I’ve just read an interesting article in my Dad’s The Pensioner magazine. The article addresses what I believe is a key element of delivering successful social care. But it might not be an aspect that immediately springs to mind.
It’s not about what are often seen as purely “social care” issues, such as disability benefits, standards in care homes or the availability of respite care and well-trained carers.
Instead, it addresses the failings of the housing market.
In Housing for Older People, author Charles Pitt* makes the point that there is a lack of suitable, affordable and available housing for older people in the UK. He wasn’t talking specifically about older people needing care, but it’s pertinent to the debate nevertheless.
For many elderly people the option to stay at home, with care coming in as required, is preferable to moving into a care home. And a lot less costly to them and to the state. But to do that you need the right type of housing.
Housing that is accessible internally and externally, including sufficient space to allow room for carers and any necessary equipment to manoeuvre around. Housing that is able to adapt to changing needs as the person ages.
Such accommodation makes home life so much easier (and possible) for the individual and their carers.
I grew up in a lovely old family home but I’m so glad that my parents moved out to a more manageable house in their late sixties. They were in the fortunate position of being able to sell the family house and build a smaller one in the garden. My mother, an ex-nurse, was clear-eyed about what they would need as they grew older. As in so many things, she was spot-on.
It has clear advantages:
· Accommodation is all on the ground floor
· A decent-sized bedroom (big enough to manoeuvre equipment like the manual hoist)
· En-suite bathroom (giving easy access from where Dad sleeps)
· A spare bedroom (great for a live-in carer)
· Wide doors (that can accommodate Dad’s wheelchair on the days he needs it)
· Just two wide steps up to the front door (wide enough for Dad’s walking frame).
Quite simply, it has made the difference between being able to keep Dad at home and moving him into a care home.
If my parents had still been in our old family home back in 2008 I doubt that Dad would have been able to come home after his accident. Certainly not after his stroke. The house had steep and shallow stairs, bedrooms all on the first floor and a bathroom off the middle landing, so there were stairs to the bathroom from both the ground and the first floor.
I dread to think what it would have cost to install a stair lift or help Dad negotiate stairs to the bathroom in the middle of the night or keep moving wheelchairs and manual hoists between floors.
Housing for Older People cites government figures that estimate 74% of all household growth in the UK over the next 20 years will be by older people. Yet currently, only 2,500 specialist homes for older people are built each year. It’s a drop in the ocean.
Not all older people want to downsize, of course, but for those who do opportunities can be very limited.
This part of Aberdeenshire is a generally affluent area and the main profit for the commercial house builders over the last few decades has been in building detached 4, 5 and 6-bedroomed houses. “Luxury executive” ones, naturally.
What were once small cottages have frequently been done up and extended into bigger family homes. There is a “retirement village” nearby, but the cost of the houses and maintenance charges are beyond the reach of many.
It all adds up to a real lack of suitable housing to downsize into, specialist or otherwise.
It can leave people struggling on in their own homes (requiring more care to help them cope or putting them at greater risk of a fall or other accident). Either that or settling for a care home place before they really need it.
If we are serious about providing decent social care for an ageing population (and sometimes I have my doubts) then the right housing provision is crucial. Not only can it help keep care costs down by facilitating community care, but it also has considerable knock-on benefits for the wider housing market.
In fact, the article quotes figures from housing charity Shelter, which estimates that if only 20% of older homeowners were able to move into retirement housing then 840,000 family-sized homes would become available.
Providing good social care is an issue that impacts on all of us, directly or indirectly. Meeting the needs of our elderly citizens doesn’t just help them; it benefits communities as a whole. Older people, or indeed anyone needing care, aren't some separate group that always need separate solutions. They are an integral part of what makes up our society as a whole. So good social care isn't just about social services budgets; it’s about housing and infrastructure too.
The housing market is already behind the demographic curve. We don’t have more time to waste.
* Pitt, Charles. Housing for Older People, The Pensioner, Spring 201.8
Charles Pitt is associate director of Connect PA, the public affairs consultancy that advises the Civil Service Pensioners’ Alliance.
I was just about to publish this post when I spied the front page of yesterday’s print edition of the i newspaper. Lo and behold, the main headline echoes the very issue I’ve just written about – lack of suitable housing for wheelchair users.
The newspaper cites the findings of a new report, Still Minding the Step and launches it’s own campaign, Fair Housing for All. So if this post has fired you up, or you just want to explore it further, use the links below to find out more.