Adaptive Strategies and Person-Environment Fit among Functionally Limited Older Adults Aging in Place: A Mixed Methods Approach

Abstract

Older adults prefer to age in place, necessitating a match between person and environment, or person-environment (P-E) fit. In occupational therapy practice, home modifications can support independence, but more knowledge is needed to optimize interventions targeting the housing situation of older adults. In response, this study aimed to explore the accessibility and usability of the home environment to further understand adaptive environmental behaviors. Mixed methods data were collected using objective and perceived indicators of P-E fit among 12 older adults living in community-dwelling housing. Quantitative data described objective P-E fit in terms of accessibility, while qualitative data explored perceived P-E fit in terms of usability. While accessibility problems were prevalent, participants’ perceptions of usability revealed a range of adaptive environmental behaviors employed to meet functional needs. A closer examination of the P-E interaction suggests that objective accessibility does not always stipulate perceived usability, which appears to be malleable with age, self-perception, and functional competency. Findings stress the importance of evaluating both objective and perceived indicators of P-E fit to provide housing interventions that support independence. Further exploration of adaptive processes in older age may serve to deepen our understanding of both P-E fit frameworks and theoretical models of aging well.

Mobility Modification Alleviates Environmental Influence on Incident Mobility Difficulty among Community-Dwelling Older People: A Two-Year Follow-Up Study

“…The finding that mobility modification attenuated the risk that environmental mobility barriers pose for manifest mobility difficulty, supported our hypothesis. The findings are also supported by the “Disablement process model” by Verbrugge and Jette (1994), according to which a gap between environmental demands and personal capability can be narrowed through mobility modifications [ 13 ], as people modify their behaviour in an effort to optimize their person-environment fit [ 9 , 27 ].…”

The physical environment, activity and interaction in residential care facilities for older people: a comparative case study

“…Other researchers have also stressed the importance of studying older people in relation to their environment by using different methods and not depend solely on quantitative assessments of the physical environment (67)(68)(69). The examination of RCFs using mixed methods enabled us to compare and contrast the elements of the two RCFs.…”

Improving housing and neighborhoods for the vulnerable: older people, small households, urban design, and planning

“…The most influential is the ecological theory of aging (ETA) where people's behavior depends on individual competence, stresses placed by the environment, and the interaction between the person and environment (Lawton and Nahemow 1973;Lawton 1980). Several other theories build from this theory, often via critique, adding a sense of the older person's agency (choices, compensations, skills optimization), and the dimension of change over time (Lien et al 2015;Baltes and Baltes 1990; Diaz Moore 2014). A second body of theory, on aging well, active aging, or a positive view of aging, focuses on the social environment and the capacity of older people to maintain capacities, engage with others, and maintain independence over time (WHO 2002;Wahl et al 2012;Rowe and Kahn 1998).…”