Guarantee for independent living? Invest in pre-care
There are plans afoot for a cross-party guarantee for independent living- in essence, investment in ‘pre-care’ measures to ensure our homes and communities are designed for age and mobility, so that more people are able to take care of themselves and their families at home, for longer.
It’s a great plan, but is it just re-working strategies that have already been mooted, for years? Strategies such as lifetime homes, that create a home designed to enable people to live their for their lifetime, with little need for alteration to accommodate decreasing mobility.
There is another interpretation of lifetime homes: that of the cost of adaptation, or providing care. In the automotive industry, lifetime costs already takes into account not just the build and running costs, but the impact beyond- the environmental considerations in shipping parts, and the end disposal. Should we not apply that ‘whole life’ cost to our homes too? How much is the hidden cost of future adaptation, provision of care?
It’s not hard to design the home from the outset so that doorways are wide enough for a wheelchair, that doorways are aligned to facilitate later installation of a hoist to help transfer within a room, and from one room to another.
But many in the design and build process forget that the one room that is subject to a home adaptation more than any other is the bathroom.
And the one area within that room that is most commonly changed in some way is the toilet. It may be something as simple as adding a grab rail, raising the toilet seat height, or changing the seat. Sometimes it is a bigger alteration- like switching the conventional WC for a wash & dry one.
There is much focus on the cost of care. Numerous trials have proved, time and again, that effective use of daily/ independent living aids makes better use of available funds, compared to the cost of providing a carer to visit.
There is a hidden cost here too, in providing care support- that of the impact of having a stranger help you on and off the toilet, of having a stranger wipe our bum. What price the feeling of dignity, independence? And what cost to the NHS on treating the mental, and physical, issues, arising as a result?
To my mind, any strategy that enables someone to retain any degree of independence is a good thing. We just need a more holistic approach to costs. We need incentives to encourage housing providers, be it in the private or public sector, to design, and build, homes that require little or no major adaptation. We need a view that a capital cost that empowers someone to be independent for even a few months is better- and actually cheaper- than turning to the established method of providing care support.
That way, those that really do need the care support, where assistive technology, living aids are not suitable, can benefit, and potentially receive better care from resources that are less under pressure.