Spatial dispersion of housing units as an important factor influencing long-term care operational costs (original) (raw)
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Developing a framework for housing models to age in place
2019
The global population is ageing at a rapid pace, accordingly many countries implement ageing in place policies to prevent unmanageable growth of costs of institutionalised care settings. Like many other countries, the Dutch government also shifted towards ageing in place policies to reduce the costs of institutionalised care settings. Ageing in place is aimed at allowing the elderly to live independently and stay part of the community. Therefore, policies and services are increasingly aimed at supporting the elderly in ‘place’, where ‘place’ consists of the dwelling and its surrounding environment. However, the current ‘place’ may not always be the best option for the elderly to receive care and support in order to age in place. The playing field of housing and care has made a significant transition since the decentralisation of the General Act on Exceptional Medical Expenses. Due to the changes in national policy and legislation, the binary perspective on housing for the elderly, i...
2019
Background: The risk of entry into a nursing home has been shown to vary according to geographical and clinical factors, although the effect of location could be due to confounders. The main objective of our study was to describe their perception of their place of residence in adults aged over 65 in four European countries. Methods: The cross-sectional survey was carried out in February 2016 by a poll institute in a representative sample of individuals from a population of retired residents in four European countries, selected by quota sampling. A total of 4160 subjects aged 65 or older were selected. For descriptive analysis, qualitative variables were presented with absolute frequencies and percentages. A Principal Components Analysis was performed, and clusters were identified using results from the analysis. Results: The study population comprised 4160 individuals from Germany, Belgium, France and Italy. Overall, 2389 (57%) were women; 1414 (34%) were aged 65 to 69, and 2709 (65...
Preparing to age in place: attitudes, approaches, and actions
Housing and Society, 2016
Aging in place (AIP) implies an ability to live in one's own home, preferably to the end of life, to avoid institutionalization. AIP can be approached in a number of ways; however, the goal of remaining in a personal home with the ability to physically navigate through its design is paramount. Preparing to age in place during one's younger years can mitigate house design needs that may occur later in life and under more challenging circumstances which may affect such implementation. The purpose of this research was to characterize those who had purposefully undertaken efforts to age in place for the remainder of their lives through either house modifications or relocation to more appropriate housing. In an anonymous online survey of 225 participants, 24% of boomers (aged 50-64) and 38% of nonboomers (aged 65+) had made modifications, and 12% had relocated. The strongest motivators for home modifications were to stay independent (81%) and in the community (70%), whereas anticipating declining health was the least (35%). This study contributes to the literature by examining the concept of AIP through attitudes and approaches to accommodating future needs. Suggestions for design and related industry professionals are made to be creative to accommodate aging clients while emphasizing independent living.
Aging in Place or Relocation? Plans of Community-Dwelling Older Adults
Journal of Housing For the Elderly, 2014
This study examines the anticipated housing options of 416 community-dwelling older adults from a semi-rural upstate New York county using data from the first two data collections of the Pathways to Life Quality Study. Aging in place, either with or without home modifications to meet special needs as they arise, is seen as the most likely anticipated housing, followed by moving to a retirement community and living with others. Measures of psychosocial well-being, variables assessing resident satisfaction with current homes, health status, and moving intentions were entered into structural equation models in an effort to predict perceived likelihood of living in select housing arrangements. Our findings indicate that those who were considering a move were more likely to consider retirement communities rather than moving closer to relatives. Home satisfaction measures were related to the anticipation of remaining in one's home with modifications. Factors that can be predictive of ability to successfully age in place, such as better health and social support networks, were not significant. Additional research on moving intentions in conjunction with housing options is needed. Although many new types of senior housing have emerged in recent years, marketing and educational materials may not be reaching the older adult populations.
An Analysis of the Factors That Influence Elders’ Choice of Location and Housing
International Journal of Business Administration, 2016
This study was aimed at determining the pull and push factors that influence elders' choices of housing and location. The study sample consisted of 150 seniors aged 60 years and older. The participants were selected by using "snowball sampling technique" and were included in a survey. It was found that the rate of participating elders who did not want to move from their current houses was higher than those who did. The rate of females who did not want to move was higher than that of males (p<0.001). The study results revealed that the most important push factor for elders who moved or considered moving was making plans for the place they wanted to live for the rest of their lives. The mean score of males at this point was found to be higher than that of the females (p<0.001). The main pulling factor among elders who wanted to stay in their houses was the feeling of security. The mean score of females at this point was higher than that of males (p<0.01).
Voices on Relocation and Aging in Place in Very Old Age--A Complex and Ambivalent Matter
The Gerontologist, 2013
This cross-national qualitative study explores how very old people reflect upon relocation and aging in place. Design and Methods: Swedish and German data is utilized in this study. Eighty community-living participants, 80-89 years of age were interviewed with open-ended questions at home by trained interviewers. The interviews were analyzed by using conventional qualitative content analyses. Results: Reasoning about relocation or aging in place in very old age is a complex and ambivalent matter. A variety of reflections, emotions, and behaviors, for and against a move are revealed. Reasons to move reflect the urge to maintain independent, to stay in control and avoid loneliness. This is mainly expressed reactively. Reasons not to move reflect a strong attachment to the home and neighborhood. Moreover, reasons not to move reflect practical aspect such as economy and strain, as well as fear of losing continuity of habits and routines. Implications: There is a need for society to develop counseling systems to meet very old people's ambivalence and practical considerations to a move or not to move. Thus, the ambivalence to stay put or to relocate needs to further be explored from an applied perspective by also taking non-movers into account.
Planning for aging populations: inside or outside the walls
Progress in Planning, 2001
Over the past 15 years, OECD countries have come to recognise that their elderly populations are already, or will be, the fastest growing segments of their populations in the coming decades. In recognition of these demographic facts, public and private sectors planners with responsibility for housing, health and social services and transportation have divided into two camps. In one camp are those who believe that the full integration of the elderly population within their communities is the best way to insure the maximum life satisfaction of the elderly population over the longest period of time. This view manifests itself in proposals to allow`in-law suites' to be built in areas zoned for single-family dwellings, deinstitutionalisaton and concomitant development of community-based care, and public transit systems made fully accessible to seniors regardless of their level of physical ability. In the other camp are those who believe that the elderly population wants and seeks a built environment which speci®cally caters for their particular needs. The most visible manifestations of this perspective are the`seniors only communities' with their separate health and social services, and transportation systems. This paper focuses on integration versus segregation in planning housing, health and social services and transportation for seniors over the past 15 years (1986±2000). We emphasise that the planning outcomes of integrated-based and segregated-based solutions need to be understood within the broader socio-economic and legal contexts in which planning takes place. Underlying the integration-segregation dichotomy is the broader theoretical dichotomy of equity-ef®ciency.
Journal of Aging Studies, 2020
Older persons prefer to age in place or stay put in their current dwellings and move less frequently than any other age group. However, current residential mobility theories do not fully account for these preferences and behaviors because they focus on why older people move rather than on why they remain in their dwellings and do not consider the temporal or human developmental context of these residential decisions. It is essential to understand why older persons are reluctant to move because their ability to age successfully-have healthy, independent, active, and enjoyable lives-depends on where they live. When they stay put, they also rely more on family caregivers and paid home care providers to maintain their independence, rather than on the supportive services offered by senior group facilities, such as assisted living. They demand more home modification and financial service products, and their residential decisions influence the supply of housing that younger populations can potentially buy or rent. This paper's theoretical analysis proposes that Carstensen's socioemotional selectivity theory (SST), a lifespan theory of motivation, improves our understanding of why older persons age in place-either in their dwellings or more broadly in their communities. It offers an alternative interpretation of how life-changing events, such as retirement, lower incomes, spousal death, physical limitations, and health declines, influence their residential decisions. Whereas residential mobility theories view these transitions as disruptions that change the appropriateness or congruence of where older people live, SST proposes that older persons perceive these events as signs or cues that they are closer to death and must differently prioritize their goals and emotional experiences. Feeling their time is "running out," older persons are motivated to stay put because moving requires preparations that are physically and emotionally trying and they are able to adapt to their current housing shortcomings. Their residential environments are now also a source of difficult-to-replace positive emotions and provide them with a supportive network of intimate and reliable interpersonal relationships. It is challenging for them to learn how to safely and efficiently conduct their usual activities and routines in another location and to establish new residential attachments and social connections. They would benefit from any net positive emotional payoffs only in a distant future, an unattractive prospect when they perceive a limited time left to live. Empirical studies must test the theoretical propositions presented in this paper. However, the disproportionally large projected future growth of the age 75 and older population with a heightened awareness of their limited time left to live should be a strong rationale for such investigations.
Moving house in old age and acceptability of different housing options
In Slovenia like in many European countries the predominant housing option for the elderly is living at home with the support of home care services and / or family, or living in an institutional care setting. Various studies indicate that elderly are unwilling to move house, and that health issues are one of important factors influencing decision to move. In our study we tested how willing the elderly would be to accept various housing options, in case of poor, diminished health. In this article we research this issue, based on a large representative quantitative survey among persons aged 50 and above (n=930) carried out in 2015. We look at the attitudes people have toward different housing options, with particular focus on less known options such as senior cohousing, household groups, caregiving family for the elderly people and multigenerational communities. Based on cluster analysis we analyse which housing options are acceptable to the older people of Slovenia, how people group regarding the acceptability of moving house when in need of care, and what are the characteristics of these groups, i.e. their sociodemographic characteristics, current dwelling and neighbourhood characteristics, urban/rural difference and attachment to dwelling and neighbourhood.