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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 study aims to explore how including biophilic elements in the architectural and interior design of assisted living facilities can improve the well-being and quality of life of older people. This research paper explores the concept of biophilic design and its potential benefits for assisted living facilities.

A total of 39 peer-reviewed articles were reviewed. The research involved a comprehensive review of databases such as Scopus, EBSCO, Elsevier, JSTOR and Google Scholar using keywords and Boolean operators with reference to the study. The study’s inclusion criteria for articles were restricted to academic articles published between 2013 and 2022. The analysis of the current research will offer insights into the concept of biophilic design research and its impact on the well-being and quality of life of baby boomers in assisted living facilities.

The research advocates the benefits of biophilic design to enhance the psychological well-being and quality of life of baby boomers dwelling in assisted living facilities. Biophilic design is a strategy that blends natural elements into built environments to improve our connection with nature to enhance the physical and psychological health of older people. In the context of assisted living facilities, where residents commonly experience a variety of physical and psychological health concerns, adopting biophilic design in architecture holds enormous promise.

The research focuses on applying biophilic design in assisted living facilities and its holistic approach to the overall well-being of older people. The conceptual model proposed in the study has defined the positive aspects of the biophilic design on the psychological and physiological health of older people. Few studies have been done on the impact of biophilic design, specifically on baby boomers.

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.

This paper aims to provide an evidence assessment and narrative synthesis of literature regarding the key characteristics of older people living in service-integrated housing (SIH) facilities and their “accommodation journey”.

A rapid evidence assessment was conducted: 22 research publications met the inclusion criteria and were analysed using narrative synthesis.

The quality of studies in this area is low, but consistency across components of the results of studies included in the review is apparent. Results suggest key characteristics of older people that drive moves into SIH are a decline in health, increased dependency, increased health service use and carer burden. Suggested key characteristics of SIH residents are high levels of health problems, dependency and health service use, but high self-reported health and well-being. Results indicate that the key driver for older people leaving SIH is a lack of workforce competency to manage further declines in health and dependency status.

Current policy may not realise or account for the complex health and care needs of SIH residents. Investment into integrated care, robust community health services and workforce development to facilitate a comprehensive assessment approach may be required to support residents to remain in SIH and live well. Further longitudinal studies are required to map the progression of SIH residents’ health status in detail over time to provide an understanding of preventative and enablement support, development of care pathways and workforce planning and development requirements.

This evidence assessment is the first to consider the accommodation journey of older people residing in SIH.

This study aims to, chronicle literature, case studies and applied research to suggest that communications and public relations play a key role in the success of the best nursing homes and long‐term care facilities.

Research employed included a case study of four highly qualified nursing home facilities, followed by an electronic survey offered to all licensed nursing homes throughout New York State. Results from each segment of the research were compared and contrasted.

This research confirmed the thesis that long‐term care facilities which are independently identified as being high quality have a propensity to focus on communications with all stakeholders – particularly their residents and family members. Communications with all stakeholders are key to facility success.

The case study focused only on larger facilities; and survey response was limited without individual e‐mail addresses.

A set of guidelines for Communications in Nursing Homes and Long‐term Care Facilities was prepared as an outcome of the research.

This segment of the population is expected to more than double in the next 25 years, reaching nearly 90 million by 2050. The topic presents an important issue and sensitively considers it amidst a backdrop of change in western society.

Senior buildings have been designed as purposeful space programs. Therefore the elderly need coherent information about different senior housing concepts. The study seeks to set out a method for measuring the quality level of senior housing.

The method includes measuring four different factors: local services, building and yard, apartment, and on‐site services. Measuring the quality level of two separate residential areas and senior housing facilities demonstrates the use of the quality level measurement system.

The overall quality level of Facility 1 was significantly lower than that of Facility 2. The lower quality level measurement for Facility 1 was primarily the result of the lack of premises for lease to commercial or other tenants and the lack of on‐site services. The quality level measurement system is a successful tool for assessing the functioning and quality standard of residential areas and housing facilities in the point of view of elderly people.

This study has developed a unique application for measuring the quality level of residential areas and senior housing facilities. The measurement system is useful for estimating the quality level of a facility and also for analyzing different quality level factors to identify possible problems. While the intention is to provide a method primarily for expert assessments, seniors and their relatives could also use the method as an aid in weighing up the suitability of different senior housing facilities.

The purpose of this paper is to explore the association between level of physical activity (PA) and perception of quality of life (QOL) and physical health in frail and non-frail older adults.

Volunteer participants in this quantitative cross-sectional study were a convenience sample of 236 independent residents (120 frail, 116 non-frail) in an assisted living facility in Israel. Frailty was measured by Fried et al.’s phenotype; QOL and physical health were measured using the World Health Organization Quality of Life Instruments (WHOQOL-BREF) questionnaire. PA level was ascertained from attendance lists completed by exercise class instructors in each class during the eight-week study.

Frail older adults who engaged in regular PA (at least 2.5 h/week) reported the same physical health as non-frail older individuals performing a similar level.

Unsupervised PA performed independently was not taken into consideration; exercise class attendance may be a less reliable criterion of PA than collection of objective data, i.e. calories burned; participants were selected from an economically homogeneous population of a specific assisted living facility with easy access to a variety of PA.

The level of PA performed by frail older adults impacts their perceived QOL and physical health. The logs were an incentive to attend PA classes.

A minimum of 2.5 h a week of regular PA can be a protective factor that improves perceived QOL and physical health in frail older adults.

Aging is a growing concern in American society, whether one examines the issue in terms of growth of the elderly population, growth in expenses related to this population segment, or a concern about quality of life for people as they grow older. The population of the U.S. has aged throughout the twentieth century. While in 1900, only 4.1% of all Americans were over 65, the figure increased to 12.8% by 2000. The oldest old in the population, those 85 and over, increased even more, from only 590,000 people in 1900 to 3.7 million people in 2000. It is estimated that by 2030, when the baby boomers have become old, more than 20% of the U.S. population will be over 65. Some estimates are that those 85 and over will quadruple in size by 2030. Even given the reality that people are remaining physically healthy and may work longer than in the last generation, it is overwhelmingly clear that one of the major overall policy issues of the next several decades will be how to fund both the social and health services needs of the ever increasing elderly portions of the U.S. population. Nor is this issue of an aging population only a U.S. problem. Most developed countries are already experiencing this issue, and there are some European countries, such as Italy, that are already experiencing a declining population due to birth rates below replacement. When this happens in a country, then the elderly as a proportion of the population increase, and the issues of rising health care costs linked to changing population demographics become important policy issues in that country (Quadagno, 2005).

This paper aims to synthesize the published literature regarding the impact of environmental design on the improvement of elderly residents’ physical activity.

To provide convergent evidence about the association between facility design/management and physical activity of elderly population, searches were conducted in the PubMed and Google Scholar databases, as well as in specific active living design journals such as Applied Gerontology, Aging and Physical Activity, Housing for the Elderly and Sports Sciences. The inclusion criteria for the final list were the articles that were qualitative, quantitative and mixed-methods studies as well as systematic reviews; written in English; related to the built environmental design; wholly or partially focused on physical activity in elderly population; and published in peer-reviewed journals between 1984 and 2019.

Overall, 30 studies were included in the final list. The results of this review demonstrate that design interventions can raise physical functioning inside and outside of long-term residential facilities. Increasing opportunities for walkable spaces and reducing physical barriers can result in higher levels of physical activity for the elderly population.

This systematic review discloses the design strategies to enhance the level of physical activity by the elderly population based on the findings of the published literature. Overall space layout and accessibility to outdoor walkable spaces were addressed to generally promote the moderate levels of physical activity in elderly population.

Increasing opportunities for walkable spaces and reducing physical barriers result in higher level of activity for the elderly population. Corridor design and interior design ergonomic considerations were highlighted in the literature. Space layout and accessibility to outdoor walkable spaces promote the moderate levels of physical activity.

Environmental design considerations are unique aspects of enhancement of activity level in the elderly population.

This systematic review discloses the design strategies to enhance the level of physical activity by the elderly population based on the findings of the published literature. Overall space layout and accessibility to outdoor walkable spaces were addressed to generally promote the moderate levels of physical activity in elderly population.

The perspectives of people with dementia and their care partners regarding “extra care” housing are currently unknown. The purpose of this paper is to report findings of a consultation study exploring the perceived barriers and facilitators of a relocation to extra care housing, from the perspective of people living with dementia, and their care partners.

Fieldwork consisted of paired or 1-1 interviews and small focus groups with potential users of an alternative model of extra care support for people living with dementia in the South of England. The consultation took place between June and August 2013. The interviews and focus groups were audio recorded, transcribed verbatim. The transcripts were analysed thematically.

Benefits of extra care were identified as the opportunity for couples to remain living together for longer, creating a supportive, dementia-friendly community, and a reduction in the strain experienced by the care partners. Barriers centred on a sense of loss, stress and uncertainty. Living and caring at home was perceived as preferable to shared care.

The findings presented here have limited generalisability for two reasons. First, the shared care approach consulted on was very specific. Second, the participants form a purposive sample and as such are not representative of a wider population. Despite best intentions, the voice of people with dementia, are underreported in this consultation. Only one person with early on-set dementia was interviewed and the remaining two people with dementia were interviewed alongside their care partner.

The findings cast doubt on the viability of extra care facilities, designed for couples living with dementia, if extra care continues to be conceptualised and marketed as a preventative lifestyle choice. The findings indicate the value of consulting with people with dementia, and their care partners, when designing new forms of housing with care specifically for people living with dementia.

The findings of this consultation exemplify the wish of couples living with dementia to remain together, in what they perceive to be “home”, for as long as possible. Couples living with dementia are therefore unlikely to wish to move into an extra care facility as a lifestyle choice option, early into their journey with dementia. This raises questions about the suitability of extra care, as a form of housing with care, for couples living with dementia.

This paper contributes to the body of literature, exploring the feasibility of new and innovative alternative care and housing options, for people with dementia. This paper is one of the first to explore extra care as a housing and social care option for couples with dementia.