Ageing-in-place and integrated care: Findings from the ODESSA project.
Professor Karim HadjriHead of School of ArchitectureThe University of Sheffield
1 March 2019London
Content
1. ODESSA Project introduction.2. Age-friendly environments.
• Case studies.• Exploratory focus groups.• Final focus groups.
3. Design alternatives and guidelines.
An international research venture investigating current long-term care delivery models for older people to allow them to live
independently for longer (3/2015-2/2018)
ODESSA: Optimising care delivery models to support ageing-in-place
EU-China: Understanding Population Change.
ODESSA: Optimising care delivery models to support ageing-in-place
EU-China: Understanding Population Change.
Key issues
1. Overcoming isolation, keeping up social networks and accessing public services for older people within the community.
2. The physical environment is often a barrier to accessibility, mobility and independence.
3. The challenges of retrofitting existing homes and their affordability.
ODESSA Project Aims
A better understanding of ageing-in-place in the three countries and identify common features of an effective system of integrated care under different policy and society circumstances.
Project Objectives
1. housing choices, needs, and preferences of older people.
2. the potential for engaging communities in effective and inclusive models of social care delivery to support healthy ageing.
3. design alternatives for age-friendly housing environments.
Work Packages
1. WP1: Older people’s housing conditions and living arrangements.
2. WP2: Older people’s housing and care expenses and residential mobility.
3. WP3: Care delivery and community support/ connected communities.
4. WP4: Age-friendly housing environments. 5. WP5: Innovative financial channels to provide
serviced-homes and promote ageing-in-place.6. WP6: Comparative study and future scenario
building.
ODESSA Project Framework
Automony
Affordability
Ageing in Place
StrategyStrategy
Financial innovationFinancial innovation
WP2
WP1
Comparison and Scenario Building
IdentificationIdentification
Vulnerable groups Vulnerable groups
PlanningPlanning
health and social care modelhealth and social care model
Global Challenge of Ageing Society
Demographic TrendAgeing Equality
Financial ModelCost-effectiveness
AnalysisRisk Analysis
Ageing-friendly HousingInclusive design
Fall prevention Monitoring and care delivery
Social Network SupportDignity
IndependenceCommunication
WP5
Sustainability
WP4
WP3
Theo
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Theo
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Empi
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Polic
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arni
ngPo
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WP6
Housing Condition
Living Environment
WP4: Age-friendly housing environments.
Karim Hadjri; Tulika Gadakari; JunjieHuang; Jingjing Wang.
WP4 Age-friendly environment
Age-friendly design of the physical environment is increasingly being encouraged by many governments and organisations given its role in the promotion of better health, wellbeing and overall quality of life of older people, which would facilitate ageing-in-place.Age-friendly housing can facilitate wayfinding, improve quality of life, maintain and empower social networks and increase autonomy. Inclusive Design standards such as Lifetime Homes should form the basis to support the production of age-friendly environments.
WP4 Objectives
1. Review best practice age-friendly and smart homes in EU (UK, France, NL) and China.
2. Establish whether there are practical replications, similarities or differences between the countries.
3. Propose design alternatives and guidelines for age-friendly housing environments that support ageing-in-place.
WP4 Methodology
Literature Review
Assistive Technology Universal Design & MobilitySocial &
Community
Dementia Care
International Good Practice
Focus Groups
UK
France
China
Case Studies in
China
Case Studies in
UK
Case Studies in
France
Retrofitting Recommendations
ExploratoryFocus
Groups in China
Recommendations for Work Package
5 and 6
Literature Review
Findings
Case Studies in
NL
WP4 Case studies
Age-friendly environments equipped with assistive technology.
Selection criteria:1. Inclusive design2. Assistive technology3. Provision for care4. Recent development
WP4 Case studies
The user requirements and the domains were established as key issues affecting older people following a comprehensive literature review.
Five User Requirements:1. Mobility2. Sensory3. Cognitive4. Health and Safety5. Social Inclusion
WP4 Methodology
Case studies
WP4 Exploratory Focus Groups, Beijing
1. 12 retired university employees, Tsinghua University.2. 14 participants representing three generations.3. 15 people from the Chaoyang Minjin Committee.
WP4 Exploratory Focus Groups, Beijing
Domains and themes for the focus groups:
Domain Accessibility Sensory Cognitive TechnologyThemes principles of
Lifetime Home Standards; age-friendly design
effects of home comforts, environment, colours and contrasts, lighting, temperature, sound, sensory health and wellbeing
the connection between the sense of identity, autonomy, control, independence and a familiar home environment; self-identity, independence and control, wayfinding
familiarity; current or previous use of assistive technology; assistive technology that supports daily activities, safety, access health care; social inclusion
WP4 Exploratory Focus Groups, Beijing
WP4 Exploratory Focus Groups, Beijing
Discussion Questions1.Have you made any modifications/adaptations to your
current home due to accessibility and mobility issues?2.What concerns do you have in relation to sensory
health and wellbeing? 3.If your independence is affected by your current
home, what are the main underlying reasons?4.Which Assistive Technologies do you use?5.What Assistive Technologies can enhance your health
and wellbeing?6.What Assistive Technologies will support your daily
activities?
WP4 Exploratory Focus Groups, Beijing
Results: Themes and sub-themes?
Theme Sub themes1 Ageing-
in-placedesign, spatial sufficiency, architectural design, wanting to stay home, age well, quality of life, flexible housing, and multi-functional spaces
2 Cultural multigenerational living, background, death, rural, urban, society, and ethics.
3 Safety falls, emergencies and accidents4 Economic money, affordability and savings5 Political government and policy
WP4 Exploratory Focus Groups, Beijing
Results: What is ageing-in-place?1. being able to live with children and grandchildren.2. stay in familiar community and surroundings.3. the sentimental value of the home.4. fear of abandonment.5. fear of loneliness.6. economic reasons.7. care home facilities in China were at an early stage
and not yet of good quality.
WP4 Exploratory Focus Groups, Beijing
Results: Barriers to ageing-in-place:1. unable to modify homes or install devices
especially when living with children.2. inadequate medical and professional care service
at home.3. accessibility issues such as – no lifts, poor
staircase design, narrow corridors, slippery floors.4. affordability issues.5. Some technology was not yet supported by the
Chinese health and care system.
WP4 Exploratory Focus Groups, Beijing
A sketch made by one of the participants
WP4 Exploratory Focus Groups, Beijing
WP4 Exploratory Focus Groups, Beijing
WP4 Exploratory Focus Groups, Beijing
“I think, the technology can’t replace emotion.” “Emotion in caring is more important than these products and technologies”.
“We do not have enough living space, I have a two-bedroom apartment, but I need to look after my grand-children. So three generations are living together, the space is not enough!”.
“I feel really uncomfortable when I hear the term ‘dementia’”.
WP4 Findings
User Requirements Design Framework domains for Mainstream HousingRetrofit Technology
MobilityTotal features: 33
Universal - Bedroom - Bathroom -Kitchen
Universal
SensoryTotal features: 28
Light - Indoor Air Quality -Visual/Hearing - Materials and Colours - Outdoor Spaces
Universal - Light - Indoor Air Quality - Visual/Hearing
CognitiveTotal Features: 15
Normalness - Kitchen - Memory -Mental Health
Normalness - Easy to use -Memory - Mental Health -Personalisation
Health and SafetyTotal Features: 32
Universal - Bathroom - Kitchen Telemedicine - Telecare - Fire Safety - Surveillance - Access -Intelligent Systems
Social InclusionTotal Features: 11
Physical - Virtual Maintaining contact
WP4 UK & France Focus Groups
WP4 UK & France Focus Groups
WP4 UK & France Focus Groups
WP4 UK & France Focus Groups
WP4 Focus Groups
Findings:Mobility• Wheelchair accessibility; ramp; lift/stairlift; wide
doors; walk-in shower.• Accessible emergency call systems.• Less importance to features that were perceived
to be of high assistance such as reclining shower seats, ceiling hoists, bath hoists.
WP4 UK & France Focus Groups
Findings:Sensory• Access to adequate natural light or daylight in the
home. • Access to good outdoor views and outdoor spaces.• Better lighting, convenient light and temperature
control. • Technologies for health & safety.• Home automation.
WP4 UK & France Focus Groups
Findings:Cognitive• Both design and technology that helped with
memory and orientation was highly significant. • Displaying identifiable pictures or memorabilia
at the entrance door to help with wayfinding was deemed ‘Important’ by all groups in UK and ‘Very Important’ in France.
WP4 UK & France Focus Groups
Findings:Group discussion The concept of ‘homes for life’ or adaptable housing that evolves as people age was well received.• Some older people would not like to move in a
home which was completely ‘fitted for old age’ as they would feel overwhelmed.
• The issue of managing people’s perceptions and ensuring a normal environment that was attractive was discussed at length.
WP4 UK & France Focus Groups
Findings:Group discussion• There is a danger that if everything is important
then this will make the future home very complex, hence it is important to prioritise and be more strategic to provide a future-proof solution.
• Participants also discussed what aspects of inclusive design and technology that can make older people feel stigmatised.
An accessible apartment.
Symposium publicationhttps://www.sheffield.ac.uk/polopoly_fs/1.832699!/file/Odessa-Symposium-publication-2019.pdf
Conference publicationhttps://www.sheffield.ac.uk/architecture/latest/odessa-conference-1.747080
Symposium in Chongqing, China
3 December 2018. Sino-British Ageing Innovation Forum.
Symposium in Chongqing, China
Next steps - impact creation
The results of the projects need now to be taken further as policy and practice guidelines and standards in UK and China. 1. The setup of an Anglo-Chinese ageing-in-place
Knowledge and Development Exchange (KDE) Network.
ODESSA Impact Project team
JunjieHuang
JingjingWang Yiru Pan Isaiah
DurosaiyeDavidMorris
Thank you.