An Affordable Facilities Management for Elderly in Residential Buildings


Student thesis: Doctoral Thesis

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Awarding Institution
Award date17 Dec 2018


The population of elderly people is significantly increasing across different parts of the world. In fact, it is estimated that the number of elderly people will exceed the number of children within the next half decade. Due to the increasing number of cases of decline in the health of the elderly, there will be increased demand for facilities that enable them to maintain their independence as much as possible as they continue to age. Based on previous studies in the literature, there is a positive interaction between people and their living environment. Hence, a good living environment is essential for a satisfactory life and vice versa, particularly for the elderly whose health condition may be degenerating and frail. Although there have been some recent studies about the relationships between the facilities in the living environment of the elderly and their quality of life (QoL), the significant contribution of their health condition has not been investigated. Therefore, this study aims to ensure an affordable facilities management (FM) for the elderly in residential buildings through the investigation of the complicated relationships between the elderly changing health condition, FM components, affordability measures and personal QoL.

In accordance with research triangulation, both quantitative and qualitative research methods were employed in the current study, including multiple data sources and/or analytical techniques for each method. The study was initiated with an extensive literature review of relevant knowledge involving a wide range of topics, including changing conditions of elderly health, FM components, housing conditions and quality, quality of life, etc. Based on the outcome of the literature review, a conceptual HC–FM–Aff–QoL model was proposed for elderly people through various hypothesized relationships. To test the conceptual model and hypothesized relationships, multiple empirical studies were conducted, namely a survey (i.e., quantitative data) and multiple case studies (qualitative data). A purposive sampling technique was applied in this study to ensure appropriate selection of participants who fulfilled certain pre-set criteria.

A questionnaire survey was administered to elderly people aged 60 years and over through emails to various organizations, daycare centres for the elderly, neighbourhood elderly centres, enhanced home and community care services centres, integrated home care services centres, non-subvented centres for the elderly, and district elderly community centres in Hong Kong. A total of 165 valid responses were obtained, including 32.8% males and 67.2% females. Statistical techniques employed included factor analysis, reliability tests, Pearson's and partial correlation analyses, multiple standard and hierarchical regression analyses, and structural equation modelling. The statistical model was developed for results confirmed by at least two of the various statistical analysis mentioned earlier. The results of the questionnaire survey confirmed the research hypothesis, including the effect of: (1) FM components on elderly health conditions; (2) elderly changing health condition on their personal QoL; (3) FM components on the personal QoL of the elderly; (4) elderly changing health condition on affordability measures; (5) FM components on affordability measures; (6) affordability measures on personal QoL; and (7) moderating effects of FM components interacting with elderly health conditions to enhance their personal QoL.

Three case studies were conducted to cross-check and verify the final model. Elderly people of different age groups, including young-old elderly, middle-old elderly and old-old elderly were invited to conduct semi-structured face-to-face personal interview to share their deep thoughts and opinion on relevant questions. A total of 25 responses were received in the case studies including 6 in young-old elderly cases, 12 in middle-old elderly cases and 7 in old-old elderly cases. The subjective causal relationships among the elderly changing health condition, FM component needs, affordability and personal QoL domains of the elderly were analysed in detail.

Based on the congruence of the results of the quantitative and qualitative research methods, the final HC–FM–Aff–QoL model for the elderly was developed. The final model confirmed the following: (1) overall QoL is influenced by good interpersonal interactions within the living environment; (2) physical health of the elderly is affected by their skin condition and ear condition; (3) psychological health of the elderly is significantly increased by positive interpersonal interaction; (4) social relationships are influenced by friendship support received by the elderly; (5) the presence of turning spaces and clear spaces within the residential apartment of the elderly impact on their independence; (6) lighting is very instrumental to the physical health of the elderly; (7) ventilation is significantly important for satisfying elderly overall QoL; (8) furniture significantly influences physical health and independence of the elderly; (9) non-slip flooring in the elderly residential apartment is very essential for their overall QoL; and (10) non-slip flooring is affected by the total amount for a satisfactory unit. The results of the quantitative evaluation for the affordable FM model indicates that (1) affordability for overall QoL is influenced by housing type, housing tenure, household expenditure and doors; and (2) affordability for independence household expenditure.

In accordance with the research results, practical recommendations were made to better meet the FM needs of the elderly and enhance their QoL, including conducting a micro-climate study of the living environment at the design stage to maximize natural lighting and ventilation, attending to the brightness and hue of artificial lighting, adjust both seating height of furniture and total height of wardrobe and kitchen cabinets, ceramic tiles in wetness-prone areas and PVC tiles with non-slip granules in other areas, installing digital thermostats for heating and cooling systems and review guidelines for increasing the width of doors to ensure easy access. The study also addressed potential bias in the final results by adopting remedial action such as sufficient sample size for sophisticated statistical analysis and generalizability, etc. In addition, future research directions were suggested.