Does your home suit you?

Making the housing link to long term health conditions in later life

Sue AdamsCare & Repair England

Remit of presentation

Brief overview of emerging policies

Policy message: Make your own provision/ plans for later life care

What can people do to prepare their homes, particularly if they have a long term health condition?

How can OTs contribute?

Who?

Care & Repair England; national housing charity aims to address poor and unsuitable housing conditions amongst older population, particularly low income home owners (since 1986)

Pioneered; local Care & Repair services, Minor works grants, Handyperson, Housing Options, Healthy Homes, Older People & “Housing Activism” plus related policies esp. adaptations and PSHR

Age of Uncertainty……..

Age of Uncertainty………….

Fundamental shift in thinking

Revision of ideas around role of the state vs the individual including disability and later life (OP=half+ of all disabled)

Social model of disability and responsibility of society in enabling independence and inclusion being questioned

Social Model of Disability

Disability arises from the barriers presented by society and the built environment rather than being inherent in the person themselves

Society should make adjustments to ensure the inclusion of the individual, regardless of their differences

Eg. Housing world argued for universal Lifetime Homes design principles – lost?

Age of Uncertainty: Social Care

State is re-negotiating its ‘contract’ with citizens and their care & support, particularly in later life

Dilnot reviewed adult social care funding and Law Commission reviewed legislative framework

White paper & Bill - now progressing through Parliament

Age of Uncertainty: Housing

State’s role in housing – massive change

100% cut in private housing funding

73% cut to DCLG capital funding, end of social housing grant

Welfare reform

Localism, deregulation: Planning reform/ Building Regs reform

[DFG survived last CSR…….]

Time lag……..

Between ideological shift and law

Between policy & implementation

This can be problematic for practitioners, but we can expect…

Where will this take us?…..

Enable individual choice

Promote self help

Closer ties between health & care

Do we have the right homesto enable self help?

Making the health connection

Suitable stock now?

1.4 million individuals reported having a medical condition or disability that resulted in them requiring specially adapted accommodation

22% said they lived in unsuitable homes

Survey of English Housing – Annual, CLG

Suitable stock in the future?

The number of older disabled people is expected to double from 2.3 million in 2002 to 4.6 million by 2041

On current projections in 2036, 810,000 people aged 75 or more would be living in properties that they consider unsuitable for their needs.

The vast majority (c 70+ per cent) 567,000 will be owner occupiers

Building for the Future?

Low rate of new build and less adaptable than much of the older stock (all tenures)

Majority will still wish (or have to) live in mainstream housing, hence rising need for adaptations

Issues: security of tenure/ welfare reform

The housing and health link

Integration Agenda

Health and Social Care integration- theme in DH policy

Need to put housing into the frame

LTCs and demographic trends set to transform approach to health care – housing key to many strategies

Long Term Health Conditions

There are 15.4 million people in England with at least one long-term condition

Three out of every five people aged over 60 in England suffer from a long-term condition

Major challenge in health care is treatment of multiple LTCs

Long Term Health Conditions

Housing link to: Arthritis Stroke Heart Disease Macular Disease Dementia COPD/ Respiratory

Housing links to health issues

Physical Respiratory

conditions Arthritis Cardiovascular

conditions Falls Accidents General increased

risk of infections

Emotional Stress Depression Social Isolation

LTC & housing self help guides

Ran housing options workshops with people with range of conditions

Limited information about housing options on main health condition sites

Barriers to accessing help and information unless in crisis

Stories and feedback from local Care & Repair services

Filling an information gap

Ideas for making adjustments to existing home in advance of crisis

Thinking about longer term suitability and alternative options

Recognise limitations for individual actions in some cases – not a solution for everyone but a start

Limits

Can only go so far with poorly designed property

Limits to individuals’ resources

Self help guides useful for…..

‘Younger old’ individuals esp. for early stage diagnosis

Carers and families of people with higher level needs

Professionals – key role in passing on information & could locally tailor

Example of self help guide content

Making your home easier to live in when you have a xxx conditiondesign and layoutventilation and heatingsafety and securitygoing out and aboutgadgets and equipment

Thinking about moving home – www.firststopcareadvice.org

Sources of related advice and information

Illustration of topics covered

Ventilation and air quality (furnishings, moisture level control etc)

Room layout, storage, positioning of frequently used items

Viability of adaptations, equipment and assistive technology potential

Occupational Therapy

Key to the self help and prevention agenda

Integration in action

Shift to enabling role?

Looking ahead

Opportunities?

Rhetoric of health, care and housing working together – maybe trial projects around self help as part of Health and Well-Being Strategies?

Clinical Commissioning Groups?

Hospitals??

Opportunities

Pass on information via self help groups – maybe develop locally tailored supplements

Lessons from our ‘If only I had known’ housing help in hospitals projects – integration in action

Look out for

DH Strategy on Long Term Conditions

DH funding for information provision (in White paper)

Integration and prevention initiatives

Have a look now at new Hospital2Home Package

Contact Details info@careandrepair-england.org.uk

Weblink to six Housing and Health Condition practical guides plus ‘If only I had known..’ reports

www.careandrepair-england.org.uk

Click on Home from HospitalHospital2Home pack -

http://housinglin.org.uk/hospital2home_pack/