Lessons on residential care from across the pond

Postcard from America: Retirement villages and senior communities can work

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This year’s World Mental Health Day focus on older adults was a timely reminder that, as in so many other areas, the wellbeing of older people is too often overlooked.

We hear of shocking abuses and neglect in care homes, or simply the callous and frequent disregard of individuals, their wishes and preferences. Older people fear going into residential care, with research suggesting that as many as 2 in 5 residents suffer from depression. This is simply not good enough. We must do better by older people, and, with an anticipated doubling of those over 85 by 2030, we need to move fast.

To address this challenge and create a new vision for present and future generations of older people, I worked with the think-tank Demos to establish a Commission looking at the future of residential care. And in this capacity, I recently visited Boston to see what lessons could be learnt from its models of retirement villages and senior communities.

It was eye-opening. I visited a college which had built a retirement village on its campus with residents required to take part in a minimum of 150 hours of education a year. Residents were even invited to take classes with the main student body, and as I sat in the cafe in the village, I overheard residents engaged in lively discussions about the latest things that came up in class rather than health problems.

In fact, even those who needed assisted living and nursing care continue taking part in courses as far as they are able. As inspiring, I visited a retirement village which has a co-located school which built intergenerational work into its curriculum. It even had a programme for pupils to learn about Alzheimer’s which included interaction with residents with the disease.  These intergenerational approaches clearly reaped rewards for older people and younger students alike and the sense of community was palpable.

But as well as bringing communities together, the models I saw worked to nurture a genuine sense of home for residents, based on the ‘Green House’ model with the kitchen as the heart of the home and a rejection of the institutional and medicalised environments older people in the UK are too often living in.

I met residents who were involved in the design of technology that supported them as their needs increased, and models where residents were able to have a financial stake in their homes. These are models which clearly put the needs and wishes of their residents front and centre, and work to not just maintain but improve the wellbeing of their residents.

While there are undoubtedly good models in the UK too, with MyHomeLife, SharedLivesPlus and fledgling co-housing initiatives, there is much more to do and little time to do it if we are to deliver the kind of residential care that older people deserve.

Paul Burstow MP is former Care Minister and Chair of Demos’ Commission on Residential Care.

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