Saving money on care by investing in housing

Last month, I attended the launch of a new All Party Parliamentary Group (APPG) on Housing and Care for Older People Inquiry report on housing for people with dementia entitled, Housing for people with dementia - are we ready? This served as a welcome reminder for me of my dad who died with dementia 4 years ago last month, and also that there are urgent and important issues that are at risk of being overshadowed by the Covid-19 pandemic.

The report is well worth a read and contains useful top tips and good practice, and over 40 recommendations. There is no one big action and, as Lord Best states in his Foreword, unlike with Covid-19:

“there is no vaccine for dementia”

However, a couple that stood out for me are:

• a) the need to rapidly increase the supply of Extra Care / Assisted Living and Retirement Housing and the importance of making this dementia ready, for example with Homes England funding or the support of the GLA Affordable Homes Programme
• b) the potential to use Dementia Dwelling Grants via DFGs as they have done in Herefordshire and Worcestershire to fund adaptations, and
• c) the opportunity to prevent future loneliness when making housing decisions, including importantly what we can do for ourselves - one in 14 of us over 65 will find ourselves living with dementia, and by 2030 this will have increased to 1 in 10 of those over 65.

I was also very struck by a quote from the current President of ADASS, James Bullion, who gave evidence to the APPG Inquiry. He stated:

“Every decision about care is a decision about housing”

Indeed, people living with dementia need support to make housing decisions and these conversations need to take place early on before judgement is impaired. Post diagnosis assessments and support need to include housing circumstances as well as care and support planning. People also need help in settling in following a move, both in navigating the new accommodation and in joining a new community. The right technology is also important and at the launch event a name derived from the Greek meaning “to defend, to help” was mentioned!

Above all people need to be enabled to live independently if that is their choice and as one person who is currently living with dementia has said:

“there is always a way”

However, information and advice is key. Whilst the report points out there are pockets of excellent practice, the sharing of information and good practice is important. The needs and wishes of the individual and their family must come first.

Following the recent experience of care homes during the Covid-19 pandemic there has been increased reticence about moving into Institutional settings and this trend is likely to continue. There is therefore an urgency for dementia-friendly accommodation across all tenures. However, people will not only be living in specialised housing but also in the wider community. Dementia-friendly attitudes and community spirit need to be harnessed to respond.

In my view, all too often affordability is a barrier. Good quality care and accommodation shouldn’t come at a high price. The cost of developing specialist housing or installing adaptations can be well worth public sector investment if they prevent people from having to move to a Care Home, which would ultimately be more expensive.

From a strategic and policy perspective, the interdependency between Housing, Social Care and the NHS in supporting people with dementia needs to be recognised, as I know all too well from personal experience. As someone who has worked in commissioning, this means funding needs to be correspondingly reformed, to prevent the need for higher cost services. Ultimately the Government, Local Authorities and the NHS will save money on care by investing in Housing. 

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And for more on the scope of the APPG Inquiry, access the report and view recordings of the launch, visit the APPG on Housing and Care for Older People page, which is part of our Innovations in Housing and Dementia topic page.