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Adapting the adaptations process: tackling the barriers within policy and practice
- Author:
- MCCALL Vikki
- Publisher:
- UK Collaborative Centre for Housing Evidence
- Publication year:
- 2022
- Pagination:
- 42
- Place of publication:
- Glasgow
This report gives insight to the fragmented policy landscape in Scotland around adaptations, with further experiences gathered from England, Wales and Northern Ireland. There are many good practice examples throughout Scotland, and key stakeholders emphasise the important role for adaptations in the impact they make in people’s lives. However, the current systems that supports home adaptations in Scotland are fragmented, overly complex, and bureaucratic. These challenges undermine the preventive potential that adaptations can offer to service users. The report presents the perspectives of key stakeholders on how we can tackle the barriers within policy and practice within the adaptations process. Adaptations involve health and wellbeing-related home and environmental modifications for social, private renters and home-owners. In Scotland and throughout the UK, there are various adaptations processes that support the access, assessment and delivery of adaptations for service users. The report offers a new process for understanding the adaptations process, presenting barriers attached to governance, need awareness, information and advice, assessment, funding, design, delivery, evaluation & performance monitoring. Adaptations to homes and wider environments are essential for supporting health, social care and wellbeing needs, preventing health crises and future proofing homes for a diverse and ageing population. The processes that support adaptations, however, are fragmented, difficult to understand, and involve clear divergence between both local authority area and tenure. The evidence offered in this report leads to a clear need for finding a common approach across Scotland for supporting adaptations. (Edited publisher abstract)
When and why frail elderly people give up independent living: the Netherlands as an example
- Author:
- STEVERINK Nardi
- Journal article citation:
- Ageing and Society, 21(1), January 2001, pp.45-69.
- Publisher:
- Cambridge University Press
As yet determinants of the need for nursing homes and old age homes are not clearly understood. This study focuses on the need for living in an old age home and a theoretical model predicts under what circumstances frail elderly people will express the need for living in such a home. Findings show that loss of comfort and affection are among the main predictors of strong orientation towards living in an old age home. Resources to counter the loss of comfort and affection-a spouse, income, home adaptations, private help, informal and formal home care-were only partly effective in deterring orientation towards living in an old age home. Pressure from others to apply for an old age home had the strongest effect. The findings are discussed and some implications for policy are considered.
Age-friendly housing: future design for older people
- Authors:
- PORTEUS Jeremy, PARK Julia
- Publisher:
- RIBA Publishing
- Publication year:
- 2018
- Pagination:
- 192
- Place of publication:
- London
This book sets out the underlying design principles that should be applied in the design of future housing for an ageing population, focuses on anticipating the needs and aspirations of the next generation of older people. It looks at how well-designed buildings can facilitate the provision of care, support independence and wellbeing, while providing companionship and stimulation. It also examines how to ensure that buildings remain flexible over a long life. It is illustrated with case studies alongside contributions from a range of experts and examples of best practice. Although focusing mainly on new-build housing, it also includes a section on adaptation and refurbishment. It also briefly looks at what designing for an ageing population implies for communities, towns and cities, as well as for our living spaces. It provides a comprehensive resource to inform architects, designers, and planners to be braver and wiser in designing with older people in mind. (Edited publisher abstract)
Primary research with practitioners and people with lived experience: to understand the role of home adaptations in improving later life
- Authors:
- BAILEY Catherine, et al
- Publisher:
- Centre for Ageing Better
- Publication year:
- 2018
- Pagination:
- 152
- Place of publication:
- London
The findings of a qualitative research project, led by researchers from Northumbria University, to explore the experiences of older people who use home adaptations and the impact on their quality of life. For the study, six older people were given wearable cameras to see how they interacted with their home environment and 24 participants were interviewed. Focus groups were also conducted with 39 providers and practitioners involved in the home adaptation process The report presents findings on the triggers that drive an individual to make changes to their home - including changes to health our housing need; accessing adaptations - identifying support services and funding; having adaptations installed; and the outcomes that result from the adaptation, such as improved physical and mental health and experience of the process. It also includes two detailed participant case studies, which include camera data and images. The results found that the decision to adapt the home was often made when the person was already struggling, with people delay making changes because of the clinical appearance of adaptations and their association with a loss of independence. People were also largely unaware of how to access home adaptations. Professionals also struggled to navigate the complex system easily. Once adaptations had been completed, the majority of participants experienced positive outcomes, including fewer falls and reclaiming their home and garden. The recommendations include the need for more positive messaging about home adaptations, including information on the benefits of adapting the home; for adaptation services to work with signposting agencies and health services to simplify the home adaptation processes; and for Central Government needs to provide better guidance on home adaptation outcome measures. (Edited publisher abstract)
Homes that help: a personal and professional perspective on home adaptations
- Author:
- DOCKING Rachael
- Publisher:
- Centre for Ageing Better
- Publication year:
- 2018
- Pagination:
- 23
- Place of publication:
- London
Summarises the findings of qualitative research led by a team from Northumbria University to explore the experiences of older people who use home adaptations, and practitioners who work alongside them. The research used wearable cameras and interviews to capture the views of older people and document how they interact with their homes. It also held focus groups with providers and practitioners involved in the home adaptation process. This report presents summary findings using a common home adaptations participant journey: the triggers that drive an individual to make changes to their home - including changes to health our housing need; accessing adaptations - identifying support services and funding; having adaptations installed; and the outcomes that result from the adaptation, such as improved physical and mental health and experience of the process. The results found that people delay making vital changes to their homes because of the clinical appearance of adaptations and their association with a loss of independence. People are also largely unaware of how to access home adaptations and even professionals struggle to navigate the process easily. Once adaptations had been completed the resource found the majority of participants experienced positive outcomes, including fewer falls and reclaiming their home and garden. (Edited publisher abstract)
Healthy homes: accommodating an ageing population
- Author:
- MEESE Helen
- Publisher:
- Institute of Mechanical Engineers
- Publication year:
- 2018
- Pagination:
- 27
- Place of publication:
- London
This report looks at what needs to be considered to meet the housing needs of an ageing UK population in the future. It argues that appropriately designed housing that can adapt to people’s changing needs will reduce demands on healthcare services, enable greater flexibility in how individuals manage their lives, and could save NHS and social care system over £2.5 billion a year. It calls for an examination of the existing housing stock to assess how to create low-cost assistive technology that can be used within the home to increase physical activity of our older population and for the construction industry to be encouraged to offer adaptive, intelligent homes that cater for the health and wellbeing of future generations of older people. The report recommends establishing financial incentives to the construction industry to build housing that enables people to age well, the creation of a new standard for housing design and construction and for national investment in programmes that focus on technology for prevention of ill health in old age. (Edited publisher abstract)
The collaborative home improvement agency
- Authors:
- PHILLIPPA Francis, RAMSAY Malcolm
- Publisher:
- Foundations
- Publication year:
- 2016
- Pagination:
- 32
- Place of publication:
- Glossop
This guide sets out a vision for a collaborative home improvement agency and highlights importance of working collaboratively with other services and providers, for both the agency and the people using its services. It highlights the role of HIAs in an integrated health and care system which promotes wellbeing at home and can provide a preventative response to reduce, delay or remove the need for costly institutional care. It suggests that HIAs services will increasingly need to be focused in two areas: highly targeted services to high need individuals, and low level preventative services to a larger population, both grant-eligible and self-funders. It then looks at the importance of understanding and influencing commissioners, developing partnerships with other providers, and HIAs role in shaping the market for the supply of equipment and home modifications. Practice examples are included throughout which provide ideas about how collaboration can work successfully. The guide is aimed primarily at home improvement agencies and related service providers, but will also inform commissioners and policy makers in local government, health and wellbeing boards, health trusts and clinical commissioning groups. (Edited publisher abstract)
Use, non-use and perceived unmet needs of assistive technology among Swedish people in the third age
- Authors:
- LOFQVISTA Charlotte, et al
- Journal article citation:
- Disability and Rehabilitation: Assistive Technology, 11(3), 2016, pp.195-201.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Purpose: To describe the most prominent use of or perceived unmet need of assistive technology (AT) and to compare the characteristics of users, non-users and those expressing perceived unmet need with respect to overall health, independence in everyday life, environmental barriers and socio-demographic features. Method: The study is based on data collected in the “Home and Health in the Third Age Project”. In all, 371 individuals participated and data were collected during home visits in southern Sweden by interviewers trained specifically for this project. The data collection comprised well-proven self-report scales and observational formats on the home environment and health indicators as well as questions about basic demographics and socio-structural data. Results: The proportion of users constituted almost half of the total sample. The most common types of AT used were for furnishing/adaptation (35%) and the highest perceived unmet need concerned AT for communication, in total 8%. Those cohabiting were to a higher extent users of AT for furnishing/adaptation, compared to those who lived alone. A higher perceived unmet need was seen among those who lived alone compared with cohabiting people. Conclusions: These findings are of importance for future planning and development of policy to improve health services for the new generation of elderly. (Publisher abstract)
Older adults' perceptions of mobility: a metasynthesis of qualitative studies
- Authors:
- GOINS R. Turner, et al
- Journal article citation:
- Gerontologist, 55(6), 2015, pp.929-942.
- Publisher:
- Oxford University Press
Purpose of the Study: Optimal mobility is an important element of healthy ageing. Yet, older adults’ perceptions of mobility and mobility preservation are not well understood. The purposes of this study were to (a) identify studies that report older adults’ perceptions of mobility, (b) conduct a standardised methodological quality assessment, and (c) conduct a metasynthesis of the identified studies. Design and Methods: Studies with community-dwelling adults aged ≥65 years, focused on perceptions of mobility pertaining to everyday functioning, used qualitative methods, and were cited in PubMed, Embase, CINAHLPlus, or Geobase databases were included. Study quality was appraised using the McMaster University Tool. Results: Out of 748 studies identified, 12 met inclusion criteria. Overall quality of the studies was variable. Metasynthesis produced 3 overarching themes: (a) mobility is part of sense of self and feeling whole, (b) assisted mobility is fundamental to living, and (c) adaptability is key to moving forward. Implications: Older adults’ perceptions of mobility can inform interventions that would involve actively planning for future mobility needs and enhance the acceptance of the changes, both to the older adult and the perceived response to changes by those around them. (Edited publisher abstract)
Is extra care housing in England care-neutral?
- Authors:
- MAYAGOITIA Ruth, et al
- Journal article citation:
- Journal of Assistive Technologies, 9(1), 2015, pp.3-20.
- Publisher:
- Emerald
Purpose: Extra care housing (ECH) is housing for older people that aims to provide flexible care while fostering independence. This paper discusses the remodelling of existing buildings, such as residential care homes or sheltered housing units into ECT. It examines the impact that some of the successes and failures in improving accessibility during remodelling had on care provision, in order to offer advice to social housing providers planning to remodel existing properties into ECH. A building is said to be care-neutral if it does not have any impact, positive or negative, on the support and care regime that takes place in the building. Design/methodology/approach: The data consisted of an inventory of accessibility features and assistive technology (AT) items in flats and common areas. The data were drawn from ten ECH schemes in different regions of England. Findings: Most of the AT found was low-technology supporting independence, such as grabbers; some was specific to care provision, such as hoists. Even after remodelling, the design and layout of most buildings did not fully comply with accessibility standards, leading to increased provision of care for some tenants: a care-negative situation. Research limitations/implications: The research presents successful examples of accessibility, AT and care integration that required active tenant involvement and creative design input from care staff, architects and builders who were AT and accessibility aware. It is argued that for new and remodelled ECH buildings to be care-neutral, designers need to work towards the most inclusive model of ECH. Originality/value: This is original research that has produced guidance for builders, developers, policy makers and other stake holders. (Edited publisher abstract)