Dr Rachael Docking is Ageing Better’s Senior Evidence Manager. Rachael’s remit is to work on their evidence work stream and manage one of their programmes of work, as well as providing cross-cutting evidence support to other work-streams. Rachael leads on their homes and neighbourhoods programme and has also been managing a commissioned review on inequalities in later life.
Jill is 68 years old. She’s still working and cares for her husband. With reduced mobility due to osteoarthritis, Jill has been in a lot of pain, living in a house that wasn’t suited to her changing needs and didn’t know where to turn to for help. She began to develop coping strategies like shuffling upstairs on her bottom, and couldn’t bathe or shower properly.
After a needs assessment from a local occupational therapist, Jill had a number of adaptations installed at home, including a wet room and extra stair rail. As a result she can now shower herself and though still in pain, the adaptations have helped her remain in her own home.
It’s common to think that this kind of situation happens to ‘other people’. But the reality is that the longer we live the more likely we will experience these sort of challenges. At the age of 65, around 16% of us will struggle with at least one basic daily activity like cooking, washing, dressing or going to the toilet. By our late 80s over one in three of us will have difficulty undertaking five or more daily activities unaided.
Adapting and improving the home can vastly improve its comfort and usability, and ensuring an ability to carry out daily activities safely, comfortably and with dignity. Yet figures show that at least half a million people in England are living without the adaptations they need – and this is probably an underestimate, given the way that the data is collected.
The Centre for Ageing Better’s report published last month shows that people can be put off installing adaptations until they reach a point of crisis. Like Jill’s experience, this can have a hugely detrimental impact on people’s quality of life, and is no way for anyone to live.
The majority – more than 90% – of people aged over 65 in England live in mainstream housing, rather than specialist housing or residential care. But current UK housing is in poor condition, often not accessible or adapted to meet people’s needs as they get older.
Luckily for Jill she eventually got the right kind of support. But making small changes to homes such as installing handrails, ramps, and level access showers is something that we should all be prepared to do before problems arise.
The evidence shows that these changes are most effective when installed early on in combination with home repairs and improvements. They need to be tailored to each individual person –focussing on what they want, rather than what others assume they need. This is important not just for those of us needing such support, but will help reduce pressure on our health and social care system.
Action is needed to remove the barriers that delay people from installing aids and adaptations. These include Local Authorities not providing enough information and advice about what’s available and a lack of well-designed products which blend into the home and don’t appear overly medicalised.
If we want a good quality of life and to remain living at home into old age, we must prepare for it. The earlier we do, the easier it is to take control and make the changes to our homes that will help ensure we can enjoy our later lives in a safe and supportive environment.