Housing with Support for Older People. An evidence review

Housing with support is purpose-built, non-institutional accommodation where older people have their own front door and where support or care services are available. The implementation of housing with support for older people is rapidly expanding, particularly as life expectancy is increasing throughout the world. This expansion is likely to intensify in the context of coronavirus disease 2019 (COVID-19), which has revealed the risks of relying primarily on nursing homes. In order to ensure that housing with support meets the needs of the population it aims to serve, we need to understand the perceptions and experiences of older people themselves. Doing so can allow those involved in policy and practice to incorporate the preferences of older people, which could contribute to more appropriate housing models and to efforts to increase demand for housing with support. Additionally, it is imperative that the expansion of housing with support be informed by a systematic and comprehensive assessment of its impact thus far. Therefore, this mixed methods systematic review aimed to: 1) explore older people’s perceptions and experiences of housing with support and 2) examine the impact of providing housing with support for older people on their quality of life. 

Following a search of four databases and a grey literature search, 39 qualitative articles and 36 quantitative articles were included. The qualitative and quantitative evidence showed that individual choice and autonomy are crucial for older people to successfully transition to, age in place in, and die in place in housing with support. Additionally, housing with support can allow older people to continue to live in their own locality, allowing them to maintain their previous social networks and access the same amenities and community services, which eases their transition to their new home. 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. Above all, housing with support enables a self-directed life that maximises free choice and independence, which is integral to improving quality of life for older people.