Making it a reality: Designing and adapting for older age

I want to start this blog with an experiment.

Humour me (if you will), open a document or grab a piece of paper, and spend the next 30 seconds mapping out what comes to mind when I say:

“Housing for older people”

When I run this exercise in person, I like to give people a list of prompt questions to help them dig deeper into their vision. I ask if they thought of a specific home, like that of an elderly relative, or did their mind create something more generalised, like a nondescript bungalow with ramped access and white PVC handles. Sometimes I’ll ask if they pictured themselves outside, looking in, or if their imagination took them inside the home to show them different objects or spaces the phrase called to mind.

Next I’ll ask what it is about that home that makes it ‘feel’ like a home for an older person- and if there’s anything that could be changed to make it better.

And then, when all is said and done, I’ll ask them to look around this home that they’ve built in their mind, where they have the freedom to create anything they choose, and ask:

“Would you like to live there? Would you move there now? Today?”

It’s a simple enough question- but it almost always catches people off guard- because its one thing to design a house for an older person, but themselves, in all their complexity, with all of their likes and dislikes, their beloved objects and fluffy jumper collection? Not so much.

Who should be thinking about designing, and adapting, for older age?

It’s common to think about housing for older people as a niche market- a concern held only by those of us who find ourselves careening suddenly towards a landmark birthday, with bus pass in hand- but it’s a mistake.

It’s a mistake because most of us would really quite like to grow older when we think about it.

It’s a mistake because current estimates suggest almost 1 in 4 of the UK population will be over 65 by 2050.

It’s a mistake because almost 1 in 3 of the children born in the UK today will live to blow out the candles on their 100th birthday cake.

And it’s a mistake because that kind of thinking lets us turn a blind eye to estimates which suggest only 10% of the UK housing stock is currently designed or adapted to support people with a significant physical or cognitive health condition- which will be most of us, if we live long enough.

Which means, with the HAPPI design principles in mind, we need to be thinking about how our houses can support us as early as possible- especially if we (like the 85% of older people UK)- would like to spend the rest of our days in the home of our choosing, rather than battling it out for the 1 in 10 homes that suit our needs later on.

Which is all well enough to say, in theory, but how do we know what we might need, or want, or not want in practice?

Involving Older People in home design

The Designing Homes for Healthy Cognitive Ageing (DesHCA) project (opens new window) has spent the past 18 months researching with older people, builders, architects, housing professionals and local authorities to answer that question. We’ve explored big data to learn about the kinds of adaptations people tend to make to their home in later life, and how this interacts with factors like their age, health status, education level and social class. We’ve spoken directly to older people about the houses they live in today, what they’ve changed in the past, and what they’d like to change in the future. And we’ve worked alongside professionals in architecture, design and construction, to learn about how the design process can help, or hinder, the process of designing for healthy cognitive ageing.

Each of these activities have brought with them their own unique insights- insights which we brought together and used to help develop new, virtual models of what supportive homes could look like in the future, if we started thinking seriously about designing for our old age today.

Then we did the unthinkable. We asked people to tell us what they really thought of our designs. Not just architects, or builders, or policymakers. We asked everyone, from industry, to policy, from third sector workers to older people themselves.

And we learned a lot.

Visualising homes for healthy cognitive ageing

One of the hardest parts about talking about design is getting everyone on the same page. Take, for instance, the thought experiment we started with; no two imagined houses would, or could, ever be the same. Our idea of what a home should look like, let alone a home that supports older people, will be deeply informed by our own background, or experiences, and our professional expertise.

Which is, of course, fine for a thought experiment- but difficult to share accurately, or quickly, with another person.

A drawing, picture, or collage might succeed in showing part of an idea, in the same way a top down blueprint of a house might give you an idea about the space-but it isn’t the same as walking through the house and seeing it for yourself.

Luckily for the DesHCA project- modern Virtual Reality technology makes it possible for people to do exactly that and helped us get a level of feedback from our professional participants and older people alike that we would never have dreamed of. For example:

• These are homes for living in, which means they will get messy, and they will need to be cleaned. Designs that look good when ‘new’ can easily hide bad design choices if they don’t make it easy for the someone to clean or maintain their home.
   
• Its easy to miss the simple things, like how moving the washing machine to a separate room might help people manage issues with soiled clothes more easily and keep dirty linen away from food areas.
   
• People need more storage, lots of it, at a height that they will be able to access without relying on their balance to use a kitchen step or ladder.
   
• Planning for trips and slips, means spending a lot of time looking down, and focusing on thresholds, doorways, and level changes to remove potential hazards at the design stage.
   
• Outdoor space matters, many older people found themselves using their gardens for relaxing, gardening, and socialising during the pandemic, and many would want access to a garden if they moved.
   
• People don’t want to live in a ‘house for old people’, they want to live in a home that supports them through the many challenges they will face throughout their life. They want spaces that could as easily store a pushchair as a mobility scooter, or a bathroom they could use easily if they broke their leg, or needed support with personal care.
   
• People often imagine a home that supports older people as medicalised or ugly, but may not notice when designs are accessible by default, or when changes to support people’s physical, cognitive, or sensory needs are well integrated into the design of the home.  

Designing for Older Age means designing for all of us.

If there’s one thing that we’ve learned about designing homes for healthy cognitive ageing, it’s that there’s never one problem, and there’s never one solution.

We’ve learned a lot from allowing people to explore our ideas using Virtual Reality- but we know that each solution brings its own problems (as featured in another Housing LIN blog by David Burgher).

We know that there will never be a ‘one size fits all’ design for a home that could support every older person no matter their circumstances, and that each choice we make in terms of size, design, or expense could require change and investment across UK housing policy and industry.

We would argue that VR technology allows stakeholders from all walks of life to make meaningful choices about the design of their homes, or the homes of the future: but we know that building the assets into VR represents huge up-front investment for housing designers and contractors which doesn’t match the traditional payment schedule.

We’ve seen how well older people can engage with complex conversations about building and home design when the information is presented in an accessible way, via VR, but we know that each VR session requires 1:1 support and dedicated devices, which can create a problem for those with limited staffing and budget.

But we’ve also seen people’s passion first hand- we know that people want to live in the homes of their choosing for as long as possible, and that supportive home design could make that happen, improving the lives of hundreds of thousands of people in the process.

We believe that change is coming, and that we can build a brighter and happier future for our older selves, if only we start today.

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This blog is published to coincide with HAPPI Awareness Week (12-16 December 2022). Find out more about the ‘care ready’ HAPPI design principles here. 

And if you found this of interest, sign up to next week’s HAPPI Hour, our last webinar of the year on Tuesday, 20 December, when Cate amd Professor Alison Bowes will be presenting about the DesHCA Project. Secure your place here. 

The DesHCA Project will be making its findings available throughout 2024. You can visit this website or email Dr Catherine Pemble to find out more.