Housing with care for later life: a literature review

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Published: 22 February 2006

Housing with care for later life: a literature review

There is growing interest and investment in housing schemes for older people that combine independent living with relatively high levels of care.

A review published by the Joseph Rowntree Foundation looks at UK evidence around issues of:

· independence

· social integration, and

· the capacity of housing with care to meet a range of care needs

It focuses on primary research & service evaluations, drawing out key messages for service providers and commissioners.

The authors have added a ‘caveat’ because of the small evidence base, but it provides valuable insights into how well ‘housing with care’ serves current policy objectives and whether it meets the needs & aspirations of older people.

The general conclusion of the review was that evidence supports the idea that housing with care promotes independence and generates high levels of resident satisfaction, but that messages around other key areas are more ambivalent.

Quoting from the Findings:

Reflecting the current emphasis on evidence-based policy & practice, researchers at the Centre for Housing Policy at the University of York conducted an extensive search for empirical research evidence published since 1999 relating to housing with care for later life.

They found just eleven UK studies that sought to evaluate rather than describe schemes, encompassing 24 different schemes.

The review of these studies found.

· UK studies consistently demonstrated that it is the combination of independence and security that residents value. However, residents and providers do not always seem to have a shared understanding of what constitutes ‘independence’.

· Housing with care offers opportunities for social interaction and companionship, and there is much evidence of mutual support and neighbourliness. However, people who are very frail or who have sensory and cognitive impairments are consistently reported to be on the margins of social groups and networks.

· In some circumstances housing with care can provide an alternative to residential care, but the evidence suggests that it is not always a substitute for these settings. Residents moved to residential or nursing home care for a number of reasons, including increasing care needs and their own or their relatives’ preferences for something different, or perhaps something more.

· Evidence suggests that housing with care can have a positive impact on the health and well-being of residents, and that it is beneficial to their quality of life. However, studies relied heavily on expressions of resident satisfaction/contentment in arriving at their assessments; more robust quality of life measures were lacking in the evidence base.

· The evidence on the cost-effectiveness of housing with care is particularly limited and sometimes contradictory. Such as there is seems to indicate that housing with care may be more expensive than residential care, but may be cheaper than care delivered into ‘ordinary’ housing settings.

Sections headings in Findings

· Evidence from the UK

· Promoting independence

· An alternative to residential care?

· Home for life?

· Health status and quality of life?

· Is housing with care cost-effective?

· Gaps in the UK evidence base

· Evidence from other countries

Further information

Housing with care for later life: A literature review by Karen Croucher, Leslie Hicks and Karen Jackson

Findings with link to Pdf download