An architectural view of aged care

Apartments in shades of grey are linked by a graded pathway to provide accessibility.The Longevity Revolution along with the recent pandemic is asking questions about aged care and retirement living. Can we keep doing the same? The short answer is no, but what to do instead?

A report from an architectural group reviews the literature and makes some strategic suggestions for the future. The research looked at how the market can re-align itself to the aspirations of upcoming ageing generations. As we know from previous research, it isn’t looking like retirement villages, and there’s a preference for aged care at home. 

The costs of aged care are discussed at length. Consequently, affordable strategies are needed for both older people and for government.  

Using models from overseas they suggest serviced apartments, communal flats and co-housing. Multi-generational living is presented as a new idea. It is premised on the notion that people will be happy to move when their current home no longer suits. We already have multi-generational living in our existing neighbourhoods. The homes just aren’t accessible for everyone at every age. Nevertheless, the researchers eschew the notion of mandatory universal design standards in dwellings. 

The report returns to the notion of specialised housing products for older people and talks of being able to convert “normal dwellings” to enable home care. The multi-generational neighbourhood model is presented as a combination of different housing options where young and old exchange services.

The title of the report is Aged Care in Australia and argues for the market to create new and sustainable ideas. It was prepared by Architectural Research Consultancy for Carabott Holt Architects.

Editor’s note: Researchers claim the Productivity Commission supports voluntary uptake of universal design standards, not regulation (see p.4). Nevertheless, the Productivity Commission recognises, “The Australian Government should develop building design standards for residential housing that meet the access and mobility needs of older people.” (See the Summary of Proposals.) The PC report goes back to 2011 when Livable Housing Australia was set up to lead a voluntary roll out of UD features in housing. As we know, this has not worked.

The image is courtesy Guy Luscombe’s NANA project report.

Future proofing existing social housing: A case study

A group of red brick three storey apartments shaded by trees. What about a post-pandemic social housing stimulus project? Not a new idea, but such ideas usually relate to new housing. So what about modifying existing social housing? This is so that people can stay in their community for longer as they age. Lisa King argues the case in a research paper with a focus on older women. 

King’s paper begins with a literature review of the issues related to older women and housing. The case study takes the floor plans of existing dwellings and makes changes to show how to make them more accessible. The case study includes studio units and two bedroom units. There is also a site plan, a demolition plan and costings too. 

King summarises the research by giving a rationale for choosing 1960s dwellings, and says the project is scaleable, modular and cost effective.  In addition, this type of work provides employment for small and medium businesses. And of course, it optimises existing stock while improving the lives of residents. King sums up with, “The result would be universally accessible housing and an asset which would assist meet the growing demand for residents to age-in-place with dignity.”

A thoughtful and nicely written paper and well referenced. Although the focus is on older women, the concepts apply across all social housing. The title of the paper is, Future-proofing Existing Social Housing: A case study helping meet older women’s housing needs.  

For a short read King’s paper was featured in a Domain article, Trapped inside: Why social housing apartments need an urgent revamp.  

Housing, Health and Accessibility

Multi coloured graphic depicting the key elements in the guidelines "How housing can improve health and well-being".There are five key areas for healthy housing and accessibility is one of them. The WHO guidelines on housing and health and accessibility takes into consideration ageing populations and people with functional impairments. It recommends an “adequate proportion of housing stock should be accessible.

In the remarks section it argues that living in an accessible home improves both independence and health outcomes. Although the guidelines argue for only a proportion of housing stock, it has put the issue on the agenda. It shows it is as important as all other factors. However, the notion of proportion can lead some agencies to think that means specialised and segregated housing. 

The other key areas are crowding, indoor cold, indoor heat, and home safety. For more detail there is an additional document showing method and results of the systematic review that underpinned this section of the Guidelines – Web Annex F. and includes interventions such as home modifications and assistive technology. 

The Healthy Home

View of the website landing page for Healthy Home Guide.Joining the dots between all aspects of physical and social sustainability is important for a healthy life and a healthy planet. Central to this is the design of our homes. The Healthy Housing Design Guide from New Zealand says they need to be durable, efficient in size and cost, and friendly to the occupants and the environment.

The three bar menu icon on the landing page of this online resource takes you to the content of the Guide. Universal Design leads in the table of contents. This is pleasing as most other guides leave it to a last thought at the end. The design detail features wheelchair users for circulation spaces, which, of course are good for everyone. Among the interesting images is a lower storage draw doubling as a step for child to reach the kitchen bench. The case studies focus on energy efficiency and sustainability.

This is a comprehensive document beginning with universal design, site and location, through to air quality and acoustics and ending with certifications. The Guide characterises a healthy home by the acronym HEROES:

      • Healthy: 
      • Efficient: 
      • Resilient: 
      • On purpose:  
      • Environmental: 
      • Sustainable:

The style of the website is pleasing but the landing page gives little idea to navigation. It says “Welcome” and then asks visitors to stay super involved. There is a bar with an arrow to go to the Foreword. The navigation is via the three bar menu icon at the top left of the page. 

The video from the launch of the guide takes you through the content. Universal Design gets a mention at the 25 minute mark. It is introduced by Henry McTavish.

Tomorrow’s Homes: A sustainability perspective

Tomorrows Homes front coverUniversal design in housing faces the same policy and industry challenges as the sustainability movement. Consumers are unclear about their choice, and confused by terminology and rating systems. Home builders are locked into supply chains that limit innovation, and financial institutions can’t see the value of such designs. 

The Australian Sustainable Built Environment Council (ASBEC) has devised a policy framework for transitioning to sustainable homes. It identifies five key actions:

    1. National leadership
    2. Benchmarking and upskilling
    3. Building a foundation of leading homes
    4. Engaging consumers
    5. Leveraging finance

Tomorrow’s homes: A policy framework outlines how the structure of the housing industry creates restrictions on doing anything differently. It also has suggestions for appealing to consumers by using language they relate to. Comfortable, healthy, affordable, easy to use – in short, appealing to their aspirations. Consumers don’t frame their aspirations in words such as sustainable, accessible, or universal design. And they don’t aspire to ageing or disability.

Inclusion and efficiency in home renovations

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The concept of comfort can be used to join the dots between inclusive design and energy efficiency. This is the suggestion from Hasselt University in Belgium. The authors conclude in Merging Inclusive Design and Energy Efficiency as a disruptive approach to housing renovation that:

“When the concept of comfort is expanded to include the a full range of spatial, usability, and cognitive aspects, the merging of ID and EE can offer inhabitants a more complete sense of comfort, and by doing so increasing adoption of both types of measures, in line with wider governmental and societal goals.”

Abstract. There is a pressing need for housing renovations that both accommodate lifelong living and significantly increase energy efficiency. Much research has been done on both Inclusive design (ID), particularly in the context of accessibility, and energy efficiency (EE). However, they are treated independently and faced with limited adoption. A simultaneous renovation for ID and EE might lead to renovation concepts that better fulfil the residents’ desire for comfort in addition to savings in money and time. Comfort is an important driver for both types of renovations. As a result when the concept of comfort is expanded to include also spatial/usability, social, cognitive and cultural aspects, the merging of ID and EE can offer residents a more complete sense of comfort, thereby increasing the adoption of both ID and EE.

 

Housing multigenerational households in Australia

House half built showing timber frameworkThe top five reasons for multigenerational living are financial, care arrangements and support, adult children yet to leave, starting or continuing education, and older (grand)parents moving in. The reasons behind the trend towards multigenerational living are not quite as simple as the list implies.

Cultural factors are also part of the story. Home ownership of a detached dwelling is critical to successful multigenerational living. There is usually greater flexibility to modify and adapt the home as needs change, which is not possible in apartments or rental properties.

These are the findings in a book chapter by Edgar Lui, Hazel Easthope, Bruce Judd and Ian Burnley. They end the chapter by discussing policy implications and include the need to adopt universal design principles in all new properties and major refurbishments. They add that although these principles have been around for more than 50 years they are yet to materialise in home designs as voluntary codes  which are unlikely to be agents of change.

The title of the chapter is “Housing Multigenerational Households in Australian Cities: Evidence from Sydney and Brisbane at the Turn of the 21st Century.” 

The title of the book is, Housing in 21st-Century Australia: People, Practices and Policies.

Introduction

“Over the last two decades new and significant demographic, economic, social and environmental changes and challenges have shaped the production and consumption of housing in Australia and the policy settings that attempt to guide these processes. These changes and challenges, as outlined in this book, are many and varied.

While these issues are new they raise timeless questions around affordability, access, density, quantity, type and location of housing needed in Australian towns and cities. The studies presented in this text also provide a unique insight into a range of housing production, consumption and policy issues that, while based in Australia, have implications that go beyond this national context.

For instance how do suburban-based societies adjust to the realities of aging populations, anthropogenic climate change and the significant implications such change has for housing? How has policy been translated and assembled in specific national contexts?

Similarly, what are the significantly different policy settings the production and consumption of housing in a post-Global Financial Crisis period require? Framed in this way this book accounts for and responds to some of the key housing issues of the 21st century.”

Tick of approval for Visitable Housing

A woman is pushing a stroller in the front door and you can also see a nice wide hallway.The terms “visitable housing” and “visitability” are essentially about people who use mobility aids having the same rights to visit friends and family in their homes. It doesn’t necessarily mean they can live there or stay overnight. The three key features associated with visitability are a step free entrance, wider doorways and a usable toilet on the entry level. Part M of the UK building code reflect these features. 

Visitability differs from full accessibility and universal design. It was devised as a minimal baseline to entice the property industry to get on board with the ideas. Although the concept has been around for twenty years, it has gained little, if any, traction. Visitability is not a concept easy to sell unless the buyer thinks they need it. And few do. 

Perceived value of visitable housing

A research project carried out in Ohio in 2015 looked at: home-buyers’ perceived value and perceptions of visitable features; developer, designer and builder perspectives; real estate agent views; estimated costs; and which house buyers were most likely to buy. The aim of the report was to create a persuasive argument for adopting visitability in new homes in Ohio. However, the researchers acknowledge industry resistance and suggest incentives to encourage uptake, or mandating the features.

The report is structured into three sections based on their surveys of homeowners and home buyers, industry stakeholders, and real estate agents. All groups were asked to assess photos of visitable features in homes. In all instances, participants believed the homes would sell for more and sell more quickly. Industry stakeholders estimated the features would cost less than one per cent of construction costs. This is in line with other research.

The title of the report is, Perceived value of visitable housing in Ohio. It is also available through Academia.edu

Elements of the research are available in their paper, Homeowner and homebuyer impressions of visitable features.  

In Australia minimal access features are now in the National Construction Code in the form of the Livable Housing Design Standard. States and territories are adopting the Standard into their respective building codes at different dates in 2024 and 2025. Queensland adopted the Standard in 2023.

Livable Housing Design: Not our problem

Easy access inside and out of this home.Why do we keep building homes as if we are never going to grow old? The answer is complex. But the perceptions of developers, designers and builders gives us some insights. A Brisbane study collected data from site-visits, building documents and interviews with industry stakeholders. Four key themes emerged showing why nothing has changed: voluntary approach, otherness, immediacy, and inertia.

The strongest theme was the voluntary approach. Being a first mover is considered too risky by industry stakeholders. Consequently, there is no motivation to change practices. There is a view that people needing inclusive housing are not part of the mainstream market – they are “others”. Therefore, the answer to the problem is group homes and retirement villages. Inclusive design is assumed to be ugly and undesirable. Therefore, marketing these features will not work.

For now or for later?

For industry, the focus is the new home buyer not the long term use of the dwelling. So builders assumed that a young family wouldn’t want it. Consequently, there isn’t a market for it. Inertia, was expressed as the reluctance to “change the way we do things around here”. The culture of building by rote dominates the house building system.

There is more in this study about interventions that might assist, one being regulation. Keeping a competitive level playing field is paramount in the industry. The key point is that inclusive housing is considered someone else’s responsibility and is not a mainstream concern. Consequently the Livable Housing Design Guidelines are insufficient in themselves to bring about change. 

The title of the open access article is, Livable Housing Design: The voluntary provision of inclusive housing in Australia. Although published in 2014 the document remains current. Although there is to be a change to the building code in 2022 to mandate accessible features, not all states agree.  

The picture is from the gallery of Lifetime Homes in Tasmania.  

Accessible Housing: what’s it worth?

Three stacks of coins sit alongside a wooden cut-out of a house shape.Home builders argue that people won’t pay extra for universal design features. The assumption of extra cost aside, they are also assuming that people wouldn’t pay more. But would they? A study from Europe asked just that question and the answers are surprising. Renting is the norm in many European countries and so it is difficult to compare with owning. However, finding out how much extra rent people are prepared to pay gives us some indication.

A survey of renters in Germany and Slovakia found that 40 per cent would pay an extra 10% more, and 40 per cent would pay up to 20% more for a more accessible dwelling. Only 12% said they would not pay more. And the age of the respondents wasn’t a factor in the findings. The survey covered many other aspects of home living, and the findings are detailed in the article. There’s lots to take away from this study – the willingness to pay more for an adaptable or accessible dwelling is just one factor.

You can access the article via ScienceDirect or via ResearchGate, or directly download the PDF.   

Editor’s Note: Another way to measure the worth of universal design in housing is to ask, “How much would you pay to stay home and not go to aged care – what would that be worth?”

Abstract: The role of this study was to determine which changes people think they need to make in their home in response to getting older. At an advanced age, the likelihood of different limitations, such as vision impairment, hearing impairment, or physical inability, are increased. At present, when faced with such limitations, tenants are often forced to leave their long-term living spaces, as these spaces cannot serve their “new” individual needs. This transition from the privacy of their home to a new environment is often a painful change. They must leave a well-known environment, as their homes cannot be adapted to their new needs. The aim of this paper is to develop a comprehensive approach for the design of an exterior and interior space which can serve people through all stages of life, particularly in terms of mobility. This means that, even if an unexpected situation incurs changes in an individual’s movement abilities or physiological limitations not only by natural aging, but also according to accidents or disabilities their living space can be adapted to the given conditions. The results of a survey conducted in Germany and Slovakia are presented. In the survey, respondents expressed their opinion on what they considered important in creating an adaptive environment, considering various life changes. Based on the results of the survey, studies of possible modifications of flats and houses are developed. These results are analyzed in terms of three age groups: people aged below 35, those aged 35–50, and those aged over 50. People under 35 are considered to be quite young, with different views on life and on the environment. Their priorities typically differ from those of people around 50. People aged 50 more; have been under medical treatment for a consistent amount of time. This group of people is still active; however, they experience different design requirements for their potential home.

 

Views of home design by age

A young woman is standing looking out of the window. The room is busy with lots of things on shelves and table tops.The conclusion that younger people look for different design elements in a home than older people is somewhat obvious. However, it is good to have a study that shows this. Surveying people in three age groups, researchers found some key elements that should help designers design across the lifespan.

Younger people have a different design focus because they rarely consider the impact of unexpected events, even ageing, on the functionality of the home. After all, accidents happen to other people, don’t they? And no-one aspires to growing old or developing an impairment or chronic and disabling condition. 

The title of the publication is, “Requirements and opinions of three groups of people (aged under 35, between 35 and 50, and over 50 years) to create a living space suitable for different life situations.” The abstract below gives a good overview of the topic. 

Institutional access is via Science Direct, or a free read via ResearchGate.

Abstract:

The role of this study was to determine which changes people think they need to make in their home in response to getting older. At an advanced age, the likelihood of different limitations, such as vision impairment, hearing impairment, or physical inability, are increased. At present, when faced with such limitations, tenants are often forced to leave their long-term living spaces, as these spaces cannot serve their “new” individual needs.

This transition from the privacy of their home to a new environment is often a painful change. They must leave a well-known environment, as their homes cannot be adapted to their new needs. The aim of this paper is to develop a comprehensive approach for the design of an exterior and interior space which can serve people through all stages of life, particularly in terms of mobility. This means that, even if an unexpected situation incurs changes in an individual’s movement abilities or physiological limitations not only by natural aging, but also according to accidents or disabilities their living space can be adapted to the given conditions.

The results of a survey conducted in Germany and Slovakia are presented. In the survey, respondents expressed their opinion on what they considered important in creating an adaptive environment, considering various life changes. The results of the survey are statistically processed and analyzed by the ANOVA method, a form of statistical hypothesis testing. The results are processed graphically and presented in tables, along with explanations.

The results could be of an interest to the architects and designers of such environments. Based on the results of the survey, studies of possible modifications of flats and houses are developed. These results are analyzed in terms of three age groups: people aged below 35, those aged 35–50, and those aged over 50. People under 35 are considered to be quite young, with different views on life and on the environment. Their priorities typically differ from those of people around 50. People aged 50 more; have been under medical treatment for a consistent amount of time. This group of people is still active; however, they experience different design requirements for their potential home.

Happy homes, friendly neighbourhoods

An older woman walks on a bitumen path in a park. Two older men are sitting on a seat along the pathway.The notion of age-friendly cities is not new, and neither is age-friendly housing design. However, researchers tend to look at one or the other but not both. A study by a group at University of South Australia has sought to join the dots showing the dependency of one upon the other. Creating age-friendly environments begins at home, across the threshold to the street and on to the broader environment. Like any chain, it is as strong as it’s weakest link. While some local authorities are doing their best to be age-friendly in their area, they are not able to influence the design of mass market homes. That is the role of state governments and their control of the National Construction Code.

The report of the study titled, Towards Age-Friendly Built Environment, supports previous research and recommendations. Given that not much is changing, this is another worthy paper. The key point is linking life at home with life in the community and showing how it supports the health and wellbeing of older Australians. This in turn takes the pressure from government funded home modifications and support services – not to mention tax payers.

Abstract: The population of aged people is increasing dramatically throughout the world and this demographic variation is generating different challenges for societies, families and individuals in many different ways. One of the effective approaches for responding towards demographic ageing is to have more evidences on creating age-friendly communities. Despite of having number of researches on ageing, there is limited knowledge on identifying components for developing age-friendly communities and cities. This research therefore, aims at discovering the benefits of properly designed age-friendly communities and interrelationships of key related concepts. To accomplish this aim, relevant research papers have been reviewed and subjected to thematic analysis.This study emphasizes on improving the overall wellbeing of elderly not only by finding out the improvement strategies on the health care facilities but also by finding strong evidences on benefits of designing their housing and immediate outdoor environment. Therefore, this study recommends future research directions on developing built environments responsive to the aspirations and requirements of aged population which can not only assist the adoption and maintenance of an active lifestyle, but it can also be beneficial to the physical and psychological overall well-being of aged population. More studies on planning urban environmental settings targeting aged population can be beneficial to not only aged people but for people from every age group. Thus, these settings will be advantageous for anyone with varying requirements with changing generational needs and lifestyles from a child to a couple to aged people.

Home for Good

A vase of purple and white flowers sits on a small table with a cup of tea, an open book and a pair of glasses.What is a home? It’s so much more than a shelter from the elements. The concept of home gives us a place in the world. It underpins our identity, our relationships and our understanding of who we are and where we fit in the scheme of things. It is intrinsic to the human condition. Yet it is overlooked in the development of policies to support housing provision.

Home for Good is a policy brief “intended to restore the idea of home as both a psychological and social asset to our discourse on housing, rather than just a financial asset. It is specifically concerned with the role of the home as we age, positing that successful ageing is dependent on a person’s access to a home that provides security, community, safety and autonomy”. The policy brief poses a policy framework for a national approach to providing older Australians with homes that meet their social, emotional, environmental, and psychological needs.

The policy brief says nothing about the design of homes, but it does tap into the real meaning of home for many older people – the social equity. Hence the reticence to move to age segregated living. The article can be downloaded from the Analysis & Policy Observatory. It’s by Emma Dawson and Myfan Jordan of Per Capita. Easy to read.

Also see 2013 qualitative Australian research about housing design and older people, Chasing ‘The Great Australian Dream’: Definition of and “Ideal Home’ among Baby Boomers. It’s interesting to not that in less than ten years our terminology has changed from “the elderly” and “the aged” to “older Australians”.

Extract from Abstract: “The study reveals that ‘ageing in place’, is a preferred option for the aged. This raises questions as to how well the housing system and neighbourhood environments are able to support ageing in place, and what aging factors should be taken into consideration when designing Baby boomer’s home to facilitate health and wellbeing. Therefore, this research designed a qualitative approach to investigate Australian Baby Boomers homes around Queensland, predominantly in the Brisbane area, using semi-structured interviews and observations.”

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