EQUAL: Profiling the Housing Stock for Older People: From Domesticity

The study set out to profile the full spectrum of housing, support and care in which older people currently are living, with the aim of classifying the housing stock so as to embrace both architectural and quality of life variables.

The study comprised two strands;

1. The first was an analytic study of 120 housing and residential settings in six typical localities in the UK, based on a combination of plans and visits to both standard and innovative examples. This brought breadth and inclusiveness to the research.
2. The second was a detailed ethnography of the home lives of 60 older informants living in the six localities. This gave the research depth and insight.

The purpose of the larger, analytic study was to identify the key elements of any new classification or housing profile. This work also included a re-evaluation of the existing literature on older people and their housing options. A second aim of the analytic study of the large sample of homes was to provide a 'test-bed' to evaluate the key dimensions that we identified in the literature and through an extensive study of a wide range of domestic settings.

To reflect a wide range of geographical and locational parameters, we sampled along two transects, one in the south-east and the other in the north-west. The former ran from rural East Anglia, through Central London and on down to the South Coast. The latter ran from the Fylde coast, through Merseyside and Greater Manchester to rural Cheshire.

The database of house plans that informed the research comprised 280 examples. For each example in the database, detailed floor plans were obtained and checked for accuracy. The database included examples of all of the types of accommodation, which we envisaged that older people might be living in and also covered the main types of tenure.

For each example on the database we produced a measure of self-containment and a breakdown of the space standards for the main activities of the home. Each was assessed to determine its compliance with Part M of the Building Regulations and the Lifetime Homes standard. A 'configurational analysis' of each example was carried out to reveal the main features of the layout and the extent to which different house types are associated with different design principles. This allowed us to compare the characteristics of the different types of housing that older people are living in with the characteristics of the general UK housing stock.

A major innovation of our research, compared to previous research that had addressed the housing needs of older people, was the intention to develop a way of classifying the housing stock that took into account the experiences of older householders. To this end, we included within the larger study a more detailed ethnography of the home lives of 60 older people, drawn from the six localities where we conducted fieldwork. Our informants were living in a wide range of house types and tenures, but had in common the fact that they were experiencing a change in their housing circumstances. This focused attention on the relation between people's housing, support and care needs and the ability of different home environments to respond to their requirements.

With the help of our older informants we therefore:

• Gathered detailed information about the housing circumstances of the 60 older people living in the six localities;
• Understood, through discussion with the older people themselves, the ways in which the design and layout of their housing was either enhancing or detracting from their quality of life, including any arrangements for care and support;
• Produced, and made widely available, a report and guidelines for all concerned - architects, planners, managers, older people, their relatives and carers which reveals what older people prefer and need in their housing.

A fundamental aim of the research was to be responsive to the voices of our informants as they described their ideas and aspirations about the kind of housing and support they wanted, as they grew older. A major part of our mission was to voice the views of older householders directly to designers and to articulate their concerns in a way that could influence housing policy and best practice.

The main finding of the research is that the most appropriate basis for a new classification of housing and care is not through developing a more sophisticated typology of built forms but by specifying the level of care that each dwelling can accommodate. The built forms of housing are relatively fixed and adapt slowly whereas concepts of care evolve rapidly in response to changing social trends. Integrating the two in a single description - as, for example, in the term 'sheltered housing' - is therefore not the best way forward. Rather, the attempt to integrate the two has led to a proliferation of terms. Our research suggests that the two elements of the equation, housing and care, are best dealt with separately.

The amount of care that is needed or offered can provide the basis of a simple and consistent three-tier classification. Basically, most older people require one of three broad levels of care:

1. Most older people live independently with little need for additional medical or personal intervention other than that which might apply to the generality of the population, in circumstances such as an illness or in an emergency. We may consider this first level as that of independent living. It is how most adults of all ages choose to live.
2. Some people, however, need a little more support, usually with housework, personal care or medication. Support is usually provided at a low intensity but on a regular basis, or intermittently but for a more prolonged period of interaction. It may be a weekly encounter, or one that takes place every few days or for a short time on most days. The contact time between helper and recipient is of the order of about 3-5 hours per week, or less than an hour's contact time per day. Here, the distinction between personal and medical help is fuzzy, and how it is regarded by service providers may depend as much on the qualifications of the person who is helping as on the nature of the help itself.
3. The third level, that of requiring care, implies a more structured, regular, intense and durable relationship between the carer and the recipient. This is more about regular daily care, perhaps on more than one occasion each day and probably of the order of more than one hour a day in total. Again, care could be medical or personal and the boundary between the two may often be unclear.

All three levels can be delivered in a way that promotes independence. In principle, they can all exist in a wide variety of home settings. However, in practice not all homes are capable of accepting all three levels of independence support and care. Ensuring that all house types and tenures are inclusively designed is therefore the means to ensure variety and choice for older people in how they live at home and relate to others of a similar age or to different age groups, in a situation where independence, support and care provide a dimension of consistency. 

This research project was headed by Julienne Hanson, Professor of House Form and Culture at University College London (UCL) together with Professor Mike Rowlands at UCL's Department of Anthropology and Leonie Kellaher from the Centre for Environmental and Social Studies in Ageing (CESSA). The team included Dr. John Percival and Reem Zako.