Assessing the adaptability of the existing homes of older people

A rapidly growing number of older people wish to remain in their existing homes for as long as possible, in many cases leading to the need for adaptations. The extent of the adaptations required is influenced by the nature of the individual's impairments and by the design of their property. An approach to understanding the impact of the needs of older people on adaptation requirements based on the development of standard User Profiles and Mobility Profiles is presented together with an analysis of a varied set of 82 properties selected from across the UK.

Can adapting the homes of older people and providing assistive technology pay its way?

Background: Adaptations and assistive technology (AT) have an important role in enabling older people to remain in their own homes. Objective: To measure the feasibility and cost of adaptations and AT, and the scope for these to substitute and supplement formal care. Design: Detailed design studies to benchmark the adaptability of 82 properties against the needs of seven notional users. Setting: Social rented housing sector. Main outcome measures: Measures of the adaptability of properties, costs of care, adaptations and AT, and relationships between these costs. Results: The adaptability of properties varies according to many design factors and the needs of occupiers. The most adaptable properties were ground floor flats and bungalows; the least were houses, maisonettes and flats in converted houses. Purpose-built sheltered properties were generally more adaptable than corresponding mainstream properties but the opposite was the case for bungalows. Adaptations and AT can substitute for and supplement formal care, and in most cases the initial investment in adaptations and AT is recouped through subsequently lower care costs within the average life expectancy of a user. Conclusion: Appropriately selected adaptations and AT can make a significant contribution to the provision of living environments which facilitate independence. They can both substitute for traditional formal care services and supplement these services in a cost-effective way.

Adapting the homes of older people: A case study of costs and savings

Meeting the demand for independent living from the increasing number of older people presents a major challenge for society, government and the building industry. Older people's experience of disabling conditions can be affected by the design and layout of their accommodation. Adaptations and assistive technology (AT) are a major way of addressing this gap between functional capacity and the built environment. The degree of adaptability and the differences in the average cost of adaptation of different types of property are large and there is major variation within property type. Based on a series of user profiles, it was found that a comprehensive package of adaptations and AT is likely to result in significant economies arising from a reduction in the need for formal care services. This finding is sensitive to assumptions about how long an individual would use the adaptations and AT, as well as to the input of informal care and the nature of their accommodation. The present study, which focused on social housing, has implications for how practitioners specify ways of meeting individual needs as well as providing a case to support the substantial increase in demand for specialist adaptation work.

Truth in complex adaptive systems models should be based on truth by constructive verification

It is argued that the truth status of emergent properties of complex adaptive systems models should be based on an epistemology of proof by constructive verification and therefore on the ontological axioms of a non-realist logical system such as constructivism or intuitionism. ‘Emergent’ properties of complex adaptive systems (CAS) models create particular epistemological and ontological challenges. These challenges bear directly on current debates in the philosophy of mathematics and in theoretical computer science. CAS research, with its emphasis on computer simulation, is heavily reliant on models which explore the entailments of Formal Axiomatic Systems (FAS). The incompleteness results of Gödel, the incomputability results of Turing, and the Algorithmic Information Theory results of Chaitin, undermine a realist (platonic) truth model of emergent properties. These same findings support the hegemony of epistemology over ontology and point to alternative truth models such as intuitionism, constructivism and quasi-empiricism.

Introducing assistive technology into the existing homes of older people: Feasibility, acceptability, costs and outcomes

We examined how far, and at what cost, the housing stock could be modified to accommodate the assistive technology (AT) necessary to enable older people to remain in their own homes. A multidisciplinary team devised seven hypothetical user profiles for 10 case study areas, with five local authorities and five housing associations in England and Wales. Each profile was considered at two times, five years apart, with the users' functional abilities deteriorating in between. In addition, in-depth interviews were carried out with a sample of 67 older people in the case study areas about their use and experience of a wide range of AT. The interviews showed the need to listen to older people and that they welcomed AT when it addressed a perceived need. The results showed that the extent of adaptation required of buildings to accommodate a user's needs varied greatly. It was also found that there was confusion about the terminology of AT, including the idea of the 'smart house'. The study shows that the adaptability of the housing depends on a range of factors and costs.

Introducing assistive technology into the homes of older people: Some lessons from the Netherlands - A case study

The authors have just completed a study of assistive technology (AT) and how it can be introduced into the existing homes of older people. As part of this empirical study some collaboration with the Netherlands took place for two reasons. First to learn about the use of assistive technology from a country where its creative use was well established and second to learn how older people influence policy. Two Dutch consultants helped the team and a short visit was paid to Eindhoven. As a result of this collaboration new ways of using AT were found and comparisons made with the policy and legislative background. In addition lessons were drawn about the involvement of older people.