A Novel Adaptation of the HOME Inventory for Elders: The Importance of the Home Environment Across the Life Course
2. Purpose of the Study
3. Materials and Methods
3.2. Analytical Strategy
4.1. Sample Description
4.2. HOME Inventory Results
4.3. Integration with Qualitative Results
Conflicts of Interest
Appendix A. Focus Group Discussion (FGD) Guide
- Could you describe the role of older people in Sri Lanka?
- What are some of the good things of growing older?
- What are some of the bad things of growing older?
- What is it like to grow older? What experiences do you have that you did not have during your younger days? (Seek personal examples.)
- What does this life look like?
- Where does this person live?
- Who takes care of him/her?
- What does he/she do all day?
- Tell me about older people whose lives you admire. What are they like? Why do you admire their lives?
- What are things that older people can do that helps them to live a good and healthy life?
- What are some barriers to achieving this ideal life? (Moderator should probe for social, structural, economic barriers.)
- Probe for ways they deal with specific problems they just mentioned.
- How do older people use religion and religious practices to deal with their problems?
- What is depression?
- How can you tell that someone is depressed? What does it look like? (probe for behaviors and physical symptoms)
- Do people get more or less depressed as they get older? Why is that?
- What might be reasons that older people experience depression?
- Have you known an older person who has been depressed? What did this look like?
- What should the family do when an older person starts to behave/feel/think this way, if anything?
- How are older people who are depressed treated? Are they treated differently by others (family and community members) because of their depression? Why are they treated this way?
- Do families hide the fact that an older family member is depressed? If so, why?
- We know that people sometimes get more forgetful as they get older.
- What types of problems have you seen related to forgetfulness?
- When, if ever, is it necessary to go to a doctor? (Moderator should probe whether this depends on age, severity of forgetfulness.)
- Describe a person who you think should be taken to a doctor due to forgetfulness?
- What other places might families go to get help for forgetfulness?
- What type of help and support do people need as they get older? (Moderator should generate a comprehensive list of needs.)
- How do different family members provide this help and support to older people?
- Who usually holds the main responsibility to help the elderly to meet these needs? Why do you say this?
- What makes a good caregiver? What is an ideal situation and type of person to take care of an older person?
- What types of support can the older family member give to others?
- How can the elderly contribute to their families?
- How do you spend your free time? (Moderator should generate a list of activities and get a sense of what is understood by the Sinhalese word for “leisure”.)
- Are there things you would like to do in your free time that you are not able to do? Why?
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|Category||Number (Percent)||Mean (SD)||Range|
|Never schooled||12 (5%)|
|Primary (grade 1–5)||72 (29%)|
|Secondary (grade 6–10)||82 (33%)|
|Passed GCE (O/L)||52 (21%)|
|Passed GCE (A/L)||22 (9%)|
|Physical Environment||6.78 (1.9)||1–10|
|Variety of Stimulation||3.87 (1.9)||0–9|
|MoCA a||18.7 (6.4)||4–30|
|Impaired (<24)||177 (71%)|
|Unimpaired (≥24)||71 (29%)|
|IQCODE b||3.3 (0.5)||1.5–5.0|
|Dementia (≥3.38)||80 (32%)|
|No dementia (<3.38)||168 (68%)|
|Distress (Kessler-10) c||16.6 (6.5)||10–43|
|Quality of Life (ICECAP-O) d||17.4 (2.4)||5–20|
|Physical Environment||Percent “YES“|
|Variety of Stimulation|
|Emotional and Verbal Responsiveness|
|HOME Domain||MoCA (Higher Score = Less Impairment)||IQCODE (Higher Average = Cognitive Decline)||Kessler-10|
(Higher Score = Higher Distress)
|ICECAP-O (Higher Score = Higher Capability)|
|β (95% CI)||p-value||β (95% CI)||p-value||β (95% CI)||p-value||β (95% CI)||p-value|
|Moderate||1.01 (−0.53 to −2.55)||0.20||−3.96 (−6.95 to −0.97)||0.01||−0.23 (−2.42 to 1.96)||0.84||0.48 (−0.32 to 1.29)||0.24|
|High||2.06 (0.57 to 3.56)||0.01||−3.88 (−6.77 to 0.99)||0.01||−0.99 (−3.10 to 1.13)||0.36||0.92 (0.14 to 1.70)||0.02|
|Moderate||1.61 (0.15 to 3.07)||0.03||−0.29 (−3.15 to 2.60)||0.84||−3.31 (−5.33 to −1.29)||0.001||0.28 (−0.47 to 1.02)||0.47|
|High||1.70 (0.18 to 3.22)||0.03||−2.12 (−5.09 to 0.85)||0.16||−3.15 (−5.24 to −1.05)||0.003||1.29 (0.51 to 2.06)||0.001|
|Moderate||−0.27 (−1.70 to 1.17)||0.72||0.58 (−2.21 to 3.37)||0.68||1.03 (−0.97 to 3.03)||0.31||0.45 (−0.29 to 1.19)||0.23|
|High||−0.24 (−1.67 to 1.18)||0.74||0.06 (−2.71 to 2.83)||0.97||−0.64 (−2.62 to 1.35)||0.53||0.74 (0.00 to 1.47)||0.05|
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Hale, K.; Østbye, T.; Perera, B.; Bradley, R.; Maselko, J. A Novel Adaptation of the HOME Inventory for Elders: The Importance of the Home Environment Across the Life Course. Int. J. Environ. Res. Public Health 2019, 16, 2826. https://doi.org/10.3390/ijerph16162826
Hale K, Østbye T, Perera B, Bradley R, Maselko J. A Novel Adaptation of the HOME Inventory for Elders: The Importance of the Home Environment Across the Life Course. International Journal of Environmental Research and Public Health. 2019; 16(16):2826. https://doi.org/10.3390/ijerph16162826Chicago/Turabian Style
Hale, Kathryn, Truls Østbye, Bilesha Perera, Robert Bradley, and Joanna Maselko. 2019. "A Novel Adaptation of the HOME Inventory for Elders: The Importance of the Home Environment Across the Life Course" International Journal of Environmental Research and Public Health 16, no. 16: 2826. https://doi.org/10.3390/ijerph16162826