Live-in Care Workers in Sheltered Housing for Older Adults in Israel: The New Sheltered Housing Law

Supportive housing schemes were historically aimed to provide group accommodation for older adults. With the aging of residents, facilities were required to enable them to receive care services in order to allow them to age in place. Thus, different countries and different facilities developed different models of housing with care, reflecting cultural and policy diversities. Despite all of the different models, there are many commonalities among the supportive housing schemes across countries. These include provision of dwelling units and care services provided by either the facility or by external agencies. The aims of this article are threefold: to describe the historical development of the ever-evolving supportive care housing phenomena; to point at variations in models of housing and care within the international context; and to present a new Israeli model that enables residents to privately hire live-in care workers to meet their care needs. This is a unique model in the international context that has not been reported before. The article describes the main ideas of the new model and discusses the challenges that it raises and pinpoints the unresolved issues associated with the presence of live-in care workers employed by residents of sheltered housing that should be addressed.     

Supportive Housing Initiatives in Arkansas

Abstract

Arkansas has a significant need for improving the availability of affordable housing with access to supportive services for its large population of elderly and persons with disabilities. Factors that contribute to this need are the high level of poverty, general poor health, low employment rate for persons with disabilities, and the geographic and social isolation problems typical of a rural State.     

Housing Policy in the United States

No abstract available for this article.     

The Impact of Economic,Demographic, and Cultural Changes on Preferences for Independent Living Arrangements and Seniors Housing in South Korea

Abstract

Asian countries are experiencing demographic, economic, and cultural changes that are altering housing and living arrangements. Many South Korean baby boomers will enter retirement with sufficient financial resources to live independently of their children if they choose to do so. Using a derivation of push-pull and life-course movement models, regression analysis results indicate that preference for both independent living arrangements and seniors housing is related to availability of pension resources, sex, presence of a son, and attitudes about intergenerational living, in-home care, and seniors housing. Pensions are an enabling factor; however, the cultural expectation of the eldest son providing housing for his aging parents may continue to moderate the demand for seniors housing developments. [Article copies available for a fee from The Haworth Document Delivery Service:     

Organizational Fields and Third Sector Housing in Ireland,North and South

This paper applies organizational field analysis to compare the structure of the third sector housing fields in Northern Ireland and the Republic of Ireland. Following preliminary accounts of history, structure, funding, and regulation, four key dimensions of field structure are compared: interaction, subgroups, structural equivalence, and patterns of domination. In both fields studied, early steering by the state into specialist roles has been overtaken by state funded expansion in general needs housing--increasing the dominance of larger organizations and tensions around voluntary sector identity. However, differences remain in the extent of domination and tightness of field structure, with greater emphasis on whole organization regulation, and adherence to professional and trade bodies in Northern Ireland. It is also shown how cross-border activity and the espousal of a European model will influence future trajectories.     

Assisted Living for Lower-Income and Frail Older Persons from the Housing and Built Environment Perspective

Abstract

This paper examines the linkages between housing and supportive services from the built environmental perspective. When it comes to linking supportive services, it is usually true that the wealthier an individual is the more private resources he or she has available to define a personal support system at every step in the aging process; the poorer the individual is, the fewer choices she or he has and the successful linkages of government subsidized housing, health and supportive services become more important to successful aging of that person. Low-income and aging individuals are the real testing ground for whether current policy allows holistic support linkages to occur and whether programs are available in both the quantity and quality to empower low-income older persons with options and support choices.

The discussion that follows is limited to supportive services and aging in place in conventional housing and affordable purpose built assisted living programs and facilities; it omits institutional living. For low-income older persons, institutional care provides few if any housing choices or individual power to control support delivery, and thus linkages between cooperating support professionals and programs becomes increasingly moot.     

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.     

Scandinavian Contrasts and Norwegian Variations in Special Housing for Older People

De-institutionalization is a general trend for Scandinavian long-term care over the last decades. Denmark and Sweden have taken this trend a step further than Norway has, as Denmark suspended institutional care altogether in 1987 and Sweden in 1992. Since then, residential care has been provided to individuals in special housing in various forms. This housing is in principle “independent housing,” where residents are tenants and are provided services according to needs and not sites. This article concentrates on the Norwegian variations to this system, as this is the only country of the 3 that still provides residential care under 2 “regimes,” an institutional care regime and an assisted housing regime. Is assisted housing essentially different from institutional care, or is it better described as old wine in new bottles? The latter may be the case for Sweden, whereas Denmark stands out as having the most housing-oriented care model. Institutional care (i.e., nursing homes) still dominates in Norway, where assisted housing is merely a minor supplement to institutional care in most municipalities. The article explores the reasons for these trends and, in particular, the reasons for the Norwegian resistance to assisted housing as an alternative form of residential care.     

Competing Drivers of Hybridity: Third-Sector Housing Organisations in Northern Ireland

This paper explores the complex process of hybridisation of third-sector housing and support organisations (TSOs) in Northern Ireland. The focus of the study is the policy field of housing-related support services, known in the UK as ‘Supporting People’. This is a hybrid policy field involving several government departments, a number of market mechanisms and two types of third-sector actors. The exercise of organisational agency to adapt to competing drivers is illuminated through mental health and homelessness case studies. The paper explores how competing external influences from the Northern Ireland Assembly, horizontal policies for the third-sector and vertical service commissioning policies interact with TSOs’ own adaptation strategies involving the deployment of robust third-sector identities. Hybridisation is found to involve not only the dominance of state drivers and the promotion of market mechanisms in both fields, but also enactment of third-sector identities. Our analysis of hybridization in this case counters Billis’ (2010) representation of third-sector identity as weak, in flux, and subject to erosion by focusing on the agency of TSOs to strategically adapt to and negotiate external drivers and thereby achieve competitive advantage. Through the enactment of identity in this adaptation process, resources such as legitimacy, charitable income and volunteers are secured. This provides opportunities for policy makers to add value if they are prepared to emphasise horizontal over vertical policy goals.     

将廉租房与公租房并轨，创新租赁型保障房管理模式

目前,我国基本形成了以廉祖住房为基础、以公共租赁房为重点,包括适当发展经济适用房和限价商品房、加快各类棚户区改造在内的城镇住房保障体系。这种住房保障制度和体系存在诸多问题,如产品种类偏多、管理不善、退出机制缺失等。针对租赁型保障房,应创新运行管理模式,逐步将廉租房与公租房并轨,统一规划、统一建设、统一审核、统一管理,实行分级补贴、租补分离、明收明补,以完善租赁型保障房制度体系。     

Testing of the Function Focused Environment Assessment and the Function Focused Policy Assessment in Assisted Living

This study tested two new instruments, the Function Focused Environment Assessment (FF-EA) and the Function Focused Policy Assessment (FF-PA). The measures were developed for clinical evaluation of assisted living (AL) settings to help optimize function and physical activity among residents. In total, 106 AL settings and 242 residents were included. There was evidence of item reliability (0.92) and interrater reliability (kappa =0.40, p = .015; agreement 85%) of FF-EA and item reliability (0.89) and interrater reliability (kappa =0.48, p = .001, agreement 82%) of the FF-PA, and support for validity of both measures based on INFIT and OUTFIT statistics and hypothesis testing.     

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.     

The Prospect for the Future of Continuing Care Retirement Communities in New York State

No abstract available for this article.     

Affordable Clustered Housing-Care: A Category of Long-Term Care Options for the Elderly Poor

ABSTRACT

What we label as affordable clustered housing-care options are making it increasingly possible for poor and frail older Americans to age in place comfortably and securely in residential-like settings combining both affordable shelter and long-term care. The hallmark of these housing arrangements is their sizable population clusters of low-income frail persons in need of supportive services. Despite their greater availability and the compelling factors underlying their growth, the diversity of their supportive services and operations cloud their identity resulting in uncertainty as to whether they have a common mission. In response to the need for a more careful delineation of this aging in place option, this paper describes the distinguishing features of these hybrid settings and constructs a typology of their representative exemplars or prototypes.     

You Can't Get There From Here: Reaching the Outdoors in Senior Housing

By providing access to outdoor environments, exterior doors can enhance the sense of freedom in residential environments for aging. However, doorways may also present barriers to outdoor access. Using environmental audits, this study examined doorway problems at 68 assisted living facilities in three geographic regions. Results were compared with resident surveys (n = 1,128), staff surveys (n = 432), and resident focus groups (n = 76). Specific doorway issues were found to be associated with residents’ weekly minutes of walking, outdoor usage, and perceived ease of reaching outdoor areas. The main problems were door opening/closing, thresholds and landings, and self-locking doors. The findings indicate that exterior doorways often present barriers to assisted living residents, resulting in lower levels of walking and outdoor use. By discouraging these health-related behaviors, doorway problems may negatively affect residents’ health and well-being. Practice implications suggest that many existing doorway problems, such as high thresholds or excessive opening force, are easily remedied.     

Chapter 6 Life-Span Design in the Near Environment

Abstract

Elderly are influenced daily by their buildings and their very independence can be shaped by the design of residential structures and interiors. This article addresses the incorporation of assistive technology into the design of near environments for this population. First, a brief overview of assisted living in the United States, identifying the definitional and regulatory problems confronting assisted living is provided. Next, we identify the importance of the near environment in life-span design. We then examine the Nordic model of design for assisted living and efforts in the United States relating to the design component of assisted living facilities. We conclude by reviewing the importance of the near environment and its role in housing policy, regu-lation, productdesign, andfacilitydesign.     

The Continuation of Dwelling: Safety as a Situated Effect of Multi-Actor Interactions Within Extra-Care Housing in Sweden

This article examines the space–time situatedness of residing within extra-care housing (ECH) in Sweden. EHC constitutes an example of ordinary housing but is often categorized, along with senior housing, as “in-between housing.” What differentiates the extra-care housing from the ordinary is an age limit for moving in, the provision of communal facilities, and the presence of staff at certain times each week. Two housings with different environmental and architectural conditions have been analyzed through spatial analyses, observations, and interviews with residents (n?=?18). The article concludes that the two different assemblings enabled two very different possibilities for accessing “safe aging.” One offered opportunities for the continuation of identities which contributed to feelings of safety, and one demanded the reconstitution of identities for developing meaning in the new housing.     

Housing Preferences of Vulnerable Elders in Suburbia

This article explores whether well and vulnerable elders residing in the suburbs differ in terms of: their level of satisfaction with their current living arrangement; their perception that they face a move within the next two years; and their level of interest in a series of different housing options. Our data support theoretical models that pose that diminished economic, physical, and social resources "push" vulnerable elders towards relocation. The data revealed that while the majority of well and vulnerable elders expressed high levels of satisfaction with their current homes, the vulnerable elders were significantly more likely to feel they faced an upcoming move. Housing options of interest to these vulnerable elders and implications for community planners are also addressed.     

The Physical Housing Environment and Subjective Well-Being Among Older People Using Long-Term Care Services in Japan

Abstract

For older people using long-term care services, the conditions of their life-space may be critical. The relationships between the physical housing environment and aspects of health were examined among older people in Japan (aged 65+ years, N?=?1,928) by multivariable logistic regression analysis, adjusting for sociodemographic characteristics. Lack of safety, low access to emergency assistance, low or high indoor temperature, poor sanitary conditions, and state of home disrepair were significantly associated with negative aspects of health among people with low activities of daily living (ADL) independence. Home care service providers and policymakers need to consider the importance of appropriate environmental conditions for the most vulnerable groups.