which experienced high rates of incidence and death from this cause. This paper aims to ascertain how institutionalized older people assessed their residential environment during the pandemic and to [...] Read more.
The most vulnerable residential settings during the COVID-19 pandemic were older adult’s nursing homes, which experienced high rates of incidence and death from this cause. This paper aims to ascertain how institutionalized older people assessed their residential environment during the pandemic and to examine the differences according to personal and contextual characteristics. The COVID-19 Nursing Homes Survey (Madrid region, Spain) was used. The residential environment assessment scale (EVAER) and personal and contextual characteristics were selected. Descriptive and multivariate statistical analysis were applied. The sample consisted of 447 people (mean age = 83.8, 63.1% = women, 50.8% = widowed, 40% = less than primary studies). Four residential assessment subscales (relationships, mobility, residential aspects, privacy space) and three clusters according to residential rating (medium-high with everything = 71.5% of cases, low with mobility = 15.4%, low with everything = 13.1%) were obtained. The logistic regression models for each cluster category showed to be statistically significant. Showing a positive affect (OR = 1.08), fear of COVID-19 (OR = 1.06), high quality of life (OR = 1.05), not having suspicion of depression (OR = 0.75) and performing volunteer activities (OR = 3.67) were associated with the largest cluster. It is concluded that a better residential evaluation was related to more favourable personal and contextual conditions. These results can help in the design of nursing homes for older adults in need of accommodation and care to facilitate an age-friendly environment. Full article
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14 pages, 415 KiB  
Article
Validation of the Spanish Version of the Fear of COVID-19 Scale (FCV-19S) in Long-Term Care Settings
by Pilar Cárdenas Soriano, Carmen Rodriguez-Blazquez, Maria João Forjaz, Alba Ayala, Fermina Rojo-Perez, Gloria Fernandez-Mayoralas, Maria-Angeles Molina-Martinez, Carmen Perez de Arenaza Escribano and Vicente Rodriguez-Rodriguez
Int. J. Environ. Res. Public Health 2022, 19(23), 16183; https://doi.org/10.3390/ijerph192316183 - 3 Dec 2022
Cited by 6 | Viewed by 2318
Abstract
Fear of coronavirus disease 2019 (COVID-19) is one of the main psychological impacts of the actual pandemic, especially among the population groups with higher mortality rates. The Fear of COVID-19 Scale (FCV-19S) has been used in different scenarios to assess fear associated with [...] Read more.
Fear of coronavirus disease 2019 (COVID-19) is one of the main psychological impacts of the actual pandemic, especially among the population groups with higher mortality rates. The Fear of COVID-19 Scale (FCV-19S) has been used in different scenarios to assess fear associated with COVID-19, but this has not been done frequently in people living in long-term care (LTC) settings. The present study is aimed at measuring the psychometric properties of the Spanish version of the FCV-19S in residents in LTC settings, following both the classical test theory (CTT) and Rasch model frameworks. The participants (n = 447), aged 60 years or older, were asked to complete the FCV-19S and to report, among other issues, their levels of depression, resilience, emotional wellbeing and health-related quality of life with validated scales. The mean FCV-19S score was 18.36 (SD 8.28, range 7–35), with higher scores for women, participants with lower education (primary or less) and higher adherence to preventive measures (all, p < 0.05). The Cronbach’s alpha for the FCV-19S was 0.94. After eliminating two items due to a lack of fit, the FCV-19S showed a good fit to the Rasch model (χ2 (20) = 30.24, p = 0.019, PSI = 0.87), with unidimensionality (binomial 95% CI 0.001 to 0.045) and item local independency. Question 5 showed differential item functioning by sex. The present study shows that the FCV-19S has satisfactory reliability and validity, which supports its use to effectively measure fear in older people living in LTC settings. This tool could help identify risk groups that may need specific health education and effective communication strategies to lower fear levels. This might have a beneficial impact on adherence to preventive measures. Full article
14 pages, 399 KiB  
Article
Friendly Residential Environments and Subjective Well-Being in Older People with and without Help Needs
by María Ángeles Molina-Martínez, Sara Marsillas, María Sánchez-Román and Elena del Barrio
Int. J. Environ. Res. Public Health 2022, 19(23), 15832; https://doi.org/10.3390/ijerph192315832 - 28 Nov 2022
Cited by 3 | Viewed by 2017
Abstract
Previous studies have shown that friendly environments are associated with well-being and higher quality of life in older people. This study aimed to investigate the relationship between friendly environments and subjective well-being by segmenting the population according to the need for help in [...] Read more.
Previous studies have shown that friendly environments are associated with well-being and higher quality of life in older people. This study aimed to investigate the relationship between friendly environments and subjective well-being by segmenting the population according to the need for help in performing activities of daily living (ADLs) in a representative sample of people over 55 years of age in the Basque Country (Spain) (n = 2760). To determine the predictive power of friendliness on subjective well-being, two separate linear regression models were obtained according to the need for help in ADLs. The results obtained show a greater explanatory power of the model in the case of people who required help. However, in the case of people who do not need help, subjective health had a greater weight in the predictions. This paper’s findings support the greater importance of the characteristics of the physical and social environment, as people’s functional status worsens, with friendliness being an explanatory factor for people’s well-being as they age and their dependency increases. Full article
12 pages, 341 KiB  
Article
Aging in the Right Place for Older Adults Experiencing Housing Insecurity: An Environmental Assessment of Temporary Housing Program
by Atiya Mahmood, Rachelle Patille, Emily Lam, Diana Juanita Mora, Shreemouna Gurung, Gracen Bookmyer, Rachel Weldrick, Habib Chaudhury and Sarah L. Canham
Int. J. Environ. Res. Public Health 2022, 19(22), 14857; https://doi.org/10.3390/ijerph192214857 - 11 Nov 2022
Cited by 4 | Viewed by 3444 | Correction
Abstract
Research on programs offering senior-specific housing supports and enabling “aging in the right place” (AIRP) for “older persons with experiences of homelessness” (OPEH) is limited. This paper presents an environmental assessment of a “transitional housing program” (THP) in Metro Vancouver, Canada, for OPEH [...] Read more.
Research on programs offering senior-specific housing supports and enabling “aging in the right place” (AIRP) for “older persons with experiences of homelessness” (OPEH) is limited. This paper presents an environmental assessment of a “transitional housing program” (THP) in Metro Vancouver, Canada, for OPEH to AIRP. Data were collected using Aging in the Right Place Environmental (AIRP-ENV) and Secondary Observation (AIRP-ENV-SO) audit tools designed to evaluate multi-unit housing for OPEH. The 241-item AIRP-ENV tool was used to assess the built environmental features of four multi-unit buildings of the THP. The AIRP-ENV-SO tool was used to collect contextual data on the function, safety, and land use of the surrounding neighborhood. Findings identified built environment and urban design features that support THP residents’ safety, security, accessibility, functionality, social activity, autonomy, and identity. The THP buildings were rated ‘Good’ for accessibility, functionality, autonomy and identity, while ‘Satisfactory’ or ‘Poor’ for safety, security, and social activity. Findings point to the built environmental features (e.g., size and layout of spaces) required in the THP to create opportunities for increased social engagement among residents and enhanced safety and security. The AIRP-ENV and AIRP-ENV-SO audit tools can help inform programs across the housing continuum to develop supportive built environments that promote AIRP for OPEH. Full article
28 pages, 13600 KiB  
Article
Best Practices from Eight European Dementia-Friendly Study Cases of Innovation
by Elisa Pozo Menéndez and Ester Higueras García
Int. J. Environ. Res. Public Health 2022, 19(21), 14233; https://doi.org/10.3390/ijerph192114233 - 31 Oct 2022
Cited by 5 | Viewed by 4153
Abstract
The concept of dementia-friendly cities and communities has achieved great dissemination in the international context since 2016. Although it is usually related with community networks and services, evidence and guidelines show the close relationship between the built environment design, health promotion, and the [...] Read more.
The concept of dementia-friendly cities and communities has achieved great dissemination in the international context since 2016. Although it is usually related with community networks and services, evidence and guidelines show the close relationship between the built environment design, health promotion, and the preservation of relationships with the local surroundings. Recent publications emphasize best practices in urban areas and care management. However, this is a very complex reality in each country depending on the sociosanitary services, the demographic, and geographic structure and many other different aspects including cultural ones. Moreover, design should also consider not only basic aspects such as habitability or universal accessibility, but also heritage, identity, and the feeling of normalized living. Knowledge about international experiences and innovative approaches is, as yet, an object of study as demographic ageing is still challenging all the welfare systems, especially in Europe. This study presents eight descriptive study cases in three different European countries—the United Kingdom, Belgium, and The Netherlands—to analyze the relationship between dementia-friendly initiatives and their intersection with design, urban planning and the provision of care. The results can provide strategic lines for development and innovation towards dementia-friendly societies and cities achieving SDG numbers 3 and 11 simultaneously. Full article
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25 pages, 9243 KiB  
Article
The Ancient Town Residential Environment of the Elderly in Xiangxi Tujia: Survey, Questions, and Recommendations
by Fupeng Zhang, Lei Shi, Simian Liu, Jiaqi Shi, Mengfei Cheng and Tansheng Xiang
Int. J. Environ. Res. Public Health 2022, 19(17), 10820; https://doi.org/10.3390/ijerph191710820 - 30 Aug 2022
Cited by 6 | Viewed by 2359
Abstract
This study uses behavioral observation, interviews, and questionnaire research to investigate the residential environment. It also evaluates the elderly in four representative ancient towns of Xiangxi, namely, Liye Ancient Town, Furong Ancient Town, Liexi Ancient Town, and Xichehe Ancient Town. It includes indoor [...] Read more.
This study uses behavioral observation, interviews, and questionnaire research to investigate the residential environment. It also evaluates the elderly in four representative ancient towns of Xiangxi, namely, Liye Ancient Town, Furong Ancient Town, Liexi Ancient Town, and Xichehe Ancient Town. It includes indoor air (CO2, PM2.5, PM10) and light intensity monitoring for the residential environment. The results showed that the elderly had a significant sense of frustration and loneliness. Of the elderyly, 70% believed the current living environment had an impact on healthy living, and 45% believed the safety and convenience of the living environment should be improved. More than 80% of the elderly were dissatisfied with their indoor acoustic environment, and more than 70% were dissatisfied with their home transportation. More than 85% of the elderly considered traditional wooden components and spaces to be the source of cultural identity. Furthermore, the average indoor PM2.5 concentration during the fire pit fire was 350–600 µg/m3, about 4.7–8 times the Chinese standard value. The average concentration of PM10 in all rooms was more than 400 µg/m3, approximately three times the Chinese standard value. Also, targeted environmental improvement strategies were proposed. The study results provided actual information to develop a systematic approach and a targeted design based on the needs to improve the residential environment of the elderly in ancient cities. Full article
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23 pages, 6957 KiB  
Article
Decision-Making Mechanism of Joint Activities for the Elderly and Children in Integrated Welfare Facilities: A Discussion Based on “Motivation–Constraint” Interaction Model
by Wenjing Luo, Zhi Qiu, Yurika Yokoyama and Shengyuan Zheng
Int. J. Environ. Res. Public Health 2022, 19(16), 10424; https://doi.org/10.3390/ijerph191610424 - 21 Aug 2022
Cited by 1 | Viewed by 1868
Abstract
In China, joint activities for the elderly and children in integrated welfare facilities lack systematic decision procedures. By learning from the “leisure constraint” theory, the study puts forward six influencing indicators of motivation and constraint in the aspects of preliminary coordination, activity space [...] Read more.
In China, joint activities for the elderly and children in integrated welfare facilities lack systematic decision procedures. By learning from the “leisure constraint” theory, the study puts forward six influencing indicators of motivation and constraint in the aspects of preliminary coordination, activity space and effect. By using semi-structured interviews and questionnaire surveys analyzed by deviation value computation, the study analyzes the evaluation value of influencing factors in the decision procedure of potential activity cases, where administrators and nurses act as two decision makers. Further, it discusses the decision-making mechanism based on the “motivation–constraint” interaction model. Firstly, it analyzes the dominant forces in the decision procedure, which are “motivation oriented”, “negotiation oriented” and “constraint oriented”. Secondly, it reveals that administrators and nurses as two decision makers tend to give positive motivation evaluations and deliberative constraints evaluations, respectively. Additionally, it analyzes the decision procedures of activities with distinct feasibility differentiation. Thirdly, it positions the levels of occurrence potential as “should occur”, “occurred but should be improved”, “potentially could occur” and “hard to occur”. Eventually, it analyzes the requirements and potential for joint activities under different service modules, which provides a theoretical foundation for the systematic planning and development of the joint activities. Full article
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13 pages, 697 KiB  
Article
Personal Characteristics for Successful Senior Cohousing: A Proposed Theoretical Model
by Pilar Monton, Luisa-Eugenia Reyes and Carlos-María Alcover
Int. J. Environ. Res. Public Health 2022, 19(4), 2241; https://doi.org/10.3390/ijerph19042241 - 16 Feb 2022
Cited by 3 | Viewed by 3187
Abstract
This paper aims to propose an integrated theoretical model with which to identify the personal characteristics, behaviors, and competencies of individuals who have successfully seen a senior cohousing project through to the residential stability phase. Numerous early-stage senior cohousing projects are registered each [...] Read more.
This paper aims to propose an integrated theoretical model with which to identify the personal characteristics, behaviors, and competencies of individuals who have successfully seen a senior cohousing project through to the residential stability phase. Numerous early-stage senior cohousing projects are registered each year. However, only a few of them are actually built, and when they are, the construction process takes an average of 10 years. Would-be cohousing residents have to put their tenacity and other competencies to the test to overcome the obstacles in their path before their residential complex is completed. The model proposed here analyzes senior cohousing initiatives as entrepreneurial undertakings. To this end, it draws upon a comprehensive review of the literature on entrepreneurship to identify the personal characteristics, behaviors, and competencies typical of entrepreneurs. In this model, participants in senior cohousing projects make use of these entrepreneurial competencies to help them overcome the obstacles to completing their housing development. However, for the would-be cohousing residents, the objective is not simply to build the residential complex but to enjoy the satisfaction and well-being this housing typology offers. Here, too, we find their entrepreneurial competencies can play a role. Full article
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35 pages, 526 KiB  
Article
A Mixed-Methods Analysis of Care Arrangements of Older People with Limited Physical Abilities Living Alone in Italy
by Maria Gabriella Melchiorre, Sabrina Quattrini, Giovanni Lamura and Marco Socci
Int. J. Environ. Res. Public Health 2021, 18(24), 12996; https://doi.org/10.3390/ijerph182412996 - 9 Dec 2021
Cited by 14 | Viewed by 2781
Abstract
Older people with limited physical abilities, who live alone without cohabiting family members, need support ageing in place and to perform daily living activities. In this respect, both the available informal and formal care seem crucial. The present study aimed to explore the [...] Read more.
Older people with limited physical abilities, who live alone without cohabiting family members, need support ageing in place and to perform daily living activities. In this respect, both the available informal and formal care seem crucial. The present study aimed to explore the current role of the care arrangements of older people, especially if they have functional limitations. Qualitative interviews were carried out in 2019 within the “Inclusive ageing in place” (IN-AGE) research project, involving 120 older people who lived at home, alone, or with a private personal care assistant (PCA) in three Italian regions (Lombardy, Marche, and Calabria). A mixed-methods analysis was conducted. Results showed that support networks are still mainly made up of family members, but also of domestic home help (DHH) and PCAs, friends/neighbours, and public services, albeit the latter provide support in a residual way, while the former is not as intensive as it was in the past. Frequency and geographical/living proximity of help play a role, emerging also as a territorial differentiation. The paucity or absence of support, especially from the family, risks compromising the ability of ageing in place. It seems, thus, necessary to innovate and improve, in particular, home services, also through real formal and informal care integration. Full article
11 pages, 367 KiB  
Article
Moving around a Large City in Latin America: The Mobility Challenges Faced by Older Adults with Disabilities
by María-Eugenia Prieto-Flores and Mark W. Rosenberg
Int. J. Environ. Res. Public Health 2021, 18(24), 12984; https://doi.org/10.3390/ijerph182412984 - 9 Dec 2021
Cited by 4 | Viewed by 2711
Abstract
A growing body of research has shown that barriers in the urban environment can be disabling by reducing the ability of older people to manage independently in the community, but also because they can negatively affect health by limiting the possibilities to move [...] Read more.
A growing body of research has shown that barriers in the urban environment can be disabling by reducing the ability of older people to manage independently in the community, but also because they can negatively affect health by limiting the possibilities to move outside the home. In this study, we ask how obstacles in the urban environment are associated with the need for help to go to places in the community. To respond to this question, we used the Annual Household Survey of the City of Buenos Aires, Argentina 2018, which had a specific questionnaire for people with disabilities. From this sample, we selected adults aged 65 years or older with difficulties in at least one of six domains: vision; hearing; upper and lower body mobility; cognition; self-care; and communication. The final sample consisted of 513 persons (weighted = 109,316). First, we conducted a principal component analysis identifying three factors from variables of obstacles to access and use the urban environment: transportation; outdoor spaces; and information. Second, through a logistic regression model, we observed a direct relationship between these factors and the need for help to move in the community, controlling for sociodemographic characteristics, health status, and number of disabilities. This paper provides evidence on the significance of improving urban spaces to reduce dependent mobility. In Latin America, cities still face many challenges in becoming more age-friendly. Full article
8 pages, 2823 KiB  
Communication
Cross-Sectional and Longitudinal Association between Neighborhood Environment and Perceived Control in Older Adults: Findings from HRS
by Sunwoo Lee
Int. J. Environ. Res. Public Health 2021, 18(21), 11344; https://doi.org/10.3390/ijerph182111344 - 28 Oct 2021
Cited by 1 | Viewed by 2013
Abstract
The current study examined how neighborhood environments are related to older adults’ perceived control over time. A longitudinal study design was employed using data sampled from the Health and Retirement Study (HRS) 2014 and 2018. In total, 3170 older adults, whose age ranged [...] Read more.
The current study examined how neighborhood environments are related to older adults’ perceived control over time. A longitudinal study design was employed using data sampled from the Health and Retirement Study (HRS) 2014 and 2018. In total, 3170 older adults, whose age ranged between 60 and 99 years at the baseline, were followed up with a 4-year lag. Measures included two domains of neighborhood characteristics: social cohesion and physical disorder (at baseline and follow-up) and perceived control (at follow-up). Path coefficients between the latent factors were examined using structural equation modeling. Results showed that there was a significant cross-sectional and longitudinal association between neighborhood social cohesion and older adults’ perceived control, while neighborhood physical disorder was cross-sectionally associated with perceived control. Study findings provide evidence for promoting social integration and social capital in their neighborhood that might contribute to older adults’ perceived competence and beliefs in control. Full article
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11 pages, 649 KiB  
Article
Working at Green Care Farms and Other Innovative Small-Scale Long-Term Dementia Care Facilities Requires Different Competencies of Care Staff
by Bram de Boer, Yvette Buist, Simone R. de Bruin, Ramona Backhaus and Hilde Verbeek
Int. J. Environ. Res. Public Health 2021, 18(20), 10747; https://doi.org/10.3390/ijerph182010747 - 13 Oct 2021
Cited by 9 | Viewed by 2997
Abstract
The culture change movement within long-term care in which radical changes in the physical, social and organizational care environments are being implemented provides opportunities for the development of innovative long-term care facilities. The aim of this study was to investigate which competencies care [...] Read more.
The culture change movement within long-term care in which radical changes in the physical, social and organizational care environments are being implemented provides opportunities for the development of innovative long-term care facilities. The aim of this study was to investigate which competencies care staff working at green care farms and other innovative types of small-scale long-term dementia care facilities require, according to care staff themselves and managers, and how these competencies were different from those of care staff working in more traditional large-scale long-term dementia care facilities. A qualitative descriptive research design was used. Interviews were conducted with care staff (n = 19) and managers (n = 23) across a diverse range of long-term facilities. Thematic content analysis was used. Two competencies were mainly mentioned by participants working in green care farms: (1) being able to integrate activities for residents into daily practice, and (2) being able to undertake multiple responsibilities. Two other competencies for working in long-term dementia care in general were identified: (3) having good communication skills, and (4) being able to provide medical and direct care activities. This study found unique competencies at green care farms, showing that providing care in innovative long-term care facilities requires looking further than the physical environment and the design of a care facility; it is crucial to look at the role of care staff and the competencies they require. Full article
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22 pages, 2462 KiB  
Article
Non-Linear Effects of the Built Environment and Social Environment on Bus Use among Older Adults in China: An Application of the XGBoost Model
by Lanjing Wang, Chunli Zhao, Xiaofei Liu, Xumei Chen, Chaoyang Li, Tao Wang, Jiani Wu and Yi Zhang
Int. J. Environ. Res. Public Health 2021, 18(18), 9592; https://doi.org/10.3390/ijerph18189592 - 12 Sep 2021
Cited by 27 | Viewed by 4256
Abstract
Global aging has raised increasing concerns on the health and well-being of older adults. Public transport is a viable option to improve the mobility and quality of life among older adults. However, policies that promote the public transport use among older adults are [...] Read more.
Global aging has raised increasing concerns on the health and well-being of older adults. Public transport is a viable option to improve the mobility and quality of life among older adults. However, policies that promote the public transport use among older adults are rare. This study utilizes the eXtreme Gradient Boosting (XGBoost) decision tree to explore the non-linear associations of the built and social environment with bus use among older adults in China. The bus use of older adults was obtained from the Zhongshan Household Travel Survey (ZHTS) in 2012. Results show that non-linear relationships exist among all built environment and social environment characteristics. Within certain thresholds, the percentage of green space land use, land use mixture, bus-stop density, and dwelling unit density are positively related to bus use among older adults. Likewise, one social environment variable, the proportion of older adults in a neighborhood, is the key social environment variable. Furthermore, the dwelling unit density and proportion of older adults appear to have an inverse U-shaped relationship. Additionally, age, ownership of motorcycles, and distance from home to the nearest bus stop also show non-linearity. The findings presented in this paper facilitate effective planning interventions to promote bus use among older adults. Full article
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16 pages, 536 KiB  
Article
Investigating the Association between Outdoor Environment and Outdoor Activities for Seniors Living in Old Residential Communities
by Shiwang Yu, Na Guo, Caimiao Zheng, Yu Song and Jianli Hao
Int. J. Environ. Res. Public Health 2021, 18(14), 7500; https://doi.org/10.3390/ijerph18147500 - 14 Jul 2021
Cited by 14 | Viewed by 3704
Abstract
Many seniors live in old residential communities (ORCs) with low-quality outdoor environment (OE), which hinders the residents’ outdoor daily activities (ODAs). This paper empirically investigates the association of OE on ODAs for seniors living in ORCs. A questionnaire was designed and distributed in [...] Read more.
Many seniors live in old residential communities (ORCs) with low-quality outdoor environment (OE), which hinders the residents’ outdoor daily activities (ODAs). This paper empirically investigates the association of OE on ODAs for seniors living in ORCs. A questionnaire was designed and distributed in six central districts of Nanjing city. A total of 258 questionnaires was finally collected, of which 60.08%, 29.46%, 9.69%, and 0.78% respondents were scattered into four age groups (61–69, 70–79, 80–89, and ≥90), respectively. Based on reliability analysis, correlation analysis, and regression analysis, the results show that: (1) social activities are mainly associated with noise; (2) leisure activities are significantly associated with road accessibility, slip-resistance measures, greenery, and staff; (3) utilitarian-type activities are significantly associated with stairway accessibility, slip-resistance measures, greenery, and seating; (4) there is a significant association between nature-exposure activities and layout, greenery, and poor air quality. The findings could guide Chinese officials when renewing ORCs by addressing the most important outdoor environmental factors associated with ODAs. Full article
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16 pages, 1569 KiB  
Article
The Importance of Age-Friendly City on Older People’s Continuity and Life Satisfaction
by Siew-Imm Ng, Xin-Jean Lim and Hui-Chuan Hsu
Int. J. Environ. Res. Public Health 2021, 18(14), 7252; https://doi.org/10.3390/ijerph18147252 - 6 Jul 2021
Cited by 10 | Viewed by 4829
Abstract
According to continuity theory, successful aging is promoted when older people are able to continue familiar activities as a way to maintain self-identity. The purpose of this study was to examine the importance of both external resources provided by Taipei city and older [...] Read more.
According to continuity theory, successful aging is promoted when older people are able to continue familiar activities as a way to maintain self-identity. The purpose of this study was to examine the importance of both external resources provided by Taipei city and older adults’ internal resources in internal and external continuity and life satisfaction. The data were from the 2019 Taipei City Senior Citizen Condition Survey acquired through face-to-face interviews. Only the community-based sample without disability was included in the analysis (n = 1494). Structural equation modeling was used for the analysis. Both internal and external resources significantly promoted internal continuity (physical activity, Internet use, and lifelong learning) and external continuity (work, social connectedness, and social participation), and the effects of personal resources were larger. External continuity was positively related to life satisfaction. The effects of external resources on continuity and life satisfaction were stronger in older women than in older men. Age-friendly cities may provide support for activity continuity and promote well-being for older people. Policy suggestions are discussed. Full article
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2 pages, 245 KiB  
Correction
Correction: Mahmood et al. Aging in the Right Place for Older Adults Experiencing Housing Insecurity: An Environmental Assessment of Temporary Housing Program. Int. J. Environ. Res. Public Health 2022, 19, 14857
by Atiya Mahmood, Rachelle Patille, Emily Lam, Diana Juanita Mora, Shreemouna Gurung, Gracen Bookmyer, Rachel Weldrick, Habib Chaudhury and Sarah L. Canham
Int. J. Environ. Res. Public Health 2023, 20(13), 6260; https://doi.org/10.3390/ijerph20136260 - 30 Jun 2023
Viewed by 1085
Abstract
Table Correction [...] Full article
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