Indoor and Built Environment

As home-based health services emerge as a focal point of international discussions of primary healthcare, the home environment is now recognised as a place for safe and independent living, and also delivery of care. Consequently, research into how housing improvements can directly impact health and care outcomes is an increasingly important area of trans-disciplinary research. The links between health and housing are well established and indicate that housing interventions may be an important mechanism in health maintenance and improvement. Studies of home modifications have been published across a number of fields and the extent of their effects are diverse. We undertook a scoping review according to systematic PRISMA-P (Preferred reporting items for systematic review and meta-analysis protocols) guidelines to map the breadth and scale of the evidence base, identify themes and gaps in the evidence as well as grading home modifications research quality. Seventy-seven studies from 16 countries were included and revealed that home modifications evidence is measured in terms of a diverse range of effects. Seven key themes emerged including (in decreasing order); injury and falls prevention; improved function, self-care or independence; physical health and well-being; caregiving; economic effectiveness; ageing process; and social participation. The strongest experimental evidence has been conducted in relation to falls prevention.

This paper develops a novel index of vulnerable homes in terms of fuel poverty that is based on the analysis of different existing fuel poverty indicators and their relationship to the residential sector. The new index of vulnerable homes unifies the many indicators hitherto employed, and assesses the home vulnerability situation regardless of whether or not it is in fuel poverty by using three dimensions: monetary cost, energy and thermal comfort. The monetary dimension analyses vulnerability in relation to the available net income to face everyday life. The energy variable assesses the vulnerability related to the constructive characteristics of the dwelling. Finally, the introduction of the thermal-comfort variable enables the evaluation of the vulnerability related to the inner temperature of the dwelling and its perception by occupants. The combination of the different resulting values in each dimension and its relationship to the quality of life of occupants establishes a hierarchy of vulnerable levels. As a result, a multi-dimensional index is defined which relates technical aspects (characteristics of the dwelling) and social aspects (quality of life of households). The index of vulnerable homes provides a more complete assessment of the home situation than the existing fuel poverty indicators by identifying which variables require a greater assistance.

The primary purpose of this research is to determine influential indoor and outdoor environmental elements that affect senior households’ perceptions of housing affordability. This paper proposes major considerations for indoor and outdoor environmental elements which could make homes for senior households to be affordable and thus support their ageing in place. Our research adopted an empirical approach based on a survey. Relevant research was reviewed to identify potential indoor and outdoor environmental elements that could affect senior residents’ opinions about housing affordability. Sixteen indoor and outdoor environmental elements were selected. The survey targeted senior residents living in the central Michigan area in the United States. The results of this paper were based on descriptive statistics, mean difference tests, correlation coefficients and regression models to explain the relationships between indoor and outdoor environmental elements and senior residents’ perceptions of their housing affordability. Major findings proved statistically significant correlations between interior environmental elements and senior households’ perceived housing affordability. Most housing programmes and policies for housing affordability have focused on financial elements. Findings from this research, however, added several indoor and neighbourhood environmental elements for consideration to improve senior households’ perceived housing affordability and support their ageing in place.

Hearing impairment is a part of the natural ageing process for many people, similar to the occurrence of wrinkles on the face. In order to improve the quality of life for old age seniors, it is necessary to provide a built environment that is appropriate for hearing impairment. The listening ability of the elderly is significantly diminished, particularly in noisy and reverberant environments due to hearing loss. A basic design guideline for houses built for hearing impaired seniors is that excessive noisy and reverberant environments should be avoided. The purpose of this paper is to develop housing acoustic design guidelines that consider hearing loss due to old age relative to natural factors of everyday life, through a detailed literature review. The guidelines take into consideration floor impact sound, heavyweight floor impact sound, unit-to-unit sound insulation, indoor background noise sources, reverberation time, ceiling height, light–fan switch, bell–chime system and illumination level.

In retrofit-purposed projects such as building renovations, the early decision-support mechanism to determine an optimistic circulation plan and spatial allocation is strongly required for architects, owners and residents. In this paper, we introduce such a case study based on the building information modelling-enabled approach that has been explored using an actual project at Yeongwol, South Korea for resolving diverse residential types, including elderly housing units. The objective of this paper is to demonstrate an actual analysis of building remodelling design alternatives regarding indoor circulation and spatial allocation problems, especially considering elderly housing units. Another significant feature of this paper is a quantitative and explicit approach to the indoor walkability index using building information modelling. After acquiring indoor circulation data, such as metric distances between rooms, number of turns, spatial depth, vertical access, or any other BIM-enabled data, an appropriate and teleological weighting function was applied to determine the indoor walkability index. The usefulness of the approach was demonstrated in this paper, based on a Yeongwol project. building information modelling-enabled data provided prompt and reliable quantitative analysis results as soon as various design alternatives appear within the given timeframe to resolve circulation and spatial allocation problems for remodelling homes for the elderly.

Female elderly individuals make up the majority of public housing residents. Inappropriate guidelines have been neglecting their differentiated needs and this has been negatively affecting their quality of life in public housing. Recognizing the specific needs of female seniors is a key to successful provision of public housing by the government because the proportion of female seniors in public housing has been increasing. This research aims to assess urban public rental housing through post-occupancy evaluation of six housing projects that were developed by public housing authorities in Korea. Focusing on flexibility, safety, accessibility and support for care, questionnaires and interviews were conducted to provide gender-sensitive directions for public housing designs in an ageing society. There are four main findings: (i) The nuclear family-oriented floor plan needs to be changed to provide flexibility reflecting the diverse lifestyles of one or two member residents. (ii) The life safety guideline that assumed housing is mainly catered for healthy young residents would need major revision. (iii) Accessibility issues would need to consider the presence of a caregiver and flexible application, depending on the lifecycle of elderly individuals. (iv) The support for care with a complicated smart home system would need improvement.

This study examined full-time recreational vehicle dwellers in the USA and revealed that mobile and stationary recreational vehicle dwellers were mainly the ‘young-old’ and those entering retirement ages, at an average of 60 years of age. Many recreational vehicle dwellers on limited incomes were found to occupy their recreational vehicles on a permanent basis. Because food security definitions require adequate space for food security, it was assumed that food strategies and food security in limited spaces such as the recreational vehicle might differ among mobile and stationary recreational vehicle dwellers based on their income levels and ability to comply with expected social and cultural standards for housing and recreational vehicle populations. By comparing mobile and stationary recreational vehicle dwellers and further grouping recreational vehicle dwellers as those over and under 65 years of age, this study examined how personal assessments varied in terms of kitchen space, food security and related household food strategies.

This study focused on kitchen space assessments and their relation to food security. The stationary full-time occupancy of the recreational vehicles as primary housing is not regulated by law or housing codes. Thus, this study's results will be valuable to understanding aged individuals' housing perceptions and needs in order to provide foundational information for policy and regulation development for alternative housing, such as recreational vehicles and smaller dwellings.

This study aimed to investigate the association of spatial configuration with social interaction for elderly. A social housing in Seoul was selected for the case study. Using space syntax and social network analysis, the association was examined statistically. This research employed an integration indicator which is most closely related to space use pattern. Questionnaire and interview surveys were conducted to illustrate the pattern of social network. Using the collected data, NetMiner was utilized to conduct a quantitative analysis. Degree, closeness and betweenness indicators were employed to measure relationships in these networks and between individuals. The characteristics of the association established by the statistical analysis between spatial network of housing estate and social network of elderly were discussed. Our results show that spatial network properties can explain characteristics of social network. The accessibility of residential spaces for elderly individuals in social housing apartment complex has an effect on the strength of the social network with neighbours. Also, analysis of the spatial configuration accessibility for the elderly population with integration values has illustrated that the result was opposite to the general theory that ‘the locations with high accessibility could foster more interactions’. Our findings have suggested that we can have a better knowledge to foster more social network among elderly by planning improved spatial network.

The World Health Organization (WHO) strives to assist and inspire cities to become more ‘age-friendly’ through the Global Age-Friendly Cities Guide. An age-friendly city offers a supportive environment that enables residents to grow older actively within their families, neighbourhoods and civil society, and offers extensive opportunities for their participation in the community. In the attempts to make cities age-friendly, ageism may interact with these developments. The goal of this study was to investigate the extent to which features of age-friendly cities, both facilitators and hindrances, are visible in the city scape of the Dutch municipalities of The Hague and Zoetermeer and whether or not ageism is manifested explicitly or implicitly. A qualitative photoproduction study based on the Checklist of Essential Features of Age-Friendly Cities was conducted in five neighbourhoods. Both municipalities have a large number of visual age-friendly features, which are manifested in five domains of the WHO model, namely Communication and information; Housing; Transportation; Community support and health services; and Outdoor spaces and buildings. Age-stereotypes, both positive and negative, can be observed in the domain of Communication and information, especially in the depiction of third agers as winners. At the same time, older people and age-friendly features are very visible in the cityscapes of both municipalities, and this is a positive expression of the changing demographics.

Supporting facilities (SF) including handrails, signage, finishes, furniture and recreational facilities facilitate the daily life of older persons. Memory loss is one of the most common signs of dementia affecting the daily life of older persons. Therefore, they may need special SF in residential homes. In order to improve the quality of daily life of older people with dementia, this study aims to investigate the effects of SF on the memory loss of those living in care and attention (C&A) homes. A questionnaire survey was conducted among elderly C&A home residents aged 65 and above in Hong Kong. A Supporting Facilities-Memory Loss model was established based on correlation and regression analyses. The model confirmed the following: (1) none of the SF items affects long-term memory loss; (2) satisfaction with signage, finishes and furniture leads to a reduction of short-term memory loss; (3) satisfaction with handrails, signage and finishes enhances spatial memory and (4) satisfaction with the location of signage reduces time confusion. Practical recommendations are proposed, including using large and well-placed signage with pictograms and icons, avoiding the removal and modification of furniture, enhancing colour contrasts between different functional rooms, installing handrails with a consideration for orientation strategies, and so on.

Due to the rapid growth of the ageing population and the shrinking of family size in China, there has been a steady increase in the demand for nursing homes. The Chinese government has encouraged the development of nursing homes. However, there is no clear understanding of the thermal environment of nursing homes and the thermal comfort of their residents. Therefore, this paper describes a pilot study that was undertaken to investigate the thermal comfort of senior residents living in nursing homes. A wireless sensor network system was developed to continuously monitor the thermal environment of nursing homes for an entire year. Site measurements and a questionnaire also were conducted. The results revealed significant seasonal variations in the thermal environment of nursing homes and in the thermal comfort, thermal sensation and adaptive behaviours of older adults. The calculation of thermal comfort was modified according to the older adults’ behaviour patterns. The knowledge acquired in this initial study will enrich knowledge of the thermal comfort of older adults living in nursing homes. It also will provide preliminary insights for caregivers, designers and policymakers in their efforts to deliver a more comfortable, healthy and sustainable environment in nursing homes in China.

Due to a rapidly growing ageing population, China is experiencing a rapid urbanisation, resulting in the uneven construction of public facilities. Therefore, the elderly have disproportionate access to public facilities and services. These problems are much more serious in old cities because of a fierce contradiction between society and land use. However, elderly populations are significant to the old city because they are the soul of the old city. Importantly, the old city is a container of memories of their lives as well as an environment they are acquainted with and unwilling to leave. Therefore, whether the urban space in the old city is ageing-friendly and whether the elderly are isolated or integrated in the current urban environment are questions addressed by this study. Based on the World Health Organization’s concept of an elderly-friendly city, this study constructed an elderly-friendly urban space evaluation system based on accessibility, social inclusiveness and equity and analysed four types of ageing facilities in 25 blocks of Old Beijing City. The results showed that the ageing resources in Old Beijing City are insufficient and uneven, and revealed that the development of the old city has a positive impact on the construction of an elderly-friendly community.