The discussion of the competence-environmental press model earlier provided two options for people who experience difficulties dealing with the tasks of daily life. On the one hand, people can increase their competency in order to develop better or new skills for handling the tasks. For example, to remember better where you put your car keys, you can learn a new memory strategy. On the other hand, people can also modify the environment to make the task easier. For example, you can put a hook for the car keys next to the door you exit so that you see them on your way out.
These two options represent applications of theory to real-world settings that also apply to helping people deal with the challenges they face in handling tasks of daily living in their homes. When it comes
160 CHAPTER 5 to these kinds of issues, the most frequent solution involves modifying one’s home (i. e., changing the environment) in order to create a new optimal balance or better “fit” between competence and environmental press (Scheidt & Schwarz, 2009).
Many strategies are available for modifying one’s home to help a person accommodate to changing competencies. Minor structural changes, such as installing assistive devices like hand rails in bathrooms and door handles that are easier to grip, are common strategies. In other cases, more extensive modifications may be needed to make a home fully accessible, such as widening doorways, lowering countertops, and constructing wheelchair ramps.
Although minor alterations can often be done at low cost, more extensive modifications needed by people with more extensive limitations may be unaffordable for low-income individuals. Even though the cost of such interventions is significantly lower than placement in nursing homes or even assisted living, funding is lacking. As a result, many older adults with functional impairments experience a mismatch between their competency and their environment (Wahl, Fange, Oswald, Gitlin, & Iwarsson, in press).
Research indicates that home modifications that are done to address difficulties with accomplishing activities of daily living (ADLs) typically reduce disability-related outcomes (Wahl et al., in press). Whether these modifications also help older adults who are prone to falling remains inconclusive.