An important concept within the current social and health policy discussion on healthy ageing is ‘ageing in place’. This refers to elderly people living in their homes independently as long as possible, an option desired by most elderly people. It also makes sense in light of the economic costs associated with an ageing population and with very expensive care in nursing homes. Where full-time stationary care is not absolutely necessary, other living arrangement options with the necessary support structures are often more “humane”. To promote ‘ageing in place’, there are a variety of strategies and services operating at different levels, which include age-friendly environments, social services, assistive technologies, etc. The overall socio-political task of promoting the welfare of society, particularly for elderly people with special needs, requires the participation of a number of different organisations and actors, including private, public, non-profit and informal support networks. However, interactions between these different organisations and actors are often poorly coordinated. The research team in their project ‘Ageing in place – challenges and opportunities at the interface between property management and older residents’ seek to facilitate ageing in place. The research focuses on the role, challenges, and evolving service options of property management (profit- and non-profit) organisations in supporting elderly residents and cooperating with other relevant actors. Conditions needed for ‘ageing in place’
In their work, Althaus, Birrer and Hugentobler highlight a number of conditions that are needed for ‘ageing in place’ to be possible and meaningful, including access to a variety of services, strong social networks, favourable structural conditions and access to housing. A well-developed network of outpatient services is needed. There are a number of different services in Switzerland which can meet the needs of elderly people but the problem is often access to these services. There are three main obstacles: a lack of knowledge about the services available, difficulty making sense of the different service options available and excessive costs associated with some services that might be needed but are not affordable with a modest budget.
Participation in social activities not only improves quality of life but also plays an important role in providing a support network to elderly people. Within the local residential environment, individuals are often able to help each other in a variety of different ways, which can allow elderly people to live independently in their own homes. Structural conditions are also important for ‘ageing in place’. Homes need to be free from barriers in order to provide a safe and accessible environment. Safety is also important to allow elderly people to live in their own homes independently. Access to housing is clearly another important issue. Elderly people are typically disadvantaged in terms of finding appropriate housing options if they lack internet access. With increasing age, older people are sometimes perceived as being less desirable tenants. Finding a new flat, appropriate to their needs, can be particularly problematic when elderly people are forced to leave their homes because of renovation or buildings being replaced.
There are a number of challenges associated with ‘ageing in place’ for elderly people, including physical and mental health issues and financial difficulties, which have been identified in the research project. In terms of mental and physical health, living needs of elderly people can change both gradually, but sometimes also suddenly. Physical and psychological changes often develop over time, which require medication to be taken regularly and also pose risks to the safety of the elderly person. One of the most frequently cited reasons for eviction or nursing home admission is the assessment that a person poses a risk to themselves and/or others. Housing and support needs can also change rapidly, for example in the case of a fall, resulting in mobility impairment which may make it impossible for the elderly person to continue to live in their (non-barrier-free) current home or to return there after a stay at the hospital.
Financial issues also pose a challenge for elderly people to be able to live in their own homes independently. A person’s financial status will affect whether they can access support and the nature of that support. Elderly people are often highly economical and can often continue for a significant period of time without paid help. For other elderly people, being able to access and afford support services is extremely important. However, knowledge about how to fund such services or get access to financial support is often lacking, which is problematic.
In addition to the difficulties faced by elderly people in their daily lives, Althaus, Birrer and Hugentobler have also emphasised the challenges that exist at the interface between elderly people, real estate management and various other service organisations. In order to address such issues, interface management and coordination of support options is required, which is highly demanding. Elderly people are faced with the need to navigate a variety of different services and options. It is often difficult for them to understand or have sufficient information about what different organisations can offer in terms of support and what might be the best option. If service providers provide more clarity about their different roles and areas of expertise, elderly people would be able to navigate support systems more easily, particularly if support from partners or family members in choosing and making these decisions is not available to them.
Property management companies are faced with the challenge of acting on behalf of owners and investors but are also responsible for the concerns of tenants. Difficulties can arise if complaints are made by tenants or when repairs are required. The property management industry is generally under time and performance pressures, which poses a further challenge. Efficiency improvements, including the digitisation and automation of operations and the increasing specialisation and outsourcing of certain tasks, will allow for easier interface management. Furthermore, if companies recognise the boost to their image that may be obtained by supporting ageing in place, the outcome for elderly people is likely to be positive.
Promotion of ‘ageing in place’
Given the conditions needed for ‘ageing in place’ and the associated challenges, a number of steps have been identified to help elderly people live in their homes independently. There are six main ways of promoting ageing in place, which include: ensuring there is help and support available in the neighbourhoods where elderly people reside, providing access to professional services, assistance with the increasing fragility of elderly people, providing necessary structural adjustments to homes, ensuring the safety of residents and ensuring support is available when properties are being renovated to prevent homelessness. In good practice, these approaches are often combined through the use of integrated models.
Three main solutions are indicated by the research team: living with services, offers for networking and social participation in the residential environment and processes for better coordination and provision of assistance. Living with services involves residential projects, where services can be adapted to different needs and can be combined with other services to provide comprehensive support. For example, a housing estate may be combined with a concierge service. The challenge arises in making such services affordable for those with lower incomes. However, with the increasing move towards a needs-based approach, elderly people in less affluent circumstances could be adequately supported to live in their own homes independently.
The second solution includes the promotion of offers amongst residents and in the local community to provide mutual support. This assumes a supportive network of relationships and social participation in the living environment is central to living independently well into old age. Potential options include organised neighbourhood help and the use of a social caretaker. The third solution includes the potential for the coordination of services and stakeholders which elderly people can access via a communication hub. The hub should be able to provide direct support and advice to elderly people faced with difficult situations. Alternatively, property management companies could be accessed via apps or online platforms. These could help elderly people access different services, potentially including offers as proposed in the second solution. For such apps or online platforms to be effective, it is important that they adequately address the needs of elderly people and are easily useable. Based on this knowledge, the research team together with a landlord, a housing management company and a housing cooperative is currently developing three pilot projects that promote ageing in place with regards to the specific local contexts and needs of elderly people.
“ETH Forum Wohnungsbau” conference
In April 2018, an international conference entitled ‘ETH Forum Wohnungsbau’ is to be held as part of the research project. The aim of the event is to demonstrate and discuss the most current transformations in housing development and the relevant trends in urban-planning, against the background of the interplay of academic findings and professional practice and by using best practice examples. The yearly held conference boasts renowned panels and serves as a platform and a meeting point for decision-makers in the fields of property development, architecture and construction, as well as policymakers and administrative staff at the local, cantonal and national level.
Impact and future developments
Althaus, Birrer’s and Hugentobler’s work has highlighted that elderly people represent a diverse range of individuals, with different levels and types of need, knowledge and capacities. It is expected that there will be an increasing number of older people experienced in the use of digital technologies as a means of communication and information. The future generation of elderly people, however, is likely to have significantly less money available on average than today’s younger pensioners. The proportion of older people, who have no family members living nearby will also increase and thus many elderly will be dependent on alternative sources of support and assistance. It is imperative that strategies to promote ‘ageing in place’ can accommodate such developments.
For decisionmakers to focus on ageing in place as a policy choice requires a comprehensive set of well-coordinated services and organisational collaboration. It would turn into a cynical strategy if under the disguise of this concept nursing home beds are reduced and services cut, leaving some elderly people isolated and without the support needed.
“Ageing in place – Challenges and Potential at the interface of housing management and residents” Eveline Althaus and Angela Birrer with the support of Sarah Fuchs, Corinna Heye and Margrit Hugentobler, May 2017.
For many elderly people, ageing in one’s own home and staying there as long as possible is a very important goal. The ‘ageing in place’ project focuses on the demands, options and the service provisions that need to be promoted in dealing with ageing and elderly tenants from the perspective of property management.
Innosuisse – Swiss Innovation Agency; Age Foundation and other project partners
- Dr Corinna Heye
- Dr Ulrich Otto
- Dr Joris Van Wezemael
The research focus of the team – Margrit Hugentobler, PhD in Urban, Technological and Environmental Planning from the University of Michigan, Ann Arbor (USA) and former director of ETH CASE, Eveline Althaus, PhD in Science (Housing Studies) at ETH Zurich and Angela Birrer, MA in Social Anthropology from the Graduate Institute of International and Development Studies, Geneva – is on innovation in housing, housing in old age and sustainable urban development.
ETH Wohnforum – ETH CASE
ETH Zürich, Departement Architektur
Wolfgang-Pauli-Strasse 27, HIT H 13
CH – 8093 Zürich-Hönggerberg
T: +41 044 633 46 60