Housing has a large part to play in the prevention and planning at this level, with the commitment 5 pertaining to:
“take further action to support safe and supportive home environments and the importance of the use of adaptations and assistive technology, in maintaining the independence and quality of life of people with dementia and their carers”.
The result from this strategy commitment has been a useful exploration of the design of housing to assist people with dementia.
The policy focus, reiterated in the strategy document Age, Home and Community: A Strategy for Housing for Scotland’s Older People: 2012 – 2021, has been very much on enabling people to live in their own homes for longer. This is very important for people’s feelings of independence and wellbeing. In a current study we are conducting at the University of Stirling around Dementia, Housing and Volunteering (funding by the Abbeyfield Society) we have found in talking to those living with dementia they were fiercely defensive about their home space.
However, there are times when that current housing is inadequate for people's changing health needs. In another study for Stirling Council around older homeowners we found a group that wished to move but found it a challenge due to the lack of housing options currently available. The report indicated that this was putting pressure on the social rented sector.
The importance of having the option for social renting cannot be underestimated in the planning for an ageing population and increasing numbers of those living with dementia. A recent report published by the National Housing Federation and HACT (2015) noted that:
I wholeheartedly agree with this, although the social housing sector in particular has suffered chronic underinvestment that undermines its ability to prevent and plan for dementia. At the moment, there is much more reaction than proactive planning. The enthusiasm is extremely high in the housing sector to embrace dementia design, care and prevention but in an era of ongoing resource limitations this is a particular challenge.
Furthermore, the context for housing and dementia is the current integration of health and social care, in which housing plays an important part. This is because of a move for ‘acute to community-based settings, and to ensure services and resources can be used more flexibly to better meet need’ (JIT 2015). The Scottish Federation of Housing Associations, for example, point out in this context that housing organisations provide more support than simply housing, including budgeting and money management assistance, benefits and welfare rights advice, befriending and advocacy services, coordinating care with other support services e.g. health, social work, leisure and education. Housing workers have a wide base of skills they can bring to help those living with dementia. Working together, the housing sector can help people living with dementia in a variety of ways to live independently through a range of tenures.
However, it must be acknowledged that it has to be an integrated solution to solve the problems faced by housing in helping support and care for those with dementia. It has to go hand-in-hand with health and social care integration plans and in this time of change, it is time to bring dementia to the centre of thinking about housing planning for the ageing population.
So what do we need to do?
- Keep placing dementia and housing as a priority as we plan the health and social care integration in Scotland
- Invest in design and technology innovation that helps people living with dementia live as independently as possible
- When planning for housing start thinking about dementia design as soon as possible
- Enlist skilled professional housing practitioners in the planning around supporting those living with dementia
Dr. Vikki McCall is a Lecturer in Social Policy and Housing at the University of Stirling. Current projects include: The role of volunteers in dementia care, Housing and older owner occupiers.