physical environment examples health

Get resources on specific hazards and their control, including identification, risk assessment and inspections, to keep your workplace healthy and … In the end, home modifications that are the best fit for the situation may or may not be an “ideal” fit with the functional abilities of the client or caregiver or with the home environment. There is a direct relationship between health and housing. (1997). Everyone who has an impact on the quantity and quality of housing—from consumers to builders to clinicians to regulators and legislators—needs evidence that environmental modifications can improve functioning and health outcomes, are cost-effective, and reduce the need for future modifications. Barriers, particularly environmental hazards, are common and pervasive (Gill et al., 1999). Mineral Resources: The crust of the earth is full of various mineral resources. Occupation, Participation and Health, 24, 32-39. U.S. Access Board. At the heart of the problem is a lack of understanding and consensus about both independent and dependent variables. Its goal is to lay the groundwork for a thorough integration of human factors research with the design and implementation of home health care devices, technologies, and practices. To reduce injury and facilitate caregiver assistance, a number of products and devices have been developed to make moving around the home and transferring easier, safer, more efficient, and more dignified, both for the care recipient and the caregiver (see Chapter 8). Debilitating tinnitus causes constant disruption of a person’s emotional, cognitive, psychological or physical state. ), Staying put: Adapting the places instead of the people. Reducing environmental demands to improve P-E fit can be accomplished through a variety of home modification strategies (i.e., prosthetic facilitators), including assistive technologies and accessible design features (i.e., specialized equipment and environmental features intended to support people with specific disabilities) and universally designed products and spaces (i.e., environmental features intended to support people regardless of ability), that meet the activity and health needs of individuals and their care providers. Public Health Nursing, 13, 83-89. environmental innovations due to disrepair, inadequate systems, and lack of space. To be effective, assessments must produce unbiased, objective information that is both valid and reliable. Available: http://120.72.90.83/longwoods/content/18048 [accessed June 2010]. In contexts in which interventions cannot be randomly assigned nor the environment controlled, randomized controlled trials, and blinded studies in particular, are based more on an inappropriate research paradigm than one that is likely to produce valid and generalizable results. As a result, there are critical methodological challenges for studies in this field (Wahl et al., 2009). by third-party payers (LaPlante, Hendershot, and Moss, 1992). This type of assessment is illustrated by a number of instruments, such as the Housing Enabler (Iwarsson, 1999) and the Cougar Home Safety Assessment (Fisher, Coolbaugh, and Rhodes, 2006; Fisher et al., 2008). While health programs and housing programs in the United States operate independently of each other, the needs of individuals would suggest they should not. Anemaet, W.K., and Moffa-Trotter, M.E. Promoting independence for wheelchair users who live alone: The role of home accommodations. ), The psychology of adult development and aging (pp. Psychological and Social Sciences, 57, S366-S379. Like other technologies, there will be issues with the design of sensor networks that fit unobtrusively in the home environment (e.g., visibility of packaging and antennas), are easy to install and maintain, and are integrated with each other and with other home technology systems. (2002). Transfer Safety and Self-Care Activities. Although mental illness itself is heritable, a wide variety of factors like genetics, economic, social, and physical influences also contribute to the development of a disorder. Sanford, J.A., Griffiths, P.M., Richardson, P., Hargraves, K., Butterfield, T., and Hoenig, H. (2006). A second study reviewed 64 studies of environmental interventions for the management of Alzheimer’s disease (Gitlin, Liebman, and Winter, 2003) and reported that environmental interventions had some level of success in 90 percent of the studies, resulting in significant improvement in experimental group participants in 10 of 11 randomized clinical trials. Thus, while willing to spend dollars on medical model interventions, such as caregiving and assistive devices, the system does not generally support the environmental interventions that are necessary to reduce the cost of caregiving and technology or even ensure that they are effective. Available: http://www.nytimes.com/2009/09/15/technology/15speech.html [accessed June 2010]. Reviews of Environmental Health, 19(3-4), 223-252. Many houses are built above ground level and have a set of steps leading up to a porch, deck, or landing at the door. As a result, UD is compatible with the ICF, which suggests that disability is not a single point requiring specialized intervention, but a continuum of ability that would benefit from less demanding design. Many home modifications would be unnecessary if homes had originally been designed to better meet people’s needs. Disarmed complaints: Unpacking satisfaction with end-of-life care. Ono, Y., Lagerstrom, M., and Hagberg, M., et al. To ensure that these technologies can be used by consumers, particularly older adults who make up the majority of home health recipients and who are less familiar with technology, the design of these devices will need to be based on more user-centric principles. in the medical model, policy decision makers must also recognize that non-randomized, pre-post designs undertaken by experts in the environment will produce the most valid and reliable data regarding the effectiveness of physical environmental interventions. In the past, health and wellness were often ignored as facility managers strived to lower energy costs in buildings. Measuring the impact of the physical environment. Home modifications and performance of routine household activities by individuals with varying levels of mobility impairment. Public opinion of universal design in housing. Still, modifications for healthy, independent living in the community should be a public health concern for which funding is made available. For example, in a prospective cohort study to determine whether the prevalence of environmental hazards increased the rate of nonsyncopal (i.e., not from fainting) falls among older adults, Gill, Williams, and Tinetti (2000) had a trained research nurse assess home hazards using a standard instrument that included 13 potential slip and trip hazards. Nonetheless, with the Americans with Disabilities Act and its mandated accessibility guidelines clearly forging the way (although it has no jurisdiction in home environments), accessible design is inextricably tied to U.S. civil rights legislation. Existing and emerging healthcare devices for elders to use at home. 207-228). Evaluation of restorative care vs. usual care for older adults receiving an acute episode of home care. Ecology and the aging process. In contrast, an environment that does not fit an individual will result in negative performance outcomes or performance deficits that may prevent him or her from participating in an activity altogether. Emerging Infectious Diseases, 8, 233-236. (2000). Projection of chronic illness prevalence and cost inflation. However, while individuals who suffer from trauma or chronic illness are placed into the rehabilitation system, others, such as seniors with declining abilities, are typically on their own to find out how and where to enter a complex system of services that could be provided by any number of programs. Available: http://www.access-board.gov/adaag/html/adaag.htm [accessed June 2010]. Journal of Environmental Psychology, 22, 273-288. The inability to measure critical outcomes has too often resulted in studies in which the effectiveness of environmental interventions lacks statistical significance. Similarly, agencies that pay for modifications often introduce system bias by requiring assessments that adhere to their guidelines and result in recommending only interventions that will be reimbursed. The Physical Environment Physical environment include buildings, rooms, windows, equipment that should be considered. Technology and Disability, 2(4), 9-18. However, physical interventions alone will not suffice. Gitlin, L.N., Liebman, J., and Winter, L. (2003). Sohn, J. For example, in Philadelphia, the local AAA, the Philadelphia Corporation for Aging, provides an extensive in-home modification and repair service from assessment to implementation. Regular maintenance and upkeep of a home, particularly for individuals who are in poor health or have functional declines, may become unmanageable or unaffordable (Lawler, 2001). Low back injuries among home health aides compared with hospital nursing aides. 9 Information Technology and Systems in Home Health Care--George Demiris, 11 Impact of Cultural, Social, and Community Environments on Home Care--Steven M. Albert, The National Academies of Sciences, Engineering, and Medicine, The Role of Human Factors in Home Health Care: Workshop Summary, http://www.nytimes.com/2002/10/08/international/asia/08JAPA.html, http://www.design.ncsu.edu/cud/about_ud/udprincipleshtmlformat.html, http://govinfo.library.unt.edu/seniorscommission/pages/final_report/sencomrep.html, http://www.ahrq.gov/downloads/pub/advances2/vol1/Advances-Gershon_88.pdf, http://www.ilcusa.org/media/pdfs/Caregiving%20in%20America-%20Final.pdf, http://assets.aarp.org/rgcenter/il/inb49_falls.pdf, http://www.biomedcentral.com/1472-6963/4/28, http://120.72.90.83/longwoods/content/18048, http://www.agingtech.org/documents/Advanced_Home_ Healthcare_P&S.pdf, http://www.access-board.gov/adaag/html/adaag.htm, http://www.nytimes.com/2009/09/15/technology/15speech.html, 2 The People Who Receive and Provide Home Health Care, 6 The Health Care Challenge: Matching Care to People inTheir Home Environments--Neil Charness, 7 Informal Caregivers in the United States: Prevalence, Caregiver Characteristics, and Ability to Provide Care--Richard Schulz and Connie A. Tompkins, 8 Medical Devices in Home Health Care--Molly Follette Story, 10 The Physical Environment and Home Health Care--Jonathan Sanford, 12 Effects of Policy, Reimbursement, and Regulation on Home Health Care--Peter A. Boling, Appendix: Workshop Agenda and Participants. When these conditions are introduced into homes of older adults or individuals with other chronic conditions, they frequently exacerbate conditions in which many health and safety hazards already exist, including lack of space, clutter, poor lighting, and loose rugs (Gershon et al., 2008). Milbank Quarterly, 82, 157-194. This law was intended to protect society from squalid living conditions that were associated with smallpox and tuberculosis epidemics. The greatest obstacle to the success of home-centered health care is ensuring that the government, private insurers, and the public wholly embrace environmental intervention as a necessary component of the health care system, regardless of the real or perceived value it adds to an individual’s home. Each appliance had its own capability—the microwave scanned bar codes to calculate cooking times, and the refrigerator calculated the weights of food items to determine when items were running low—and they were also connected to the main computer system that sent a shopping list to the resident’s cell phone, which is also integral to the smart home. Now, primarily due to occupant demand and an understanding that the cost of personnel far exceeds the cost of energy and even the cost of rent and taxes, health and wellness are becoming part of overall sustainability strategies. Differences between medical and social models have important implications for health and independent living in the home and community. Personal safety, violence, and home health. Second, and perhaps more influential, is that environmental modifications are not considered to be medical interventions under the old medical model. However, simply getting this technology into homes is only part of the problem. Many homes are not designed to support either prosthetic or therapeutic needs. Consumers often associate prosthetic and therapeutic interventions with the stigma of disability and institutional care (Pynoos et al., 1997; Wolford, 2000), which are not perceived to be compatible with the residential appearance and are seen to reduce the market value of their homes (Gilderbloom and Markham, 1996). In fact, it provides economic disincentives for UD by supporting specialized assistive technology and (to some extent) accessible design solutions, which may have lower initial costs, but greater long-term costs and far less benefit to multiple individuals or society. These include the location of housing in unsafe neighborhoods, overheated room temperatures, poor indoor air quality, and unsanitary conditions. Gerontological Society of American Annual Conference, Dallas, TX. While the increased application of universal design principles requires changes in consumer and provider behavior, it most significantly requires fundamental changes in regulatory policy, from building and zoning codes to reimbursement. Seniors commission report. Randomized controlled trials have been used for interventions that have introduced assistive technologies and environmental strategies into the home (e.g., Gitlin et al., 2001a) when the physical environment is the intervention, but most real-world circumstances make it difficult to use these and other experimental intervention designs (e.g., random/. Under government insurance requirements, the maker of the PC, which ran ordinary Microsoft Windows software, had to block any nonspeech functions, like sending e-mail or browsing the Web…. (1995). A synthesis of the evidence. As a result, assessments undertaken by construction professionals may overestimate the need for environmental interventions. Medicare, for example, will pay for personal assistance, assistive devices, and medical technologies but not home modifications (i.e., accessible design). Center for Technology and Aging. As a result, there are few published cohort studies that have described and compared the types of UD interventions used by people within and across user groups or have evaluated the effectiveness of specific ones in meeting needs across individuals. Trouble in paradise? The design or the physical condition of the home itself can be a barrier to environmental innovation. There should also be adequate lighting operated by motion detectors or timers at all walkways and doors to help maintain independence and ensure the safety of individuals with mobility issues as well as those with vision loss. Power. As a prosthetic environment, the home can compensate for limitations in functional abilities to enable individuals to carry out basic activities associated with daily living safely and independently, participate in social roles, and receive personal assistance from caregivers as needed. 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