OBJECTIVE. To investigate longitudinal changes in activities of daily living (ADL) dependence and aspects of usability in housing among clients receiving housing adaptation grants in Sweden.

METHODS. The ADL Staircase and the Usability in My Home instruments were used to collect data on three occasions: at baseline 1 month before housing adaptation, at follow-ups 2 to 3 months after housing adaptation completion, and after another 6 to 7 months. In all, 131 clients, living in ordinary housing 24 to 93 years of age were consecutively enrolled.

RESULTS. Overall ADL dependence did not change significantly whereas dependence in “Bathing” decreased over time. “Activity aspects” and “Personal and social aspects” of usability improved at different phases in the process.

CONCLUSION. This study delivers new insights about the complexity of longitudinal person–environment–activity transactions, specifically targeting activity and usability. The results are useful for developing efficient strategies for evaluating housing adaptations within occupational therapy practice and research.

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