2 May 2019
Following research with practitioners and people with lived experience to understand the role of home adaptation in improving later life, Ageing Better is calling for a greater range of more attractive products to enable people to adapt their homes and remain independent as they age.
Older people with health conditions and mobility issues are delaying making vital changes to their homes, such as installing handrails and ramps, due to the off-putting and stigmatising appearance of products, as well as the complexity in getting support and information, Ageing Better's new report warns.
The report, 'Homes that help: A personal and professional perspective on home adaptations', is based on interviews carried out by Northumbria University, with older individuals and their families, as well as professionals including Occupational Therapists, handyperson services and local authority staff. It also involved an innovative camera study with 30 individuals documenting the way they navigated their homes – the first time this technology has been used in this setting.
It found that participants with reduced mobility often made the decision to install equipment and adapt their homes too late, usually once they were in crisis such as after an injurious fall or a long period of struggling to move around their homes and carry out basic activities such as daily washing. People in the study revealed they used often-hazardous coping strategies such as limiting their food and drink intake to avoid using the bathroom, using baby wipes instead of bathing, and sleeping on the sofa as they couldn’t climb the stairs to their bedroom.
Many people said that the clinical appearance of equipment and adaptations – including handrails, ramps and accessible bathing equipment – were off-putting. They associated them with ageing and vulnerability, with items often designed to be practical rather than attractive, and making their homes reminiscent of hospitals and clinics.
One participant commented: “Couldn’t grab rails be designed by some wonderful person at one of our great universities, to make them look more beautiful than they really are now? Because they’re ugly and horrible. And I don’t want to have ugly, horrible things in my house.”
Watch the research team explain what the typical process of installing a home adaptation looks like:
Dr Rachael Docking, Senior Evidence Manager, Centre for Ageing Better commented:
“Most people over 65 live in ordinary homes, rather than specialist housing, and this is where they want to stay as they grow older. Adapting and improving homes can vastly improve people’s comfort and enable them to maintain their independence and dignity.
“Evidence suggests that most of us will experience some difficulty with day-to-day activities at some point in our lives, and our research shows that there is much greater benefit to making changes to homes early on, before you reach crisis point and risk falls, injury and a much-reduced quality of life. It’s completely understandable that people are put off buying products that will make their home look and feel like a hospital or cause them to feel self-conscious.
“We need attractive products as standard and a much greater range to be available, including from high street retailers. We also need everyday products like kitchens and bathrooms to be designed inclusively, so they’re suitable for all ages. No one wants to buy a product ‘for older people’.”
Cathy Bailey, Associate Professor in Nursing Midwifery & Health at Northumbria University, said:
“Our research captured a range of older people’s experiences of when, how and why they had their homes adapted.
“Getting to this end point was not always easy. Some people were making this decision following a crisis such as a hospital stay, a fall or, a change in health status. There were also difficulties with getting up-to-date information, or finding out how long the process might take or the status of their financial and health-related eligibility.
“Overall, our participants told us that home adaptations are a good thing and this is supported by international evidence. However it’s not just about installing home adaptations. We need to simplify the process to ensure a flexible and timely response. From within our ageing population there is also an urgent need for positive messaging about home adaptations.”
The Centre for Ageing Better is calling on retailers, buyers, designers and manufacturers to work together to ensure a better range of more attractive products to support people at home are made more visible in the mainstream market.
Government should also use the opportunity of the £98 million ‘Healthy Ageing’ fund, part of the Industrial Strategy Challenge Fund, to invest in products and services that are ‘inclusively designed’ and therefore suitable for people of all ages, incorporating insights from the people who will use them at every stage. For example, kitchens and bathrooms that are designed to be accessible for people of all ages, not simply creating products for older individuals.
The research also reveals that the process under which local authorities give information and support to help people make changes to their homes can be so complex and varied that even professionals working in the area struggle to navigate it. This, combined with under-staffing, results in funding ‘bottlenecks’ and long waiting lists, with people in urgent need of support and funding to adapt their homes suffering long delays for equipment or ‘going it alone’ and getting inferior products and support from door-to-door sales people.
NHS data suggests that 24% of men and 31% of women over 65 struggle with one or more Activity of Daily Living – including, washing, dressing, eating and going to the toilet – approximately 3.3 million people. By people’s late 80s, over one in three people have difficulty undertaking five or more of these activities unaided.