Frail older people ageing in place alone and their perception of the built environment in rural and urban sites: a mixed-methods study.

backgroundWhen older people have limited physical ability, several difficulties could arise from a built environment that is not appropriate for their needs, especially when they live alone without cohabiting with their relatives. The study explores how frail older people with functional limitations are ageing in place alone and how they perceive and manage the built environment, i.e., housing (home and building) and neighbourhood, with regard to both urban and rural sites.

methodsData were collected for the main IN-AGE "Inclusive Ageing in Place" study, which was carried out in 2019 in Italy. For this paper, semi-structured interviews involving 40 participants aged 65 years and over in the Marche Region (Central Italy) were processed, and a mixed-methods analysis (quantitative/qualitative) was conducted. Simple quantitative/descriptive elaborations (univariate and bivariate analyses) were integrated with thematic content analysis.

resultsThe findings suggested, among others, the following issues: high costs for managing the home, poor relationships with neighbours in some cases, scarcity of proximity services especially in rural sites, and the presence of architectural/mobility barriers, even though the latter are little perceived when inside the home. Moreover, the majority of seniors were emotionally attached to their living place, although feelings of loneliness and isolation emerged, also following depopulation in rural areas.

conclusionsDespite the small/not representative sample size, the results highlight how, a built environment that is perceived as inadequate, could hamper ageing in place and participating in communities for frail seniors. This could be managed with appropriate interventions to be implemented taking into account the diversity between rural and urban sites. CLINICAL TRIAL NUMBER: Not applicable.