Perspectives on risk for older people with dementia in extra care housing in the UK: Findings from a longitudinal study

Abstract

This paper discusses the findings from a qualitative, longitudinal study into the suitability of extra care housing for people with dementia. Particular attention is paid to the perceptions and responses of care professionals to risk management in relation to the specific needs of people with dementia Extra care housing is widely promoted as a popular option for older people with dementia, largely because it can maximize independence and offer a homely alternative to other forms of housing with care. At the same time, older people with dementia are often perceived as one of society's most vulnerable and 'at risk' groups who are in particular need of protection. This paper explores the potential paradox between managing risk and at the same time supporting independence in the extra care housing setting. Conclusions drawn suggest that care staff adopt a guarded approach to managing risk, shaped by social and organizational preoccupations and policies that overemphasize risk elimination. This leads to the undermining of attempts to support independence and choice for tenants with dementia. The paper recommends the development of comprehensive risk-assessment processes and strategies for supporting behaviors that staff experience as anxiety provoking and difficult to manage. These developments should be based on a person-centered approach to identifying the needs, preferences, and values of individuals to maintain safety while promoting independence.

The transition to technology-enriched supported accommodation (TESA) for people living with dementia: the experience of formal carers

“…The new knowledge derived from this study in the use of PCPs confirms some of the evidence that the supported housing model could assist people living with dementia (Evans and Means, 2006). Through the accounts of the formal carers it has been shown that this model not only is being delivered using a PCC approach as operationalised by McCormack and McCance (2017 a ) in their PCPF, but also contains the added value of the environmental improvement, another feature identified by other authors as essential to PCP (Brownie and Nancarrow, 2013).…”

Can extra care housing support the changing needs of older people living with dementia?

“…Studies indicate high levels of satisfaction among residents of ECH and confirm its potential to promote a good quality of life for people living with dementia (Evans and Means, 2006), not least compared with other long-term care settings (Reimer et al, 2004), although there is some evidence of problems with access to social care (Phillips et al, 2013). suggested three factors that enable residents with dementia to remain independent: freedom to come and go, opportunities for self-care, and the choice of how to spend their time.…”

“…Studies indicate high levels of satisfaction amongst residents of ECH and confirm its potential to promote a good quality of life for people living with dementia (Evans & Means, 2006), not least compared with other long-term care settings (Reimer, Slaugher, Donaldson, Currie, & Eliasziw, 2004), although there is some evidence of problems with access to social care (Phillips, Dobbs, Burholt, & Marston, 2015).…”

Living with dementia in supported housing: A systematic review and thematic synthesis of qualitative research

“…Study Evans & Means, 2006), a mixture of supported housing settings (Barrett et al, 2020) and supportive seniors' housing in Western Canada (Stewart-Archer et al, 2016). Studies were described as exploratory, longitudinal or mixed methods.…”