"Ageing in place": the views of older homeowners On maintenance, renovation and adaptation.

• Author: Davey, Judith

Abstract

"Ageing in place" is favoured in policies on ageing and is the preferred option of many older people. For older homeowners, remaining at home may depend on their ability to keep their homes in good condition, safe, suitable and comfortable. This research illuminates the attitudes, opinions and preferences of some older New Zealanders with respect to their current and future housing circumstances. A considerable degree of self-sufficiency was found with respect to home maintenance, but fewer people were capable of doing their own renovation work, and there were clear gender differences. The respondents mostly shared a strong desire to remain living independently in the community for the rest of their lives. The most popular option for a new residence was a separate house, but one smaller and easier to manage than their family home. To this end, many had already moved to low-maintenance housing suited to ageing in place. Others had aspirations for such a move. Some of those who wished to remain in their long-term family homes were considering adaptations to make this possible, and some had already adapted their homes to cope with health issues. The study concludes that most of the respondents were resourceful people, who thought about the future, and planned for work to be done on their houses. They represented a common New Zealand ethos of independence and capacity, linked to homeownership as an aspiration.

INTRODUCTION

"Ageing in place" is a well-used concept as governments look to the future in an ageing world. In 1994, the health and social policy ministers of OECD countries reached an agreement on the overall objective of policies for the care of frail older people:

Elderly people, including those in need of care and support should, wherever possible, be enabled to continue living in their own homes, and where this is not possible, they should be enabled to live in a sheltered and supportive environment which is as close to their community as possible, in both the social and geographical sense. (OECD 1994:3) Internationally it has become accepted that traditional institutional care that keeps older people apart and medicalises old age is no longer desirable and perpetuates a negative view of ageing. Most OECD countries are committed to reducing the number of people living in institutions (OECD 2003:11). "The ageing process should no longer be viewed as an inevitable economic and social isolation from the rest of the community" (OECD 2003:173). Ageing in place therefore implies that older people will remain in the community, either in their family homes, in homes to which they have moved in middle or later life, or in supported accommodation of some type, rather than moving into residential care. It also implies living independently of other family members. There has been a decrease in intergenerational living in most developed countries, even for frail older people (OECD 2003).

In New Zealand, policy statements also promote ageing in place. The New Zealand Positive Ageing Strategy (Dalziel 2001:10) aims to encourage and assist older people to remain in their own homes, in order to enhance their sense of independence and self-reliance. And the Health of Older People Strategy (Ministry of Health 2002:3) proposes an integrated approach to health and disability support services, which is responsive to varied and changing needs, supports older people remaining in their own homes, and reduces the need for institutional care.

The policy emphasis on ageing in place is reflected in the personal preferences of older people themselves, who prize their autonomy and independence. This emerged from consultation forums with older people held to contribute to the New Zealand Housing Strategy (Housing Corporation New Zealand 2005:61) and in literature reviewed for the CHRANZ Accommodation Options report (Davey et al. 2004). In New Zealand a high proportion of people remain in their own homes until the end of their lives. (2)

As part of activities in the International Year of Older Persons, the (then) Senior Citizens Unit and the Ministry of Social Policy carried out a study of the factors affecting the ability of older people to live independently (Dwyer et al. 2000). The study pointed out the social, economic and service requirements if people are to age positively "in place". These include family support and care and the provision of home-based services through public, private or voluntary sector agencies. However, "Well designed, easy to manage, affordable, warm and safe housing is as important to independent living as inputs of care" (Dwyer et al. 2000:33, quoting a study undertaken In the United Kingdom).

For older owner-occupiers, (3) remaining at home may depend on their ability to have their houses maintained, modified or adapted in order to keep them in good condition and able to fulfil their needs. Most housing has not been designed with older age and impairment in mind, and the arrangements of the home environment often inhibit the ability of a person to manage their daily life. In addition, maintaining a property to a reasonable standard can be difficult for low-income homeowners. Deficiencies in housing may reinforce dependency and increase pressure on support agencies (Harrison and Davis 2001, Tinker et al 1999). Less than adequate housing conditions might ultimately threaten wellbeing and health and lead to premature entry into residential care.

As policy is developed to promote ageing in place, it is important to take into account the attitudes, opinions and preferences of the older people themselves and how they see their current and future housing circumstances. This is in line with United Nations research priorities which call for research on the quality of life of older people to take into account the views of the older individuals themselves (United Nations 2002). The research described in this paper was funded by the Ministry of Social Development, and aimed to explore housing issues with older homeowners from their own perspectives, covering:

* current suitability of housing

* likely future suitability of housing

* maintenance (defined as regular work needed to maintain housing quality; e.g. clearing gutters, cleaning exteriors)

* renovation (defined as work to renew the housing fabric and services or to extend accommodation, which is not usually required on a regular basis; e.g. major repainting, rewiring, adding rooms)

* adaptation (defined as changes to housing required as a result of disability or frailty affecting the residents; e.g. installing ramps, safety rails, special bathroom fixtures)

* the perceived influence of housing quality (including all of the above) on the ability to age in place.

RESEARCH DESIGN

Information was collected through face-to-face interviews with 30 older homeowners, living in the Wellington, Hutt Valley and Kapiti/Horowhenua regions. Interviewees were recruited through the FRENZ database, held at Victoria University of Wellington. (4) The sample design included quotas based on age and gender/household composition. The respondents were fairly evenly distributed between "young-old" (aged 60 to 74) and "old-old" (75-plus) categories. Couples and single people, men and women, were selected in each age group. The questionnaire, developed in consultation with the Ministry of Social Development, contained structured and semi-structured questions. The emphasis was on eliciting the respondents' opinions and preferences, on a subjective basis. Hence, in the account that follows, verbatim quotations...