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

Most older people would prefer to remain at home and receive care at home until the end of life. In the UK, around 16% of older people die at home ( Hall et al, 2011:3 , Figure 1:1) and around 10% of people with dementia die at home ( Public Health England (PHE), 2019 ). In Europe, including the UK, the population is ageing and it is important that older people are enabled to remain at home whenever possible ( Hall et al, 2011 ). As dementia progresses, this can become more difficult, but can be managed if the appropriate support is provided. This article explores ways to support people with moderate dementia to remain at home.

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The National Dementia Strategy: innovation or reiteration

The Psychiatrist ◽

10.1192/pb.bp.109.025361 ◽

2010 ◽

Vol 34 (7) ◽

pp. 292-294 ◽

Cited By ~ 1

Author(s):

Claire Hilton

Keyword(s):

Mental Health ◽

Older People ◽

Healthcare Policy ◽

Health Needs ◽

Mental Health Needs ◽

People With Dementia ◽

New Strategy ◽

Strategy Innovation ◽

The Uk

SummaryThe National Dementia Strategy is based on constructive ideas to develop services for people with dementia, their families and carers. However, it is likely that this new strategy will have little impact because it is neither adequately funded nor mandatory. This opinion is based on patterns of implementation of healthcare policy in the UK over many years, especially that relating to the mental health needs of older people.

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Co-resident care-giving and problematic sleep among older people: evidence from the UK Household Longitudinal Study

Ageing and Society ◽

10.1017/s0144686x1800168x ◽

2019 ◽

Vol 40 (6) ◽

pp. 1195-1222 ◽

Cited By ~ 1

Author(s):

Emma Maun ◽

Karen Glaser ◽

Laurie Corna

Keyword(s):

Longitudinal Study ◽

Older People ◽

Longitudinal Research ◽

Sleep Problems ◽

Poor Sleep ◽

Care Needs ◽

Care Givers ◽

Care Giving ◽

Resident Care ◽

The Uk

AbstractIn light of current pressures within formal social care services, informal carers assume an important role in meeting the care needs of a growing number of older people. Research suggests relationships between care-giving and health are complex and not yet fully understood. Recently, wide-ranging associations between sleep and health have been identified, however, our understanding of the links between care-giving and sleep is limited at present. This study assesses longitudinal patterns in co-resident care-giving and problematic sleep among older people in the United Kingdom. Our sample included 2,470 adults aged 65 years and older from the UK Household Longitudinal Study. Problematic sleep was defined as two or more problems in going to sleep, staying asleep or sleep quality. Using logistic regression models, we assessed how co-resident care-giving status, intensity and transitions influence the likelihood of problematic sleep in the following year, adjusting for potential confounding factors. Adjusted analyses found co-resident care-givers were 1.49 (95% confidence interval = 1.06–2.08) times more likely to report problematic sleep in the following year, relative to those not providing care. Care-giving over 20 hours per week and continuous co-resident care-giving also significantly increased the odds of problematic sleep. This suggests older co-resident care-givers may be at greater risk of incurring sleep problems than non-care-givers. Further longitudinal research is needed to investigate care-giver-specific consequences of poor sleep.

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

Dementia ◽

10.1177/1471301218801743 ◽

2018 ◽

Vol 19 (5) ◽

pp. 1492-1508 ◽

Cited By ~ 1

Author(s):

Simon Chester Evans ◽

Teresa Atkinson ◽

Ailsa Cameron ◽

Eleanor K Johnson ◽

Randall Smith ◽

...

Keyword(s):

Older People ◽

Living Alone ◽

Care Staff ◽

Key Factors ◽

Care Needs ◽

People With Dementia ◽

Care And Support ◽

Acceptable Quality ◽

Extra Care Housing

With over two-thirds of people with dementia living in the community and one-third of those living alone, it is important to consider the future housing needs of this population, particularly as symptoms of cognitive impairment increase. Policy in England has focused on enabling people living with dementia to remain in their own homes for as long as possible, often with the support of a family carer. However, many people struggle to maintain an acceptable quality of life in their own homes as their dementia advances, often due to the design limitations of mainstream housing and the challenge of finding specialist domiciliary care that is affordable and of sufficient quality. Extra care housing offers a model that aims to support older people living in their own apartments, whilst also offering specialist person-centred care as and when it is needed. This paper reports on a longitudinal project that explored how extra care housing can respond to the changing social care needs of residents, including those living with dementia. Participants included residents and staff from four extra care housing schemes, one of which was a specialist dementia scheme, in two regions of England. Interviews were carried with 51 residents across 4 rounds at 5 month intervals between October 2015 and June 2017. Interviews were also carried out with 7 managers, 20 care staff and 2 local authority commissioners of housing for older people. Key factors included person-centred care and support, flexible commissioning and staffing, appropriate design of the environment and suitable location of the scheme within the wider community. The challenge of delivering services that addresses these issues during a period of reduced public spending is acknowledged. Further research is suggested to compare different approaches to supporting people with dementia, including integrated and separated accommodation, and different stages of dementia.

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The association between white matter hyperintensity volume and cognitive/physical decline in older people with dementia: A one-year longitudinal study

Aging & Mental Health ◽

10.1080/13607863.2021.1980859 ◽

2021 ◽

pp. 1-8

Author(s):

Rismah Hairu ◽

Jacqueline C. T. Close ◽

Stephen R. Lord ◽

Kim Delbaere ◽

Wei Wen ◽

...

Keyword(s):

Longitudinal Study ◽

White Matter ◽

Older People ◽

White Matter Hyperintensity ◽

Physical Decline ◽

People With Dementia ◽

One Year

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Connected communities? LGB older people and their risk of exclusion from decent housing and neighbourhoods

Quality in Ageing and Older Adults ◽

10.1108/qaoa-04-2015-0019 ◽

2016 ◽

Vol 17 (2) ◽

pp. 107-118 ◽

Cited By ~ 5

Author(s):

Dylan Kneale

Keyword(s):

Social Networks ◽

Longitudinal Study ◽

Older People ◽

Design Methodology ◽

Home Ownership ◽

Content Type ◽

Property Wealth ◽

And Bisexual ◽

The Uk ◽

English Longitudinal Study

Purpose – The purpose of this paper is to explore the way in which the housing and neighbourhood accessibility and neighbourhood connectedness of older lesbian, gay and bisexual (LGB) people aged 50 and over, differ compared to non-LGB older people. Design/methodology/approach – This paper utilises data collected as part of the English Longitudinal Study of Ageing as well as theories around social exclusion to explore these issues, using information from 5,442 survey respondents including 260 identified as LGB. Findings – Little evidence is uncovered of a link between being LGB and experiencing exclusion from decent housing, public transport or neighbourhood amenities. Significant differences were uncovered in levels of home ownership and the numbers who reported having seen a friend the previous day, the likelihood of which were both lower for LGB people compared to non-LGB people. Research limitations/implications – All analyses are subject to caveats around the size of the sample and the method of identifying LGB older people. The findings could suggest older LGB people may be less likely to have property wealth from which to draw down in retirement. Furthermore, the findings on older LGB people being less likely to have seen a friend the previous day, may suggest a need for more opportunities to be made available for LGB people to maintain their social networks closer to home to offset the risk of social isolation. Originality/value – This is one of the first studies to examine how the housing and neighbourhood accessibility and connectedness patterns of older LGB people differ from non-LGB people in the UK.

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What makes extra care housing an appropriate setting for people with dementia? An exploration of staff decision-making

Dementia ◽

10.1177/1471301217724966 ◽

2017 ◽

Vol 18 (5) ◽

pp. 1710-1726

Author(s):

Hilde Verbeek ◽

Sue Tucker and ◽

Mark Wilberforce ◽

Christian Brand ◽

Michele Abendstern ◽

...

Keyword(s):

Care Pathway ◽

Care Home ◽

Statistical Modelling ◽

Community Based ◽

People With Dementia ◽

Care Coordinators ◽

Actual Care ◽

The Uk ◽

Home Placement ◽

Extra Care Housing

Extra care housing facilities in the UK are intended to offer a community-based alternative to care home placement. However, little is known about staff’s views of the appropriateness of extra care housing for people with dementia. This paper describes a mixed-methods study which explored this issue using statistical modelling of frontline staff’s recommendations of the best care setting for care home entrants; thematic analysis of transcripts from a simulated Resource Allocation Management Panel meeting; and content analysis of care coordinators’ reasons for not considering extra care housing in actual care home applications. Frontline practitioners saw extra care housing as a valuable alternative for a significant minority of care home entrants. However, extra care housing was not recommended if people needed care at night. Social care managers expressed general support for the idea of extra care housing, but appeared overwhelmingly focused on maintaining people at home and unsure where in the care pathway extra care housing sat. More evidence is needed on whether extra care housing can be an alternative to care homes and how services should be arranged to meet the needs of people living in extra care housing.

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