The characteristics of residents in extra care housing and care homes in England

Abstract

Extra care housing aims to meet the housing, care and support needs of older people, while helping them to maintain their independence in their own private accommodation.It has been viewed as a possible alternative, or even a replacement for residential care.In 2003, the Department of Health announced capital funding to support the development of extra care housing, and made the receipt of funding conditional on participating in an evaluative study. This paper presents findings on the characteristics of the residents at the time of moving in, drawing on information collected from the 19 schemes in the evaluation and a recent comparable study of residents who moved into care homes providing personal care. Overall, the people who moved into extra care were younger and much less physically and cognitively impaired than those who moved into care homes. However, the prevalence of the medical conditions examined was more similar for the two groups, and several of the schemes had a significant minority of residents with high levels of dependence on the Barthel Index of Activities of Daily Living. In contrast, levels of severe cognitive impairment were much lower in all schemes than the overall figure for residents of care homes, even among schemes designed specifically to provide for residents with dementia. The results suggest that, although extra care housing may be operating as an alternative to care homes for some individuals, it is providing for a wider population, who may be making a planned move rather than reacting to a crisis. While extra care supports residents with problems of cognitive functioning, most schemes appear to prefer residents to move in when they can become familiar with their new accommodation before the development of more severe cognitive impairment.

Who Lives Where and Does It Matter? Changes in the Health Profiles of Older People Living in Long Term Care and the Community over Two Decades in a High Income Country

“…The age and gender distributions found in other studies are similar to the results here [8, 9, 18]. Normally people move to long term care when their community support breaks down due to increasing dependency or loss of support structure.…”

“…Recent studies have reported a lower prevalence of dementia within long term care in the UK in comparison to CFAS II [9, 19, 20], however this could be because they only included individuals with a formal diagnosis of dementia [19, 20]. Others suggest estimates closer to CFAS II although a direct comparison cannot be made as the study diagnosis of dementia was different for each [18, 21].…”

“…One study from the US reported similar levels of health conditions when comparing the mean in those with and without dementia but as stated above, these estimates could be skewed [26]. Other reports on multiple health conditions that separated for those with and without dementia in long term care from either within the UK or other high income countries do not compare the overall number of conditions in those with and without dementia [8, 9, 25]. …”

“…There are few reports in the literature that can compare the characteristics of people living in long term care or assisted living facilities with those in the community and those that do focus on physical function and health [8, 9]. Population based studies provide an opportunity to extend such work to provide a balanced description.…”

A community hub approach to older people’s housing

“…This is reflected in the popularity of housing that comes under the housing with care umbrella in many countries (Evans 2009). A range of characteristics have been highlighted as particularly appealing to residents including the availability of flexible care and support, age friendly environments, on-site facilities and a desire to be part of a 'community' in later life (Darton et al 2012;Evans and Vallelly 2007;Shipley 2003).…”