Perceptions of implementing bathroom modification to promote aging in place among community-dwelling older adults

Research Objectives: To understand community-dwelling older adults’ perceptions of bathroom modification and factors influencing their decision-making on implementing modifications, with the guidance of the Health Belief Model.

Design: Qualitative research design with the use of semi-structured individual interviews.

Setting: Community setting.

Participants: Twenty community-dwelling older adults (mean age = 72) with or without impairments were recruited using convenience and snowball sampling.

Interventions: Not applicable.

Main Outcome Measures: An interview guide. The Health Belief Model was used to guide content analysis.

Results: Three main themes emerged: (1) “If it makes sense, I would do it:” Perceived need as the ultimate determinant. (2) Barriers: Cost, access, and “look handicapped.” (3) Aging with choice: Alternative solutions supporting aging in place. The findings of this study were similar to what the Health Belief Model conveys: one would act to improve health when they believe that they are at risk, the action is beneficial, and they can overcome barriers. However, perceived need was reported to be the most significant determinant of implementing modification. Even if older adults recognized the benefits, received recommendations from others, and had low perceived barriers, they would not act if they did not believe they needed modification. Unaffordable costs and lack of access to resources were major barriers. Concerns regarding accessible features (e.g., grab bars) looking old and “handicapped” indicated that ageist and ableist culture was another barrier. Participants reflected that though effective, bathroom and other home modification was just one way to promote aging in place. Alternative solutions, such as staying physically active and moving to a more accessible home after functions started to decline, could also help avoid unintentional home injuries.

Conclusions: Whether older adults would implement bathroom modification is multifaceted. When working with older adults demonstrating potential needs for bathroom and other home modification, rehabilitation professionals should educate on risks and benefits, understand individuals’ barriers, provide resources, follow up regularly, and more importantly, respect their choice. Macro-level changes such as popularizing aging-friendly housing not requiring major modifications may be desired.

Author(s) Disclosures: No conflicts to declare.