The term 'own home' refers to housing that has not been specifically designed for older people, whether the resident owns that house or rents it (privately or from the public sector). The vast majority of older people in England and Wales are owner occupiers, with the most recent census reporting that 75% of households with a Head Reference Person over the age of 65 were owner occupied (ONS, 2013). The census also showed that this age group were statistically the most likely to own their home outright (67% compared to 31% of the total population), as many will have paid off their mortgages whilst still working. This has implications for 'moving on' as the majority of specialist housing for older people does not have the option to buy the unit, so people who make that decision are often forced to go from being a homeowner to a tenant in rented accommodation. This is then a barrier to people moving into this type of housing. Some extra care schemes now offer units to buy, but then there is the issue with selling the unit on once the older person has passed away, as the unit has a much smaller target market and can only be used to house someone of a certain age, and usually with deteriorating health.
63 It is common to develop a sense of belonging in our homes and the stronger this is, the safer and more comfortable an older person will feel (Rioux, 2005). The Kings Fund's study into securing good care for older people provided multiple sources of research to provide evidence that staying at home in later life is the majority of people's preference (Wanless, 2006). But none of this research is as powerful or hard-hitting as the fact that 89.8% of older people choose to live in non-specialist housing, a significant proportion of the over 65's. This figure can be worked out based on the fact that only 7% of older people in the UK (530,000) live in specialist housing, excluding care homes (Pannell and Kenway, 2012), and the most recent census states that 3.2% of older people in the UK (291,000) live in care homes (Office for National Statistics, 2014). The majority of specialist housing for older people is social housing and 77% is available for rent only, which has implications for an older person’s tenure if they opt to move into this type of housing (Pannell and Kenway, 2012).
Whilst research into specialist housing is invaluable, efforts should be focussed on improving preventative measures in order to enable older people to stay independent in their own homes. "Finding reliable help to take care of everyday household needs is all many seniors need to allow them to stay in their own home" (Cronkright, 2007). However, a study by the Royal Voluntary Service, revealed that the fragmented nature of families today, caused by divorce, labour migration, etc, mean that a lot of older people now live a long distance away from their children (Royal Voluntary Service, 2012). This raises concerns about the availability of family support and informal care (Tiomassini et al, 2004). Not living near to relatives can make it very difficult for an older person to access the kind of care Cronkright is talking about. Funding and installing adaptations to the home are one way in which the government tries to enable people to remain independent. Disabled facilities grants (DFGs) are means-tested grants allocated to those who need adaptations to their home, as assessed by an occupational therapist. In the event of disability, three-quarters of older people would prefer to stay in their homes and have them adapted, instead of moving (Milne 1999). The report Better outcomes, lower costs: Implications for Health and Social Carebudgets of investment in housing adaptations, improvements and equipment: a review of the evidence, commissioned by the Independent Living
64 Review, identified that the provision of housing adaptations and equipment for disabled people results in significant savings to Health and Social Care budgets (Communities and Local Government et al, 2008). This is because installing adaptations can also help prevent further injury or disability as the assessors look for potential hazards and try to correct them when installing adaptations. A review by the Welsh Government, which involved interviews with local authorities, RSL’s and service users, found that adaptations have a positive impact on the end user, are a cost effective use of public money and deliver on key policy objectives (Jones, 2005). However, on the downside, it is confusing to access DFG's and the process takes a long time (Jones, 2005). Wales has more recently been criticised by the Older Persons’ Commissioner for Wales, for taking an average of 326 days to pay out DFGs (BBC News, 2012), demonstrating that obtaining a DFG is still a long process. Heywood (2001) found that minor adaptations had a positive effect on the health of 77% of respondents interviewed, however problems occurred when English local authorities try to use cheaper materials or substitute products as they are under so much pressure to cut costs.
Home care is provided by Social Services for people living in their own home and assessed as having a substantial or critical need for it. However, accessing support in your own home if you have lower level needs can be very tricky for an older person. Those living in their own homes do not have the access to the kind of support offered by a warden to people living in sheltered housing. This is a major inequality that should be addressed as the warden offers a preventative service, access to which could prevent an older person from having to move out of their home due to a deterioration in health.
Technology is also enabling people to stay at home when they might not have otherwise considered doing so. Telecare and other at-home monitoring systems are fitted to suit the lifestyle of the client. If there is a change in behaviour picked up by the monitors then a signal is sent to a call centre, who will phone the home to check the client is okay. If nobody answers, they will phone the client's emergency contact to go and check on them. This provides peace of mind for the older person, as well as for their family. But is support in the form of technology what older people want? Visiting support workers can provide a lifeline for a socially isolated senior
65 (Cronkright, 2007), but increasingly this type of service is being replaced by the cheaper, more technological option. Installing these technological aids is often presented to older people as 'the right thing to do' if you want to stay in your own home, but there is a paradox here as adding these technologies can change the feel of the home on an emotional, physical and virtual level (Neven, 2014).
Whilst staying in their own homes is clearly the favoured option for older people, there is much more that can be done to ensure that privately owned housing is part of the whole system of care. Currently, it is on the periphery of the system, with owner occupiers only entering the system at times of crisis, such as hospitalisation or following a fall. This leads to a high level of stress, as individuals only learn about the system when something bad has happened, which is far from ideal. Providing support for owner occupiers could offer them a trustworthy link into the system, someone to question about their options before they reach crisis point.