Understanding the home environment of older adults living with dementia: A scoping review of assessment tools.

Rigorous assessments to better understand the person-environment interaction are essential to comprehend how neurocognitive disorders influence in-home functioning of older people living with dementia. No recent synthesis identifies validated instruments targeting the human (e.g. caregivers) and nonhuman (e.g. objects) elements of the home environment interacting with this population and used with the perspective of aging in place. Consequently, following Arksey and O'Malley's (2005) scoping review method, 2,182 articles were identified in six databases and in gray literature. Two reviewers independently selected 23 relevant articles describing 19 validated assessment tools targeting elements of the home interacting with older people with dementia, namely: nonhuman environment (n = 13), human environment (n = 3), and person-environment interaction (n = 3). This overview highlights the scarcity of tools addressing the human environment and the person-environment interaction to foster sustainable at-home living for older people with neurocognitive disorders, demonstrating the need to incorporate new evidence-based, holistic methods into dementia home care.

Exploring the home environment of adults living with autism spectrum disorder: a qualitative study.

Introduction: The challenges experienced by adults living with autism spectrum disorder (ASD) regarding their interaction with their home environment are thinly documented, although these issues persist with age. Based on the Model of Competence, this study aims to explore the human and nonhuman elements of the home environment influencing the functioning of autistic adults. Methods: An exploratory-descriptive qualitative study was conducted in Quebec City, Canada, with autistic adults (n = 6). Individual semi-structured interviews were undertaken by a single interviewer until data saturation was reached. A content analysis was conducted using NVivo software with a list of codes adjusted according to new emerging themes. Results: Eight themes emerged and were grouped into three categories: 1) Person - Adult living with ASD: coping skills, anxiety; 2) Microsystem - Home environment: entourage, sensory elements, spatial arrangement; 3) Person-environment interaction: routines, socialization, control. The experiences of autistic adults highlight the varied interactions experienced with the nonhuman and human elements of their homes, sometimes resulting in a situation of handicap related to their activities and roles. Conclusion: This qualitative exploration of the environmental challenges experienced at home by autistic adults introduces a better understanding of the person-environment interaction, allowing for easier functional assessment and improved home support.

Experiencing accessibility of historical heritage places with individuals living with visible and invisible disabilities.

Introduction: Around 16% of world's population lives with visible and invisible disabilities. People with disabilities' participation may be limited because of the environmental obstacles. Moreover, historic heritage places were built before the development of accessibility standards and the rights of people living with disabilities and the majority were not designed to be accessible. Access to historic heritage places is important for carrying out the activities in place but also to create and reinforce identity. The aim of this study was to explore the experiences of people with visible and invisible disabilities when visiting heritage sites considering accessibility issues. Methods: This study is a qualitative interpretive description. Participants were adults with visible (e.g., motor disability) or invisible (e.g., autism) disabilities. For data collection, go along interviews (also referred to in the literature as "walking interview" in two different locations in the Historic District of Old Quebec in Quebec City were conducted. Thematic analysis was done. Results: Twenty-one participants completed two go along interviews: one in the Séminaire de Québec (Seminary of Quebec City) and the other in Petit-Champlain and Place Royale areas of Quebec City. Three themes emerged: (1) Obstacles and impact on participation; (2) Disabling accessibility; and (3) Heritage meaning. Discussion: The barriers identified by participants are diverse and differ according to the person and the type of disability. However, social and leisure activities were particularly limited, despite the strategies developed by some participants. Participants in the study demonstrated an interest in accessing to heritage places, therefore it seems essential to consider the needs of people with disabilities when developing accessibility solutions, and to seek a balance between preserving heritage and promoting inclusive and equitable access for all.