Ageing in Place: Not there yet

A suburban house in UK showing before and after the ramp. The ramp makes several zig-zags up the front of the house. It looks ugly.What home modifications are needed most and how much are they needed? Mary Ann Jackson analysed 50 home modification reports in Victoria to get an answer. She found that when it comes to ageing in place we are not there yet. 

The homes visited all had a doorsill or step at the front door and tight spaces. A screen door complicated matters, and meter boxes also intruded on entry space. Many of the fittings, such as taps and handles were poorly designed to suit ageing in place. 

Jackson advises that accessibility issues are endemic to Australia’s existing housing stock. This is a big problem when 39.5% of households include a person with disability. 

Architect and Planner Jackson says, “Cooperation, collaboration, and a clear recognition of the emotional, physical, and economic cost-benefit of ageing in place will be needed to rebuild Australia’s housing stock to better accommodate all inhabitants throughout life.” The title of the newsletter article is Ageing in place – are we there yet?  

The picture above is famous for its technical compliance, but not usability, and definitely not aesthetics.

Older people and perception of home

Within the findings of an AHURI report is a section on the qualitative research on older people and the perceptions of their homes in terms of ageing in place. The report is titled, “The role of home maintenance and modification services in achieving health community care and housing outcomes in later life”, and is by Andrew Jones, Desleigh de Jonge and Rhonda Phillips for the Australian Housing and Urban Research Institute, 2008. 

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.Phillippa Carnemolla’s conference paper expands on some of these ideas for ageing well at home. She found that home modifications address both social and individual needs. The title of the paper is,  The potential of a home modification strategy – a universal design approach to existing housing

 

Consumer inertia about remodelling to stay put

A kitchen in the middle of renovations.Although older people are keen to avoid residential aged care, they seem slow to make any home adaptations to make this possible. The concept of ageing is put down to luck and genes. People aren’t aware of the ways they can control their own destinies and experience of ageing. As much as we might like to put off the inevitable, it will happen sooner or later. 

Western cultures extol the virtues of youth and beauty so it is little wonder that anything related to ageing is viewed negatively. That includes making adaptations to the home when it’s time for renovations. Remodelling or modifications are usually done as a result of a major health event. By then good solutions are lost in favour of the quickest way to solve the problem. This often results in poor outcomes and low-quality construction. And this gives modifications a bad name because they are rarely aesthetically pleasing.

If we placed home modifications in the retirement planning box, perhaps things would change. This topic is discussed in, Overcoming Inertia to Jumpstart Home Modifications for Aging in Place.  Here are some very pertinent snippets:

“Discharge planning is a quick process at the end of treatment. Remodeling takes time. Designing good solutions is iterative, and unless drawings, permitting, procurement, and scheduling are performed in an orderly process, the results may be chaos, poor problem-solving, and low-quality construction. Home modifications are then seen as a health solution, rather than as a proactive, forward-thinking policy.”

“The researchers uncovered deeply rooted skepticism throughout the general population regarding the idea that individuals could control the course of their aging experience. People tend to assume that whatever happens—good or bad—is a matter of luck or genetics. This mindset creates a paradox: the more professionals in the field of aging urge folks to take action, the less likely consumers are to trust such professionals, because they are making recommendations contrary to consumers’ sense of what is possible.”

Abstract: Three quarters of older adults in the United States would prefer to age in place, but our current housing stock is not suited for older adults with mobility issues and chronic disease. Modifying one’s current home, prior to onset of advanced aging, can prevent falls and illnesses common in late life. Confusion on how to motivate older adults to remodel remains, but there are bright spots in policy regarding home modifications. This article details home modification programs and policy going forward to solve this challenge.

 

Ageing and the Australian dream

An older man stands by a post with his arms folded looking a little puzzled.. He is wearing a shirt and has his pullover tied around his waistLooking at housing through a typology lens, Matthew Hutchinson discusses the issue of suitable housing for an ageing population. He claims that segregated and congregated living is unlikely to serve the upcoming older cohorts. Instead he poses the idea of “salt and peppering” suitable housing for older people in developments. There is a mention of accessible features in the research, but ideas such as having stairs to stay fit are questionable. A useful text giving an Australian context, but lacking is the concept that all new homes can be designed for ageing in place, at any age, and also provide a safe workplace for care staff and family carers. However, there is much more useful discussion in this chapter.

Hutchinson’s book chapter is titled, The Australian dream or a roof over my head. An ecological view of housing for an ageing Australian population. 

The chapter is a result of a PhD research project and can be found in, Designing for Health & Wellbeing, Home, City, Society.  You might be able to freely access some of the text via Google Books

Editor’s note: Ideas such as salt and peppering in communities takes us back to the proportion argument. Without a register of accessible homes that means they will disappear into the general milieu of the marketplace. Having stairs to stay fit sounds good, but we can’t put off ageing for ever. Besides, accidents and chronic illness can happen at any age to render a person immobile either temporarily or permanently. That’s not the optimum time to think about moving. 

 

Older Australians: no plans to move

We expect to grow old, but because we don’t aspire to grow old, we rarely plan for it. “I’ll worry about it when the time comes” is a usual response. A new report from AHURI looks at the housing situation for older Australians and some previous research is confirmed.

Most respondents felt their current home would suit them as they grow older. Eliminating steps is obvious, but what about other features? Generally, older people would like to own a detached dwelling (69%) with three bedrooms (50%). Those in the 75+ group think that a two bedroom apartment is a good idea, probably because they can eliminate steps. Most importantly, they don’t want to be in the private rental market.

Older Australians are not planning ahead. If they are, they lack information on how to go about it, what to look for, and what their options are other than age-segregated housing. A significant proportion of respondents hadn’t thought about planning ahead for their living arrangements. 

Plenty of material in this report for anyone interested in housing and older people. Title of the report is, Older Australians and the housing aspirations gap. You can download the Executive Summary and the Full Report separately. 

Editors’s comment:  Although home owners said their homes would support them in later life, this might not be an objective view. With a desire to stay put, can we rely on their self-assessment when they have so much emotional and financial investment in their current home?To be sure that homes will suit people throughout their life, every home needs to be designed for the life course. We need all new homes to be fit for that purpose

 

Housing, older people and resilience

An old weatherboard farm building sits in front of a tall dark brooding mountain.People want to stay put as they age. That means housing design is critical in supporting this desire, as well as ageing-in-place policies. A new study from New Zealand looked at issues of appropriate housing for older people, and how people and communities can develop resilience to adverse natural events. The findings relate to ageing societies across the globe and within the context of changing environmental conditions. The decision tools that researchers devised from this participatory research are useful for older people and for architects and other designers. 

The title of the article by Bev James and Kay Saville-Smith is “Designing housing decision-support tools for resilient older people“. There are several useful references at the end of this excellent study. 

ABSTRACT: Our ageing populations make it critical that older people continue to live and participate in their communities. ‘Ageing in place’, rather than in residential care, is desired by older people themselves and promoted as policy in many countries. Its success, both as policy and practice, depends on housing. House performance, resilience, functionality and adaptability are all essential to maintaining independence. Three New Zealand research programmes have worked with older people to investigate issues around housing, ‘ageing in place’ and how older people and communities can become resilient to adverse natural events. Using participatory research techniques, those programmes have generated evidence-based decision-support tools to help older people maintain independence. These tools have been co-designed and widely tested with older people and others. Designed to help older people identify priorities and information requirements, assess diverse factors determining thermal performance and dwelling resilience as well as repairs and maintenance needs, the tools help improve decisions around: repairs and maintenance assessment and solutions; dwelling and location choices and housing options. Various organizations have adopted the tools. This work demonstrates how research outputs can be used to facilitate older people’s housing choices while also giving architects and designers guides for meeting older people’s housing needs.

Image by David Mark.

Staying put and walking more

An older man and woman are walking away from the camera down a street. They are wearing backpacks and holding hands.A new Australian study found that older people who live in separate houses walk more than those in retirement villages. The Curtin University study accounted for several factors before coming to this conclusion. It adds to the literature that for most people, staying put in your own home is the best way to age. Of course, we need homes and neighbourhoods designed to support this. While the study has some limitations, it is another angle on staying put versus age segregated living arrangements.

The title of the article in Sage Publications is The Potential Importance of Housing Type for Older People’s Physical Activity Levels. You will need institutional access for a free read. 

Abstract

Limited research has investigated the effect of housing type on older people’s physical activity, and the small amount of work to date has relied on self-reported activity levels. The aim of this study was to assess whether housing type is associated with objectively measured physical activity among community-dwelling older people. In total, 430 Australians aged 60 years and older completed a survey and wore an accelerometer for a week.

Controlling for a range of confounding variables (age, gender, physical health, neighborhood walkability, and the density of open spaces in the local area), participants living in separate houses were found to engage in higher levels of activity compared with those living in retirement villages. In addition, those living in separate houses and apartments were significantly more likely to meet the physical activity guideline of 150+ min/week compared with those living in retirement villages.

Age-Friendly Housing Resources

Front cover of the book showing yellow boxes approximating rooms in homes. Age Friendly Housing.RIBA’s book, Age-Friendly Housing: Future design for older people, is about anticipating the needs of older generations. It is available for purchase from UK.

“This book embeds the principles of how we should approach the design of future housing for an ageing population, reminding us that this is not about `other people’, but about each of us.

This book focuses on anticipating the needs and aspirations of the next generation of older people, and touches on what this implies for our communities, our towns and our cities, as well as for our living spaces.It will look at how well-designed buildings can facilitate the provision of care, support independence and wellbeing while providing companionship and stimulation. It will also examine how to ensure that buildings remain flexible over a long life.

Dealing mainly with new-build, but with a section on adaptation and refurbishment, this book sets out the underlying design principles that should be applied and the early decisions that must be taken. Richly illustrated with case studies alongside contributions from a range of experts and examples of best practice, this comprehensive resource will inform and empower architects, designers, planners and clients to be braver and wiser in designing with older people in mind.”

See also lists of design-related resources relating to age friendly and accessible housing: Design Hub – Building homes and communities, 

Hope I die before I get old: state of play for housing liveability in Australia

From the Editor: This academic paper and presentation was made at the 2011 State of Australian Cities Conference (SOAC). It raises the issues of housing an ageing population in a context of industry believing retirement villages and aged care are the places to put older people.  However, the majority of people will age in their current home – a home that is not suitably designed for this purpose. Around 200,000 new homes are built each year – each one a lost opportunity. It remains to be seen if the Australian Building Codes Board will push ahead with regulations for accessible housing in 2020 – 2022. 

SOAC slide cover

Download the paper  Hope I die before I get old article PDF

Download the slideshow Hope I die before I get old Slideshow PDF

Jane Bringolf