Is extra care housing in England care-neutral?

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Abstract

Purpose

– Extra care housing (ECH) is housing for older people that aims to provide flexible care while fostering independence. The purpose of this paper is to examine 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.

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

– This multidisciplinary, original research on remodelling into ECH 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.

Related collections

Most cited references 15

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Does assistive technology substitute for personal assistance among the disabled elderly?

Helen Hoenig, Donald H Taylor, Frank Sloan (2003)

This study examined whether use of equipment (technological assistance) to cope with disability was associated with use of fewer hours of help from another person (personal assistance). In a cross-sectional study of 2368 community dwellers older than 65 years with 1 or more limitations in basic activities of daily living (ADLs) from the 1994 National Long Term Care Survey, the relation between technological assistance and personal assistance was examined. Among people with ADL limitations, multivariate models showed a strong and consistent relation between technological assistance and personal assistance, whereby use of equipment was associated with fewer hours of help. Among people with disability, use of assistive technology was associated with use of fewer hours of personal assistance.

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The great efficacy of personal and equipment assistance in reducing disability.

J Madans, L Verbrugge, Robert C Rennert (1997)

Personal and equipment assistance are common strategies to reduce disability. This study sought to determine how often assistance reduces or even completely resolves health-related difficulties in everyday tasks. Data are from the NHANES I Epidemiologic Followup Study. Adults aged 35 to 90 reported difficulty doing 12 everyday tasks on their own without assistance. Those stating that they had much difficulty or were unable were asked if they had personal assistance and/or equipment assistance, and their degree of difficulty with assistance. Use and efficacy of assistance are studied by gender, age, intrinsic (unassisted) degree of difficulty, and type of assistance. Most people use assistance for the 12 tasks; "personal assistance only" is the principal type used for upper-extremity and body transfer tasks; "equipment only" ranks first for lower-extremity tasks. Assistance reduces difficulty for the great majority of persons (75% to 85%) and completely resolves difficulty for about 25%. Equipment only proves to be the most efficacious strategy for reducing and resolving limitations. Equipment's success may be due to greater perceived gains when people accomplish the assistance by themselves.