Introducing assistive technologies (AT) into the existing homes of older people

The design of accessible environments, for use by all, is a legal requirement for all public buildings, under the Disability Discrimination Act 1995 (DDA, 1995) since October 1999 and the removal of all physical barriers becomes enforceable in 2004. Accessibility has transferred from being a social and moral issue to a legal requirement. The Research Group for Inclusive Environments at the University of Reading undertakes research to better understand methods to make the built environment more accessible. This paper presents the findings from the research project, Project Crystal, investigating the design of environments for better communication for deaf and hard of hearing people. At the last COBRA conference the preliminary findings from the pilot questionnaire were presented. During the year the questionnaire has been distributed more widely and a test environment has been used to investigate the effects the variables of lighting and colour have on people's ability to communicate. This paper will present some of the findings from the project, which is almost complete, and generalise on the effect wall surface design has on accessibility of an environment for people with a hearing impairment.

Lighting the homes of people who are visually impaired

An extended research project, funded by the Thomas Pocklington Trust, and carried out by the Research Group for Inclusive Environments (RGIE) at The University of Reading, has examined the lighting found in the homes of people who are visually impaired (VIP). This paper will summarise the results of this substantive study. All the surveyed homes have been occupied by people with sight loss, some of the dwellings were shared with sighted partners. There are several safety issues concerning domestic lighting where inadequate provision may contribute to the incidence of personal injuries occurring in the home. Qualitative and quantitative data from questionnaires, photometric surveys and faceto- face interviews have been obtained from 57 homes. The nature and extent of the visual impairment of each study participant has been identified. This paper will identify important findings from the study, including: a range of areas and tasks within the home that visually impaired people find inadequately lit; the variability of illuminance provided for task lighting and general lighting; and how effective visually impaired people find a selection different lighting systems to those that they commonly use. The research team are able to offer preliminary design guidance for lighting the homes of people who are visually impaired. These will be summarised in the paper.

Assessing the adaptability of the existing homes of older people

A rapidly growing number of older people wish to remain in their existing homes for as long as possible, in many cases leading to the need for adaptations. The extent of the adaptations required is influenced by the nature of the individual's impairments and by the design of their property. An approach to understanding the impact of the needs of older people on adaptation requirements based on the development of standard User Profiles and Mobility Profiles is presented together with an analysis of a varied set of 82 properties selected from across the UK.

Can adapting the homes of older people and providing assistive technology pay its way?

Background: Adaptations and assistive technology (AT) have an important role in enabling older people to remain in their own homes. Objective: To measure the feasibility and cost of adaptations and AT, and the scope for these to substitute and supplement formal care. Design: Detailed design studies to benchmark the adaptability of 82 properties against the needs of seven notional users. Setting: Social rented housing sector. Main outcome measures: Measures of the adaptability of properties, costs of care, adaptations and AT, and relationships between these costs. Results: The adaptability of properties varies according to many design factors and the needs of occupiers. The most adaptable properties were ground floor flats and bungalows; the least were houses, maisonettes and flats in converted houses. Purpose-built sheltered properties were generally more adaptable than corresponding mainstream properties but the opposite was the case for bungalows. Adaptations and AT can substitute for and supplement formal care, and in most cases the initial investment in adaptations and AT is recouped through subsequently lower care costs within the average life expectancy of a user. Conclusion: Appropriately selected adaptations and AT can make a significant contribution to the provision of living environments which facilitate independence. They can both substitute for traditional formal care services and supplement these services in a cost-effective way.

Adapting the homes of older people: A case study of costs and savings

Meeting the demand for independent living from the increasing number of older people presents a major challenge for society, government and the building industry. Older people's experience of disabling conditions can be affected by the design and layout of their accommodation. Adaptations and assistive technology (AT) are a major way of addressing this gap between functional capacity and the built environment. The degree of adaptability and the differences in the average cost of adaptation of different types of property are large and there is major variation within property type. Based on a series of user profiles, it was found that a comprehensive package of adaptations and AT is likely to result in significant economies arising from a reduction in the need for formal care services. This finding is sensitive to assumptions about how long an individual would use the adaptations and AT, as well as to the input of informal care and the nature of their accommodation. The present study, which focused on social housing, has implications for how practitioners specify ways of meeting individual needs as well as providing a case to support the substantial increase in demand for specialist adaptation work.

Introducing assistive technology into the existing homes of older people: Feasibility, acceptability, costs and outcomes

We examined how far, and at what cost, the housing stock could be modified to accommodate the assistive technology (AT) necessary to enable older people to remain in their own homes. A multidisciplinary team devised seven hypothetical user profiles for 10 case study areas, with five local authorities and five housing associations in England and Wales. Each profile was considered at two times, five years apart, with the users' functional abilities deteriorating in between. In addition, in-depth interviews were carried out with a sample of 67 older people in the case study areas about their use and experience of a wide range of AT. The interviews showed the need to listen to older people and that they welcomed AT when it addressed a perceived need. The results showed that the extent of adaptation required of buildings to accommodate a user's needs varied greatly. It was also found that there was confusion about the terminology of AT, including the idea of the 'smart house'. The study shows that the adaptability of the housing depends on a range of factors and costs.

Introducing assistive technology into the homes of older people: Some lessons from the Netherlands - A case study

The authors have just completed a study of assistive technology (AT) and how it can be introduced into the existing homes of older people. As part of this empirical study some collaboration with the Netherlands took place for two reasons. First to learn about the use of assistive technology from a country where its creative use was well established and second to learn how older people influence policy. Two Dutch consultants helped the team and a short visit was paid to Eindhoven. As a result of this collaboration new ways of using AT were found and comparisons made with the policy and legislative background. In addition lessons were drawn about the involvement of older people.

Effects of dairy products naturally enriched with cis-9,trans-11 conjugated linoleic acid on the blood lipid profile in healthy middle-aged men

Background: Interest in the development of dairy products naturally enriched in conjugated linoleic acid (CLA) exists. However, feeding regimens that enhance the CLA content of milk also increase concentrations of trans-18:1 fatty acids. The implications for human health are not yet known. Objective: This study investigated the effects of consuming dairy products naturally enriched in cis-9,trans-11 CLA (and trans-11 18:1) on the blood lipid profile, the atherogenicity of LDL, and markers of inflammation and insulin resistance in healthy middle-aged men. Design: Healthy middle-aged men (n = 32) consumed ultra-heat-treated milk, butter, and cheese that provided 0.151 g/d (control) or 1.421 g/d (modified) cis-9,trans-11 CLA for 6 wk. This was followed by a 7-wk washout and a crossover to the other treatment. Results: Consumption of dairy products enriched with cis-9,trans-11 CLA and trans-11 18:1 did not significantly affect body weight, inflammatory markers, insulin, glucose, triacylglycerols, or total, LDL, and HDL cholesterol but resulted in a small increase in the ratio of LDL to HDL cholesterol. The modified dairy products changed LDL fatty acid composition but had no significant effect on LDL particle size or the susceptibility of LDL to oxidation. Overall, increased consumption of full-fat dairy products and naturally derived trans fatty acids did not cause significant changes in cardiovascular disease risk variables, as may be expected on the basis of current health recommendations. Conclusion: Dairy products naturally enriched with cis-9,trans-11 CLA and trans-11 18: 1 do not appear to have a significant effect on the blood lipid profile.