‘If It Makes Sense, I Would Do It’ - Understanding Perceptions of Implementing Bathroom Modification Among Community-dwelling Older Adults

Among community-dwelling older adults, high risk of unintentional home injuries particularly in bathrooms, is a main barrier to aging in place (National Safety Council, 2021; Hanba et al., 2017). Modifications in home areas, including bathrooms, are effective in fostering aging in place by improving independence and safety (Keglovits & Stark, 2020). Nevertheless, bathroom modification is not commonly adopted by older adults. It is essential to understand why or why not older adults choose to modify bathrooms, in order to promote related services. This project aimed to understand older adults’ perceptions of bathroom modification and factors influencing their decision-making on implementing modification using qualitative interviews. Twenty community-dwelling older adults (mean age = 72) participated. Three main themes emerged after thematic analysis: (1) ‘If it makes sense, I would do it’ - Perceived need as the ultimate determinant, regardless of the awareness of benefits and recommendations from others. (2) Barriers to implementation: Cost, access, and ‘look handicapped.’ (3) Aging with choice: Alternative solutions to reduce risks of home injury. Findings indicated that even if older adults recognized the benefits of bathroom modification and had low perceived barriers, they would not take action if they did not believe in their actual needs for modifying bathrooms. Participants also reflected that though effective, environmental modification was just one helpful way to promote aging in place. Alternative solutions included doing physical exercises to stay healthy and active and moving to a more accessible home when functions started to decline. This study provided meaningful implications for OT practice. When working with older adults demonstrating potential needs for home modification, OTs should educate on benefits, understand individuals’ barriers, provide opportunities to help overcome barriers, follow up regularly, and more importantly, respect their choice.

References

National Safety Council. (2021). Injury Facts: Deaths in the Home and Community by Age Group and Cause. Retrieved February 16, 2023, from https://injuryfacts.nsc.org/home-and-community/home-and-community-overview/deaths-in-the-home-and-community-by-age-group-and-cause/

Hanba, C., Gupta, A., Svider, P. F., Folbe, A. J., Eloy, J. A., Zuliani, G. F., & Carron, M. A. (2017). Forgetful but not forgotten: Bathroom-related craniofacial trauma among the elderly. The Laryngoscope, 127(4), 820–827. https://doi.org/10.1002/lary.26111

Keglovits, M., & Stark, S. (2020). Home modifications to improve function and safety in the United States. Journal of Aging and Environment, 34(2), 110–125. https://doi.org/10.1080/26892618.2020.1743510