An International Environmental Scan of Social Housing for Older Adults

Abstract The City of Toronto is creating a standalone housing corporation to focus on the specific needs of low-income older adults living in social housing. A key focus of this new corporation will be to provide housing, health and community support services needed to optimize older adult tenants’ ability to maintain their tenancy and age in place with dignity and in comfort. To support this work, we conducted an environmental scan of service delivery models that connect low-income older adults living in social housing with health and support services. Desktop research was undertaken to identify relevant programs. For each model, key details were extracted including housing type, services offered, provider information, rent structure and funding sources. The scan identified 34 examples of social housing programs for older adults run by public, private and non-profit agencies across Canada, the United States and Europe that integrated health and supportive services. Successful models were those that understood the needs of tenants and developed collaborative partnerships with health and social service providers to create flexible place-based programs. A common challenge across jurisdictions was privacy legislation that made it difficult to share health and tenancy data with program partners. The presence of on-site staff that focused on building trust and community among tenants was considered key for identifying tenants requiring additional supports in order to age in place. These insights offer important considerations on how integrated supportive housing service models promote housing stability and support better health and wellbeing among older adults residing in social housing.

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Delivery of Community Support Services for Older Adults in Social Housing

Innovation in Aging ◽

10.1093/geroni/igaa057.3348 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 910-911

Author(s):

Matthew Yau ◽

Christine Sheppard ◽

Jocelyn Charles ◽

Andrea Austen ◽

Sander Hitzig

Keyword(s):

Older Adults ◽

Service Delivery ◽

Low Income ◽

Support Services ◽

Social Housing ◽

Service Providers ◽

Community Support ◽

Community Agencies ◽

Visible Minorities ◽

Community Support Services

Abstract Community support services are an integral component of aging in place. In social housing, older adult tenants struggle to access these services due to the siloed nature of housing and health services. This study aims to describe the relationship between community support services and social housing for older adults and examine ways to optimize delivery. Data on government-funded community support services delivered to 74 seniors’ social housing buildings in Toronto, Ontario was analyzed. Neighbourhood profile data for each building was also collected, and correlational analyses were used to examine the link between neighbourhood characteristics and service delivery. Fifty-six community agencies provided 5,976 units of services across 17 service categories, most commonly mental health supports, case management and congregate dining. On average, each building was supported by nine agencies that provided 80 units of service across 10 service categories. Buildings in neighbourhoods with a higher proportion of low-income older adults had more agencies providing on-site services (r = .275, p < .05), while those in neighbourhoods with more immigrants (r = -.417, p < .01), non-English speakers (r = -.325, p < .01), and visible minorities (r = -.381, p < .01) received fewer services. Findings point to a lack of coordination between service providers, with multiple agencies offering duplicative services within the same building. Vulnerable seniors from equity-seeking groups, including those who do not speak English and recent immigrants, may be excluded from many services, and future service delivery for seniors should strive to address disparities in availability and access.

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They Do Their Best, but Their Best Isn’t Good Enough: How Social Housing Can Support Older Tenants Aging in Place

Innovation in Aging ◽

10.1093/geroni/igaa057.075 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 23-23

Author(s):

Christine Sheppard ◽

Andrea Austen ◽

Sander Hitzig

Keyword(s):

Older Adults ◽

Social Housing ◽

Service Providers ◽

Policy Implications ◽

Service Model ◽

Building Trust ◽

Age In Place ◽

Access To Health ◽

The City

Abstract Toronto Community Housing (TCH) is the second largest social housing landlord in North America, and is home to over 27,000 older adults, half of whom live in 83 “seniors-designated” buildings. There is inadequate and inconsistent delivery of services in these buildings, negatively impacting tenants’ ability to age in place. We conducted two half-day consultations with service providers (n=74) and tenants (n=100) to identify strategies to improve unit condition, promote stable tenancies (i.e., prevent evictions) and enhance access to health and support services for older adults living in TCH. Through facilitated discussion, participants identified their top two recommendations for each priority area and reflected on the strategies that were hardest and easiest to implement, as well as the ones that would have the most and least impact on quality of life for older tenants. Participants recognized the need for more education as a way to empower older tenants and reduce stigma associated with unit condition issues (e.g., pest problems) and arrears. More frequent touch points with tenants was also recommended as a way to identify older adults at-risk of eviction and work proactively (instead of reactively) to support them. Service providers and tenants believed that system navigators working directly in the buildings would be a key facilitator to building trust and helping older tenants access needed services. Outcomes of the have several program and policy implications for TCH, as they partner with the City of Toronto to design a new integrated service model for the seniors-designated buildings.

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Promoting Aging in Place in Social Housing

Innovation in Aging ◽

10.1093/geroni/igaa057.2494 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 709-709

Author(s):

Christine Sheppard ◽

Tam Perry ◽

Andrea Austen ◽

Sander Hitzig

Keyword(s):

Older Adults ◽

Social Housing ◽

Service Providers ◽

Aging In Place ◽

Policy Decision ◽

Academic Community ◽

Community Partnership ◽

Service Model ◽

Age In Place ◽

Policy Decision Making

Abstract As cities around the globe plan for current and future older cohorts, there is a need to explore innovative housing models to help older adults age in place. This paper presents findings from an action-research academic/community partnership on a new service model at Toronto Community Housing, the second largest social housing landlord in North America and home to 27,000 older adults. As Toronto works to improve delivery of housing/support services, more knowledge was needed to understand the inadequate and inconsistent delivery of services to tenants. Interviews/focus groups with older tenants and service providers (N=116) identified challenges related to unit condition (e.g., pest control) and tenancy management (e.g., arrears), and that the fragmentation of housing and health services negatively impacts older tenants’ abilities to access supports and age in place. The presentation will conclude with discussion of planning and policy decision making approaches relevant to both Canadian and American contexts.

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A Scoping Review of Social Housing Models for Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.3346 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 910-910

Author(s):

Christine Sheppard ◽

Matthew Yau ◽

Carol Kwon ◽

Jorge Rios ◽

Andrea Austen ◽

...

Keyword(s):

Older Adults ◽

Older Adult ◽

Affordable Housing ◽

Scoping Review ◽

Low Income ◽

Support Services ◽

Social Housing ◽

Relevant Literature ◽

Housing Service ◽

Service Models

Abstract Access to affordable housing is a rising concern for many older adults, and government-sponsored social housing programs are one approach to support low-income older adult renters; however, these housing models are limited in availability and may not all be well-suited to support aging in place. To better understand how to promote the physical, mental and social wellbeing of older tenants in social housing, this scoping review mapped relevant literature to examine: 1) the characteristics of older adults in social housing; and 2) social housing service models and policies. Seven peer reviewed databases were searched for relevant articles, which were screened by two independent reviewers. A total of 140 articles met the inclusion criteria. Studies were predominately from the US and Canada; spanning over five decades of research, with publications surging in the 1980’s and in the 2010’s. Almost all studies reported on the sociodemographic and health characteristics of older tenants, and two thirds presented findings on social housing service models, including policies, staff positions and training, and access to on-site support services. This review points to a high level of vulnerability among older adult tenants living in social housing and highlights the importance of co-locating support services in social housing buildings, with dedicated tenant-support staff to identify vulnerable tenants and link them to these services. There is an acute need for more research on key issues related to housing retention, such as eviction prevention, in order to identify opportunities for social housing landlords to help older tenants age in place.

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Household Accessibility and Residential Relocation in Older Adults

The Journals of Gerontology Series B ◽

10.1093/geronb/gby131 ◽

2018 ◽

Vol 74 (7) ◽

pp. e72-e83 ◽

Cited By ~ 2

Author(s):

Marianne Granbom ◽

Nancy Perrin ◽

Sarah Szanton ◽

Thomas K.M. Cudjoe ◽

Laura N Gitlin

Keyword(s):

Older Adults ◽

Environmental Factors ◽

Residential Care ◽

The United States ◽

Multinomial Regression ◽

Housing Type ◽

Residential Care Facilities ◽

Care Facilities ◽

Nationally Representative ◽

Safety Features

Abstract Objectives It is unclear how home environmental factors influence relocation decisions. We examined whether indoor accessibility, entrance accessibility, bathroom safety features, housing type, and housing condition were associated with relocations either within the community or to residential care facilities. Methods We used prospective data over 4 years from the nationally representative National Health and Aging Trends Study in the United States of Medicare beneficiaries 65 years and older living in the community (N = 7,197). We used multinomial regression analysis with survey weights. Results Over the 4 years, 8.2% of the population moved within the community, and 3.9% moved to residential care facilities. After adjusting for demographics and health factors, poor indoor accessibility was found to be associated with moves within the community but not to residential care facilities. No additional home environmental factors were associated with relocation. Discussion One-floor dwellings, access to a lift, or having a kitchen, bedroom, and bathroom on the same floor may help older adults age in place. Understanding which modifiable home environmental factors trigger late-life relocation, and to where, has practical implications for developing policies and programs to help older adults age in their place of choice.

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Domestic and International Perspectives on Financing Adult Education and Training

Innovation in Aging ◽

10.1093/geroni/igab046.1509 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 389-390

Author(s):

Abigail Helsinger ◽

Oksana Dikhtyar ◽

Phyllis Cummins ◽

Nytasia Hicks

Keyword(s):

Older Adults ◽

Adult Education ◽

Adult Learners ◽

Low Income ◽

The United States ◽

Education And Training ◽

Technological Advancement ◽

Middle Aged ◽

Structured Interviews ◽

And Training

Abstract Adult education and training (AET) over the life-course is necessary to participate in economic, social, and political activities in the time of globalization and technological advancement. However, little research has been done to identify mechanisms to fund AET opportunities among middle-aged and older adults from a comparative international perspective. Our study aimed to identify strategies to finance AET opportunities for middle-aged and older adults through an international lens, to help identify barriers and facilitators in effort to best support adult learners regardless of education background or socioeconomic characteristics. We carried out a descriptive qualitative study to facilitate an in-depth understanding of funding mechanisms available to adult learners in the selected countries, from the perspective of adult education and policy experts. Data were collected using semi-structured interviews with 61 international adult education experts from government agencies, non-governmental organizations, and education institutions. Our informants represented 10 countries including Australia, Canada, Germany, Italy, the Netherlands, Norway, Singapore, Sweden, the United Kingdom, and the United States. Data included at least one in-depth phone or web-based qualitative interview per informant in addition to information gathered from written materials (e.g., peer-reviewed publications and organizational reports). We identified three financing options that arose as themes: government-sponsored funding; employer-sponsored funding; and self-funding. We found that government-sponsored funding is especially important for low-skilled, low-income older adults for whom employer-sponsored or self-funding is not available. Our results have implications for lifelong AET policy changes, such as adaptations of successful AET funding programs across global communities.

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Low Homeownership in Germany—a Quantitative Exploration

Journal of the European Economic Association ◽

10.1093/jeea/jvaa004 ◽

2020 ◽

Author(s):

Leo Kaas ◽

Georgi Kocharkov ◽

Edgar Preugschat ◽

Nawid Siassi

Keyword(s):

United States ◽

Low Income ◽

Social Housing ◽

The United States ◽

Housing Tenure ◽

Strong Impact ◽

Eligibility Criteria ◽

Policy Regime ◽

Advanced Economies ◽

Tax Deductions

Abstract The homeownership rate in Germany is one of the lowest among advanced economies. To better understand this fact, we evaluate the role of specific housing policies that tend to discourage homeownership. In comparison to other countries with higher homeownership such as the United States, Germany has an extensive social housing sector with broad eligibility criteria, high transfer taxes when buying real estate, and no tax deductions for mortgage interest payments by owner-occupiers. We build a life-cycle model with uninsurable income and housing risks and endogenous homeownership in order to quantify the policy impact on homeownership and welfare. Adjusting all three policies has a strong impact on housing tenure choices, closing the gap in homeownership rates between Germany and the United States by about two thirds. At the same time, household welfare would be reduced by moving to a policy regime with low transfer taxes, but it would improve in the absence of social housing, in particular, when coupled with housing subsidies for low-income households.

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Disaster Preparedness Among Older Japanese Adults With Long-Term Care Needs and Their Family Caregivers

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2016.53 ◽

2016 ◽

Vol 11 (1) ◽

pp. 31-38 ◽

Cited By ~ 9

Author(s):

Tomoko Wakui ◽

Emily M. Agree ◽

Tami Saito ◽

Ichiro Kai

Keyword(s):

Older Adults ◽

Family Caregivers ◽

Disaster Preparedness ◽

Long Term Care ◽

Community Support ◽

The United States ◽

Great East Japan Earthquake ◽

Care Needs ◽

Term Care

AbstractObjectiveIn the 2011 Great East Japan Earthquake, as in Hurricanes Katrina and Rita in the United States, older individuals were at the greatest risk of mortality. Much concern has been raised about developing plans to reduce these risks, but little information has been provided about preparedness, and the key role played by caregivers has been largely unexplored. The aims of this study were thus to examine the preparedness of family caregivers of older adults with long-term care needs and to identify the characteristics of older adults and their caregivers that are associated with poor preparedness and greater concern about disasters.MethodsShortly after the Great East Japan Earthquake, the second wave of the Fukui Longitudinal Caregiver Study was administered to the family caregivers of older Japanese individuals with long-term care needs. The sample included 952 caregivers from 17 municipalities in Fukui prefecture. Logistic regression analyses were used to identify the factors associated with self-assessed preparedness, evacuation planning, and caregivers’ concerns about preparedness.ResultsThe majority (75%) of the caregivers had no concrete plans for evacuation in an emergency, and those caring for persons with dementia were 36% less likely to have any plan. In multivariate models, caregivers who were more experienced and wealthier and who reported more family and community support were more likely to feel well prepared. Caregivers with poor health or limited financial resources or who were responsible for older persons with mobility difficulties reported higher levels of anxiety about their disaster preparedness.ConclusionsThis study indicates that most caregivers are ill prepared to respond in emergencies and that caregiver resources, community support, and the needs of older care recipients influence both preparedness and concern about disasters. Education for caregivers and the development of community support programs could provide important sources of assistance to this vulnerable group. (Disaster Med Public Health Preparedness. 2017;11:31–38)

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