Age-friendly housing in the context of the COVID-19 crisis

Our homes and living environments are a key determinant of our overall health and impact upon our personal, emotional, economic and social wellbeing. The COVID-19 pandemic not only exposed more starkly Europe’s housing crisis but also showed the fatal impact on older people living in congregated care settings and the impact of poor housing on people’s health and wellbeing. Moderated by Nadia Kamel from Eurocarers, the aim of this webinar was to increase awareness and further build the case for quality, resilient and age-friendly housing in Europe.

Alice Pittini, Research Director, from Housing Europe, the European federation and network representative federations of cooperative, public and social housing and about 25 million homes across Europe, underlined that Europe’s housing crisis was already festering in Europe when COVID-19 caused it to dip even further. In terms of affordable housing, in 2017, 10% of EU households spend more than 40% of their disposable income on housing costs, but when specifically looking at households at risk of poverty, nearly 38% of them spend 40% of their disposable income on housing costs.

The lack of access to affordable housing is changing face, affecting not only low-income groups but also young people moving to cities in search for work, the middle-class more generally, but also specific vulnerable and fragile groups in the population such as older people. With COVID-19 and lockdown measures instructing and ordering people to #stayathome, the failure of housing policies to provide affordable housing became even more obvious. In addition, there are strong correlations between the rate of overcrowding, homelessness and quality of housing and a higher mortality rate linked to COVID-19.

An urgent message was that we do not only need to get our societies ready for an ageing population but also our homes. Given that 80% of our housing stock is not suitable for independent living, with a demand for adaptation of at least 3 million homes in Germany and 2 million in France, efforts need to focus on adapting the existing housing stock, as new construction only represents about 1% of the total housing stock.

Older people need more options as official statistics show that 50% of people above 65 years old live in under-occupied dwellings. Some would probably like to down-size but are unable to do so due to a lack of suitable and affordable choices. Furthermore, 10% of the EU population above  65 years are impacted by energy poverty meaning they cannot afford to heat their homes. For the housing sector, COVID-19 should be seized as an opportunity to make housing future-proof and respond to the diverse needs of an ageing population and involve older people in the design and making decisions about the future of their homes. Social and cooperative housing sector is already active in applying a range of solutions, but more research on this issue is needed.

On the question about how social and public housing organisations can ensure homes are fit for purpose for everyone, Alice reiterated the key priority overall is that we need more homes that are affordable and of good quality for everyone. In regard to the ageing population, the social housing sector is also moving towards delivering more than just homes by getting more engaged in trying to integrate all types of services and support, and helping people to access these services, with the home seen as a hub. Building sustainable communities across all ages will require stronger cooperation between housing providers and public social and care service providers to build future sustainable housing options for all.

Silvia Urra from Tecnalia, Project Coordinator of the Homes4Life project introduced Homes4Life project by reminding the audience that healthy ageing is not only about the absence of disease but rather about our ability to do the things we value most: this depends not only on our intrinsic capacity (our physical and mental health) but also on our environment. If our homes do not help to foster our inclusion in a community, this may lead to isolation and loneliness.

Homes4Life project adopts a holistic approach and focuses on the social, personal and emotional factors that homes represent and based on the fact that many surveys of older people show that the majority of people prefer to age in their own homes even in the face of reduced capacity. Homes4Life involves a set of multidisciplinary stakeholders including representatives of older adults and informal carers; applied research institutes; the building and construction industry; and certification bodies to ensure development of a holistic taxonomy for age-friendly housing transposed into functional and certifiable requirements of what a home needs to do to be age-friendly. 

Holly Holder, Senior Evidence Manager, at the Centre for Ageing Better, a charitable foundation that aims to help people enjoy a later life and works on many interrelated elements of importance in people’s later lives – housing being one important aspect. Holly spoke about the scale of poor quality housing in England which is quite substantial with 4.3 million homes (out of a total of 23.2 million) classified as non-decent homes and impacting about 10 million people. This is based on the government definition for non-decent homes, which does not include aspects such as having sufficient  space, light, being close to friends and family, or Internet access, but focuses purely on homes that lacks modern facilities, are in a state of disrepair or have ineffective insulation or heating. Although over the past decade there has been an overall decline in the scale of the problem, most recent data show that there is an increase of people above 75 living in poor quality homes. In England, there are no policies in place to tackle these issues, further exacerbated by COVID-19.

Looking at the percentage of non-decent homes by age group and income, recent data shows that the older one gets the higher the likelihood to be in a low income group with 28% of those above 75 years with less than 11,000 GBP as their income. This points to a crucial need for state support, and the need for, not only more good quality homes, but also good quality options that can support people in effecting a change. Although money is an issue, it is not only about money, but other issues such as the need for impartial and trusted advice, accessing good quality financial products, or understanding the growing health needs of older people that can impact on their capability to invest in home repairs and maintenance. Finally, in England, the vast majority of people living in non-decent homes are homeowners, meaning they largely fall outside the scope of government schemes and are not regulated in the same way as e.g. landlords would be. In England, there is a crucial need for specific support towards this large group of low-income home owners. Targeted policies are needed for specific issues facing older people given there is a higher likelihood of them living in a cold or damp home. Finally, the crucial relationship between poor quality housing and health, which can either cause and/or exacerbate existing and common chronic health conditions prevalent in older people (e.g. respiratory and cardiovascular conditions) rendering them more vulnerable to COVID-19. The driver for change will be when we appreciate that healthy ageing is in fact to be seen as a series of interconnected elements in our daily lives that affect and influence each other such as our health, our homes, our working lives, our financial security and our communities.

On the question about the role of regional and national authorities in ensuring homes are adapted to the needs of our ageing population, Holly estimates their role as absolutely crucial, but there is also a need for greater awareness about the need to think about the ageing population in a different way, especially when the talk is about investing in the economy, which often may forget people in the process. Investment in adapting the housing stock should not be about new construction and building jobs but rather how to put policies in place that can support e.g. low income homeowners to access schemes or grants to adapt their own homes affordably. Investment in our homes is also about linking to other agendas such as environmental or green initiatives and maybe also bringing back some of the control to the local level and communities.

Alfonso Lara Montero, Chief Executive Officer, from European Social Network, representing the European network of social services departments and public authorities which counts 140 member organisations in 33 countries, keeping older people safe in their own homes and communities comprise a vast portion of social services’ planning and financing.

Whilst the vast majority of people would like to age in their own home for as long as possible, there are gaps in home support options that may be a barrier to enable this. Provision of home care is patchy across Europe ranging between 4% to 30% . In most countries, home care is mostly both locally managed and provided – mostly by home support organisations who are either companies or other sector organisations.

Significant geographical differences in terms of types of home support available persist. In the context of COVID-19, a continuity of home support was provided mainly in relation to 3 criteria: to people with the highest degree of dependency/vulnerability, people in greater isolation, or to people who attended day-care centres which were subsequently closed leaving them without any service.

Some challenges observed in the COVID-19 pandemic for homecare provision was the lack of Personal Protective Equipment (PPE), and the associated diagnostic material. In some cases, one was also able to observe a decrease in number of users of home care services due to fear about risk of infection. Good practices during the pandemic have also been captured such as the establishment of COVID case units, to support people at home after discharge from hospital. However a lack of availability of PPE has been a general challenge in the provision of home care.

Also, in the context of digital technology and telecare, a reinforcement of remote support was observed mainly by phone calls, devices (alarms) or tablets delivered to the homes of older people. Telecare also increased some examples being the installation of risk prevention equipment such as smoke alarms, gas detectors, or devices to detect falls.

Finally, to allow ageing in place, a new care model will be needed that moves away from formal, or institutional and formal concepts to a home-based care model, that is person-centred, focused on improving the wellbeing of the person and their families. Finally, to ensure its proper implementation through a skilled work force such as social workers, personal assistants, mediators, community nurses, but also new professional profiles which may arise with the development of other family support care models. In this process, digital technologies to support people and for remote decision making will also have a key role.

 

 

 

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