Housing and dementia

 

housing-and dementia

 

 

The Association for Dementia Studies is involved in a number of research projects relating to dementia and housing.

 

Green Dementia Care

 

Green Dementia Care

Green dementia care in accommodation and care settings – opportunities, barriers and good practice.

This 12 month mixed methods pilot study, funded by the Abbeyfield Research Foundation, explored the opportunities, good practice, enablers and barriers relating to green (nature-based) dementia care for people living with dementia in accommodation and care settings, particularly care homes and extra care housing schemes or villages. Key research tasks included: examining current evidence for the impact of interaction with the natural environment on people living with dementia; gathering information on opportunities for people living with dementia in these settings to engage with the natural environment; and exploring barriers and enablers to engagement. The study was conducted by the Housing and Dementia Research Consortium (HDRC) in partnership with the Association for Dementia Studies (ADS) at the University of Worcester.

There is growing interest in the impacts of engaging with nature on the physical, psychological, emotional, social and spiritual health and wellbeing of people living with dementia. Green dementia care refers to indoor and outdoor experiences and activities that aim to promote health and wellbeing through interaction with nature for people living with dementia. It includes a range of health-promoting interventions encompassing living organisms (plants and animals) and natural elements (e.g. the weather). Green care links traditional health care to gardening (horticultural therapy), agriculture (green care farming), animals (animal assisted interventions) and exercising in the natural environment (green exercise).

Increasing numbers of people with dementia are supported in care homes (residential care homes or care homes with nursing), while extra care housing is now widely viewed as an alternative form of accommodation that can provide opportunities for maximising independence. Many people living with dementia in such settings have limited opportunities to connect with the natural world often due to organisational concerns about safety and security and outdoor spaces that are not fully accessible. For people with dementia the loss of nature in their lives is often sudden and occurs when they move from their own home into accommodation and care settings. Due to fears about the physical risks involved, residents living with dementia are often discouraged from going outdoors, which means that they can quickly lose confidence to go outdoors with or without support. This puts them at risk of losing their nature relatedness (personal connection to nature) and the benefits engaging with nature may bring to their health and wellbeing.

It is hoped that the findings of this pilot study will inform the development of a large-scale multi-site, multi-provider research project involving in-depth evaluation of the impact of nature-based interventions on the health and wellbeing of people with dementia in care settings. This research theme is one of the top research priorities of the Housing and Dementia Research Consortium (the HDRC is a UK wide network of around 100 housing and care providers and commissioners and other interested parties including academics, architects, advisors, researchers, policy makers and third sector organisations committed to research and knowledge exchange across the sector). High quality, large-scale research in this area is necessary in order to inform policy and practice concerning green dementia care, including any impacts on the health and wellbeing of individuals and the cost effectiveness of care. This pilot study was an important step in developing an understanding of the opportunities for people living with dementia in residential care and extra care housing to engage with the natural world, to explore what works and why, and to identify the main barriers and enablers to engagement.

A summary report of the study is also available

 

Dementia Dwelling Grants

Researching the impact of the Worcestershire Dementia Dwelling Grants

Worcester City Council and other partners have led the development of a new grant for people living with dementia to improve their wellbeing and to enable them to stay at home longer before having to move into residential or other long-term care. These Dementia Dwelling Grants (DDG) will provide aids and home adaptations that are thought to benefit people living with dementia. The Association for Dementia Studies has been commissioned to provide an independent evaluation of the pilot programme.

The evaluation will combine qualitative and quantitative methods including case study interviews in order to explore the effect of the DDG on people living with dementia at home and to provide the Council with evidence to inform its future planning and for dissemination to other local authorities and interested parties.

For further information about this project please contact Simon Evans simon.evans@worc.ac.uk

 

Enriched opportunities programme

 

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The Enriched Opportunities Programme (EOP) was developed by ExtraCare Charitable Trust and Professor Brooker and her research team as a means of ensuring that people living with dementia in care homes and extra-care housing can continue to enjoy a good quality of life.

EOP brings together what is known as best practice in a structured, systematic and proactive way. Key facets of the programs include a specialist staff role “the EOP Locksmith”; staff training; individualized case work; liaison with health and social care teams; activity & occupation; and leadership.

 

ASSET

Adult Social Services Environments and Settings (ASSET)

Adult Social Services Environments and Settings (ASSET) is an independent research project that was commissioned and funded by the Department of Health’s NIHR School for Social Care Research. The project ran from February 2012 to January 2014 and was led by ADS in partnership with the Personal Social Services Research Unit (PSSRU) at the University of Kent, the School for Policy Studies at the University of Bristol, Housing and Care 21 and the Housing Learning and Improvement Network. The overall aim of the project was to explore how best to provide adult social care in housing with care schemes in England, in order to maximise quality of life for residents and make the best use of resources. The project comprised three main stages: a review of what is already known about adult social care and housing with care; surveys of adult social care providers and housing with care organisations to identify what models of working are in use; and case studies of housing with care schemes to explore in detail how they work with adult social care, the experiences of residents and relatives of receiving services, and the cost of different models of care.

Key findings from this research include:

• For some older people a move to housing with care is associated with a better quality of life when compared with living in mainstream housing. Local authority approaches to commissioning adult social care were shown to vary considerably in response to a complex range of drivers including public spending cuts, welfare reforms, the personalisation agenda and changing aspirations for later life.

 • There is an urgent need to provide better financial information to current and prospective residents and their families. This could include information on personal budgets, direct payments and charging arrangements.

 • The housing with care model can support residents who are very diverse in terms of their abilities, needs and care packages, including those not receiving any planned care

A full summary of the project can be found here

Contact: simon.evans@worc.ac.uk

Project website

 

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ECHO - The Provision of Social Care in Extra Care Housing

 

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The ECHO project is a two year study which is funded by the Department of Health (DH), National Institute for Health Research (NIHR) and the School for Social Care Research (SSCR). 

The project started in October 2015 and its broad aim is to explore how care is negotiated and delivered in extra care housing schemes for older people. Find out more about the ECHO project

The ECHO project is a collaboration between the School for Policy Studies at the University of Bristol, the Association for Dementia Studies at the University of Worcester, the Personal Social Services Research Unit at the University of Kent, and the Housing Learning and Improvement Network. The team is led by Ailsa Cameron, senior lecturer based at the Centre for Research in Health and Social Care, School for Policy Studies, University of Bristol.

 

Watch these videos

At the Future of Extra Care Workshop in Bristol in January, two videos were launched that focus on this NIHR SSCR funded project that explores how care is negotiated and provided in extra care housing schemes for older people. 

Undertaken by researchers from the universities of Bristol, Worcester and Kent, the ECHO project’s first film, ‘Listening to residents in extra care housing: findings from the ECHO research project’, documents the key objective of the ECHO project, to gain residents' first-hand perspective on living within their extra care scheme. 

The second film, ‘Influencing policy and operations: outcomes from the ECHO research project’, looks into the ECHO project’s more professional approach, documenting the findings of dialogue between commissioners and managers from ECH schemes.

 

ECHO Research Findings: Film 1

 

Listening to residents in extra care housing: findings from the ECHO research project.


 

ECHO Research Findings: Film 2

 

 Influencing policy and operations: outcomes from the ECHO research project.

 

Dementia and sight loss project

Dementia and sight loss: Developing social care practice in different housing settings

This independent project was commissioned by the National Institute for Health Research School for Social Care Research. The project ran from July 2012 until January 2014 and was led by the Centre for Housing Policy at the University of York, in collaboration with the Association for Dementia Studies at Worcester University, Bournemouth University Dementia Institute, and the Cambridge Centre for Housing and Planning Research at Cambridge University. The overall aim of the project was to investigate how best to provide care and support for adults living with sight loss and dementia in a range of housing settings.

Meeting the social care and support needs of people with concurrent dementia and sight loss presents complex challenges. However, the policy aspiration to enable a greater proportion of people with complex needs to live and die in their own homes requires the specific challenges of providing care and support in these settings for people with concurrent dementia and sight loss to be understood and addressed. Previous research has highlighted a number of factors which limit the effective delivery of social care and support specifically for people with concurrent sight loss and dementia, not least that models of care need to respond to both conditions, rather than working in isolation.

This project aimed to address this gap by building evidence for developing practice guidance in social care and support for people with dementia and sight loss in a range of housing settings. The research drew on the experience of people living with dementia and sight loss, family members where present, and a range of service providers, commissioners and support planners to explore current practice in social care from a range of perspectives, and to identify models of practice, areas where practice could be enhanced and improved, and areas where there is a divergence of evidence.

The research team brought together the necessary range of expertise and skill sets from across the four partner universities and key experts from the Thomas Pocklington Trust and Housing and Dementia Research Consortium in order to address the complexity of examining models of social care delivery to people with concurrent sight loss and dementia within independent living settings.

The findings from the Project can be viewed here

The main outputs from this project will include evidence-based practice guidance and key principle statements highlighting how social care and associated support can best be delivered to people with dementia and sight loss living in a range of housing settings. The development of the guidance included a stakeholder Consensus Event with practitioners, key experts and people with dementia and sight loss and family members. The results will be disseminated to a wide range of audiences via a programme of activities and through a diverse range of media including lay summaries, presentations and online resources.

For further information please contact:

Dr Simon Evans: simon.evans@worc.ac.uk

The other partners on the project were:

 

Housing and Dementia Research Consortium (HDRC)

The Housing and Dementia Research Consortium (HDRC) is a membership group of organisations and individuals who are committed to research and knowledge exchange focusing on ‘what works’ for people living with dementia in housing and care settings. 

A core group of organisations makes up the steering group and funds the Research Coordinator’s position. The Association for Dementia Studies has hosted the HDRC since September 2014.

Aim

The aim of the HDRC is to deliver timely, appropriate, high quality research in order to build a stronger evidence base to support the way services and buildings are designed for people with dementia, and to directly influence policy and practice in relation to accommodation and care services for people with dementia in the UK and beyond.

Background

In recent years, housing providers have increasingly focused on the needs of people with dementia through the design of the built and social environment, and in the way care and support services are provided. A variety of models and approaches have been adopted but there is as yet limited evidence as to what works best for people with dementia at all stages of their journey from diagnosis to end of life. 

A group of housing providers identifying research priorities within the sector offers significant advantages over any single provider seeking research funding, while a consortium increases opportunities for coordinated, multi-site research. In addition, findings from such research are likely to be more generally applicable than research undertaken on single provider developments. 

Relevant, large-scale research can have a significant impact on the sorts of developments commissioned in the future, as well as current practice, thereby directly benefiting people with dementia living in different accommodation settings. Finally, a consortium can enable housing providers and their service users to be more active research partners, rather than being passive recipients or research subjects.

Services

The HDRC is uniquely placed to understand the housing-related priorities of people living with dementia and their carers. In 2014-2015 the HDRC consulted with its members, with people living with dementia in different housing settings, their family carers and care staff in order to set the research priorities and provide an evidence base to guide the HDRC’s work. 

The HDRC is well placed to understand the needs of the housing sector. The HDRC’s work is shaped by its members and steering group which include some of the largest, most innovative and well-respected housing providers in the UK. 

We can provide support with: 

  • Developing a dementia strategy
  • Creating a dementia friendly community
  • Carrying out research, evaluation and consultancy projects
  • Dementia friendly design assessment
  • Providing access to expertise through our extensive networks of academic researchers in dementia, housing and care
  • Facilitating access to research participants
  • Undertaking reviews of the literature on specific topics
  • Developing Briefing papers
  • Helping with the preparation of applications for funding.

Membership

Approximately half of the 90 members of the HDRC are accommodation and care providers and commissioners, and the rest are other interested parties such as academics, architects, consultants, researchers, policy makers and third sector organisations. 

In order to ensure the manageability and focus of the consortium, a core group of members form a steering group which engages with the wider membership as appropriate and provides funding for the Research Coordinator. 

Current steering group members are: 

  • ExtraCare Charitable Trust 
  • The Guinness Partnership
  • Hanover
  • Housing & Care 21 
  • MHA
  • Hallmark Care Homes

The Housing Learning and Improvement Network (Housing LIN) and the Alzheimer’s Society are also represented.

For more information about the HDRC please visit the website at: http://housingdementiaresearch.wordpress.com/ 

 

If you are interested in joining the HDRC, please contact the Research Coordinator, Dr Julie Barrett at: j.barrett@worc.ac.uk