Creating a supportive environment for older adults in China --exploring factors associated with the need for home modifications based on a cross-sectional survey in Central China

• Published in: BMC geriatrics Vol. 23; no. 1; p. 795
• Main Authors: Li, Jiajing, Wu, Bei, Wang, Jing
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 02.12.2023; BioMed Central; BMC
• Subjects: Activities of daily living; Adult children; Age; Aged; Aged patients; Aging; Care and treatment; China - epidemiology; Chronic illnesses; Cross-Sectional Studies; Cross-sectional survey; Demographics; Educational Status; Environments; Families & family life; Flooring; Geriatrics; Health aspects; Home environment; Home modification; Households; Humans; Independence; Independent Living; Investigations; Living arrangements; Middle Aged; Need; Older adults; Older people; Psychological aspects; Quality of Life; Questionnaires; Rural areas; Social aspects; Socioeconomic Factors; Surveys; Towns; China; Environments; Home modification; Need; Older adults; Cross-sectional survey; Independence
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-023-04458-0

A supportive home environment is critical to the safety and quality of life of older adults. Home modification is an effective way to build a supportive home environment for older adults' aging in place. However, there is a lack of knowledge on older adults' need for home modifications in China. We conducted a cross-sectional survey in three provinces of China (Hubei, Hunan, and Henan) using stratified and cluster sampling methods in 2021. A total of 5485 older adults aged 60 and over were included. The outcome variables were: need for home modifications, level of need, and type of modification needed. Exposure variables included: demographic and socioeconomic characteristics, as well as health conditions. Logistic and Poisson regressions were applied to examine the needs for home modifications and its associated factors. Nearly 30% of the older adults needed home modifications. The most common choice of home modification was the need for handrails at the bedside, toilet, or threshold (31.64%), and paving un-slip tiles or vinyl flooring (17.45%). Age (IRR = 1.01, P < 0.001), education (IRR = 1.11, P < 0.01), and level of assistance (IRR = 2.31, P < 0.001) were more likely to be positively associated with needs for modification. Participants in the age group of 70 to 79 years, with primary school education, and low-level physically dependent had significantly higher needs for modifications than those of advanced age, lower level of education, or higher level of physically dependent (p < 0.01). The overall need for home modifications in China is low. Home modification programs are needed to tailor individuals' needs and provide services to those with the most home modification need.