Role of the built environment in use and access: A comparison of objective and perceived indicators of person-environment fit among older adults with functional limitations

The built environment plays a significant role in the health and well-being of older adults, especially among those with functional limitations. Housing, in particular, serves as a central support or barrier to independence. Considering the projected exponential growth of the U.S. population aged 65 and older by the year 2050, it is expected that the percentage of persons aging with disabilities will subsequently increase. Housing independence for these growing populations will need to be considered. A better understanding of how people and their environments interrelate, or person-environment (P-E) fit, can assist in the creation of appropriate policy and practice interventions to support independence in older age. In response, this study aimed to explore the role of the built environment on use and access among older adults with functional limitations. Data were collected using a concurrent embedded mixed methods approach using objective and perceived indicators of P-E fit. Twelve older adults living in community-dwelling housing participated. While objective indicators identified accessibility problems within the home, participants’ perceptions of usability revealed a range of adaptive environmental behaviors employed to meet actual or perceived functional needs. Our findings suggest that objective access does not always prescribe or dictate perceived use, as usability appears to be malleable with age and functional competency. Future studies are needed that further examine the interaction between older adults and their home environment, and more specifically the association between actual or perceived functional status and environment-specific adaptation behaviors.