Professor Anthea Tinker , Kings College London,

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Ageing in place (for fun?)

• Professor Anthea Tinker , Kings College London,
• International Society for Gerontechnology,
• Eindhoven Master Class 10.11.09

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Outline of presentation

• The demographic background in Europe
• The evidence for ageing in place
• Some question marks about staying at home
  policies (how much fun is it for some people?)
• Some options for staying in own home
• Some options for moving to some form of supported
  housing (still in a home of ones own)
• A case study of supported housing in the UK
• Some other options (which could be more fun)

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1. The demographic background in Europe

• Growing proportions of older people
• Growing proportions of very old people
• Also
• More living alone
• The decline of co-residence
• Low levels of institutional living e.g. 2 in UK,
  8 in the Netherlands

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Percentage of total population aged 60 and over
in 2006 and projections for 2050

• 2006
  2050
• Western Europe 23
  24
• Netherlands 20
  31
• UK 21
  29
• Source UN 2006
• UN definition of an older person
• A projected increase in the of older people

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Percentage of total population aged 80 as a
of all aged 60 in 2002 and projections for 2050

• 2006
  2050
• Western Europe 20
  34
• Netherlands 19
  32
• UK 21
  30
• Source UN 2006
• UN definition of an older person
• UN definition of a very old person
• A projected increase in the of very old people

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2. The evidence for ageing in place

• Ageing in place (i.e. staying at home) has been a
  feature of policies in developed countries for
  many years
• Factors affecting decisions to move or stay
  included attachment to current home, caring
  relations, neighbours and neighbourhood, access
  to services and amenities
• This is in response to the views of older people,
  dislike of institutions and the policy belief
  that it is cheaper than alternatives

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3. Some question marks about staying at home
policies

• How much fun in these situations?
• The growing number of very old people and
  especially those with dementia
• Limitations in community services
• Problems for carers
• Problems with the housing stock

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4. Some options for staying in own home

• Staying in existing own home
• Moving to family or family moving in
• Moving to new mainstream housing
• Moving to some form of supported housing (still
  in a home of their own)

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For all staying in own home options the
potentiality for technology

• It may be fixed, portable or electronic and
  needed for
• - Contact e.g. for information, reassurance,
• social, practical
• - Help with personal, domestic, mobility
• problems
• - Medical (for diagnosis, treatment,
  rehabilitation)
• (Telecare and Telemedicine)

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Technology

• Note that it
• Has to be provided in response to the needs of
  the older person (McCreadie, C and Tinker, A,
  Ageing and Society, 2005, 25, 91 - 110)
• Needs to be provided in an acceptable format
• May not be used (see e.g. Wessels, R et al
  Technology and Disability, 2003, 15, 231-238)

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Smart homes

• Putting the technology together
• A term used to describe the electronic and
  computer controlled integration of many of the
  devices in the home

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Staying is existing own home

• The importance of suitability balanced by
  familiarity
• The need for adaptations

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Moving to family or family moving in

• This could be in existing homes (either the older
  person or that of the family)
• Granny flat options
• Could be remodelled such as dividing up an
• existing home
• Could be an extension or purpose built
• addition

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Moving to new mainstream housing

• Preferably built to lifetime standards/universal
  design
• Need for locations which give access to services
  and shops

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Some options for moving to some form of
supported housing

• In the UK sheltered housing is the same as
  supported housing in some other countries where a
  person has a self contained home with a warden,
  communal facilities and an alarm
• Lessons from the UK are that
• - there must be local demand and need
• - decisions about location are key
• - flats must not be too small
• - support to others in the community needs to
  be thought through

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The options and question marks moving to
supported housing

• Sheltered housing does not provide enough help
  for people who are in need of care. As a result
  very sheltered housing or extra care housing
  developed where, in addition to the facilities
  above there is usually a full time member of
  staff, extra communal facilities and one meal a
  day

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6. A case study of sheltered housing in the UK

• Remodelling sheltered housing and residential
  care homes to extra care housing
• Funded by the Engineering and Physical Sciences
  Research Council
• A multi-disciplinary project
• May 1 2005, for 2 years (extended to 31.7.07)
• Conclusion what sounds a good idea is not
  always so

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The research team

• Professor Anthea Tinker and Dr Fay Wright,
• - Kings College London, Institute of
  Gerontology
• Professor Julienne Hanson and Hedieh Wojgani
• - University College London
• Dr Alan Holmans, University of Cambridge
• Dr Ruth Mayagoitia-Hill and Els van Boxstael
• Kings College London, Centre of Rehabilitation
  Engineering
• (3 student projects)

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Aims and objectives

• The aim of the research was to produce advice on
  remodelling sheltered housing and residential
  care to become extra care housing
• The objectives were to consider the process of
  remodelling, including how any problems had been
  avoided, side tracked or overcome and the
  outcomes in terms of some of the benefits and
  some of the costs

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Some findings

• General satisfaction by tenants with their flats
  (especially compared with residential care)
• Schemes had, in general, become more accessible
  compared with before remodelling
• Most flats and facilities (for tenants and staff)
  were bigger and better
• The grounds/gardens were often better than before
  

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Some findings (ctd)

• Remodelling does not necessarily cost less than
  building a new scheme, nor does it always save
  time.
• Remodelling often takes a long time at the
  planning stage, especially in respect of securing
  funding and trimming the budget once a scheme has
  been agreed.
• Expect the unexpected.
• 9 out of the 10 schemes ran over budget
• Disappointing extent of provision of technology

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Some findings Existing tenants

• In 6 of the 10 schemes remodelling took place
  with tenants in situ
• Many tenants enjoyed the process and good links
  with builders
• However, health and safety concerns and building
  had to be remodelled in stages
• Did not get on well with new tenants who were
  usually much more disabled

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Some findings New tenants

• Removal of worry
• Glad not a care home
• Glad of privacy
• Enthusiastic about care staff in most schemes
• Misfits- younger tenants with a disability

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7. Some other options (which could be more fun)

• Share a home with others e.g. a group of women or
  people with similar backgrounds
• Form a housing co-operative
• Move abroad?
• Live in an hotel
• Live on a cruise ship?

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More information

• anthea.tinker_at_kcl.ac.uk
• Kings College London website under Gerontology