Dakotas Aging in Place Study Back »

Executive Summary

Educational Goals

  • Increase our understanding about knowledge, motivation, and barriers to implementing universal design.
  • Increase our knowledge about younger adults’ preference for aging.

Program Justification
Many studies indicate, that most people, as they age, hope to do so in their own homes and communities. The citizens of South Dakota are no exception to this trend, in one study 92% of the South Dakotans surveyed reported that they wanted to stay at home if possible and 92% said they would prefer to die at home as well. However, there seems to be a disconnect between preferences and behavior. Nearly 31% of homeowners have not considered an aging in place renovation. However, it is important for housing to be flexible, adaptable, and able to be used by all, the foundations of which is a basis for universal design. Because so many homes are missing the basic accessibility features (lever style doors and faucets, extra wide hallways and doors, accessible electrical controls, no step entrance, and single level living) to support aging in place, home modification are needed. Unfortunately, home modification are experience. The key is to increase the number of universal design homes available in the housing stock so that the magnitude of the home modifications needed are reduced. For example, to make halls and doorways wider often require significant and costly modifications. By the time most people need modifications they are living on a fixed income  Thus, it is an imperative that we better understand the barriers to aging in place, particularly around design. We need to determine how to raise awareness of universal design and what will drive the demand for this type of housing in South Dakota.

Target Audience
Adults in South Dakota.

Public and Private Values
Currently, many adults who require home modifications require financial assistance. Many assistance programs are funded by state and federal tax resources. In worst situation, individual financial resources exceed the threshold to receive assistance, but are not robust enough to support needed modifications. Increasing the number of universally designed homes may reduce the strain placed on public resources by reducing the need for costly modifications. Further, older people caught in the unique position of having too many resources to receive assistance will be more likely to live in a home that does not need modifications, if universal design can become the norm in private housing. A second important public benefit is the emphasis to utilize Home and Community Based Services (HCBS) for adults who need long-term care supported by Medicaid. Existing homes may have hazards for both the person with the disability and their caregiver (whether professional or family). Universally designed homes are better suited for the provision of HCBS. For example, bathrooms are often small without universal design features (e.g., lever shower controls), making it difficult, if not dangerous, for personal cares such as bathing. Increasing the number of universally designed homes available may reduce injuries in professional and family caregivers. Finally, universal design is less likely to have a negative impact of the resale of homes. Unlike accessible design, universal design is meant for people at every stage of life (e.g., pregnancy, short-term injury, end-of-life decline, etc.). As a result, universal design is seamless, meaning that most observers will not know the home is designed to support wheelchair users or other people with disabilities. In contrast, home owners who have installed specialty features (e.g., walk-in tub) may experience challenges selling their home because perspective homeowners see the feature as undesirable.

Program Development
This business plan describes an exploratory study that will be used to gain understanding about existing gaps in consumer knowledge, motivation, and barriers to implementation of accessible and universal housing design options in South Dakota. These results, in combination with existing research on the topic, will be used to inform the development of a program business plan in 2019. Current evidence suggest that basic accessibility, let alone universal design, is largely absent from the existing stock of private homes. This is relevant to South Dakotans because many report a preference for aging in place. The home can be a significant barrier to remaining in the home because an increase in age increases the risk of developing mobility-limiting disability. Beyond disability that may accompany aging or end-of-life, design of the home can make it difficult for someone with a temporary injury or illness to interact comfortably with their home. Evidence suggests that home modifications, specifically universal design, may provide numerous benefits. First, home modifications combined with other interventions may reduce the risk of falling for adults experiencing frailty. Second, promoting universal design (as opposed to accessible design) may help retain appeal of homes to future buyers. Finally, universal designed homes are better equipped to support caregiving. Currently most homes are not well-designed for the provision of caregiving activities (e.g., bathing). Evidence suggests there are a variety of reasons why the uptake of universal design in private housing has been limited. First, universal design is an abstract concept, meaning that it requires explanation. This makes it difficult for consumers to understand. Second, universal design is often used interchangeably with concepts like accessibility. As a result, most people see universal design as irrelevant to them or their family. Accessibility is largely consider unattractive and undesirable. Unlike universal design, accessibility is meant to meet the needs of a specific group of people (e.g., wheelchair users). Third, contractors express concern that the cost of universal design is prohibitive because consumers are not demanding changes and therefore unwilling to take the risk.

Key Contact
Leacey E. Brown, SDSU Extension Gerontology Field Specialist

Resources Needed

  • Recruitment Materials.
  • Funds to Provide an Incentive for Program Participants.
  • Evaluation Plan.
  • Survey.
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