We all want older people to enjoy a good quality of life – to have autonomy and independence for as long as possible. Housing with support can achieve this, providing older people with their own front door and their own home, living alongside other older people in a community where support and care services are available on site. It is expanding as a model of housing for older people in Ireland and throughout the world – a trend that is likely to intensify in the context of COVID-19, which has made clear the risks of relying primarily on nursing homes.

Exploring perceptions and experiences

We at the HRB Evidence Centre were commissioned by the Department of Health and the Department of Housing, Local Government and Heritage to review international evidence on housing with support, so that its expansion in Ireland can be informed by evidence. We aimed to explore older people’s perceptions and experiences of it, and examine its impact on their quality of life. Following a search of four databases and a grey literature search, 75 articles across 10 countries were included.

We found that many older people moved to housing with support because they felt lonely living alone and burdened by maintaining a large house. For instance, one woman said: “I was just getting tired of living alone after my husband died. It’s just not too much fun to be alone. Even though I had friends and I played bridge once a week, it’s not the same. Your house gets very lonely when you don’t have anyone in it. You know – five rooms to keep, three bedrooms. So I just made a change.”

“I needed companionship with others my own age.”

Others moved because they wanted to live alongside other older people, as this woman described: “My neighbourhood was mostly young couples with children. I needed companionship with others my own age.”

Regardless of their primary motivation for moving, older people who made the decision for themselves felt this eased the transition. Individual choice and autonomy were found to be crucial for successful transition, so they could age in place and die in place in housing with support. Additionally, when housing with support was available close to their original home, this allowed them to maintain their established social networks and access the same amenities and community services, further easing the transition.

Improved wellbeing and increased independence

In housing with support, older people can access health services, social activities, housekeeping, and a wide range of other services. Importantly, older people felt that this made life easier, improved their well-being, and helped them live independently for longer. Personal care and support services are a key aspect of housing with support, and reablement, cognitive support, and mental health services are particularly important. Yet communal spaces, organised social activities, volunteerism, and mutual support are also fundamental to well-being, as they foster social engagement and create cohesion in the community.

One woman described this well when she said: “I volunteer in the choir, we sing for the long-term care residents every Wednesday. Being socially active is very helpful, because being home was lonely.”

“We’re all connected … It’s like a family here.”

Moreover, opportunities to socialise and make friends led older people to feel a strong sense of community. “We’re all connected,” said one woman. “And we are not alone. It’s like a family here since I’ve been getting to know the girls. I just call them ‘the girls’. Nobody calls me ‘Mrs.’ anymore.”

Overall, our review found that:

  • Housing with support has strong potential to enhance quality of life for older people
  • Older people value autonomy, independence, and choice in terms of where they live and how they live
  • Maintaining previous social networks is highly beneficial
  • Wellbeing is influenced by access to care and support services, but also to social activities

Above all, housing with support enables a self-directed life that maximises a sense of independence that’s integral to well-being. An important avenue for future research will be to examine the experiences of older people living in similar housing here in Ireland as well.

Informing policy to meet the needs of our older people

The findings of the review will inform the Government’s work in this area in the months and years ahead. By understanding the perceptions of older people themselves, we can reflect their preferences in future policies – helping shape housing models that meet their needs. We all want to live in a society that respects, honours, and cares for older people. Providing them with housing options that can improve their quality of life is a fundamental way of achieving this.

Our evidence review, ‘Housing with support for older people’, was authored by Camille Coyle, Olivia Cagney, Sarah Buggy, Louise Farragher, Caitriona Lee, Darren Patje and Jean Long.