Perceived aspects of home, health and well-being among people in Sweden aged 67-70 years

Introduction: The fact that the majority of older people wish to remain and live independently in their current homes calls for a more comprehensive understanding of which aspects of the home support healthy ageing. Perceived aspects of home influence life satisfaction, perceived health, independence in daily activities and well-being among people aged 80 years and older. However, health and perceived aspects of home among senior citizens in earlier phases of the ageing process are scarcely studied. Aims: The overarching aim of this thesis was to extend and deepen the current knowledge of the dynamics of perceived aspects of home and health among people aged 67-70 years, living in ordinary housing in southern Sweden. Meaning of home, external housing-related control beliefs and usability were investigated in relation to physical and mental symptoms, depressive mood and psychological well-being. In addition, the complexity of these dynamics and what it means to people as they age was explored from an individual perspective. Methods and Results: The thesis is based on survey data collected with 371 participants recruited from the SNAC-GÅS study, and in-depth interviews with a new sample (N=13). Participants were aged 67 – 70 years and lived in ordinary housing in southern Sweden. Data was collected through home visits. Descriptive statistical analyses revealed significant differences among subgroups in regards to the likelihood of reporting physical and mental symptoms, depressive mood and psychological well-being (autonomy and purpose in life) (Studies I & III). Multivariable linear and logistic regression models showed that participants reporting positive evaluations of perceived aspects of home reported fewer physical and mental symptoms (Study II), had better psychological well-being and reported less depressive mood (Study III). Analyses of in-depth interviews (Study IV) revealed that perceptions about home become progressively important after retirement. In addition, not only the immediate home environment but also local neighborhoods influence perceptions of home. These analyses also revealed that home brings emotional and social benefits but also worries about how to cope with complex ambivalence when reflecting upon the future housing career. Conclusions: Bringing together results from quantitative and qualitative research, this thesis shows that perceptions about home are associated with health and well-being already at age 67-70. The findings highlight that health implications of housing are not restricted to physical attributes of the home such as housing standard or environmental barriers; consideration should also be given to perceived aspects of home. In health care and social services practice contexts, being aware of and being able to recognize these factors might support older people to maintain health along the process of ageing. This knowledge can be used to inform and facilitate societal planning in terms of housing provision; additionally it is important to consider designing local neighborhoods to nurture social interactions because of older persons extended view of home. Finally, to be able to help senior citizens to deal with their ambivalence when planning for their future housing arrangements, health care professionals involved in housing-related counseling need to be aware and approach such worries earlier than is usually done today