Housing and Older People: responding to a
growing need
The Housing and Support Needs of Older Tenants
seminar Dublin 29.10.15
Professor Anthea Tinker Institute of Gerontology, Social
Science Health and Medicine, King’s College London
anthea.tinker@kcl.ac.uk
Outline of presentation
A warm welcome for the report
Housing and older people: responding to a growing need
A. Specific issues to do with sheltered housing
B. Alternatives to sheltered housing
C. Some other general issues
1.
2.
3.
The importance of outdoor space
The importance of housing, universal design and adaptations
Investing in assistive technology
D. Some conclusions
Outline of presentation
A warm welcome for the report
Especially the mixed methods of quantitative (818 participants)
and qualitative (6 focus groups)
Good to have sheltered and very sheltered (which is what some of
the report is about) as well as mainstream researched
Many of the findings echo other research
(A minor quibble – I would have preferred the questions about
home to refer to this rather than house)
Housing and older people: responding to a growing need
Including some references to the report
A. Specific issues to do with sheltered housing
- Lack of knowledge by older people, families and professionals –
clear finding in the report which echoes other research
- The popularity of sheltered housing (though much seems to be
extra care)
Points that arise from other research:
- Often needs remodelling as not suitable
- Sometimes lack of demand when care needs too great
A. Specific issues to do with sheltered housing: extra care
housing
- Generally thought the UK leads the way
Early evaluations e.g. Tinker, 1989 showed that it was popular
with management, older people and staff but that it was
generally more expensive than staying at home with an
innovatory service although generally cheaper than hospital or
residential care.
Extra care housing is especially valuable for frail older people but
some schemes are outdated.
Specific issues to do with sheltered housing: extra care
housing
Recent evaluations (e.g. Netten et al, 2012) very positive
but important to note that less than 10% of older
people live in this form of housing.
Key findings were that ‘People had generally made a
positive choice to move into extra care housing , with
high expectations often focussed on an improved social
life. After they had moved in, most people reported a
good quality of life, enjoyed a good social life and
valued the social activities and events on offer’.
Specific issues to do with sheltered housing: extra care
housing
Recent research (Best and Porteus, 2012) suggests that it
may not be economic for all schemes to have a range of
communal facilities which may have to contract and on
site staff. They also put the case for the provision of 2
bedroom flats which might encourage older people to
downsize
B. Alternatives to sheltered housing
Findings from across the world are tending to focus on
small clusters of housing with varying degrees of support.
This has a long history in Scandinavian countries. Some
have a proportion of the flats for people with high needs.
In Spain Barcelona has developed large blocks of purpose
built flats with telecare and round the clock staff
assistance
Different models such as intergenerational links
B. Alternatives to sheltered housing
In the Netherlands there is an emphasis on making
residential care homes more home like and in one
there is interaction with the neighbourhood including
older schoolchildren coming in after school to work
with staff.
In Weidervogelhof, Netherlands there are a variety of
buildings and support allowing for transitions of care so
that a greater amount of support can be offered. For
example a ‘care hotel’ has 6 rooms for rehab and
transitions
B. Alternatives to sheltered housing
There are examples from housing of the success of
home sharing which is often when an older
person provides a home at low or no cost to
another person in return for an assigned
amount of help. Co - housing which can be for
e.g. people over the age of 50 or
intergenerational is more widely provided in
Denmark, Sweden and the Netherlands has
been well evaluated.
C. General issues: 1. The importance of outdoor space (including
involving older people in decisions)
The report highlights the importance of outdoor space
Other research:
- Need for green spaces and importance of places that feel safe
- Value of ‘Lifetime neighbourhoods’ where the built
environment is well maintained, walkable and engenders a
sense of security and belonging
- The example of a current piece of research
Mobility, Mood and
Place (MMP) explores
how places can be
designed
collaboratively to
make pedestrian
mobility easy,
enjoyable and
meaningful for older
people.
Mobility, Mood and Place
is a multidisciplinary project comprising three research topics and a lively programme of
knowledge exchange and stakeholder liaison. Our three topics are:
• Work package 1: Co-created environments. Bringing together researchers, designersin-training and older participants to envision places - from homes to public spaces which are inclusive, enabling and inspirational.
• Work package 2: Environment and affect. Exploring the emotional dimensions of place
using mobile neural imaging methods to record measurable responses to different
environments.
• Work package 3: Life course of places, health and mobility. Investigating how physical,
built and social environments evolve over time and how they impact on inequalities in
health-related mobility as people move into older age.
Mobility, Mood and Place is funded by Lifelong Health and Wellbeing, a cross-council
initiative addressing the challenges and opportunities of an ageing population.
What have we done so far?
1. Co-created environments
Image © Douglas Robertson
To envision places, from
homes to public spaces,
which are inclusive,
truly enabling and
inspirational for older
people, we must include
older people in the
design process
We are bringing together
researchers, designers-intraining and older
participants, including
stroke survivors and
people with dementia, in
focus groups, interviews
and interactive co-design
workshops, to identify
proposals for better living
environments
Mobility, Mood and Place is funded by Lifelong Health and Wellbeing, a cross-council
initiative addressing the challenges and opportunities of an ageing population.
This year, year 2, we are again working in an
Mobility, Mood and Place is funded by Lifelong Health and Wellbeing, a crossurban
environment
- Hackney Wick, London
council initiative addressing the challenges
and opportunities
of an ageing population.
C. 2 General issues: The importance of housing
The context is of rising overall demand and increasing disability of
older people.
- Particularly significant is the growth of the over 85s,
lengthening period of life with disabilities and persistent
health inequalities
- Clear evidence about the desire to age in place
- Serious issues of affordability
C. 2 General issues: The importance of housing
- More new homes to ‘Lifetime’ standards
- The value of Universal Design
C. 2 General issues: The importance of housing
- Need for more diverse housing choices including mix of
housing sizes, uses and tenures
- Need to improve housing stock to meet Decent Homes
standards (value of repairs and adaptations). Of key
importance are home modifications and research shows that
these are cost effective.
- Encouragement of and measures to encourage mobility
(especially within a local area)
C. General issues: 3. Investing in assistive technology
The value of technology. Great potential (especially for health)
but beware of the hype. For example the findings of DH funded
Randomised Control Study (the Whole Systems Demonstrator)
have caused controversy.
Also ethical issues to do with surveillance
D. Some conclusions
Research shows consistently the value of housing, including
sheltered housing, but it is not acknowledged sufficiently in policy
where there is always an emphasis on health and social care
For a truly integrated service the contribution of housing needs to
be more acknowledged