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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 [email protected]
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/