Productos inmobiliarios: un valor de cambio múltiple

2.8.2

2.8.2

2.8.2

Willingness to PayWillingness to PayWillingness to PayWillingness to Pay

Willingness to pay (WTP) refers to the amount people are prepared to pay for a variety of interventions linked to their individual needs. Predominantly used in the US as a measure of acceptability of a service. Jutkowitz et al (2010) concluded that WTP is influenced more strongly by an intervention that reduces the time spent care giving than one which offers improvements in quality adjusted life years. Their study investigated financial savings that could be made by care givers purchasing a Tailored Activity Program for PwD which included a physical environment assessment. The study does not allow us to analyse caregivers WTP for home modifications alone or the relative cost of these (Jutkowitz, Gitlin and Pizzi, 2010).

There is a strong probability that the costs of and WTP for home modifications are influenced by different countries. Van Hoof et al (2009) found that even within neighbouring European countries there is a large disparity in the provision of services

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for PwD and the social expectation of state funding for these (van Hoof, Kort and van Waarde, 2009). In the US there is no overriding source of funding for home adaptation. Options such as Medicare do not cover home modification or assistive equipment beyond mobility aids. Some services such as the Department for Veteran Affairs offer a structural alterations program for those who are eligible (Pynoos, Steinman and Nguyen, 2010). OTs in the US report that understanding the financial constraints of a service user was very important, they feel that it is inappropriate to discuss all potential home adaptations for a particular problem if it is clear that a particular client cannot afford to implement them (Stark L. et al., 2015).

Aplin, de Jonge, & Gustafsson, (2013) found that home modification services in Australia often left service users wanting extra adaptations or improved functionality but that this was not achievable due to budget restraints. This meant service users either had a limited choice or faced paying for adaptations themselves. This was especially evident in the area of occupational interest; activities that were not directly linked to ADLs or basic personal care such as access to a garden or swimming pool were not available through occupational therapy and were purchased privately by clients, often placing them under a significant financial burden.

Jutkowitz et al., (2012) attempted to determine the cost effectiveness of a home based intervention aimed at promoting independence and well-being in the US. The intervention included balance and strength training as well as occupational therapy visits to assess and provide home modifications. The average cost for home modifications within the scheme including labour costs of ordering and installing, was $439 (approx. £287). This was concluded to be within an acceptable budget for service users and incurred fewer costs than more traditional forms of home treatment. This study specifically used participants without cognitive impairment, and the home modifications were predominantly used to prevent falls and promote mobility and access ( Jutkowitz, Gitlin, Pizzi, Lee, 2012).

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Sources of Information and Products

Sources of Information and ProductsSources of Information and Products

Sources of Information and Products

As previously stated in Section 2.6, healthcare professionals have traditionally been the main source of home adaptation advice for older people (Mountain and Way, 2012). During an episode of acute care patients are assessed by therapists and given advice relating to a wide variety of home adaptations in order to assist with ADLs and prevent falls. In the UK most home adaptation advice is provided by OTs but may also be given by physiotherapists or nursing staff. During an assessment OTs consider a number of aspects which influence the advice they give such as: Readiness for change, Compliance, Finances, Personal and social support, Logistical issues relating to the house (Stark L. et al., 2015). In this way an OT offers tailored solutions to functional problems following consideration of ability and need.

There is a growing range of literature and assistance for PwD and their families, especially on the internet. Error! Reference source not found.Error! Reference source not found.Error! Reference source not found.Error! Reference source not found. and Table 5 identify written sources of information commonly available to PwD and those involved in their care. It shows that a variety of charities such as the Alzheimer’s Society, AgeUK and Home Improvement Agencies such as Care and Repair produce downloadable documents on a wide range of topics regarding dementia care including home adaptation and improvements (Mountain and Way, 2012; Care & Repair England, 2015).

Advice regarding home adaptation and equipment covers many areas, with no one source covering all aspect, Error! Reference source not found.Error! Reference source not found.Error! Reference source not found.Error! Reference source not found.. The most common area covered by the information is adapting lighting to ease the symptoms of dementia, closely followed by telecare and assistive technology. Conversely, information regarding the financing of home adaptations was only found in two sources of information from AgeUK and therefore was not specifically targeted at people with dementia.

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Title Publisher Format Cost Aimed at Available at (URL)

Disability Equipment and

home adaptations AgeUK

Online –

Print ready Free Older people

https://www.ageuk.org.uk/globalassets/age-

uk/documents/factsheets/fs42_disability_equipment_and_home_a daptations_fcs.pdf

Adapting your home: Services and Equipment to help you stay living at home

AgeUK Online –

Print ready Free Older people

https://www.ageuk.org.uk/globalassets/age- uk/documents/information-

guides/ageukig17_adapting_your_home_inf.pdf

Caring for someone with

dementia AgeUK

Online –

Print ready Free Carers

https://www.ageuk.org.uk/globalassets/age- uk/documents/information-

guides/ageukig47_caring_for_someone_with_dementia_inf.pdf?dt rk=true

Making your home a better place to live with dementia

Care and Repair England: Home improvement agency

Online –

Print ready Free PwD and carers

http://careandrepair-england.org.uk/wp-

content/uploads/2017/09/CRE-Silverlinks-SHGuide-Dementia.pdf

Equipment adaptations and

improvements to the home Alzheimer's Society

Online –

Print ready Free PwD and carers

https://www.alzheimers.org.uk/get-support/staying- independent/equipment-adaptations-improvements-home

10 Helpful hints for dementia design at home

Dementia Services Development centre

(DSDC)

Book £7.50 Carers N/A

10 Helpful hints on heating and lighting for PwD and their carers

DSDC Book £7.50 PwD and carers N/A

Designing Interiors for

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Choosing equipment to help with memory and safety

Disability Living Foundation

Online –

Print ready Free Older people https://www.dlf.org.uk/factsheets/safety

Making your home more

dementia friendly Dementia Care Online Free

Family and carers

http://www.dementiacare.org.uk/services/need-some- advice/making-home-dementia-friendly/ Home Environment and

Dementia NHS Choices Online Free PwD and Carers https://www.nhs.uk/conditions/dementia/home-environment/

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