Chapter 6. Post-Occupancy Evaluation of a Life-Care Community for the Aged in Israel

ABSTRACT

This paper presents an advanced housing arrangement for elderly people and an innovative method of Combined Post-Occupancy Evaluation to evaluate it. The method is based on what we developed and found to be a useful checklist of housing-related needs-physical-functional and psycho-social-of elderly people. According to our findings, the fulfillment of the psycho-social needs has first priority in determining the satisfaction of the elderly with their environment. The evaluation method combines a two-fold professional evaluation and an evaluation by the users. The results of the evaluation lead to several practical recommendations, including a recommended reduction of the resources devoted to public areas in old-age homes and an increase of the investments in the individual housing units, in which most of the needs of the residents are fulfilled.     

Chapter 2. Housing and Household Movement in Later Life

ABSTRACT

In most developed countries housing policies are focusing on enabling elderly and very elderly people to remain in their own homes. Attention is also turning to people in the Third Age to see how their housing needs to be different from earlier stages of their lives but also as a preparation for old age. This paper presents evidence from the United Kingdom (UK) about choices and policies at different stages of middle and old age and on the developing range of housing options to meet these needs.     

The Design of Mainstream Housing for Downsizers

ABSTRACT

In the United Kingdom, the supply of new homes to the housing market tends to be focused either on “general-needs” housing on the one hand, or on special-needs housing for the elderly on the other, with relatively few people moving into homes that will support their independence as they age. Against the backdrop of the UK's chronic housing shortage and the UK government's recent Housing Standards Review, this case study of a mainstream housing development—which meets so-called “Lifetime Homes” in “Lifetime Neighborhoods” standards—identifies specific design and locational features that have attracted “downsizers” to buy into it, as well as those they subsequently found problematic.     

Housing Concepts For and By the Elderly: From Subjects of Design to a Design Resource

ABSTRACT

The perception of elderly residents as a homogeneous group is challenged by the diversification of lifestyles and emphasis on individuality in housing. Recently, there has been a rise in Finland in housing projects initiated by groups of elderly people, where the seniors themselves are seeking to fill in qualitative gaps in the offering of housing. This article presents a comparative analysis of four senior housing concepts that represent both a producer-driven (“for the elderly”) and a resident-driven (“by the elderly”) approach. The study shows that elderly people can be a resource for residential development and that this necessitates a different “design logic” than in conventional senior housing.     

Senior Housing in Sweden—A Question of Class Differences and Collective Aging

Abstract

Private senior housing in Sweden has become an alternative to accommodation for elderly in the public welfare system. In the study presented here, the aim was to elucidate this senior housing from the perspective of the residents. The questions that were asked were: (1) Why have the residents chosen senior housing? (2) What are the differences between residents in rental apartments and tenant-owned housing cooperatives? (3) What advantages and disadvantages do the residents think that senior housing has? The interviews showed that: (1) The seniors have chosen the housing for reasons other than its being senior housing; (2) the residents in rental apartments come from the working class and socialize in collective forms, while the residents in cooperatives come from the middle class and socialize through individual initiatives; and (3) the advantages they experience in senior housing are that it involves activities and community. The disadvantages derive from the architectural planning. When the building has a communal yard or entrance, integrity can be threatened and the sense of collective aging can be a Strain.     

Naturally Occurring Retirement Community-Supportive Service Program

Summary

Devolution is defined as the transfer of power or authority from a central government to a local government. This article addresses federal policies on housing for the elderly and the devolution of funding for federal senior housing and describes two aspects of devolution of federal housing policy for the elderly. One, it points out the decreasing interest in senior housing by federal authorities as indicated by the decreased amount of funds allocated for this purpose. Two, it emphasizes the need for supportive, assistive services for residents of senior housing and how federal funds have not addressed this need adequately or sufficiently. As a consequence, there have emerged Naturally Occurring Retirement Communities (NORCs) in New York State, a housing arrangement that provides supportive and health services to all eligible residents. The article concludes with a discussion of policy implications and the need for additional research before replicating this model.     

But Not in My Neighborhood:

Reactions of community residents to proposed or built Section 202/8 apartment complexes in two communities in and near Tampa, Florida were studied through observation of two public hearings and data gathered through questionnaires mailed to a probability sample of householders in the communities. Findings indicated that the respondents were about evenyl divided between positive and negative reactions to the housing facilities. A discriminant analysis revealed that those who reacted negatively tended to be more satisfied with their own homes, to have lived longer in their homes, and to be less satisfied with their neighborhoods. Recommendations for avoiding community resistance to housing for the elderly were presented.     

Potential for the Abuse of Medication for the Elderly in Residential and Nursing Homes in the UK

ABSTRACT

Abuse of the medication prescribed to the elderly living in long-stay care homes may be perpetrated by a minority of unscrupulous doctors, pharmacists, or home staff caring for the residents. Disorganised practices and homes, poor communications, and sloppy professional practices may create opportunities for over-dosing, errors, fraud, or theft. This article describes the circumstances leading to the potential abuse of elderly residents' medication, and the measures that may be taken to avoid or minimise such abuse from occurring.     

The Mixed-Population Issue in State-Subsidized Elderly Housing: Management Problems Posed by Nonelderly and Elderly Tenants

Abstract

The management experiences of all Local Housing Authorities (LHAs) in Connecticut were investigated concerning younger disabled tenants in state-subsidized elderly housing. While as a group younger disabled tenants were more likely to violate the terms of their lease, including disrupting other tenants' enjoyment of their homes, management problems with younger disabled tenants were not reported by all LHAs. In general, serious, recurrent problems involving younger disabled tenants were concentrated among a relatively small group of LHAs. Emphasizing the diversity that characterizes the experiences of LHAs, the discussion emphasizes the need for caution in drawing conclusions about the issue of a mixed population. It also focuses on examples of how some LHAs have addressed the integration of younger disabled tenants in senior housing and proposes recommendations for viewing the issue in the broader context of public policy.     

A Comparison of Spanish and American Housing Policy Frameworks Addressing Housing for the Elderly

Abstract

Housing policies in Spain and die United States have important similarities and dissimilarities mat affect housing for the elderly. Spain, even more so than me United States, promotes homeownership. Bom countries face significant challenges in addressing the housing needs of the elderly, particularly those challenges associated wim aging in place. The paper reviews me broader housing policy frameworks in bom countries in order to understand me context for elderly housing policy. The paper identifies lessons from the American experience mat can expand housing policies in Spain.     

The experience of smoking in recovery settings: an ecological momentary assessment pilot study

ABSTRACT

Smoking continues to be the leading cause of preventable death in the United States, and people with substance use disorders (SUD) smoke at higher rates compared to their non-using counterparts. Individuals with SUDs may have different emotional experiences and expectancies than those without. The current study explored the relationship between smoking and emotional experiences among residents in recovery homes, a population that little is known about regarding their tobacco addiction. Using ecological momentary assessment (EMA), significant emotional differences were found between nicotine users and nonusers. Implications of these findings could help in the development of interventions directed toward reducing smoking cessation.     

Mental Health Needs and Supportive Services for Elderly and Disabled Residents

Abstract

This study longitudinally assesses the impact that the provision of supportive services has on the mental well-being of the elderly and disabled population living in independent housing developments. The results indicate that the use of supportive services by the mentally ill allowed them to overcome initial lower functional status and achieve a level of mental functioning virtually similar to that of the total resident population. Thus, it is argued that independent living facilities with supportive services can certainly be a successful and cost effective model for a number of frail elderly and mentally ill residents.     

Old-Age Homes and Services

Summary

Although generational co-residence continues to be the dominant form of housing and care for Indian elders and only 1% live in old-age homes, the numbers and types of these homes are growing. This article describes a recent study of 48 old-age homes in different parts of India, approximately 12%-15% of all homes. They included the more traditional free homes for the aged poor who have no family to care for them and the more recent for-pay homes for the middle-class. A small number of day-care centers, also a new phenomenon, were investigated. Two- to three-hour structured interviews were conducted with managers, supervisors, and trustees, augmented by a checklist of environmental and neighborhood features. Most homes house small numbers of residents, have common spaces for dining, TV and prayer, have access to medical care and transportation, provide meals and some assistance with activities of daily living, and are open to all castes. All are run by non-governmental organizations (NGOs), only one-third with any government assistance. Free homes tend to be bigger and older, serve non-aged clients, have less privacy and emphasize occupational therapy and income-generating activities, and are more like board-and-care homes. For-pay homes have more privacy and western-style amenities, focus on local community outreach and provide fewer meals. The gradual increase of all old-age homes has given rise to debates about their appropriate roles in Indian society and about their quality. Government grants to NGOs for homes and day-care centers (often considered more appropriate support for elders) are limited. With the National Policy on Older Persons looking to NGOs and village councils to be the primary sources of non-familial aged care, several ways to build their capacity are suggested.     

Voices of 65 Young People Leaving Care in Sweden: “There Is So Much I Need to Know!”

Abstract

The purpose of this study is to examine young care leavers’ experiences of supportive and nonsupportive factors after leaving care. Telephone interviews were conducted with 65 young people, between 18 and 26 years old, who had left care in Sweden within the previous 3 months to 3 years. The care-leaving process was in many cases described by the young people as badly planned and compressed. Some interviewees received support from the formal network (social services, foster carers, residential homes, contact persons) for housing (37) and financial matters (36), but few received support from the formal network concerning employment (14) and education (11). Emotional support was mainly provided by partners and friends. Altogether, the results suggest that access to support is a helpful factor for young people leaving care, but also that many of our interviewees had no such access, from neither formal nor informal networks.     

Nearby Nature and Long-Term Care Facility Residents

Abstract

As the population in North America continues to age, long-term care facilities for housing the elderly are likely to become even more important. Because one of the primary foci of these facilities is on sustaining and enhancing quality of life while eventually helping patients and families cope with the dying process, both the physical and social environments are critical to the facilities' success and the users' well-being. Healing, or restorative gardens and other designed green spaces have been suggested by many academics and practitioners as important components of these environments, yet there has been relatively little systematic research on the use and benefits of nature in this context. Do elderly residents of long-term care facilities benefit from access to outdoor areas? What are the design characteristics that are most important for this unique population?

Forty elderly residents of three different urban long-term care facilities were interviewed about the importance of outdoor green spaces and views within the facility, their use of the facility's outdoor spaces, benefits they derive from those spaces, and barriers to using the spaces. Facilities differed both in terms of the amount of nature in their outdoor spaces and in the design of, scale of, and access to those spaces. Results show that overall residents place a high value on access to green spaces and derive a number of benefits from these spaces, yet they spend relatively little time in these settings. Barriers to greater use of outdoor spaces included physical limitations, lack of staff assistance, and design issues. Implications for the value of nature spaces in long-term care facilities are discussed, along with specific design recommendations.     

Housing for Older People in Iceland: Apartments and Nursing Homes

The first residential and nursing homes in Iceland were built in the early 1920s, and the first apartments for older people in the early 1970s. Most of the existing housing for older persons was built in the last 30 years. Legislative provisions on housing and particularly on assisted living have not changed significantly since laws relating to the affairs of the elderly were first passed in 1983. While approximately 90% of older people in Iceland own their own home and the primary stated goal of the government is to support independent living, official policy relies on placement in nursing homes. Services and care at home, provided by social and home healthcare services, has not been developed to the same extent as in the other Nordic countries. Clearer guidelines on integrated service housing are needed to reach the government's primary stated goal. Placing more emphasis on delivering services, care, and rehabilitation to people living in the community could shorten individuals’ length of stay in hospitals, delay admission to nursing homes, and better meet the expectations of older people for independent living.     

Demographic Characteristics

This article aims to describe the characteristics of and design elements in gardens/patios at 87 residential living homes for older people and to describe and compare residents’ and staff members’ perceptions of outdoor spaces. The aim was also to investigate factors related to residents' satisfaction with and stays in the garden/patio. The result showed that many gardens/patios had several recommended design elements and, at the same time, obvious deficiencies. The residents (n = 415) valued various aspects of the garden/patio more highly than did the staff (n = 667). Managers responsible for residential living homes for elderly people should take measures to ameliorate deficiencies and deficient elements in design and accessibility that are lacking so that the garden/patio can be used as an important health promotion resource in the care of elderly people. Residents and staff are important actors in such development work.     

Health and Aging-in-Place: Implications for Community Practice

ABSTRACT

There is increasing interest in helping elders to remain independent in their homes. As the nation experiences the unprecedented growth among its oldest residents, public and private efforts are emerging to facilitate aging-in-place. However older people, particularly the oldest old, experience a myriad of issues impacting their health and ability to remain at home. This article presents the findings from a needs assessment of a Naturally Occurring Retirement Community (NORC) (n?=?114) that revealed multiple health-related issues among older people residing in high-need neighborhoods. The study utilized a holistic perspective of health to measure physical, mental, and social well-being among the older residents. Implications for community-based health interventions to enhance aging-in-place are discussed.     

Age Segregation and the Quality of Life of the Elderly People in Studio Apartments

ABSTRACT

The paper attempts to ascertain the impact of age-segregation on the quality of life of elderly people who are living in studio apartments in Singapore. After a review of the relevant literature and statistical analysis of a survey data for 390 elderly respondents in studio apartments, it was found that age-segregation have a deleterious impact on the quality of life of the elderly people. Furthermore, it was found that the perception of the elderly in relation to factors that are most significant to their quality of life is at variance with that of the policy makers. This implies that there is a need for policy makers and service providers to review their existing policies, products and services so as to be more effective in providing housing options for the rapidly aging population of Singapore.     

Sibling Roles in the Lives of Older Group Home Residents with Intellectual Disability: Working with Staff to Safeguard Wellbeing

Abstract

When parents die, siblings of older people with intellectual disability are likely to take responsibility for oversight of their wellbeing and negotiation with formal support services. This study explored the roles siblings played in the lives of older people with intellectual disability who live in group homes, and the relationships between residents’ siblings and group home staff. The siblings of 13 group home residents and the 17 supervisory staff associated with these services were interviewed, initially face-to-face and then intermittently by phone over a period of three years. Data were analysed using an inductive analytical approach. Siblings valued the relationship with their brother or sister with intellectual disability and played a significant role in safeguarding their wellbeing. Sibling–staff relationships fluctuated over time, sometimes becoming tense and difficult. Few protocols guided these relationships. A principle-based framework could facilitate negotiation between staff and siblings about expectations of communication and decision making.