Active lives for older people

Finding good quality accommodation for older people can prove a real struggle, with many concerns about the standard of care and limited lifestyle opportunities that such accommodation affords. The ExtraCare Charitable Trust, however, claims to be able to provide that ‘little extra something’ that is quality of life.

ExtraCare is a charitable trust that has pioneered an approach to housing and support for older people that offers a lifestyle that challenges more traditional, outmoded concepts of ageing.

It aims to enable residents to enjoy the privacy of their own home with their own front door when they need peace and quiet – and take part in challenging group activities when they do not.

While residents are encouraged to lead as active a life as possible, over 80 per cent need professional nursing or care support every day of their lives. ExtraCare also manages a number of social clubs, providing facilities for retired members of their local community.

Independence

At the heart of this challenge is the principle of independence. By encouraging older people to take charge of their own lives, to stay active, both physically and mentally, ExtraCare gives them the opportunity to embrace life, rather than wait for it to slip away. Through this approach, age and frailty needn’t be a barrier to what people can aspire to or achieve.

Increased life expectancy

As previous articles/studies published in ECA have shown, life expectancy is often adversely affected by inadequate care environments. An indicator of ExtraCare’s success to date, however, is the increased life expectancy of its residents. Indeed, one study found a morbidity rate of only 12.5 per cent among residents in schemes operated by the ExtraCare Charitable Trust, as opposed to a national average of 50 per cent for traditional residential care (Biggs S et al, 2001, ‘Assessing the health impact of age specific housing’, paper from the Centre for Social Gerontology, University of Keele).

Other improvements

An independent study conducted by Newchurch Ltd (www.newchurch.co.uk) among ExtraCare’s residents found the following improvements in relation to initial self assessments conducted with residents:

Average mobility improvement of more than 35 per cent. This had subsequent benefits for the residents in being able to travel out of the scheme into their local communities and engage with local interest groups and activities;
A 25 per cent reduction in reliance on medication;
A 20 per cent improvement in daily living functions;
A 10 per cent increase in sensory abilities.

Combined, these positive changes foster increased confidence among older people, which improves their willingness to engage with their particular community. It is also worth noting that each of these indicators of improvement in health and the subsequent increase in mobility outperform standards 5 (stroke) and 6 (falls) of the National Service Framework for Older People.

The Newchurch Ltd study also revealed that visits to acute hospitals by residents aged 80 or more had reduced by 50 per cent. This has been attributed to the Wellbeing programme. ExtraCare’s longest established village, Berryhill in Stoke on Trent, has seen a reduction of an estimated 500 hospital bed days per year among its 200 residents. The Wellbeing programme at Berryhill was recently commended by the House of Commons Select Committee on Health in their third report (2003), which cited the impressive standard of accommodation and “high level of resident involvement in the organisation and running of the village, which seemed to facilitate a strong sense of community and empowerment among residents”.

A comparative study undertaken by Keele University of residents living in an ExtraCare Charitable Trust Scheme with older people resident in the local community, found that the self-reported health status among ExtraCare’s residents (as measured by the Life Satisfaction Index, SF36) was maintained with age, while it deteriorated among the local sample. There was also significant evidence to suggest a compression of morbidity among individuals remaining fit and healthy until a relatively short period before their death, thereby confining morbidity to extreme old age (New Lifestyles in Old Age: health, identity and well-being in Berryhill Retirement Village, published by The Policy Press, (ISBN 1 86134 620 4).

Financial matters

In the ExtraCare villages in Stoke, Warrington and St Helens, there is a welfare and benefits team that work out of the community centre at the village who are able to support elders who live in the village and those who live in the community around, in ensuring that they are able to maximise their financial capacity and enhance their overall wellbeing. In the ExtraCare village in St Helens the benefits team secured some £80,000 of benefit support for residents that may have otherwise gone unclaimed.

Open services

ExtraCare villages seek to provide benefits to older people living in the local community through the Wellbeing Programme, opening facilities and services to older people who are not residents. The Wellbeing Programme reduces the rate of hospitalisation of residents and elders living in the surrounding community. But it also seeks to use this as a platform upon which to challenge negative perceptions of older people merely as service users, or as infirm people, and strengthen a value of their vitality in the communities within which they live, through active participation in community forums, local school activities and neighbourhood groups in the villages in Warrington and Stoke upon Trent, as well as the friends of the village currently under development in Sheffield.

Each ExtraCare village also has a restaurant that strives to offer quality meals to residents and elders in the community at a not-for-profit rate that enhances nutrition while reducing weekly shopping costs. This contributes significantly to the desired outcome of increasing the amount of disposable income an older person has in their pocket at the end of the week, especially those who are dependent on a full benefits package.

Learning into old age

Continuing education and learning is also vital to re-energising the identity of elders as citizens, rather than merely as service users or, worse still, as a burden carried by their community. The courses and activities offered at the community centre in ExtraCare villages have raised awareness, increased confidence and established the means by which elders can interact more positively within their communities.

Courses might include training in ICT, which brings with it access to the internet, enhanced communication and access to news, information and consumer services. It might include special study interests or Thai Chi classes. The woodworking course has been so successful at ExtraCare’s Ryfields village in Warrington that furniture is now being made to order for both residents and people in the surrounding community.

By updating skills and learning, older people are able to share interests with other peer groups and actively contribute to those interest areas, which helps to overcome their isolation and the negative attitudes against them. It also stimulates activity, preventing the deterioration of physical and mental health.

ExtraCare villages provide facilities for a variety of local groups that currently have no venue to meet. This offers the community the opportunity to benefit from the village being on their doorstep, as well as provide a platform upon which older people living in the village and surrounding community can come together and mix with other peer groups. Research led by Keele University has demonstrated that the broader integration of elders living in a village into the wider community is vital in managing diversity (across age groups, friendship groups, ethnicity, economic status, gender etc.) and so is a key issue in promoting well being (Biggs S et al, 2001, ‘Assessing the health impact of age specific housing’, paper from the Centre for Social Gerontology, University of Keele).

Elder childcare

Childcare is a further benefit that has been demonstrated in the villages at Warrington and Stoke. Older people now constitute the single most important provider of childcare, a vital contribution to the local economy. This is especially important during holiday times when parents often struggle to provide childcare. The village environment enables grandparents to offer a community setting for looking after children that further encourages a more substantive community interaction and integration of older people.

Social activities enhanced

ExtraCare also provides an enhanced activities programme for residents and older people in the local communities. This includes a range of activities identified by older people themselves, from indoor bowls and ceramics classes to abseiling, flying gliders or swimming with sharks. There are also the annual traditions of a day at the races and a proms concert at the Birmingham symphony hall, which have proved very popular.

Future developments

The ExtraCare Charitable Trust is currently building further villages in Lichfield, Milton Keynes, Northampton, Hereford and Sheffield, with more just around the corner. In Sheffield, during the public-consultation phase more than 5,000 people expressed an interest in the village development; given that this will cater for around 300 residents and 500 people in the local community, the need and demand cannot be underestimated.

Funding the village

The financial model for the Sheffield village is a prime example of how ExtraCare makes the figures work to help older people in the city. The total cost of building the village is £23.5m. The accommodation will be financed through contributions from ExtraCare, Arena Housing Association, a £4m grant from the Housing Corporation and a mortgage raised against the receipt of housing benefit/sales for part ownership.

ExtraCare is seeking to fund the £2.6m needed for the central village facilities through a charitable appeal in the region. Of this £1.5m has already been raised from London and Hong Kong based charities, with a further £134,000 provided by Sheffield Newspapers Old Folks Fund. This has reduced the target to less than £1m. Opportunities remain for membership of a ‘Freemen of the Village’ scheme or through the sponsorship of specific facilities by trusts, businesses or individuals.

Accessing the village

In Sheffield, just 40 of the 217 apartments and bungalows will be for sale. These sales are also structured to help support the social housing within the financial model. There is also a part-purchase scheme to allow flexibility for those interested in living with their investment. The remainder of the housing will be social housing, access to this being designated alongside the Social Services section of Sheffield City Council, in order to help assure that we are able to provide services for those who need them most.

Anyone interested in supporting the work of ExtraCare or finding out more about the villages should contact Martin Keat, Sheffield Appeal Manager on 0772 055 3661 or visit www.extracare.org.uk