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The concept of aging-in-place has gained notable significance in the last decade due to a dramatic demographic shift in global population dynamics that have considerably affected the ability of societies to adequately cater for their aging population. This paper examines some of the barriers to aging-in-place in the context of health needs, housing design and the role of retrofitting/smart home technologies in overcoming these barriers.

Using a narrative literature review approach, the authors undertook a comprehensive search of recent relevant literature focusing on five core thematic areas: health and aging, aging in place, barriers to aging in place, retrofitting and smart home technologies for successful aging in place. The authors entered appropriate keywords into interdisciplinary research databases and synthesized a coherent narrative discussing the thematic areas using the data extracted from the literature search.

There is a bidirectional relationship between aging and the home environment. Barriers to aging-in-place are mainly related to progressive decline in health, which alters the environmental needs of individuals. Appropriate building designs can significantly facilitate aging-in-place. The authors, therefore, highlight the role of retrofitting and smart home technologies as practical solutions to the challenges of the aging-in-place.

Forward planning in building design is essential to guarantee that the home environment is well adapted for the challenges of aging-in-place while also promoting healthy aging.

The paper shows the relationship between aging and the home environment and how building design considerations could enhance healthy aging-in-place.

Traditional definitions of aging in place often define aging in place specifically as the ability to remain in one’s own home or community setting in later life. The purpose of this paper is to reframe aging in place and show how narrowly defined aging in place models can be potentially negative constructs that limit options for older adults. The authors propose a paradigm shift, or a re-framing of, the popularized idea of aging in place. The authors challenge mainstream and literature-based beliefs that are deeply rooted to the idea that aging in place ideally happens in the home in which a person has lived for many years.

The paper reviews common concepts and constructs associated with aging in place as well as gaps or exclusions, and US-based aging in place policy initiatives favoring the aging in place model.

An expanded definition of aging in place embraces heterogeneity in residence types and living options. A realistic assessment of person-environment fit, matching an older person’s capabilities to his or her environmental demands, allows for the development of additional aging in place options for those living across the continuum of care.

Aging in place should be moved from the personal “success” or “failure” of an older individual to include the role of society and societal views and policies in facilitating or hindering aging in place options. The authors demonstrate that these options, in facilities within the continuum of care, can be thought of as appealing for older persons of all levels of physical and cognitive functioning.

Research about aging in place tends to stress the value of one place (one’s home) over other living settings. This limits the ability of people to age in place and curtails discussion of all the items necessary to maintain place.

The purpose of this study is to investigate the transfer of learning among older adults and the importance of physical activity (PA) related to aging in place.

A mixed-methods approach examined 10 older adults aged 65–88, who were receiving occupational therapy and contemplating aging in place. Semistructured interviews determined participants' perceptions of aging in place and PA. Accelerometers assessed levels of PA over 14 days.

Interviews revealed that most participants were aware of the importance of PA but did not specify PA as being a primary contributor to continued independence with aging. Accelerometer data revealed that, on average, 96.7% of the day is spent in sedentary behavior.

Health-care professionals may ask the question, “What will my patient do with the information he or she has learned?” This study was useful to increase understanding of older adults’ learning, lifestyles and effects on aging independently.

As older adults have true expectations of requirements for successful aging in place, realistic levels of PA and transfer of learning could improve the intended outcome of aging independently.

PA is often an overlooked factor for occupational engagement and aging in place and is novel to investigate in combination with interviews.

The design of buildings is crucial to functionality and safety for senior citizens. People often refrain from talking about old age and its related support; however, it is inevitable. The paper aims to highlight the essentials of a home design that considers the aged citizens in Nigeria.

A qualitative research technique is used in the study. A closed-ended questionnaire and an interview were used to gather information on the requirements for aging-in-place basics in home design from middle-aged and elderly households.

Findings from the study revealed that a majority of the respondents considered old age as a phase of life to prioritize in home design. Lighting, furniture and fixtures and electrical installations are variously perceived by the respondents as aging-in-place essentials.

The study has far-reaching consequences for the built environment, particularly for homeowners. It is related to the third sustainable development goal (SDG), which seeks to secure the health and well-being of people of all ages.

The study's uniqueness and usefulness are highlighted in the gaps between present house design culture and the reality of senior citizen occupants' dwellings, as well as the appropriateness to satisfy changing demands associated with old age. It would encourage homes to develop the culture and duty of providing a sustainable home that is accessible to everybody and provides emotional and physical safety for the elderly.

Smart home (SH) internet of things can promote home safety, health monitoring and independence of older adults to age-in-place. Despite its commercial growth, low adoption rates of the technology among aging consumers remain a major barrier. The purpose of this study is to examine SH technology ownership of older adults and its causal pathways with demographics, health and functioning, home safety and information communication technology (ICT) use.

A survey on technology-mediated aging-in-place was completed by 447 respondents, 65 years and older. Structural equation modeling was used to underscore the causal pathways among demographics, health, independence and home safety, ICT and home automation technology adoption.

The study found that ICT usability, home security and independence have a significant direct effect on SH ownership. Demographics had no significant direct effect, but its influence was mediated through ICT usability. With home safety as mediator, physical impairment, falls and accidents and independence had a significant association with SH ownership. Similarly, increased social support (mediated through home security) decreased the probability of SH automation ownership.

The findings signify the perceived usefulness of SH automation as theorized in technology acceptance models.

Hong Kong implements a policy for the aging population involving the core themes of “aging in place as the core,” “institutional care as backup” and “continuum of care.” Encouraging elders to live independently at home is a top priority, and elders who are not able to live at home independently are provided with various residential care services, namely Hostels for the Elderly, Homes for the Aged, Care and Attention (C&A) Homes for the Elderly and Nursing Homes (NHs). The purpose of this paper is to analyze the adoption of the publicly funded model of providing residential care services of elderly in Hong Kong.

The paper analyzes the current conundrum encountered by elders in residential care services and makes recommendations. A comprehensive literature review was conducted covering relevant government reports, academics' journal papers and nongovernmental organizations’ reports concerning residential care service of elderly from 1965 to present.

Subsidized residential care homes for the elderly (RCHEs) clearly outperform private RCHEs in terms of space and staff provisions, but the supply of subsidized RCHEs cannot meet the demand. Hence, between 2007 and 2018, the average waiting time was 33 months for NHs and that for C&A homes was 23 months. Several viable measures to meet the demand are purchasing Enhanced Bought Place Schemes (EBPSs) from private RCHEs, subsidizing elders who opt for living in private RCHEs by providing them with Comprehensive Social Security Assistance (CSSA) and residential care service voucher (RCSV) and subsidizing elderly applicants who opt for living in RCHEs in Guangdong. However, these viable measures are problematic because of the inadequate quality of EBPSs and private RCHEs, which is attributed to the costing arrangement of public and private RCHEs that were established in the colonial period. The brief history of RCHEs also indicates a deviation from the original policy aim, namely aging in place, which was introduced in the Green Paper on Services for the Elderly in 1977.

The supply and quality of community and home care services should be thoroughly examined; effective community and home care services can prevent and even delay unnecessary institutionalization. Another complementary solution is to devise a long-term plan for residential care services. To address disparities in quality standards in different RCHEs, adopting the combination of punitive and compliance models such as conducting frequent inspections and implementing an accreditation system for private RCHEs is imperative.

Although the principle of “aging in place” originated in 1977, the institutionalization rate 6.8% of elders was unexpectedly high in Hong Kong and even surpassed the Asian counterparts. It necessities to rethink how to implement policy concerning long-term care services of elders.

Despite continuing workforce challenges over the last decade, the social care system is considered a key enabler in keeping older people out of hospital. In response to the workforce challenges, White Paper was released, which acknowledged the opportunities afforded by digital technology to assist older people ageing at home, often supported by informal caregivers. Given the policy emphasis on digital-enabled care, the most appropriate methods for evaluating its impact on social care outcomes have yet to be determined. The purpose this study was to review the current literature using a systematic approach to understand the methodological limitations to inform more robust evaluations in their use in future research.

This scoping review used a systematic approach adopting the framework of Arksey and O’Malley to examine studies examining the adoption of digital technologies to assist in older people’s ability to age in place.

The 21 relevant studies identified on digital technology to assist ageing-in-place are evolving. To date, it has focused on the efficacy and usability of the digital technologies themselves rather than investigating the impact of such technologies on re/enablement outcomes for older people. To rebalance this emphasis, there needs to be more research investigating the factors that enhance useability of digital technologies by older people and exploiting narrative data gained from qualitative research as they can provide valuable insights.

To the best of the authors’ knowledge, this is the first scoping review to consider qualitative methodological approaches for exploring ageing in place.

The provision of home and community supports can enable people to successfully age-in-place by improving physical and mental health, supporting social participation and enhancing independence, autonomy and choice. One challenge concerns the integration of place-based supports available as older people transition into affordable housing. Sustainable solutions need to be developed and implemented with the full involvement of communities, service organizations and older people themselves. Partnership building is an important component of this process. The purpose of this paper is to detail the intricacies of developing partnerships with low-income older people, local service providers and nonprofit housing associations in the context of a Canadian housing development.

A community-based participatory approach was used to inform the data collection and partnership building process. The partnership building process progressed through a series of democratized committee meetings based on the principles of appreciative inquiry, four collaboration cafés with nonprofit housing providers and four community mapping workshops with low-income older people. Data collection also involved 25 interviews and 15 photovoice sessions with the housing tenants. The common aims of partnership and data collection were to understand the challenges and opportunities experienced by older people, service providers and nonprofit housing providers; identify the perspectives of service providers and nonprofit housing providers for the provision and delivery of senior-friendly services and resources; and determine actions that can be undertaken to better meet the needs of service providers and nonprofit housing providers in order to help them serve older people better.

The partnership prioritized the generation of a shared vision together with shared values, interests and the goal of co-creating meaningful housing solutions for older people transitioning into affordable housing. Input from interviews and photovoice sessions with older people provided material to inform decision making in support of ageing well in the right place. Attention to issues of power dynamics and knowledge generation and feedback mechanisms enable all fields of expertise to be taken into account, including the experiential expertise of older residents. This resulted in functional, physical, psychological and social aspects of ageing in place to inform the new build housing complex.

The time and effort required to conduct democratized partnerships slowed the decision-making process.

The findings confirm that the drive toward community partnerships is a necessary process in supporting older people to age well in the right place. This requires sound mechanisms to include the voice of older people themselves alongside other relevant stakeholders. Ageing well in a housing complex requires meaningful placemaking to include the functional, physical, psychological and social aspects of older people’s everyday life in respect to both home and community.

Most older people wish to age “in place”. However, as current housing is mainly unsuitable for later life, architects have a key role to play. Yet, there is little architectural consideration for the notion of “ageing in place” and its various facets, beyond a functional focus. Architects seem to lack support to grasp inhabitants' sensible needs, and thus synergies with other human-centred disciplines could be enlightening. To ensure homes are designed in line with people's wellbeing, the authors aim to provide a state-of-the-art view, as to build a model supporting architects through their understanding of older people-environment relationships.

In this paper, the authors investigate the key concepts that could enrich architects' design approaches on “ageing in place”. A narrative literature review scrutinising English- and French-written publications from the last twenty years in various disciplines was conducted, with a focus on older people and non-institutionalised housing.

The results highlight five essential perspectives to be taken into account when questioning housing for older people: health, affective, social, built and contextual perspectives. Their meaning and ties are developed and then synthesised into considerations, calling for architectural creativity.

This fivefold theoretical model adds to the existing architectural body of knowledge by adopting a multidisciplinary and multidimensional angle, going beyond the predominantly pragmatic vision associated with ageing. It provides stakeholders in architecture with a fresh and clear insight of meaningful relationships between older people and their residential environment.

The purpose of this paper is to explore older people’s intention to relocate from their primary homes. The study also seeks to understand the policy implications that such intentions may have.

This study employs a survey-based design via computer-aided telephone interviews (CATI). The CATI survey was employed to gather information on the behaviour of older people and whether differences exist by gender, age, health immigration status and financial knowledge. The survey-based design is triangulated with the literature on this topic area and policy issues.

The findings of the study suggest amongst others, that older South Australians overwhelmingly and significantly do not intend to move from their primary home and are content to age in place. This is particularly true as people reach the older stages of life.

The study enhances the understanding of the decision-making environment that older people are exposed to in contemplating relocation from the primary home. More specifically, it shows that factors stated in the literature that deemed to be of importance in the decision to relocate, has no significance in this study and that ageing in place should be used as a policy base.