Older people's perspectives on living in integrated housing and care settings: the case of extra care housing

Ailsa Cameron,Simon Evans,Eleanor K Johnson

doi:10.1108/jica-09-2019-0040

Ailsa Cameron, Simon Evans + Show 1 more

Open Access

https://doi.org/10.1108/jica-09-2019-0040

Copy DOI

Abstract

PurposeThis paper explores residents' perceptions and experiences of extra care housing as an integrated model of housing with care.Design/methodology/approachData were collected in a longitudinal qualitative study based on four extra care housing schemes. Data from interviews with residents, care workers, managers and local commissioners were analysed thematically.FindingsThe integration of housing with care enabled many older people to manage their care proactively. However, the increasing number of residents with complex health and care needs, including chronic illness, led some residents to question the ability of the model to support residents to live independently.Research limitations/implicationsThe study struggled to recruit sufficient residents from the specialist dementia setting who were able to communicate their consent to take part in the research. In addition, the quality of qualitative data collected in interviews with participants at this setting reduced over successive rounds of interviews.Practical implicationsThe study suggests the need to ensure that residents are fully informed about levels of care and support is available when considering a move into extra care housing.Originality/valueThis paper provides a timely opportunity to consider extra care housing as an example of an integrated housing service, particularly in light of the current challenges facing the sector.

Highlights

An expansion in the population aged over 65 living in England, increases in the number of people living with complex care needs and an expectation that the number of older people living independently will rise substantially over the two decades, taken together, place increasing pressure on health and social care services (Kingston et al, 2018)
The National Audit Office in the United Kingdom has reported that government has “not yet established a robust evidence base to show that integration leads to better outcomes for patients” (NAO, 2017, p. 7)
extra care housing (ECH) is a model of integrated housing and care that was developed in order to provide older people with a greater choice of living arrangements in later life

Summary

Introduction

An expansion in the population aged over 65 living in England, increases in the number of people living with complex care needs and an expectation that the number of older people living independently will rise substantially over the two decades, taken together, place increasing pressure on health and social care services (Kingston et al, 2018). A key element of this pressure is the growing recognition of the need for a variety of housing models to support older people to live independently. Such is the significance placed on the role of housing in supporting older people that, in England, the Care Act 2014 states that housing is an essential element of local authorities’ duty to promote integrated provision. Over the past 20 years, there has been increasing interest in the role of joined-up services in England as well as internationally (Mann et al, 2019) In part this reflects the growing demand for services and concerns about the cost-effectiveness of service provision, but it reflects a recognition that the problems people experience may be addressed more effectively and efficiently if agencies and professionals work together. The full terms of this licence may be seen at http:// creativecommons.org/licences/by/4.0/legalcode

Methods

Results

Discussion

Conclusion