This report summarises the findings of a systematic review of the best recent scientific evidence on how home adaptations can contribute to improving later lives (Powell et al, 2017).
Living in a suitable home is crucially important to a good later life. The right home environment can maintain or improve people’s physical and mental health, wellbeing and social connections, enable them to carry out day-to-day activities safely and comfortably, and help them to do the things that are important to them. More than 90% of older people in England live in mainstream housing, as opposed to specialist housing or residential care. However, current UK housing stock is often not accessible or adapted to meet people’s needs as they get older, with small room sizes, steep internal stairs, baths rather than showers and steps outside.
While many people will maintain good health and fitness for much of their later years, the likelihood of having one or more long-term condition, physical impairments, disabilities and frailty that make day-to-day life at home more difficult does increase with age. The percentage of people who have difficulty with at least one activity of daily living (basic routine activities like eating, bathing and dressing) increases dramatically from 16% at age 65 to around half of those aged 85. By people’s late 80s, more than one in three people have difficulty undertaking five or more activities of daily living unaided (Marmot et al 2016). Installing aids and adaptations into people’s homes, such as grab rails and level access showers, can improve the accessibility and usability of a person’s home environment, maintaining or restoring their ability to carry out day-to-day activities safely and comfortably.
The last comprehensive review of the evidence on home adaptations was published in 2007. Since then, there has been increasing policy attention paid to the benefits of home adaptations, particularly in relation to how they can reduce health and social care costs, many of which are outlined in this review. However, there should be much greater focus and action given to the widely acknowledged and unsustainable pressures on our health and social care systems, coupled with the fact that we are living for longer and the proportion of older people in our society is growing. In the last Spending Review, the budget for the Disabled Facilities Grant was increased to enable greater access to home adaptations for more people, yet there is still an unacceptable and under-reported number of people not getting the equipment and support they need. This review aims to provide an up-to-date analysis of evidence of the importance and effectiveness of home adaptations. The review was conducted by a team from the University of the West of England, Bristol (UWE), and related modelling work was conducted by Building Research Establishment (BRE).