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The role of extra care housing in addressing the needs of people with dementia Key findings from Ope

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Acknowledged leader in building new extra care courts ... Significant other health problems & care hours generally increased over time ' ... – PowerPoint PPT presentation

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Title: The role of extra care housing in addressing the needs of people with dementia Key findings from Ope


1
The role of extra care housing in addressing the
needs of people with dementia Key findings from
Opening Doors to Independence a three year
tracking study
  • Sarah Vallelly, research manager, Housing 21

2
Key findings from Opening Doors to Independence
3
About Housing 21
  • A national specialist working with older people
    across housing, care and support services
  • 14,000 homes nation-wide in sheltered and extra
    care courts
  • National home care provider
  • Acknowledged leader in building new extra care
    courts
  • Housing Corporation programme 40 million/320
    new homes
  • Department of Health programme 40
    million/344new homes

4
Our Interest in Dementia
  • Currently over 750,000 people in the UK have
    dementia.
  • An ageing population by 2031 there will be 15
    million people over state retirement age
  • By 2050 there will be 1.8 million people with
    dementia
  • We aspire to provide a Home for Life
  • Dementia is a key challenge for us and central to
    all our work

5
Housing 21s Response
  • Specialist Dementia Home Care Services teams
  • Dementia Day Care - Tresham
  • Dementia Voice, part of the Housing 21 Group
  • Dementia Services adviser to work with front line
    staff
  • Assistive technology SMART flat
  • Design in new extra care courts

6
Key features of extra care housing
  • On-site care team (24 hour cover)
  • Flexible care packages tailored to peoples
    individual needs
  • Enabling care ethos
  • Special design features to assist orientation
  • Individual flats with own front doors

7
About the research
3 year tracking study funded by the Housing
Corporation and in partnership with the
University of the West of England, Bristol (UWE)
and Dementia Voice
  • AIMS
  • Evaluate the contribution extra care can make to
    the long term care and support of older people
  • Limitations and challenges
  • Good practice and recommendations
  • Capture views of older people with dementia,
    relatives and staff

8
Key findings and challenges
  • Extra care is offering a good quality of life to
    the majority of residents with dementia
  • Dementia alone does not have a negative impact
  • on potential to live independently in extra
    care housing
  • Balancing independence and isolation is key to
    managing extra care schemes successfully
  • The flexibility of care and support is a key
    strength of extra care housing
  • Assistive technology where in use can be very
    effective in enabling frail older people to
    maintain their independence

9
What residents with dementia liked about Extra
Care
  • Older people with dementia were able to express
    their views
  • Extra care meets many of their aspirations
  • They particularly liked
  • - peace of mind and security
  • - independence and privacy of own flat
  • - alarm system
  • - eating in restaurant
  • - positive relationships with carers -
    particularly where
  • we were able to achieve continuity
  • - still part of the community involving
    relatives friends

10
Benefits of extra care are overwhelmingly
endorsed by older people and their families
  • Its not living with your family but its the
    next best thing
  • Resident 1 Thats right because you can open
    doors for me… Resident 2 And you can talk for
    me…. Resident 1 And I can talk for you
    (laugh), you can pick things up I cant reach
    down for.

11
Can Extra Care offer a Home for Life to older
people with Dementia?
  • Residents move in 84 years old high dependency
    needs (10 hours)
  • Significant other health problems care hours
    generally increased over time
  • Added housing years 16 residents have been
    living there over whole course of study - average
    residence period 3.6 years
  • 45 people died or moved on over the course of the
    study
  • 50 moved to nursing care
  • Repeated use of emergency alarm, distress,
    conflict and challenging behaviours were
    identified by staff as triggers for move on
  • Little evidence of wandering as a risk factor

12
Continuing care?
  • The complexity of long term care funding
    mitigates
  • against our ability to support people to die at
    home
  • An integrated strategy that involves health care
    has a
  • positive impact on residents in extra care but it
    is not
  • the norm.

13
Issues and Findings The impact of a stimulating
environment
  • Importance of eating (health and well being) and
    social aspect of eating together
  • The best Local Authorities designate a part of
    the care package for stimulating activities
  • Supporting People funding has increased the level
    of social activities
  • Day centres attached to courts were highly valued

14
Issues and Findings Design Integration or
Specialisation?
  • Advantages of a pod were-
  • - catering more effectively for wandering
  • - extra security
  • - average age was higher (89 years)
  • - higher levels of disorientation observed
  • Disadvantages
  • - less integration in social life
  • - hard for couples
  • Did benefit some older people with dementia but
    requires
  • good knowledge of the individual prior to moving
    in to
  • make the assessment

15
Issues and Findings The impact of good design
  • An environment which is easy to move around
  • Good outside design such as wander gardens can
    reduce risks and concerns
  • Some small alterations or adaptations have a
    major impact
  • But
  • Residents with dementia still need escorted
    hours as part of the care and support package
  • More rigorous investigation of effectiveness of
    design features

16
Extra care with the right ingredients can offer
older people with dementia both security and
independence, and above all a good quality of
life
Summary
  • Flexible care and support
  • A stimulating environment
  • Specialist training and support for staff
  • Integrated strategies for housing, health and
    social care
  • Access to health care

17
Future challenges
  • Extra care could provide an environment for a
    radical reassessment of the care of older people
    with complex health needs
  • Where extra care is positioned as part of an
    overall strategy for older people it is more
    likely to be the case that community health
    services use extra care housing as a key site for
    service delivery
  • Current funding levels need to be maintained.
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