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Digital systems for independent aging, support and care are not being adopted as hoped. The purpose of this paper is to examine the results of three studies to derive key factors during the development and engineering process of care and support systems for older people that can impact acceptance and uptake to provide support to future projects.

The paper analyzed the results of three qualitative studies, including two detailed case studies and a further study with 35 participants, to derive key factors. Methods for deriving factors are based on thematic analysis to identify common factors across cases and participants.

The findings point to a broad set of interconnected factors that give developers of these types of systems specific recommendations. These highlight what makes these projects complex and identify implications for the development process. Furthermore, they show way the needed user-centered and iterative methods may be in conflict with funding processes.

While others have reported on single projects or looked at acceptance, these studies were the first to explore aspects of the development process that may contribute to the lack of success to date of these types of systems. The results here support more successful outcomes in the future, both by helping people involved in the development of these systems to avoid some of the issues others face and providing input to improve the performance of the engineering process.

This article analyses community care services (CCS) in terms of availability, awareness, accessibility, and acceptance (the Four A’s approach), untangles the deep-seated factors underlying the CCS and provides some short-term, medium-term, and long-term recommendations.

A literature review was conducted, including relevant government reports, consultation papers, Legislative Council papers and articles from academic journals from 1980 to the present.

The Four A’s approach shows that applicants to both centre-based services and home-based services endure lengthy waiting times because of the limited number of CCS. Furthermore, the awareness of day respite services is approximately 50 percent, which lags behind other CCS. Accessibility is contingent on a cross-district day respite service system and a lack of consistency between the quota and the proportion of older adults in the districts. Finally, the level of service provided by CCS is unsatisfactory due to inflexible service provision. Reviewing the brief history of long-term care services (LTC) reveals the deep-seated factors at the core of their heavy reliance on the subvention model, in contrast to the adoption of the ‘mixed economy of care’ by residential care services (RCS). An imbalance in budget allocation to RCS and CCS is also revealed.

Although the principle of ‘ageing in place’ was introduced in 1977, the institutionalisation rate (6.8 percent) of older adults remains unexpectedly high in Hong Kong, even surpassing its Asian counterparts, whereas the usage rate of CCS hovers around 0.8 percent. Thus, how to implement policy concerning LTC services for older adults must be re-evaluated.

With the context of changing global and local populations and, for example, their composition and distribution, this paper offers insight to food shopping in later life with a focus on Nottingham and Nottinghamshire in the East Midlands. The work is relevant and important due to the specific population makeup of this area and the challenges in achieving the UN Sustainable Development Goals (SDGs) as a result of population changes/challenges.

The work takes an interdisciplinary view and draws on literature from both social policy and social care and business and marketing. Using this work as a grounding, and insights to primary research from a wider study in this area, the paper offers discussion and comment on:

• the importance of food and food shopping in later life;

• issues of, and concerns for, health, well-being, identity and community maintenance and resilience (as a direct result of the challenge to SDG achievement); and

• the role(s) and responsibility of business from a core business and wider business/corporate responsibility perspective as a reflection of the above and findings of the work.

the importance of food and food shopping in later life;

issues of, and concerns for, health, well-being, identity and community maintenance and resilience (as a direct result of the challenge to SDG achievement); and

the role(s) and responsibility of business from a core business and wider business/corporate responsibility perspective as a reflection of the above and findings of the work.

Using primary research undertaken by the authors, the paper supports findings from existing work from across social policy and care and business and management – related to the practicalities, challenges and the role of and approaches to food shopping in later life. It specifically offers insight to the efforts made by older food shoppers to maintain their independence and support their choices in a context of interdependence (e.g. within a family, community and environment). The importance social aspects of food shopping (as a counter to isolation and loneliness for example) are also identified and how, for example, the actions of business(es) may undermine the efforts (and resilience) of individuals and communities. “Better” understanding of food shoppers by business and other stakeholders is promoted.

This paper aims to explore the social impact of the COVID-19 pandemic, focusing on issues facing older people living in urban areas characterised by multiple deprivation.

The paper first reviews the role of place and neighbourhood in later life; second, it examines the relationship between neighbourhood deprivation and the impact of COVID-19; and, third, it outlines the basis for an “age-friendly” recovery strategy.

The paper argues that COVID-19 is having a disproportionate impact on low-income communities, which have already been affected by cuts to public services, the loss of social infrastructure and pressures on the voluntary sector. It highlights the need for community-based interventions to be developed as an essential part of future policies designed to tackle the effects of COVID-19.

The paper contributes to debates about developing COVID-19 recovery strategies in the context of growing inequalities affecting urban neighbourhoods.

The aim of this paper is to argue for the values of familial caring and relationships in addition to the provision of social media technology during the COVID-19 pandemic in Hong Kong.

The discussion of this paper has adopted an inter-disciplinary approach by integrating health care system and psychological analysis, based on cultural philosophical argument through the hermeneutic approach of classical texts and critical analysis.

The COVID-19 pandemic has exposed the dilemma between the public health measures for COVID-19 and sustaining elderly social psychological health through familial connection. From a Confucian perspective, the practice of filial piety (xiao, 孝), which demands taking care of parents, is essential for one’s moral formation, and for one’s becoming a virtuous (ren, 仁) person. The necessity of taking care of elderly parents by adult children is not something that can be explained in terms of consequentialism. Indeed, the rising trend of instrumental rationality seems to weaken rather than strengthen the sense of filial obligation. In the face of the COVID-19 pandemic which tends to separate connections between family members, the author argues that we should emphasize the values of familial caring and relationship because it enhances the elderly’s characteristic of resilience.

This paper shows that while social media technology has mitigated the negative effect of social distancing, such online relationships should never replace the bodily connections between the elderly and their family members from a Confucian perspective.

Ageing populations induce needs to adapt existing housing. With ageing, the number of frail old people, who require assistance in daily life, is also increased. Converting existing housing into assisted living enables them to remain in their community while receiving necessary support and care. The purpose is to investigate whether post-war mass housing is spatially appropriate for adaptation into group homes for older people.

The research material is attained from Finland. Spatial requirements for group homes are drawn from 130 units built or renovated during 2000–2015. Spatial characteristics of mass housing are mapped from 105 apartment buildings built in the 1970s. The latter are matched with the former by comparing the connectivity of layouts, sizes of units and the numbers and sizes of individual spaces.

Group homes typically utilize a linear layout, which can easily be created in apartment buildings. Individual spaces of a group home fit apartment buildings effortlessly. Whole group home units mostly prove to be spatially feasible but result in looser dimensioning than is typical in existing units. The mass housing stock can be considered a spatial reserve for adaptation into group homes.

This is the first study to employ a large-scale, multi-case spatial mapping approach to analyse the adaptability properties of mass housing into assisted living. The findings pertain primarily to the Finnish context, but a methodology is presented which can be applied to other countries and also to other spatial functions.

The purpose of this study is to develop new type of reverse mortgage contract. How to provide adequate services and housing for an increasing number of people that are dependent on the help of others is a crucial question in the European Union (EU). The housing stock in Europe is not fit to support a shift from institutional care to the home-based independent living. Some 90% of houses in the UK and 70%–80% in Germany are not adequately built, as they contain accessibility barriers for people with emerging functional impairments. The available reverse mortgage contracts do not allow for relocation to their own adapted facilities. How to finance the adaptation from housing equity is discussed.

The authors have extended the existing loan reverse mortgage model. Actuarial methods based on the equivalence of the actuarial present values and the multiple decrement approach are used to evaluate premiums for flexible longevity and lifetime long-term care (LTC) insurance for financing adequate facilities.

The adequate, age-friendly housing provision that is appropriate to support the independence and autonomy of seniors with declining functional capacities can lower the cost of health care and improve the well-being of older adults. For financing the development of this kind of facilities for seniors, the authors developed the reverse mortgage scheme with embedded longevity and LTC insurance as a possible financial instrument for better LTC services and housing with care in assisted-living facilities. This kind of facilities should be available for the rapid growth of older cohorts.

The numerical example is based on rather crude numbers, because of lack of data, as the developed reverse mortgage product with LTC insurance is a novelty. Intensity of care and probabilities of care in certain category of care will change after the introduction of this product.

The model results indicate that it is possible to successfully tie an insurance product to the insured and not to the object.

The introduction of this insurance option will allow many older adult with low pension benefits and a substantial home equity to safely opt for a reverse mortgage and benefit from better social care.

While currently available reverse mortgage contracts lapse when the homeowner moves to assisted-living facilities in any EU Member State, in the paper a new method is developed where multiple adjustments of housing to the functional capacities with relocation is possible, under the same insurance and reverse mortgage contract. The case of Slovenia is presented as a numerical example. These insurance products, as a novelty, are portable, so the homeowner can move in own specialised housing unit in assisted-living facilities and keep the existing reverse mortgage contract with no additional costs, which is not possible in the current insurance products. With some small modifications, the method is useful for any EU Member State.

The purpose of this paper is to present the findings of an early stage, exploratory case study of a proposed housing with care initiative (the Crichton Care Campus (CCC)). This sought the perspectives of a range of key stakeholders on the proposed model and how it might be best realised. The analyses of these findings show their relevance to debates on integrated housing with care, and reflect on the methodology used and its potential relevance to similar projects.

The study used a transactive planning approach, where grounded views are sought from a variety of stakeholders. A purposive sample identified informants from relevant health, social care and housing organisations and nine semi-structured interviews were conducted. These were transcribed and data analysis was undertaken on an “interactive” basis, relating care theory to empirical expressions.

The authors identify two contrasting orientations – inclusive “community-oriented” and professional “service-oriented”. This distinction provides the basis for a rudimentary conceptual map which can continue to be used in the planning process. Two significant variables within the conceptual map were the extent to which CCC should be intergenerational and as such, the degree to which care should come from formalised and self-care/informal sources. The potential to achieve an integrated approach was high with stakeholders across all sectors fully supporting the CCC concept and agreeing on the need for it to have a mixed tenure basis and include a range of non-care amenities.

This paper offers originality in two respects. Methodologically, it describes an attempt to undertake early stage care planning using a needs led transactive methodology. In more practical terms, it also offers an innovative environment for considering any approach to care planning that actively seeks integration – based on an acknowledgement of complexity, a variety of perspectives and possible conflicts. The authors propose that the concepts of “community-orientation” and “service-orientation” are used as a helpful basis for planning negotiations, making implicit divergences explicit and thus better delineated.

The purpose of this paper is to describe how first-line managers (FLMs) in home care (HC) reason about the opportunities and obstacles to lead the work according to the individual’s needs and goals.

In this participatory appreciative action reflection project, eight managers within one Swedish municipality were interviewed. The data were analysed using a thematic analysis.

The results showed a polarization between two different systems that FLMs struggle to balance when attempting to lead HC that adapts to the needs and goals of individuals. One system was represented by the possibilities of a humane system, with human capital in the form of the individual, older persons and the co-workers in HC. The second system was represented by obstacles in the form of the economic needs of the organization in which the individual receiving HC often felt forgotten. In this system, the organization’s needs and goals governed, with FLMs needing to adapt to the cost-effectiveness principle and keep a balanced budget. The managers had to balance an ethical conflict of values between the human value and needs-solidarity principles, with that of the cost-effectiveness principle.

The FLMs lack the opportunity to lead HC according to the needs and goals of the individuals receiving HC. There is a need for consensus and a value-based leadership model based on ethical principles such as the principles of human value and needs-solidarity to lead the HC according to the individual’s needs and goals.

This paper aims to explore whether the key drivers identified in digitalization policies are being prioritized by practitioners in health and social care and to what degree the goals of the policies are being enacted.

The investigation comprised two stages. First, the key drivers of digitalization in the national policies were identified. Second, a survey was disseminated to practitioners within health and social care, asking them to indicate their stance on each key driver (using Likert scales).

The findings of this paper are twofold. First, they demonstrate that practitioners more readily enact the key drivers centered around their everyday operations, such as improving services and care and increasing efficiency. Second, it shows that key drivers of a more rhetorical nature, such as “becoming the best,” do not yield benefits for practitioners.

This paper shows that for policies to have an effect in practice and to contribute to change, they should be rooted in key drivers centered around practitioners’ everyday operations, promoting specificity over abstraction.

While previous studies have involved policy analysis, few studies investigate the enactment of policies, how they are implemented and whether they contribute to changes in practice.