An Examination of How the ‘Household Model' of Care Can Contribute to Positive Ageing for Residents in the ‘Fourth Age’

Abstract

Background: Promoting a good quality of life for the oldest members of society has become a top priority as evidenced in UK policy. The 'household' model is a departure from traditional approaches to care provision since it offers person-centred support-combing health and social care-to older people in specially-designed, small, homelike environments. Having gained increasing popularity in care homes across developed countries, the impact of this model of service delivery on residents' quality of life and its contribution to positive ageing is of increasing interest. Belong is a not-for-profit, UK care organisation currently operating several villages under the household model. The villages comprise independent living apartments (bought or rented) and residential/nursing care households offering 24 hours personalised, on-site care for residents. In each village there is a range of facilities open to the public (including a Bistro, hairdressers and gym facilities) and a domiciliary community service. Methods: In this paper we present new data generated from qualitative interviews with a sample of household residents in the 'Fourth Age' and relatives across two villages in the North West of England, UK.

Ageing: Longevity, Successful and Positive

“…Maintaining at least a modicum of social involvement and independence may evidence of ageing successfully, whereas the requirement of care (at home or in an institution) is not. The move from one to another need not be stark and could be a gradation of care, moving from full independence, through family support and supported living environments, such as shared living environments (single building or complexes) as championed by Atul Gwande [54] and Julia Neuberger [55] in their books and more latterly "Dementia Villages" providing a secure environment for people with dementia and their families [56]. Even when dependency increases such that more intensive support is needed a more positive outlook may be experienced by those in institutionalized care than those living at home [57].…”

The Environmental Audit Screening Evaluation: Establishing Reliability and Validity of an Evidence-Based Design Tool

“…At the other end of the spectrum are small household designs that support “person-centered” models of care ( Ahmed et al, 2019 ; Kaup, 2015 ; Rabig et al, 2006 ). The architecture and interior features are scaled down and designed to focus primarily on replicating a residential environment with the goal of resident autonomy and quality of life ( Abushousheh et al, 2011 ; Proffitt et al, 2010 ; see Figure 2 ).…”

“…The architecture and interior features are scaled down and designed to focus primarily on replicating a residential environment with the goal of resident autonomy and quality of life ( Abushousheh et al, 2011 ; Proffitt et al, 2010 ; see Figure 2 ). Households (HHs) are defined as a small group of residents who live together in a clearly defined setting that has a front door and contains a functional kitchen, a dining room, and a living room ( Ahmed et al, 2019 ; Carnemolla et al, 2021 ; Shields & Norton, 2006 ). The composition of these living areas (LAs) can vary but one of the first distinctions as a HH (beyond the small size of 10–12) is the proximity of resident bedrooms to the social spaces ( Kaup, 2003 ).…”

“…In the HH model of care, there is growing evidence that there are observable benefits to residents and staff that are expressed in the dynamic relationship between the design of the spaces and the behaviors that are afforded through physical attributes ( Ahmed et al, 2019 ; Fleming et al, 2016 ; Grabowski, O’Malley, et al, 2014 ; Kane et al, 2007 ). There is also growing recognition that PCC interventions are multifactorial and comprise combinations of elements of the built environment ( Brownie & Nancarrow, 2013 ).…”

Provincial policies affecting resident quality of life in Canadian residential long-term care

“…Historically, LTC policies in Canada have prioritised biomedically-oriented quality of care [ 2 ], but over time, a culture change towards a more person-centred model of care has evolved [ 3 ]. Additional research [ 4 – 7 ], among others, has indicated that a home-like approach to care creates more opportunities for residents’ overall quality of life (QoL) and wellbeing [ 8 , 9 ]. Accordingly, many LTC oriented policies now reflect a broad spectrum of person-centered QoL indicators, for instance, early research describing 11 domains, such as meaningful activity, relationships, dignity, autonomy, and privacy [ 10 , 11 ].…”