HOME MODIFICATION PROGRAM CHALLENGES: BALANCING BEHAVIORS PREFERENCES NEEDS AND COST

摘要

According to AARP, 90% of older adults in the United States want to remain living in their homes for as long as possible. Yet, housing data suggest that many homes may not be designed to accommodate the needs of older residents, and may need to be modified. In this study data collected from a rural home modification pilot program in Southwest Virginia was analyzed to identify the challenges faced in identifying, prioritizing, and initiating home modification projects. The means-based program served 24 homeowners aged 55+ living at or below 80% of the adjusted median income. A mixed-method approach was used to analyze survey and interview data. Analysis uncovered challenges to program management and sustainability. Residents often sought home modifications in lieu of making changes to their behaviors and preferences that caused problems (e.g., removing throw rugs to reduce falls). Residents frequently miscalculated the need for modifications, the scope of work needing to be done, and the prioritization of changes. Moreover, residents often perceived some upgrades to their homes as essential even though they would not personally utilize the changed space. Program leaders reported struggling with modifying homes in which the value of homes were less than the costs of modifications, and complying with the well-intended demands of non-custodial family members when they conflicted with resident wishes. Findings were used to develop a matrix to guide decision-making in future home modification programs that accounts for the competing demands of residents and their families, contractors, and program resources and sustainability.