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We are at the threshold of a great change in architectural design. With cheaper and more ubiquitous computing, ?smart? spaces and responsive environments are increasingly becoming plausible and affordable. Are we as architects prepared? Can the profession of architecture respond to current computing technologies? Most critics agree that one of the first (most important) problems that ?smart? homes will help to address is that of spiraling costs of elderly healthcare and care giving. But what is the problem with healthcare? Even if there is a problem, the rural home is different from an urban home. Will the technologies that are designed for the urban home work in a rural setting? What are the differences between urban and rural healthcare models? In this thesis, we address the above questions through research of current problems and models of rural healthcare and through a documentation of studies and reports published over the last decade. This research helps us to understand if architecture can really augment healthy aging in rural home settings. In conclusion, we will examine the role of architecture (and architects) in the context of ubiquitous computing and ?smart? spaces in rural areas and propose a possible solution for this problem.

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This study explored the meaning of community engagement of older adults, within a social capital framework, in a community noted for its relatively high concentration of active, older adults. The multiple meanings of community engagement within the creation of a place of age were investigated using concepts derived from a social capital framework. A place of age is where older adults are integral to family life, participate in community life, and bring collective life experiences and wisdom to civic life. This research addresses gaps in the current literature about suburban places and the meanings of community engagement for an aging population within these places. The importance of this research lies with expanding the understanding of the multiple meanings of community engagement and the potential for reinforcing, through public policy, these meanings through the development and support of the social capital created by older adults in places of age. The research methodology was an in-depth case study analysis of West Saint Paul, Minnesota. In-person, semistructured interviews were conducted with 21 individuals, aged 65 years and older, who had been residents of West Saint Paul for at least 25 years. Findings of this study revealed multiple meanings of community and community engagement for study participants, but all had a strong sense of community relative to their neighborhoods and the city of West Saint Paul. All had well-developed social networks that involved family members, friends, and neighbors. Nearly all engaged in neighboring behaviors of helping out when needed and generally looking out for one another. All participants expressed a feeling of trust of others within their own neighborhoods, and most did not feel trusting of others beyond their neighborhoods. All participants had consistently voted, and all engaged in formal civic activities at some point in their lives. All participants, lifelong volunteers, were members of a Christian church, and much of their volunteer time was given to church activities. The key finding from this study was the important role of neighboring behaviors, faith-based affiliation, and family in the meaning of community engagement within each participant's life. / Ph. D.

Baby boomers are living longer, and as they age, they will need more supportive services that may include housing, mobility, nutrition, personal care, or health care. Despite the studies that have been conducted on baby boomers aging in place (choosing to stay in their home versus move to an institution), the focus has been on the old and frail and very little has been done to address the lifestyle of active (physically functioning) baby boomers. The purpose of this phenomenological study was to understand the lived, shared experiences of active baby boomers regarding their beliefs and attitudes about aging in place and the implications of this decision. The theoretical foundation of the study was based on Atchley's continuity theory. Data were gathered through in-person, semi-structured interviews with 11 participants, age 65 and older, living in a coastal area of a southern state. Data from the interviews were inductively coded and then organized around key themes. The themes from the content analysis indicated that the participants were embracing the concept of aging in place and adjusting to their limitations (i.e. physical, financial, emotional, and/or environmental) when present. Identified barriers to aging in place were access to services (specifically medical and in-home care), financial constraints, and the inability to drive or inaccessibility of transportation. This study contributes to positive social change by providing policymakers and administrators with information to strengthen the argument that the current social service delivery system is overburdened and may not meet the demands of this population in order for them to maintain their independence and autonomy. Additionally, this study raises awareness among policymakers that driving longer will in itself possess its own challenges such as visibility concerns and roadway design not conducive to aging adults.

Over 75% of adults 60 years of age or older who live in Washington, D.C. are unaware of access to Aging and Disability Resource Centers' (ADRC) community-based services. Approximately 25% of these individuals are low-income and reside in multifamily subsidized housing. With a theoretical basis in Penchansky and Thomas' construct of access, this phenomenological study explored whether increased awareness of access to ADRC service delivery may potentially better meet the needs of this socioeconomically marginalized population. Data were collected through semi-structured interviews with 20 senior citizens in Washington, D.C. who received some programmatic assistance, such as housing or meal delivery, but not necessarily through an ADRC. Interview data were inductively coded and analyzed using Braun and Clarke's thematic analysis method. Findings indicate that while there is an apparent need for community-based services, many participants who were not aware of ARDC services wanted more information about how to access the service delivery system to age in place, avoid burdening children, retain housing vouchers, and prevent nursing home placement. In contrast, seniors who accessed ADRC, based on the construct of access, found services acceptable, accessible, affordable, available, accommodating, and helpful in allowing them to remain independent and at home. The results of this study contribute to positive social change by recommending that program administrators focus on outreach to the program's target population, thereby improving access to resources so they can be self-reliant and prolong residential longevity for aging-in-place demands.

Cette thèse, inscrite dans le cadre d’un projet de recherche européen, s’intéresse au problème des réticences des personnes âgées à l’usage des TIC. Plus précisément, elle porte sur les facteurs psychosociaux influençant les attitudes des personnes âgées de 62 ans et plus à l’égard des TIC. Nous avons mené six études dans ce cadre, répartis en deux axes. Le premier axe, comportant deux études, concerne les stratégies publiques et pratiques d’orientation des personnes âgées vers les TIC. Dans la première nous avons analysé les pratiques des organismes impliqués dans l’orientation des personnes âgées vers les gérontechnologies en Lorraine. Il en ressort que les parcours d'accès sont très différentes en fonctions des départements et des localités, mais aussi en fonction du premier interlocuteur sollicité par la personne âgée et ses proches. La seconde étude avait pour objectif d’analyser les stratégies publiques et réglementations visant à inciter et faciliter l’usage des services basés sur les TIC destinés aux personnes âgées dans six régions d’Europe. Différentes étapes de développement de ces stratégies en sont ressorties et un décalage Nord/Sud a été constaté. Dans le second axe, comportant quatre études, nous avons étudié sous différents angles les facteurs influençant les attitudes des personnes âgées à l’égard des TIC. La troisième étude visait à connaître les perceptions des personnes âgées à l’égard des TIC et leurs besoins perçus. Nous avons identifié 22 items relevant de perceptions, répartis en huit composantes formant une échelle des perceptions à l’égard des TIC ainsi qu’une échelle des besoins perçus en deux composantes. La quatrième étude a évalué l’impact de l’expérience antérieure avec les TIC sur les perceptions à l’égard des TIC. Nous avons réalisé des analyses de variance des perceptions à l’égard des TIC en fonction de la possession ou non d’un ordinateur et du suivi ou non de cours d’initiation à l’informatique. Les résultats ont montré que la possession d’ordinateur et le suivi de cours associés à des perceptions significativement plus positives des TIC. La cinquième étude a analysé l’impact de la région d’habitation sur les perceptions à l’égard des TIC. Nous y avons comparé les perceptions des personnes âgées de six régions de l’Ue. Nous avons constaté une cohérence entre les stratégies publiques d’orientation des personnes âgées vers les TIC et les perceptions des personnes âgées à l’égard des TIC. Enfin, notre dernière étude portait sur l’analyse des facteurs influençant l’attitude à l’égard des TIC en fonction de différents types d’activités. Suivant la variable dépendante, différents facteurs ont été trouvés, incluant des perceptions à l’égard des TIC, des besoins perçus, l’expérience antérieure, la région d’habitation et des variables sociodémographiques. / This thesis, which was part of a European research project, focuses on the problem of the reluctance of elderly people to use ICTs. More specifically, it focuses on the psychosocial factors that influence the attitudes of people aged 62 and over to ICTs. We conducted six studies in this framework, divided into two areas. The first axis, containing two studies, adresses public strategies and practices for orienting older people to ICTs. In the first one we analyzed the practices of the organizations involved in the orientation of the elderly towards gerontechnologies in the Lorraine region of France. It emerges that the access routes are very different according to the counties and communities, but also according to the first interlocutor requested by the elderly person and his / her relatives. The second study aimed to analyze public strategies and regulations encouraging and facilitating the use of ICT­ based services for the elderly in six regions of Europe. Different stages of development of these strategies emerged and a north / south lag was observed. In the second axis, with four studies, we examined from different angles the factors influencing the attitudes of the elderly towards ICTs. Our third study examined the perceptions of older persons regarding ICTs and their perceived needs. We identified 22 perceptual items divided into eight components forming a scale of perceptions of ICTs as well as a scale of perceived needs including two components. The fourth study assessed the impact of previous experience with ICTs on perceptions of ICTs. We carried out analyzes of the variance of ICT perceptions depending on whether a computer was owned or not and the follow­up of computer literacy courses. The results showed that computer ownership and course tracking were associated with significantly more positive perceptions of ICTs. The fifth study analyzed the impact of the region of residence on perceptions of ICTs. We compared the perceptions of the elderly in six regions of the EU. We found coherence between public strategies for orienting older people to ICTs and the perceptions of older people regarding ICTs. Finally, our latest study focused on the analysis of factors influencing attitudes toward ICTs for different types of activities. Depending on the dependent variable, different factors were found, including perceptions of ICTs, perceived needs, prior experience, region of residence and socio­demographic variables.

Over 43.5 million Americans provide informal care to a fast-growing elderly population in the United States. Informal care allows care-recipients to remain functional members of society. However, research suggests that the demands of informal care can negatively impact the health of caregivers. For example, caregiver burden increases the risk for poor health in caregivers compared to non-caregivers. Caregiving research is on the rise, but the dynamics of informal care in active retirement communities remains widely unexplored. To provide adequate services to lessen caregiver burden and improve the Quality of Life (QoL) of informal caregivers, the various settings in which informal care is delivered must be evaluated. Aiming to understand the needs of informal caregivers and the protective factors against caregiver burden in active retirement communities, data from the USF Health and The Villages study, conducted from October 2011 and March 2013, were analyzed. Data from twenty-nine focus groups (N=144) was used to explore the challenges faced by seniors in a caregiver role and the availability of resources that decrease caregiver burden. The primary focus was informal care and the challenges associated with the caregiver role; findings revealed a great need for caregiver relief and limited information on existing resources is available to informal caregivers. Consistent with existing literature on caregiver burden, having no personal time, financial burden, physical demands, and poor health were commonly identified as the biggest caregiving challenges. However, findings strongly suggest that the unique structure of The Villages community encourages high social support that may be the strongest protective factor against caregiver burden in the community.

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