Dr. Stephen Ladyman
By 2026, the number of 85-year-olds in the UK is expected to double and the Department of Health estimates that in the next 20 years, an additional 1.7 million people will have a care need. It’s been called a demographic time bomb – people living longer but with more complex needs and a greater expectation that there will be the resources needed to meet their needs. That is why we have to be more creative in planning the way we support older people in the future and a key element in our planning must be the provision of age appropriate housing that helps people maintain their independence for longer.
Caring for an ageing population should be based on the principle that everyone has the right to control their own lives. The services on offer should allow individuals to maintain their independence and give them greater choice and control over the way in which their needs are met. And giving older people greater control and choice also means there must be a greater emphasis on preventing problems before they arise and providing access to better information to allow them to retain responsibility for their own choices, and for those choices to be well-informed and thought out.
Nowhere is the need for better information more critical than when it comes to housing for older people. The thought of ageing and deteriorating health can be a great worry and no-one wants to become a burden on their family, so downsizing and moving to ‘age appropriate housing’ has to be one of the options that people consider. But what are the options? What will be the impact of downsizing socially and financially? What types of retirement property are available?
Having access to clear, thorough and easily-accessible information can help relieve some, if not all, of these concerns. Unfortunately, the sector makes things more complicated by marketing retirement property under a plethora of names – retirement living, assisted living, sheltered housing, very sheltered housing and extra care are all names given to different housing products, so it is not surprising if older people find the market place confusing. And just to be crystal clear, all of these types of housing product are very different to residential care homes – what we are talking about are self-contained properties and most people who downsize into property that follows the extra care model will never need to move to a care home.
Some retirement property is no different than any other property except it is restricted to people over a given age and some properties of this type will also have an on-site manager, often part-time, who makes sure that the property is being maintained. At the other end of the spectrum will be properties in developments with access to communal facilities such as a restaurant, and that have full time on site staff registered with the Care Quality Commission, who can help with personal care needs and respond to emergencies. This latter category is called ‘extra care’ by the Department of Health but most companies market it under different names.
A report for the Local Government Association estimated that older people currently occupy 3.3 million homes that are now bigger than they need. So, If more older people made the decision to downsize, this would benefit society as a whole, having a big impact on the pressure to build new houses – but that is not the only potential benefit for society. A report for the Homes and Communities Agency estimated that, on average, a person downsizing into an extra-care property could also save the public purse about £440 per year by reducing the bill for the NHS and Social Services, which, when multiplied across the board, represents millions of pounds.
Of course, downsizing into a retirement property can also have huge benefits for individuals too, especially when the move is made in a timely fashion. If done before a person finds themselves struggling in their old property, the experience can be less stressful and the transition easier.
While it can be a worrying time, moving into the right type of property at the right time can offer older people the chance to retain their independence for longer, reduce financial outgoings and deliver significant health benefits. Studies have shown that these benefits are strengthened when the property in question is designed on the ‘extra-care’ model, as recommended by the Department of Health.
When considering downsizing older people are often concerned with preserving their capital and what this means for their families in the long run. In leasehold ‘extra-care’ developments, each resident owns the property they live in, which in turn enables them to protect their equity, safeguarding it for their families and loved ones.
Extra-care living also offers its residents a better quality of life, allowing people to maintain their independence for longer with easy access to onsite flexible care that adapts to their changing needs. About 25 per cent of residents entering extra-care go on to experience improvements in their health.
One of the biggest causes of ill-health among older people is depression linked to loneliness. With constant changes in population and increased diversity within communities, it means that while people are living longer, they are less likely to be part of or near to close-knit family who can provide support. The easy access to communal facilities in an extra-care development encourages residents to meet other people, make friends and socialise, meaning there is a much lower probability of this occurring.
Those living in extra-care properties, on average, also spend less time in hospital than those of equivalent age living in standard retirement properties. If a person does develop health or care needs, these can be delivered quickly and effectively into your own home by on-site staff.
Of course, people are always reluctant to leave the home they raised their families in and where they shared happy memories. But the prize for downsizing is potentially a big one – there can be financial benefits, health benefits and social benefits. Maintaining your independence for longer, having better access to the services you need and keeping control over your own life are all part of that prize too.
About the author: Dr. Stephen Ladyman, is a former Minister for Health responsible for Social Care and Founder of Oak Retirement.