Search results

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.

This paper explores residents' perceptions and experiences of extra care housing as an integrated model of housing with care.

Data were collected in a longitudinal qualitative study based on four extra care housing schemes. Data from interviews with residents, care workers, managers and local commissioners were analysed thematically.

The integration of housing with care enabled many older people to manage their care proactively. However, the increasing number of residents with complex health and care needs, including chronic illness, led some residents to question the ability of the model to support residents to live independently.

The study struggled to recruit sufficient residents from the specialist dementia setting who were able to communicate their consent to take part in the research. In addition, the quality of qualitative data collected in interviews with participants at this setting reduced over successive rounds of interviews.

The study suggests the need to ensure that residents are fully informed about levels of care and support is available when considering a move into extra care housing.

This paper provides a timely opportunity to consider extra care housing as an example of an integrated housing service, particularly in light of the current challenges facing the sector.

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.

It’s a global challenge to make cities and communities become an age-friendly society. This paper aims to discuss how to develop good concepts for senior residences in Norway and aim to study what the challenges are in the early planning phase, searching the answer to the following research questions: (1) What makes a senior housing attractive? (2) What are the challenges that hinder future concept development? (3) Suggest actions in order to obtain a sustainable development.

This research uses a descriptive and explorative approach describing the phenomena by (I) a short literature review describing existing concepts and challenges, (II) “Walk-through”-methodology with informal dialogue on site and (II) semi-structured interviews of property developers, architects or contractors, politicians, care providers or planners in the municipality involved in seven pilot projects in Kristiansand and Stavanger.

The authors find that new and diverse concepts need to be developed to meet the demand of the seniors. The new concepts should be developed in collaboration with both public and private actors as well as developing a communication platform to meet the needs of the seniors in terms understanding the possibilities of alternative housings, incentives to move and how to influence and get involved in the planning.

There is a limited no. of informants among the public stakeholders. Only three of the seven pilot projects are accomplished. There is an advantage if the rest of the projects are evaluated when accomplished.

Develop participation models and PPP models at the local level.

The value lies in the evaluation of the seven pilot projects.

This chapter discusses how media use changes when everyday life undergoes change, focusing on major life transitions. I briefly introduce different perspectives on evolving media repertoires across the life course, and argue for the relevance of studying periods of destabilization and reorientation, when elements of media repertoires and modes of public connection are temporarily or more permanently transformed. I argue that easily adaptable media technologies such as smartphones tend to become more important in unsettled circumstances, as easy-to-reach for tools for new forms of self-expression, information-seeking or social contact, in accordance with shifting social roles and everyday circumstances. The primary empirical material analyzed in the chapter is a small qualitative interview study with mothers, about their media use the first year with a new-born.

Homelessness is a colossal issue, precipitated by a wide array of social determinants, and mirrored in substantial health disparities and a revolving hospital door. Connecting people to safe and secure housing needs to be part of the health system response. The paper aims to discuss these issues.

This mixed-methods paper presents emerging findings from the collaboration between an inner city hospital, a specialist homeless medicine GP service and Western Australia’s inaugural Housing First collective impact project (50 Lives 50 Homes) in Perth. This paper draws on data from hospitals, homelessness community services and general practice.

This collaboration has facilitated hospital identification and referral of vulnerable rough sleepers to the Housing First project, and connected those housed to a GP and after hours nursing support. For a cohort (n=44) housed now for at least 12 months, significant reductions in hospital use and associated costs were observed.

While the observed reductions in hospital use in the year following housing are based on a small cohort, this data and the case studies presented demonstrate the power of care coordinated across hospital and community in this complex cohort.

This model of collaboration between a hospital and a Housing First project can not only improve discharge outcomes and re-admission in the shorter term, but can also contribute to ending homelessness which is itself, a social determinant of poor health.

Coordinated care between hospitals and programmes to house people who are homeless can significantly reduce hospital use and healthcare costs, and provides hospitals with the opportunity to contribute to more systemic solutions to ending homelessness.

Older adults who are or have been incarcerated constitute a growing population in the USA. The complex health needs of this group are often inadequately addressed during incarceration and equally so when transitioning back to the community. The purpose of this paper is to discuss the literature on challenges older adults (age 50 and over) face in maintaining health and accessing social services to support health after an incarceration and to outline recommendations to address the most urgent of these needs.

This study conducted a narrative literature review to identify the complex health conditions and health services needs of incarcerated older adults in the USA and outline three primary barriers they face in accessing health care and social services during reentry.

Challenges to healthy reentry of older adults include continuity of health care; housing availability; and access to health insurance, disability and other support. The authors recommend policy changes to improve uniformity of care, development of support networks and increased funding to ensure that older adults reentering communities have access to resources necessary to safeguard their health and safety.

This review presents a broad perspective of the current literature on barriers to healthy reentry for older adults in the USA and offers valuable system, program and policy recommendations to address those barriers.

We conducted consumer research with more than 2,000 adults and more than 100 representatives from retirement housing providers from across the UK to identify the “perception gap” and gathered high-profile representatives from across the retirement housing sector to discuss the data.

Our research shows that the public are unsure about the benefits and services provided by retirement housing schemes – often confusing them with care homes and nursing homes to the detriment of the sector.

We identify an untapped referrer market for retirement living, that men should be targeted with entry-level information and people should be targeted before retirement age when perceptions are less “fixed”.

We show the services that matter most to ABC1 demographic and the sources they use to find information.

We outline how the sector can make retirement housing a model of “want” instead of a model of “need”.

Background: Rising food bank usage in the UK suggests a growing prevalence of food insecurity. However, a formalised, representative measure of food insecurity was not collected in the UK until 2019, over a decade after the initial proliferation of food bank demand. In the absence of a direct measure of food insecurity, this article identifies and summarises longitudinal proxy indicators of UK food insecurity to gain insight into the growth of insecure access to food in the 21st century.

Methods: A rapid evidence synthesis of academic and grey literature (2005–present) identified candidate proxy longitudinal markers of food insecurity. These were assessed to gain insight into the prevalence of, or conditions associated with, food insecurity.

Results: Food bank data clearly demonstrates increased food insecurity. However, this data reflects an unrepresentative, fractional proportion of the food insecure population without accounting for mild/moderate insecurity, or those in need not accessing provision. Economic indicators demonstrate that a period of poor overall UK growth since 2005 has disproportionately impacted the poorest households, likely increasing vulnerability and incidence of food insecurity. This vulnerability has been exacerbated by welfare reform for some households. The COVID-19 pandemic has dramatically intensified vulnerabilities and food insecurity. Diet-related health outcomes suggest a reduction in diet quantity/quality. The causes of diet-related disease are complex and diverse; however, evidence of socio-economic inequalities in their incidence suggests poverty, and by extension, food insecurity, as key determinants.

Conclusion: Proxy measures of food insecurity suggest a significant increase since 2005, particularly for severe food insecurity. Proxy measures are inadequate to robustly assess the prevalence of food insecurity in the UK. Failure to collect standardised, representative data at the point at which food bank usage increased significantly impairs attempts to determine the full prevalence of food insecurity, understand the causes, and identify those most at risk.