Accommodation options for older people

There are a range of options available to someone looking for accommodation in later life. The type of housing chosen will depend on the potential residents circumstances and requirements. Each type of accommodation has different services and levels of care, which can be confusing, so here we break it down for you.

Staying where you are

If you are finding it difficult to cope with daily tasks or think you need some extra help, special equipment or meals, contact your local authority or the hospital social worker if you are in hospital, and ask for an assessment of your needs.

There are also different ways you can get extra help:

  • Home Improvement Agencies (HIAs), also known as 'Care & Repair' or 'Staying Put' agencies, are local not-for-profit organisations set up to help older or disabled homeowners and private tenants arrange and pay for repairs, improvements and adaptations to their homes. Many HIAs also offer additional services such as a handyperson, help with gardening, checking home security or preparing for coming home from hospital.

    You can get some free information and advice about housing and care options in later life from FirstStop Advice - visit www.firststopcareadvice.org.uk or call 0800 377 7070.
  • For extra reassurance you could have a care line phone installed which would allow you to call for help 24 hours a day if you have an accident or are unwell. Your local authority will have a service, and alarm systems are also available through charities and commercial providers.
  • Increasing in popularity are assistive technologies such as telecare or telemedicine which can help with a range of things such as monitoring movement, temperatures or taking medication.
  • If you’re physically able but just want some social contact, agencies such as Age UK or the Royal Voluntary Service (RVS) can help on a local basis. There are befriending schemes which could help, or you yourself could be a befriender or volunteer, and they hold social activities that you could attend.
  • If you’ve decided that you no longer want to stay in your current home, you’ll need to consider what type of housing will be best for you. If you’re already housed by the local authority you can ask to be transferred to a more suitable property.

Sheltered/supported/assisted/retirement housing

Depending on the provider, you will often hear these interchangeable terms used to describe the same thing.

Most of this type of housing will have a scheme manager or warden and an emergency alarm or careline service. They often have communal facilities such as a lounge, laundry, guest flat and garden. Meals are not normally provided but a few schemes include a restaurant or can arrange a hot meal. There are many different types of housing both to rent and buy.

Schemes usually consist of between 15 and 60 self-contained homes which may be bedsits (studios), flats, bungalows or luxury apartments. There is a minimum age for residents, usually somewhere between 50 and 60. This type of housing appeals to people who like living independently but want the reassurance of knowing that assistance is on hand if there is an emergency, or who want the possibility of socialising in a community of people in the same age range.

The scheme managers generally don’t provide personal care for residents, or carry out tasks like shopping or housework. Some scheme managers will live on-site, though most do not. Even if they live on-site they are usually only on duty during normal office hours.

The availability of a careline alarm service offers reassurance that help is at hand round the clock if needed. By pressing a button on a pendant or pulling a cord, a message is relayed to the scheme manager if they’re on duty or to a monitoring centre, which is staffed 24 hours a day. If help is needed, the scheme manager will attend or the centre will alert relatives or friends, or contact your GP or the emergency services.

Housing-with-care/extra-care housing/assisted living with care/very sheltered housing

This type of housing is referred to by different names, but is all designed to meet the needs of frailer older people and has higher levels of care and support on-site. It is a newer form of specialist housing for older people and is growing in popularity.

There are also some schemes which comprise a small group of bungalows or flats built on the same site as a care home and whose residents can access some of the home’s services.

These properties can be rented, owned or occasionally part owned/part rented. They are self contained homes, usually with one or two bedrooms. The services and facilities provided may vary considerably but typically include 24 hour staffing, some personal care, domestic help, an assisted bathroom, a restaurant or dining room and a residents’ lounge.

If you are considering a move to this type of housing, check what services are available and whether they meet your needs both now and in the near future. Depending on your needs, you may get financial assistance to help pay for this type of care.

Care/residential homes

In an ideal world, decisions about moving into a care or residential home will have been made in advance, and all the options carefully considered. Sadly, in a lot of cases, this type of decision is made when a crisis point has been reached, such as a bad fall, resulting in a sudden change in mobility.

Decisions may have to be made in a hurry and there can often be strong, and sometimes conflicting advice offered by family, friends and professionals. It can be difficult for the older person involved and for those who care about them to arrive at the best decisions in these circumstances.

There are different types of residential care, suitable for different needs, so it’s vital to have an up-to-date care assessment to decide what is required. Most care homes in the UK are owned and operated by private companies but there are also not-for-profit organisations (charities such as Abbeyfield) and just a few social services homes.

All care homes in England are registered and inspected by the Care Quality Commission (CQC). From April 2015 care homes must display their CQC rating throughout the home and also, where applicable, on their website. Full inspection reports are available from the home or the registration authority.

Care homes that provide personal care are called residential homes. They will vary in size and facilities. All will provide an individual room, with some able to offer a couples room, and most will have en-suite facilities and communal areas. Meals are provided, and help with personal care such as dressing, supervision of medication, companionship and someone on call at night. Care homes providing personal care give care during normal short illnesses but do not provide constant nursing care.

Care homes providing nursing care are referred to as nursing homes. They also vary in size and facilities, but all will provide personal and nursing care 24 hours a day for people who are bedridden, very frail or have a medical condition or illness that means they need regular attention from a nurse. There will always a qualified nurse on duty.

Older people with dementia may need a dementia care home. The staff will have specialist dementia knowledge, and will be up-to-date in the latest dementia innovations. The home will be fully equipped to ensure resident safety is maintained, and there will be special facilities to cope with the wide spectrum of symptoms and behaviours that a person with dementia may have. Some have specially designed gardens or shop fronts and other types of reminiscent therapies, designed to help residents feel at home.

A stay in a care home does not have to be permanent. Some people may want respite care to stay in a care home for a short period to give a carer a break, or to build up strength after an illness. Some care homes allocate specific beds for respite care; others accept residents for respite if they have a vacancy. Each local authority will have a charging policy for respite care that is different from the national charging scheme for permanent care

In new developments, there is often a mixture of the types of housing and care available which is useful for those people who might not have many urgent care needs to begin with, but anticipate that as they get older and frailer, their needs will increase. The benefit of developments like this is that it removes the need to move again, when social links have been established between the person and the other residents and carers.

Of vital importance in deciding what type of housing or care is needed is going for lots of visits, and perhaps a trial stay. Most homes will be very happy to accept potential residents on a trial basis, to see whether they can meet a person’s needs to the fullest, and for the person to see if it’s what they expected. Many factors like the overall ambiance of the house or home can only be recognised by spending time there.