Housing environments that hinder performance of daily activities and impede participation in social life have negative health consequences particularly for the older segment of the population. From a public health perspective accessible housing that supports active and healthy ageing is therefore crucial. The objective of the present study was to make an inventory of environmental barriers and investigate accessibility problems in the ordinary housing stock in Sweden as related to the functional capacity of senior citizens. Particular attention was paid to differences between housing types and building periods and to identify environmental barriers generating the most accessibility problems for sub-groups of senior citizens. Data on environmental barriers in dwellings from three databases on housing and health in old age was analysed (N = 1021). Four functional profiles representing large groups of senior citizens were used in analyses of the magnitude and severity of potential accessibility problems. Differences in terms of type of housing and building period were examined. High proportions of one-family houses as well as multi-dwellings had substantial numbers of environmental barriers, with significantly lower numbers in later building periods. Accessibility problems occurred already for senior citizens with few functional limitations, but more profound for those dependent on mobility devices. The most problematic housing sections were entrances in one-family houses and kitchens of multi-dwellings. Despite a high housing standard in the Swedish ordinary housing stock the results show substantial accessibility problems for senior citizens with functional limitations. To make housing accessible large-scale and systematic efforts are required.

In the late stage of Parkinsons disease (PD), there is an increasing disease burden not only for the patients but also for their informal caregivers and the health and social services systems. The aim of this study was to explore experiences of late-stage PD patients and their informal caregivers satisfaction with care and support, in order to better understand how they perceive the treatment and care they receive. This qualitative substudy was part of the longitudinal European multicentre Care of Late Stage Parkinsonism (CLaSP) project. Individual semistructured interviews were conducted with patients (n=11) and informal caregivers (n=9) in Sweden. Data were analysed through the content analysis technique. The final analyses generated one main category: We are trying to get by both with and without the formal care and five subcategories: Availability of health care is important for managing symptoms and everyday life; Dependence on others and scheduled days form everyday life; There is a wish to get adequate help when it is needed; Mixed feelings on future housing and respite care; and Family responsibility and loyalty for a functioning everyday life. Having regular contact with PD-specialised health care was perceived as important. Greater access to physiotherapy was wished for. Maintaining autonomy was perceived as important by patients, in both home health care and a future residential care setting. Responsibility and loyalty between spouses and support from children enabled everyday life to carry on at home, indicating a vulnerability for those without an informal caregiver. The results suggest that regular access to PD-specialised health care is important and that a specialised and multidisciplinary approach to the management of PD symptomatology is likely necessary. Non-PD-specialised staff in home health care and residential care facilities should regularly be given opportunities to obtain PD-specific education and information.

Purpose: To investigate the characteristics and change in use among very old Swedish users and non-users of assistive devices (ADs) for mobility and personal care, over a six-year period, and to investigate factors predicting AD use over a six-year period. Method: Descriptive statistics and logistic regression were used to analyse quantitative data from a subsample from the Swedish part of the ENABLE-AGE Survey Study, n = 154. Variables according to socio-demographics, environment and health were utilized. Results: The number of users increased over time, particularly those using both types of ADs (mobility and personal care). There were differences in health between users and non-users, while no such differences were seen regarding socio-demographics or environmental factors. Health factors most prominent predicted AD use after six years, but also variables within socio-demographics and the environment had an impact on the use; income for ADs for personal care and aspects in the outdoor environment for ADs for mobility. Conclusions: As ADs increases over time, it is important, to pay attention to health as well as other factors, among users and non-users of ADs, to provide important information in planning for and supporting healthy and active ageing. Implications for Rehabilitation The combination of device use for mobility and personal care increases over time for very old people. Very old people’s perceived physical mobility can indicate future needs for mobility devices. It is important to consider outdoor environmental barriers impact on mobility device use. Implications for Rehabilitation