Home modification by older adults and their informal caregivers

• Home modification by older adults and their informal caregivers.
• Older adults’ physical functionality was one of the main factors for home modification.
• How caregivers’ factors affect the decision to carry out home modification.
• This study contributes to our efforts to develop a better understanding of the complex issues involved in housing in old age and provides strong supporting evidence for this practice.

The purpose of the study was to examine dyadic factors of home modification in frail older adults and their informal caregivers for improving health care at home in the United States. A secondary data analysis used the National Alliance for Caregiving and the American Association of Retired Persons caregiver survey dataset. Among randomly selected samples from 7 states in the U.S., 737 dyads of informal caregivers and frail older adults were selected based on age and medical conditions. Descriptive analyses and a hierarchical binary logistic regression analysis were performed. The study findings showed that the prevalence of home modification in the survey population was 42.20% in the United States. The home modifying group was likely to live together in a rural area, to consist of older care-recipients and younger caregivers, and to be Caucasian (p < .05). Physically functional impairments were the strongest factors of home modification (p < .01), while older adults living with heart disease were more likely to modify their homes (p = .03). In conclusion, older adults’ and their caregivers’ factors clearly affect home modification for health care at home. Our findings revealed that home modification represents an important contribution to multidisciplinary care and is based on comprehensive assessments, multidisciplinary decision-making processes, and careful planning of individualized interventions. Relevant policy suggestions may enhance the effectiveness of home modification to support aging in place in the United States.