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Journal Article


Slaug B, Chiatti C, Oswald F, Kaspar R, Schmidt SM. Int. J. Environ. Res. Public Health 2017; 14(9): e14090964.


Department of Health Sciences & Centre for Ageing and Supportive Environments (CASE), Lund University, SE-221 00 Lund, Sweden.


(Copyright © 2017, MDPI: Multidisciplinary Digital Publishing Institute)






The physical housing environment is important to facilitate activities of daily living (ADL) for older people. A hindering environment may lead to ADL dependence and thus increase the need for home services, which is individually restricting and a growing societal burden. This study presents simulations of policy changes with regard to housing accessibility that estimates the potential impact specifically on instrumental activities of daily living (I-ADL), usage of home services, and related costs. The models integrate empirical data to test the hypothesis that a policy providing funding to remove the five most severe environmental barriers in the homes of older people who are at risk of developing dependence in I-ADL, can maintain independence and reduce the need for home services. In addition to official statistics from state agencies in Sweden and Germany, we utilized published results from the ENABLE-AGE and other scientific studies to generate the simulations. The simulations predicted that new policies that remove potentially hindering housing features would improve I-ADL performance among older people and reduce the need for home services. Our findings suggest that a policy change can contribute to positive effects with regard to I-ADL independence among older people and to a reduction of societal burden.

Language: en


ADL; ageing society; environmental barriers; housing adaptations; simulations


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