To die for The effect of housing on the health and well being of the elderly

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To die for?The effect of housing on the health
and well being of the elderly
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To die for?The effect of housing on the health
and well being of the elderly

• Julie Barratt
• Director, Chartered Institute of
  Environmental Health Wales
• Cyfarwyddwraig yng Nghymru, Sefydliad
  Siartredig Iechyd yr Amgylchedd

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What kills the elderly?

• Cold in their homes
• Accidents and Injuries sustained in their homes
• Deterioration of mental health due to being
  confined in their homes

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Cold and its effect on the elderly

• EHCS 1993 10 of people over 65 living in the
  worst housing category -700,000 households
• Winter fuel payments - 1.6 billion
• Excess winter deaths due to cold 30,000
• Increase in mortality gt in houses with lowest
  indoor air temperature due to poor thermal
  efficiency

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Issues for the elderly homeowner

• Under occupation typically one person one
  income households
• Selective heating typically 2 rooms
• Lack of mobility
• Lack of property repair, typically those items
  that reduce energy use insulation, draught
  proofing, servicing and replacing inefficient
  boilers

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Accidents and Injuries

• 1500 over 65s die as a direct result of accidents
  at home each year
• 2.7 million accidents at home each year in UK
  necessitating hospital visit (gt1m falls)
• Over 65s account for over half the serious cases

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• Over half of hip fracture patients lose ability
  to live independently.
• 1 in 5 dies within 6 months of their accident
  33 within 12 months.
• Hip fractures cost the NHS 1.8 billion per year,
  account for 20 of orthopaedic beds, and cost
  30,000 per patient including post operative
  care.
• Most elderly patients who return home go back to
  an unchanged property.

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Deterioration of mental health

• Fear of crime hard to measure, cannot measure
  quality of life or reduction in quality of life
• Dwelling house burglary is the crime most feared
  by the elderly living alone
• Actual number of DHB has fallen, but fear of DHB
  has not
• Possibility of physical injury, damage to
  property and loss of personal property
• Reduced feeling of safety, curtailment of freedom
  to travel and socialise

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• Costs police, court service, legal aid,
  probation and prison service
• Costs to NHS of treatment of physical injuries
• Emotional costs Victim Support, NHS Mental
  Health Services
• Cost of provision of supported sheltered
  accommodation
• Cost to individual of loss of independence and
  self determination

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Options

• Choices for the elderly
• Live at home - all of the risks and costs
  discussed
• Live in sheltered residential/nursing
  accommodation evidence shows that those living
  in residential accommodation tend to die 3 years
  sooner than those living independently

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What the elderly want

• To live at home
• To be warm, safe and secure in their home
• To feel safe in their home and in the community
• To have some purpose to their lives

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Delivering what the elderly want

• Initiatives
• CO2i improving thermal efficiency of homes
• Safe as Houses Crime proofing homes
• Home Safety accident proofs homes
• Luncheon Clubs promotes mental health well
  being