Ageing communities: Policy blind spots

Policy makers have been talking about population ageing, ageing-in-place and age-friendly communities for several years. But has there been any progress? The focus is still on residential care homes and this is the policy blind spot. Most older Australians are living in their own homes. So how do policies support them? And what about renters?

Three housing researchers analysed 85 policy documents against the World Health Organization’s (WHO) guidelines on age-friendly cities. They found these policies reflected outdated views of older age. That’s because the policy focus in on care and support services. This means less attention to housing, transport, walkability and cultural diversity.

Most older Australians aren’t in aged care – they are living in the community.

Policy blind spots mean they live in communities that aren’t age-friendly.

Being age-friendly for older people means age-friendly for all ages.

A child is kneeling down by the side of a lily pond. Her mother on one side and her grandmother on the other, also kneeling down. Grandfather is standing behind watching them.

The research also reveals a failure to recognise the diversity and impact of the ageing process. In particular, is the lack of recognition of diverse cultural needs.

“There is almost a complete blindness to their impacts on ageing and other social determinants of health.” Regardless most older Australians want to live where they are.

Two women sit on a bird nest swing.

For more on this topic see Most older Australians aren’t in aged care. Policy blind spots mean they live in communities that aren’t age-friendly in The Conversation.

Stay put or go? Renters lack choice

In another study, researchers asked what motivates older homeowners and renters to age where they are or to relocate. It seems older renters are not given a fair choice. For homeowners, family ties matter.

Owners with children living nearby were more likely to want to stay. They might then have a reason to call on their housing wealth and become the “bank of mum and dad”. Renters, however, want the same choice but face the most disruption. Many had to move out of their neighbourhood to find a place to rent.

This is another area where policy change is needed and for many, social housing is the answer. However, social housing is in short supply.

A family room with a couch, cushions and a throw.

For more see Should I stay or should I go? Most older Australians want to retire where they are, but renters don’t always get a choice, in The Conversation.

There’s a glimmer of hope on the horizon with the new Livable Housing Design Standard. This mandated Standard in the National Construction Code provides for accessible features such as a level entry into the home. It will support many more people to age in place and reduce the need for costly home modifications.

While it will take many years for new accessible homes to make an impact, it does mean that rental housing will be included in mainstream housing stock. However, states and territories are showing reluctance to adopt this essential Standard in the face of industry lobbying. But none of us is getting any younger.

See CUDA’s short online course which provides all the technical detail for implementing the Livable Housing Design Standard.

Universally designed dream home

This is not your average home. This one goes beyond even enhanced features in the Livable Housing Design Standard. However, it shows what is possible with creative design thinking. The good news is that the key features will be embedded in all new homes under the new Livable Housing Design Standard.

Contrary to the many myths, introducing universal design features into a home doesn’t compromise aesthetics.

Exterior view of the top part of a two storey home showing a window in the gables of the house. Universally designed dream home.

The video below is from O’Shea and Sons Builders that showcases a high-end of the market home. The additional costs are in the automation, the elevator and some of the fixtures and fittings. However, the key features are possible in mainstream homes at little, if any, additional cost.

As Nick O’Shea says, “… an absolutely amazing home where functionality and style means absolute beauty”. A really great example of universal design in action dispelling the myth that accessibility and functionality are ugly.

Filming by Unveil Media

O’Shea Builders have built other accessible homes so this is not the first. The Independent Builders Network in Queensland has other members doing good work as well. Queensland is also the first state to implement the new Livable Housing Design Standard.

Online learning – Livable Housing Design

CUDA has the licence from the Australian Building Codes Board to run their course on the Livable Housing Design Standard. The course is based on the Handbook and the Standard. This is a technical course for home-building professionals. Find out more about this course.

It covers the various ways to create level entries, doors, circulation spaces, showers and toilets.

Front cover of the Livable Housing Design Standard showing a single storey home with garage.

Housing Adaptations Design Toolkit

The Housing Adaptations Design Toolkit comes from Northern Ireland and is focused on government departments collaborating for good social housing outcomes. The aim is to integrate services to promote independent living. As such it has application to government funded home modification services in Australia an elsewhere.

Housing adaptations are a key element in supporting independent living. The other three are assistive technology, social care, and health and wellbeing.

The diagram shows the links between the four elements required for independent living.

Diagram showing the integration of services: health and wellbeing, housing adaptations, assistive technology and social care leading to independent living.

The Department of Communities and the Department of Health collaborated in the development of the toolkit.

The toolkit covers housing adaptions that range from those not needing a referral to occupational therapy services to more complex projects. It has design formats that help service users to visualise the proposed adaptations. Electronic formats facilitate inter-agency communications for the recommended adaptations and specifications.

The toolkit has seven sections. They include design principles for different rooms, space standards for different users, and helpful specification templates. There are three categories of users: ambulant, independent wheelchair user, and dependent wheelchair user.

The development of the toolkit included collaboration with people with disability. It supports a standardised approach to design principles and space standards. The image shows the front cover of the toolkit.

Front cover of the Housing Adaptations Design Toolkit.

The Housing Adaptations Design Toolkit is a guide for government funded adaptations. As such, the toolkit processes could help inform home modifications under Australia’s National Disability Insurance Scheme. This is a very comprehensive approach to bureaucratic processes and technical detail.

Economic value of wheelchair user homes

The UK organisation for accessible housing, Habinteg, has released new research on the social and economic value of wheelchair users homes. The research was carried out by the London School of Economics. They did a cost-benefit analysis of wheelchair user housing and a qualitative analysis of how their home impacts wheelchair users in everyday life. Together they showed benefits, particularly to government, outweighed the costs.

“… it’s not just the quality
of accommodation and its suitableness for living, but it’s affecting everything else to do with my life.”

“I was living a life that I chose to live, not one that was chosen for me.”

An older man and woman have their head togther and they are smiling happily at the camera. They are on the front cover of the Habinteg report: Living not existing, the economic and social value of wheelchair user homes.

The UK already has a mandated standard of basic access features in new housing called Visitable dwellings. This covers door widths and corridors. However, it fails to guarantee true visitability to everyone and is not adaptable for households over time. There are two other standards which are not mandatory: accessible and adaptable dwellings, and wheelchair user dwellings.

The cost-benefit analysis used three models based on three groups of wheelchair user households.:

  • Households with children who use wheelchairs
  • Working aged, wheelchair user households
  • People in later life who use wheelchairs (aged 65+)

They found that a working age wheelchair user, the benefit was £94,000 over a ten year period. A later years household was £101,000 over a ten year period, and for a child, the benefit was £67,000 over ten years. The financial value was divided between health, local government and the national government.

Benefits of wheelchair housing

The interviews with wheelchair users revealed the personal benefits of improved quality of life. Of being able to work, to come and go independently, and have peace of mind. Being able to work provides additional disposable income and tax revenue for the government. It also means less welfare payments and hours of home care services.

The title of the report is, Living not existing: The economic and social value of wheelchair user homes. The quotes from wheelchair users really tell the story of the difference between existence and living. The analysis shows that when it comes to cost, the real question is, how much and who pays?

Modern homes for Queensland

The Queensland Government is leading the way with their new Modern Homes Standard. Queensland will begin rolling out mainstream universally designed eco-friendly homes based on the new standards in the National Construction Code (NCC) from October 2023. While the energy efficiency requirements might cost more, the universal design features will cost little, if any, more.

The universal design features are a level entry, wider doors and corridors, a toilet on the entry level with extra circulation space, and a step-free shower. The Livable Housing Handbook has more detail.

new home construction site with timber on the ground.

The benefits to consumers are obvious, but the benefits to government perhaps less so. Consumers will eventually have homes that are suited across the lifespan that cater for most life events. Governments stand to save on unnecessary extended hospital stays, and early entry to aged care. They will also save money on government funded home modifications.

However, this has not stopped the housing industry from heavily lobbying against the universal design changes at state level. They claim that the industry has too many problems, it’s technically difficult and it would cost homeowners $40,000.00 more. Are these claims true or are they myths and misunderstandings?

Dispelling the myths

Here are some of the common claims by industry where the cost claims are confused with specialist disability housing or the old adaptable housing standard. So these claims are easily dismissed.

You can download a PDF of this list. 



You can’t do level entry to the home on steep sites or on small lots.

Steep sites are exempted from dwelling access requirements. Or you can make the entry via the garage.

You can’t do Livable Housing features in a studio apartment.

It’s often easier in studio because they only have 2 doors and no corridors.

These bigger bathrooms really add to the cost.

No big bathroom required because it can be achieved in less than 4sqm. See Livable Housing Handbook.

You can’t do it on narrow lots.

Narrow properties use space smartly with minimal corridors relying on shared circulation and open plan spaces.

Grab rails make the place look ugly.

Grab rails are not required. They can be added later if ever they are needed.

People just want a regular-looking home.

The design tweaks are not noticeable other than a level entry.

People don’t want a disability bathroom.

They won’t get one. The Standard asks for a small extra space in front of the toilet pan.

Some people want a traditional closet WC.

They can have one. Only one toilet pan on the ground or entry level needs to have some extra space in front of it.

People don’t want a front yard full of ramps.

They won’t have one. Access is from the street, parking space or garage.

The extra accessible parking places will add enormous cost to apartments.

There are no changes to parking requirements. Only the internal fit-out applies to apartments.

Door manufacturers will have to re-tool to make new products.

The door sizes are standard already.

Only a few people need these changes.

These provisions are for improving amenity and liveability for everyone. It’s about future-proofing a consumer’s biggest asset.

It’s going to be expensive.

The main cost will be some timber noggins for wall reinforcement in the bathroom.

There’s a cost of living crisis.

That’s why it’s even more important to build homes that protect families from future-shock – the cost of adaptation if life circumstances change. It makes them more sustainable.

I’ve built this kind of home before and I know it costs a lot more.

This is not Specialist Disability Accommodation or housing to the Adaptable Housing Standard. These do cost more. The Livable Housing Standard normalises these common design features. That’s why they are called universal design features. And there is little, if any, extra cost.

It’s bound to cost more because this is all new and we have to learn how to do it.

These features have been applied in seniors living since 2004 and specialist disability homes. Community housing associations apply these features. There is nothing new or onerous.

It’s not a good time for the industry to do this.

It is never a good time for industry. Meanwhile it is a very good time for people wanting to move into a home with no steps.

Why we need it

Building homes based on last century ideas of housing the population has to change and it has to be more than fashion changes. We are living much longer and want to stay put as we age. The pandemic has made people even less eager to go to aged care. People who use mobility devices want to visit family and friends in their own homes. In summary we want homes that are fit for purpose for all family members regardless of what life has in store.

The Livable Housing Design Standard is a tweak to existing designs, but it is these little details that make the difference to longer term liveability for all family members.

The size of Australian homes will easily accommodate all the new provisions in the Livable Housing Design Standard. We wait for Victoria, ACT, NT, South Australia and Tasmania to keep to their promises to follow Queensland’s lead. However, NSW still agrees with industry lobbyists and is saying “no”. ABC News has an article on Queensland’s commitment to housing fit for purpose in the 21st Century.

Bathroom aesthetics and accessibility

A touch of universal design thinking has entered the design of bathroom design and fittings. Research from many quarters has established that people want to stay home in their later years. Consequently designers need to get on board with designs that are functional and look good too. A whitepaper from Nero Tapware updates designers on bathroom aesthetics and accessibility.

“Accessible living spaces are becoming increasingly important as the majority of Australians, both with and without disabilities, have a desire to stay in their current homes rather than enter residential aged care.”

Photo of a wall hung toilet and gold coloured shower and grab rail fittings. Bathroom aesthetics.

The Nero whitepaper discusses the many aspects of design in the context of the new Livable Housing Design Standard in the National Construction Code. However, their bathroom layout and overall style is similar to the public bathroom design. A universal design approach would use the space creatively and leave out grab rails until, or unless they were needed. That’s because grab rails placement needs to fit the individual user’s requirements.

“By modifications to our built environment, architects and designers can promote usability, participation in activities, and enable older users to live comfortably and independently.”

Shower recess from the Mecca Care range with gold coloured fittings.

It is good to see product designers preparing to align with the new Livable Housing Design Standard. However, the photographs in the whitepaper do not align with the universal design concept of the Standard. That is, each picture shows grab rails which are not part of the Standard. However, reinforcement in the walls is required so that grab rails can be added later at any placement the user needs.

Aesthetics impact wellbeing

The whitepaper nicely spells out all the issues including the importance of wellbeing. It notes that a liveable home must be multifunctional and it must feel like home. Lack of colour matching and styling options can end up looking clinical. The whitepaper argues that end users feel undervalued, neglected and uncared for.

The whitepaper is titled Aesthetics, Accessibility & Ageing: Designing Livable Spaces Without Compromising Function or Style. It was published in Architecture and Design. The full 58 page Mecca Care product catalogue has great pictures and a section on assistive living.

The Mecca range is specifically for people who require assistive living designs. While the photographs show nicely designed bathrooms, grab rails take the look and feel away from a “conventional” bathroom. But if these fixtures and fittings keep you at home for longer then at least they can look good. Wall hung toilet pans, however, are a good idea for any home.

Universal in-wall bodies

A companion Nero whitepaper is A Universal Approach to Bathroom Installation. The in-wall body is an installation that separates the in-wall body from the trim kit – the visible bits. In-wall bodies allow builders and customers to select the right fittings after tilers have finished. Customers can delay their design decision informed by the latest trends. At a later date home owners can update their fittings without affecting walls and tiles.

Images from the Nero whitepaper. This post did not receive any sponsorship and is provided as a relevant item of information.

Thinking of wheelchair users…

Lifemark in New Zealand has a handy little brochure that sets out bathroom dimensions and placement of fittings for wheelchair users. They use the term universal design because the features can be used by most people. However, they do look as if they are specifically designed for wheelchair users. And there is no need to make this look like a hospital.

Designers can still be creative and provide style with colour and attractive fittings. One thing the brochure does not mention is colour contrast for people with low vision. Contrast between the floor and the wall is important, and for some, contrasting fittings work well.

The title of the brochure is Universally Designed Bathrooms. Of course, the bathroom is only one element in a home that needs to be accessible for a wheelchair user.

Livable Housing Handbook

The Livable Housing Design Standard applies to all new Class 1a and Class 2 buildings. Class 1a buildings are detached houses, row houses, terraces, townhouses and villa units. Class 2 buildings are apartment buildings and the design requirements apply inside the apartment. Public access requirements cover the public areas. To aid practitioners, the Australian Building Codes Board has produced a Livable Housing Handbook.

The Livable Housing Design Standard sets out minimum requirements for mainstream dwellings.

Front cover of the Livable Housing Design Standard showing a single storey home with garage.

The title, ‘Livable Housing Design’ comes from Livable Housing Australia’s voluntary guidelines. The features in these guidelines form the basis of the mandatory requirements, which are similar to Livable Housing Australia’s ‘silver level’.

The Livable Housing Design Handbook aims to help practitioners understand the relevant sections of the building code. These are Part G7 of NCC Volume One, Part H8 of NCC Volume Two, and the ABCB Standard for Livable Housing Design.

The Handbook covers design issues in generic terms and does not provide specific compliance advice. It aims to assist practitioners develop solutions to comply with the NCC requirements.

The intent of livable housing design is “to ensure that housing is designed to meet the needs of the community, including older people and those with a mobility-related disability.”

Front cover of Livable Housing Design Handbook.

The appendices have examples of bathroom layouts and a guide for meeting compliance with the NCC.

Going beyond the Livable Housing standard

The Australian Building Codes Board has also produced a guide for going beyond the minimum standard. The voluntary standard is generally based on Livable Housing Australia’s “Gold level”. These features provide a greater level of livability across the lifespan for more people, and go beyond the “silver level”. Consequently, exceeding the minimum mandatory requirements will still achieve compliance.

This additional set of non-mandatory technical provisions will better meet the needs of the community. They are similar to the Gold level in the original voluntary Livable Housing Design Guidelines.

Front cover of Livable Housing Design Beyond Minimum Standards guide

Australian homes are some of the largest in the world and the features in the voluntary standard should not be difficult to achieve.

Extensions and major renovations to existing homes will be based on state or territory requirements to comply with the standard. For example, if the works require a council development application.

Online learning – Livable Housing Design

CUDA has acquired the licence from the Australian Building Codes Board to run their course on Livable Housing Design Standard. The course is based on the Handbook and the Standard. This is a technical course for home-building professionals. Find out more about this course. and all the different ways to achieve a level entry.

The long road to Livable Housing

And the journey isn’t over yet. While the Livable Housing Standard is now in the national code, it is up to each state and territory to implement it. Victoria, Queensland, Tasmania, ACT and Northern Territory have agreed to implementation. South Australia has come late to the party but is now working on an implementation strategy.

Australian Network for Universal Housing Design (ANUHD) has been leading the charge for the reforms for twenty years. They believe that Western Australia could also sign up to implement the standard eventually. However, as of September 2023, NSW remains uncommitted. The livable housing story of citizen advocacy is documented in a conference paper.

Universally designed dream home

Not your average home. This one goes beyond even enhanced standards in the Livable Housing Design Standard. The video is from O’Shea and Sons Builders and shows what can be done with creative thinking. While this is a top-end of the market home, all the features are possible in mainstream homes. As Nick O’Shea says, “… an absolutely amazing home where functionality and style means absolute beauty.”

Filming by Unveil Media.

Home modifications: a clash of values

Publicly funded home modifications are a regular feature of My Aged Care and the NDIS schemes. NDIS participants seeking independence and desires to age in place are increasing, but our housing stock is not fit for this purpose. Consequently, homes need adaptation as people age or acquire a disability. However, there is a clash of values between what the client wants, what the funder wants, and what the occupational therapist (OT) deems functional. That’s a finding from researchers at the Hopkins Centre.

Our homes are not designed for disability and ageing. Consequently, modifications are essential for remaining safely and independently at home. They are an essential part of the NDIS and My Aged Care schemes.

The chart shows the key overarching themes from the research

Graphic showing the three values; aligning values and expectations, and quantifying value for money.

Researchers interviewed OTs experienced in prescribing home modifications. They wanted to gauge their experiences in the assessment process. They found that clients (homeowners) value aesthetics and property values. On the other hand, funding bodies value the cheapest option, and OTs are looking for the most functional outcome. OTs are also confronted with different decision making criteria across the various schemes.

Consequently, it is up to the OT to balance the desires of the client with those of the funder using their professional knowledge. Not an easy task, and unlikely to lead to optimum outcomes. And OTs become de facto bureaucrats in this process, which can also be a challenge to their professional values.

But what is “value”?

The research paper discusses the various aspects of value from different perspectives. The best outcomes are achieved when there is open discussion between the client, the funder and the OT. This encourages a better alignment of values.

While this paper is focused on the OT professional, it links closely with the notion of disability and ageing stigma. The idea of having a grab bar or a ramp appears to be an affront to one’s dignity. Older people see this as the beginning of the “downhill run” of life. The new Livable Housing Design Standard will help minimise this stigma by providing a step free entry and better bathroom design. Until we have sufficient stock, OTs will continue to provide home modification assessments.

The title of the paper is, Valuing home modifications: The street-level policy work of occupational therapists in Australian home modification practice.

There is also a webinar on the Hopkins Centre website that discusses client perspectives of home modifications. In a nutshell, they see modifications as value for money if they meet their specific needs to a high standard. Also, the process of getting a modification has to be straightforward without wasting time and money.

Phillippa Carnemolla’s research showed the number of care hours saved and improved quality of life with appropriate modifications.

Future-proofing is best

For those who can afford to renovate their home now, it is worth considering future-proofing, rather than leaving it “until the time comes”. The Livable Housing Design Guidelines are a good reference for anyone updating their home at any point in their life. This Guideline is the basis of the mandated Livable Housing Design Standard, but has more useful information for homeowners.

Accessible and adaptable home renovation

Sanctuary magazine has a Design Workshop section where people can apply to have their home design project workshopped by professionals. Architect Mary Ann Jackson comments on the planned renovation of a home for a family of four.

The brief is to renovate without overcapitalising, incorporate accessibility for the long term, improve layout, focus on energy efficiency and to consider acoustics.

Image of the original 1970s home

The existing home discussed in the Sanctuary magazine article. It shows a 1970s two-storey home.

The house is spacious enough but it doesn’t function well. One family member is hard of hearing so large open plan with hard surfaces is challenging. After investigating the option of a knock-down-rebuild, the homeowners, Eric and Caroline, decided to make the most of what they have.

Eric and Caroline engaged a designer who came up with a solution for most of their requirements. The article shows the existing floor plan and the proposed floor plan. Mary Ann critiques the plan from an accessibility perspective. As she says, if it is not accessible, it is not sustainable. So considering accessibility from the outset is worthwhile.

Congested space is the enemy of accessibility and having several small separate wet area rooms eats up valuable space. The walls and fittings take up space in each of these areas. Mary Ann advises at least one larger family bathroom for this family house. She goes on to discuss paths of travel and circulation space and offers improvements by moving some of the rooms around.

The kitchen is next with suggestions for work surfaces at different levels and drawers for under-bench storage. Mary Ann then moves on to the balcony and outdoor areas, explaining her reasoning along the way. The article has much more detail and is worth a read for anyone designing a home renovation.

A universal design approach

“Designing for adaptation in the future is important, and properly executed universal design facilitates multi-generational living”.

A man in a bright yellow T shirt is painting and archway in a wall inside a home. The wall is grey and there are tools on the floor. Articles on home modifications.

The article is in the Sanctuary magazine Design Workshop series, and is titled An accessible, adaptable upgrade. The article concludes with Mary Ann’s alternative design based on her assessment of the property and the family requirements. A really good example of universal design thinking coupled with cost effective energy efficiency.

See also the Livable Housing Design Guidelines for additional ideas. Many of these ideas are in the upcoming changes to the National Construction Code. It will be known as the Livable Housing Standard.

Universal design meets green building

Many home designers have argued for improved environmental sustainability while citizens have advocated for universal design. The 2022 edition of the National Construction Code (NCC) has them both covered. At last, universal design meets green building.

Sanctuary Magazine is a publication for people looking to build and renovate sustainably. Universal design is the focus of their 61st edition. So I was delighted when the editor invited me to contribute on the topic of universal design in housing.

Small things can made a big difference to the ease of use. Things like pedestals to raise washing machines off the laundry floor to minimise bending.

Image by Taylor’d Distinction

Laundry with white fittings. Washer and Dryer raised up.

My article covers the usual benefits of universal design and how it is good for everyone and the elements of updated NCC for housing. And of course, I referenced the Livable Housing Design Guidelines as a good place to start. I was also given the opportunity to offer additional suggestions based on my experience.

Additional suggestions

My suggestions are based on building my own universally designed home, and from working alongside occupational therapists. Here are some of them.

Ensure easy access to storage by installing drawers instead of cupboards under benches in the kitchen, laundry and bathroom. A pull-out workboard in the kitchen is useful too: placed at a sitting height for an adult, it also provides a workspace for children.

Install lever handles on taps and on every door so that you can operate them with your elbows when your hands are full, or if you don’t have good grip. Consider grip strength and dexterity when choosing drawer and cupboard handles and other opening and closing mechanisms. Also consider raising power points from the skirting board and placing light switches and door handles at hip height for ease of use.

In two-storey homes, think about designing a location for the installation of a lift in the future. This space can begin life as cupboards and then be utilised for the lift later.

The Livable Housing Design Guidelines don’t cover level entry to balconies and alfresco areas, but it’s just as important as level entry into the home. For more space in bedrooms, change the space-consuming walk-in robes to cupboards. You might win space in the ensuite too.

“Universal design is about designing inclusively for as many people as possible, without the need for special types of designs. When applied to housing, it’s a design process that considers the real lives of families and households – throughout their lives. In the end, it’s just good sense to have homes that can
accommodate the expected and unexpected situations life brings for all family members.”

The editor, Anna Cumming, has allowed me to share my article, A Plus for Everyone. Architect Mary Ann Jackson is also a contributor to this edition with an article on a home renovation. You can access more information about Sanctuary, other articles, and subscribe.

Posted by Jane Bringolf, Editor

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