Age-friendly Home Modification​

The global trend of populations ageing has led to an increasing demand for caregiving services, resulting in the implementation of national policies that support and protect the caregiving workforce. In response, Korea has enhanced its care system and initiated integrated care projects in local communities with the goal of promoting Ageing in Place. Ageing in Place refers to a concept and practice that supports older individuals to live healthy and safe lives in their own homes and communities rather than in institutions. This approach is gaining momentum as an alternative to nursing homes or hiring caregivers, as it is believed to improve the quality of life for older persons and facilitate their contribution and participation in their local communities.

Housing is a critical factor in achieving Ageing in Place, given the particular needs of many older persons. The Madrid International Plan of Action on Ageing and the UN Principles for Older Persons recommends that "legislation should be established to remodel and improve facilities to suit the abilities of older persons, enabling them to continue living in their own homes for as long as possible." This underscores the need for and importance of age-friendly housing renovation for older persons. As we age, our physical abilities can decline. As a result, it is essential to adjust and repair living environments to suit older individuals’ specific physical conditions. Unfortunately, many homes occupied by older persons lack adequate equipment or have outdated functionality, leading to a gradual deterioration of the living space. Therefore, age-friendly home renovations are an important means of supporting older individuals’ ability to Age in Place.

The 2020 Status of Older Persons in Korea report (Korea Institute for Health and Social Affairs, 2020) reveals that older persons experience an average of 1.6 falls per year in their homes, and 72.5 percent of these falls require hospital treatment. Environmental factors such as slippery floors, steep slopes and poor lighting are often responsible for falls among older individuals. Older persons may also struggle with basic activities such as using the bathroom or preparing meals when their housing environment does not match their physical abilities or characteristics. This can further accelerate the degradation of their physical movement. Thus, it is crucial to make repairs and modifications to homes to cater for the physical changes that come with ageing. In this context, this report introduces the "iH Age-Friendly Home Repair Project" by the Incheon Housing and City Development Corporation (IHCDC). The project aims to improve the deteriorating housing environment of the older population and support their independent living, addressing a critical need in the community.

 * This report is based on information provided by the IHCDC, as well as interviews with director Jae-sul Na, and manager Seung-yeon Kang of IHCDC.

In May 2019, IHCDC initiated a home modification project specifically designed for older population. This initiative sets itself apart from the government’s nationwide home modification program for low-income households by focusing on the needs of older persons based on analysis of their physical and behavioral characteristics. Given that the people 65 and over accounts for 15.9 percent of the total population in Incheon, the city launched this age-friendly home modification project in response to the growing demand for housing solutions that cater to the needs of its ageing population.

To take a look at the program in 2022, the IHCDC selected 44 households in 5 districts, namely Dong-gu, Michuhol-gu, Bupyeong-gu, Jung-gu, and Namdong-gu, the areas with the highest ageing population rate among the 10 districts in the city. The beneficiaries were selected through a process that involved field visits and document reviews, and recommendations from older persons related organizations, including district offices and public health centers. Priority was given to those who had not received any government support in the past, ensuring that the project reached those most in need. In order to ensure that the repair services applied were appropriate for the specific needs of each beneficiary, the selected individuals were classified into six types according to the Behavior-based Housing Modification Manual (Oh-jung Kwon, 2019). This classification enabled IHCDC to tailor a customized home modification plan for each individual. Types 1, 2, and 3 beneficiaries were relatively independent individuals, so that preventive measures were taken to enhance their household activities and housing convenience. Types 4, 5, and 6 beneficiaries, on the other hand, required assistive devices or care, and home repairs were prescribed to maintain their residual abilities or, if necessary, created a care environment.

Behavior-based Housing Modification is a unique approach to home modification that takes into account each individual’s physical and behavioral characteristics. It involves conducting an inspection of the housing environment and identifying areas that require maintenance or improvement. Then, customized home modifications are performed by providing tailored installations of equipment and materials in locations chosen to suit an individual’s physical abilities and behavior patterns. The maximum amount of support per household for home modification is 5 million KRW(approximately 3700 USD).

In-depth interview and observation process

 Source: Incheon Housing and City Development Corporation

Beneficiaries classified according to the six Behavior-based Housing Modification types then receive a diagnosis from “Naejip-yeonguso(My House Research Lab)”, a research institute on housing. This institute visits the beneficiaries’ homes and assesses the difficulties and spatial characteristics experienced during the eight major activities of defecation, bathing, washing, eating, doing laundry, sleeping, dressing, and going out. The institute records the individuals' movement and activities within their homes and analyzes the characteristics of space and movement by specific activities. Based on this analysis, the program provides preventive home repairs for those who can manage their daily routine independently. For those who require care or assistance on a daily basis, repairs are tailored to meet both the needs of caregivers and care recipients.

Construction work is carried out by the "Social Safety Foundation," a company specializing in age-friendly housing remodeling. This approach fosters direct communication between the involved parties, resulting in construction that prioritizes the beneficiaries’ needs instead of the contactors’. The fact that both parties are involved and continuously communicate throughout the project is an unique characteristic that sets it apart from other local government initiatives.

In 2022, one of the beneficiaries of the home modification project was an older citizen who had to climb steep and narrow stairs to reach her living space on the second floor. Furthermore, her bedroom was cramped and disorganized, leading to poor living conditions. Although she was relatively independent in her daily activities, her living environment was deemed to be unsafe and poor in sanitation. In response, a home modification plan was developed to improve her safety and comfort, and increase accessibility. This included organizing waste disposal and cleaning on her behalf, replacing the floor and the wallpaper, and installing safety handrails in her stairway.

Type 6 home modification: before and after a ramp installation

IHCDC has conducted a satisfaction survey on a yearly basis. The result indicates that the project is well received by beneficiaries, as it tailored to their individual needs. In a 2022 survey, over 98 percent of beneficiaries responded that they were "very satisfied." This high satisfaction rate was attributed to the improvement in stability and independence in daily life. Additionally, post-management services were provided, including on-site visits one month after housing modification to monitor beneficiaries’ independence in their daily activities. Seung-yeon Kang, the manager in charge of home modification projects, noted that they were able to build a close rapport with the beneficiaries by visiting them more than 10 times on average, and that the beneficiaries communicated directly with the Social Safety Foundation when maintenance work was needed. Given its success, IHCDC plans to expand the project to all eight inland districts of Incheon in 2023.

The "iH Age-Friendly Home Repair Project" is a significant development that has a positive social impact. At a macro-level, it reduces social and economic burdens such as medical expenses and elderly care costs. On an individual level, it provides benefits by creating a dignified living environment for older individuals, helping them to age in place. The project is especially noteworthy for its promotion of community development through collaborative work between the public and private sectors. Its emphasis on providing customized housing environments according to the needs of individual beneficiaries is an exemplary and timely approach to improving older person’s rights to adequate housing.

Haeri Kang (haerikang@asemgac.org)