Challenges of cross-national housing research with older persons: lessons from the ENABLE-AGE project

Abstract

Although it is generally acknowledged that housing is a major issue regarding health in old and very old age, most empirical research still tends to treat the role of the housing environment in a rather superficial manner. The cross-national project Enabling Autonomy, Participation, and Well-Being in Old Age: The Home Environment as a Determinant for Healthy Ageing (ENABLE-AGE) seeks to make a substantial contribution to this shortcoming. The main objective of the project is to examine subjective and objective aspects of housing and their impact on health in very old age, while health is understood mainly in terms of autonomy, participation and well-being. The project involves five European Union member countries, i.e. Sweden (coordinating unit), Germany, the United Kingdom, Latvia and Hungary. The total sample includes 1,918 older adults in the age range of 75-89 years and living in single households. We provide a systematic analysis of major challenges coming with cross-national research in the housing and ageing domain based on the experience of the ENABLE-AGE Project. Treated are: challenges related to sampling and data collection procedures, challenges related to inclusion and exclusion criteria based on housing characteristics, challenges related to differences in housing legislation, norms, and guidelines, challenges related different availability of professional expertise for person-environment assessments, challenges related to valid and reliable person-environment assessments, and challenges related to the interpretation of housing-related findings.

Characteristics of the personal and environmental components of person-environment fit in very old age: a comparison between people with self-reported Parkinson’s disease and matched controls

“…The present findings also highlight the importance of specifically investigating the impact of ageing when having a concomitant chronic and progressive disease. 18 The environmental component of the HE instrument (22) is dominated by indoor barriers. It is therefore noteworthy that nine of the top 20 environmental barriers in the PD sample were related to the exterior surroundings (Table 4).…”

“…This explorative study is however highly novel and contributes to the body of knowledge. Notwithstanding the limitations discussed, the ENABLE-AGE rests on solid 20 methodology (6,17,19), and due to the large database available (n=1,918) we were able to apply a strong design with three matched controls per case (20). 21 …”

“…All participants were enrolled after informed consent, following the Helsinki Declaration and the ethical guidelines of each country. After training, interviewers collected data at home visits (18). Details on the ENABLE-AGE have been published elsewhere (see 17,19).…”

“…The World Report on Disability (5) emphasizes the need to focus on creating environments that are accessible in order to facilitate participation in life situations. However, while most studies on ageing cover a multitude of information on the ageing person, empirical ageing research considering person and environment in a balanced manner remains rare (6,7). Considering research in clinical neuroscience, the lack of environmental considerations is absolute.…”

Relocation to ordinary or special housing in very old age: aspects of housing and health

“…It should be noted that the participants of the Swedish ENABLE-AGE national sample were relatively healthy people aged 80-89 years, living alone (Iwarsson et al 2004). Relocation occurred to both ordinary and special housing during the 4-year study period, but since the sizes of the sub-samples were small, the results should be interpreted with caution.…”