Understanding and supporting safe walking with purpose among people living with dementia in extra care, retirement and domestic housing

Purpose The purpose this paper is to explore walking with purpose in extra care, retirement and domestic housing settings to better understand and support people living with dementia in these settings, develop recommendations and inform practice. Design/methodology/approach A mixed-methods study was used: scoping literature review; online survey of extra care and retirement housing managers in the UK; case studies involving interviews with staff and family carers (n = 14) of ten individuals who engaged in walking with purpose in the different housing settings. Findings Although residents who walk with purpose constitute a minority (0–2 residents), managing walking with purpose can be challenging and time consuming. Distraction or redirection was the most common response. Other strategies included identifying the resident’s motivations and accommodating their wishes or walking with them. Culture of care, staff training and dementia-friendly design are keys to effective support for safe walking with purpose. Responses to walking with purpose in the domestic housing settings have raised serious deprivation of liberty issues. Research limitations/implications This study had a number of limitations. The completed survey questionnaires represent a self-selected sample of extra care and retirement housing settings, and responses are based on the perceptions of the staff members completing the survey. There were a relatively small number of case study sites (three extra care housing and three retirement housing), and it was not possible to interview family members for all of the residents who walked with purpose. Originality/value This study provides unique data on walking with purpose in extra care and retirement housing setting in the UK.

Addressing loneliness and isolation in retirement housing

ABSTRACTLoneliness is a significant health risk for older people, linked with bereavement, living alone and declining health. Previous research suggests loneliness is common amongst residents of English retirement housing, who show a relatively high incidence of these factors. This invites the question, what can providers of retirement housing do to help their residents avoid loneliness, thus remaining healthier and less likely to need care services? Through a survey of 326 retirement-estate managers, we investigate the role of staff and residents' groups in developing organised social activities for residents in retirement housing, and the potential of these activities for generating social contacts which may provide a pathway to avoid loneliness. The survey was informed by a literature review with two objectives: firstly, to consider the nature and causes of loneliness amongst older people and how these apply to retirement housing residents; secondly, to identify good practice models of previous interventions designed to widen social interactions for older people or provide emotional support. The sample was drawn from the all-England property portfolio of a major provider of retirement housing for people over 55. The sampled estates, mostly social rented but including some with a mixture of leasehold and rented dwellings, represent a sector also described as sheltered or supported housing, which has over 550,000 dwellings in the United Kingdom. It is characterised by having some form of staff support for people who are frail, immobile or isolated, such that they may occasionally need help available on call. In the literature review, we consider how different kinds of social contact can help develop friendships and meet social support needs, in retirement housing and elsewhere – in particular, organised group activities (clubs, classes, etc.) and specific interventions designed to address loneliness. The fieldwork suggests that organised activities in retirement housing have considerable potential to meet residents' social support needs, but that this potential is often not fully realised. A wider range of activities is needed, which may require the support of housing management staff, volunteers and community organisations.