Nobody wants to live in a clinic, adaptations should keep it hearth and home

Stigmatising and ‘clinical’ products put people off making vital changes to keep their homes safe as they grow older, new research claims. The findings have prompted calls for better designs that fulfil their practical purpose while adding a sense of home comfort

THE design of products used to make homes safer for people with impaired mobility is causing many to risk their health and well-being for fear of being ‘stigmatised’.

Research carried out for the Centre for Ageing Better (CAB) found that people are delaying making vital changes to their homes because they regard products such as handrails and ramps to be ‘clinical’ and ‘stigmatising’ in appearance.

Based on the findings, CAB has called for a greater range of more attractive products that will appeal to – rather than repel – people and so enable them to adapt their homes and remain independent as they age.

“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,” said Dr Rachael Docking, CAB’s senior evidence manager.

“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 makings 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’.”

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 health specialists, handyperson services and local authority staff.

It also involved an innovative camera study with 30 individuals documenting the way they navigated their homes – claimed to be the first time this technology has been used in this setting.

What it found was that those 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 being injured in a fall, or after 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, 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.”

CAB 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.

There’s more than the unappealing design of adaptive products, however; the process by which local authorities give information and support to help people make changes to their home can be so complex and varied, even the professionals working in the area can struggle to navigate their way through it.

This, combined with under-staffing, results in funding ‘bottlenecks’ and long waiting lists, the research claims, 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 approximately 3.3 million people – 24% of men and 31% of women – over 65 struggles with one or more Activity of Daily Living. These include washing, dressing, eating and going to the toilet. By their late 80s, over one in three people have difficulty undertaking five or more of these activities unaided.

“Our research captured a range of older people’s experiences of when, how and why they had their homes adapted,” said Cathy Bailey, associate professor in nursing midwifery and health at Northumbria University.

“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.”

Responding to the report, the Local Government Association (LGA) called on the Government to ensure adult social care is fully fund, as well take steps to enable councils to build more of the homes suitable for an ageing population.

“Councils are working hard to provide housing adaptations and mobility aids which are vital to help keep people safe and independent in their homes and prevent avoidable admissions to hospital and care homes,” said Councillor Izzi Seccombe, chair of the LGA’s Community Wellbeing Board.

“To help address requests for home adaptations the Disabled Facilities Grant needs to be fully funded to keep pace with demand. Government also needs to plug the £3.5 billion funding gap facing adult social care by 2025 and reverse the £600 million in reductions to councils’ public health grants between 2015/16 and 2019/20.

“There is a shortage of homes suitable for older and disabled people and people in vulnerable circumstances. To help address this councils need to be given greater planning powers and resources to hold developers to account, ensuring that they build the right homes in the right places needed by different groups within the local community.

“Government needs to work with councils and housing associations to provide a sustainable funding framework through which to offer the certainty and clarity to invest in the future development of housing for people with a range of needs.

“The housing borrowing cap should be also lifted so all councils can be allowed to borrow to build as this will help address the growing number of people, including those with disabilities, living longer with increasingly complex needs.”



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