College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, SA2 8PP, UK

Environments of Ageing

Older People’s Use of Unfamiliar Spaces (OPUS)

Swansea Researcher: Prof. Judith Phillips

Introduction

As urban landscapes change through regeneration or decline, the use of space changes and previously

familiar places may become unfamiliar. Unfamiliarity can lead to insecurity, disorientation, fear over

personal safety, social exclusion and loss of independence. Enabling navigation and orientation in built

environments is essential to facilitate ageing in place and assist the increasing numbers of older people

travelling the world as tourists.

Methodology

Direct assessment of participant’s navigational ability was followed by questionnaires about familiar and

unfamiliar town centres. Participants then watched a narrated film from an unfamiliar town and completed

the Cognitive Abilities Screening Instrument. A three day visit to the unfamiliar town was undertaken with

eight participants and focus groups with local residents and spatial planners were conducted.

Results

Participants who showed difficulty in following directions tended to stay in populated areas and relied on

street signage. The participants who showed no difficulty with following directions used landmarks in the

built environment and ask local people for directions. Landmarks and distinctive buildings were more

important than signage in navigating unfamiliar areas; however the meaning of space and memories

attached to places was significant particularly in familiar spaces. Landmarks were important navigational

aids but people had difficulty keeping them in view, particularly if these were upward cues in the visual field

and there was a need to negotiate the immediate environment and attend to lower cues such as broken

pavements and billboards. In such instances, people sought familiar cues at street level such as chain

shops.

Conclusions

Barriers exist in using landmarks to navigate unfamiliar places. A variety of appropriate cues are necessary

to assist navigation and provide a pleasant experience for older people. Such cues should be distinctive and

include a variety of signage, appropriate postings, colours and background historical information. Safety

and security issues should however be paramount – sensory overload was experienced through too many

cues and barriers.

Funder: ESRC New Dynamics of Ageing Programme: RES-3 52-25-0003’

College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, SA2 8PP, UK

Extracare: Meeting the Needs of Fit & Frail Older People?

Swansea Researchers: Prof. Vanessa Burholt (Lead), Paul Nash, Prof.Judith Phillips, Dr. Sarah Hillcoat-

Nallétamby, Dr. Sherrill Evans

Research Team: Dr. Sinead O’Mahoney (Llandough Hospital)

Introduction

The key assumptions behind extracare developments are that they will enable older people to live for longer

in their own homes, utilising a range of care and support services thus promoting their health and well-

being. To date, much of the extracare research indicates that residents in these schemes report a high level

of satisfaction, specifically mentioning both security and independence as key factors contributing to this.

However, in 2007, Bernard et al. indicated that frail older people did not benefit as much as fitter older

people from being in extracare facilities. The research looks at the integration and management of care

packages across three care environments; those of extracare, residential care and care in the community.

The aim was that by combining both quantitative and qualitative methodologies we could answer our

primary research question of whether extracare accommodates the needs of both fit and frail older people,

particularly those with cognitive impairments.

Methodology

A combined sample of 180 service users was used, spread evenly across the 3 care environments and split

between both North and South Wales to allow a comparison between ageing experiences and available

facilities in Urban South, and Rural North Wales. An initial questionnaire including measures of; Resilience,

nutrition, loneliness and levels of physical activity was utilized in conjunction with physical grip strength and

mobility measures. Following the questionnaire, half of the original sample was interviewed, using a semi-

structured cognitive interview technique to gather subjective experiences on ageing and the care being

received.

Results

Results indicated a significant difference in frailty between the three care environments, a finding that was

echoed in both urban and rural environments. This significance was repeated when measures of cognitive

frailty were examined separately, with those in residential care home environments again returning the

lowest scores. Interestingly there was also a significant difference between cognitive frailty in North and

South Wales when the scores from each of the care environments were aggregated.

Conclusions

The results indicate that those older people in residential care are indeed the most frail despite being

marginally less physically frail than those in extracare facilities. Those residents in extracare may exhibit

slightly higher signs of physical frailty, however, their cognitive frailty is comparable to those receiving care

in the community and is significantly less than those in residential homes. It can, therefore, be said that

extracare is currently meeting the needs of fitter older people but those needs of more frail older people are

currently being met in residential homes that is possibly an artefact of the age of the extracare schemes.

College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, SA2 8PP, UK

Funder: Wales Office of Research & Development (WORD) - RFSC07-3-012

To move or not to move? Residential relocation behaviour amongst older citizens in Wales.

Swansea Researcher: Dr. Sarah Hillcoat-Nallétamby

Research Team: Dr. Jim Ogg (Young Foundation, London)

Introduction

The project aimed to increase knowledge about the residential relocation behaviour of older people living in

Wales and the decisions they make about whether to move or remain in familiar home and neighbourhood

environments. This knowledge is needed in a policy context where promoting independent living, facilitating

older people’s choice of where and in what types of accommodation they wish to live, and ensuring high

quality housing environments for an increasingly large ageing population are key government priorities.

Methodology

Data from the 2004 Living in Wales survey (and its accompanying property survey) were analysed to identify

two groups of older people aged 55 or more living in Wales - “movers” who have moved within the past six

years and “stay putters” who have remained in their homes for six years or more. Descriptive statistics and

logistic regression analysis were performed to: establish each groups’ socio-demographic profiles; assess

whether ‘movers’ had a better quality of housing than ‘stay putters’ in terms of state of repair and

neighbourhood environment; examine “movers’” motives for their recent decisions to relocate; identify the

factors which have made some older people more likely than others to have moved in later life.

Results

Moving decreases with age (except around the age of 80+) and the majority of older people have not

moved for more than two decades. “Movers” are more likely than “stay putters” to have been born outside

Wales, to be living by themselves after the age of 75, in more modern and smaller properties, and to be

‘very satisfied’ with the state of repair of their homes. ‘Stay putters’ are more likely to be home owners and

on average, have a more positive attitude towards their neighbourhood. Key reasons for moving related to

housing (45%), personal and family reasons (24%) and neighbourhood (8%). Those most likely to have

recently moved are: the ‘younger’ old, people born outside Wales, living in modern properties built after

WWII, renting their accommodation, living in 1-bedroom accommodation and alone. Gender, illness or

disability status, household income and work status (for those of pre-retirement age) do not appear to

influence whether older people living in Wales will have moved.

Conclusions

Findings indicate the importance of distinguishing between the effects that moving in later life can have in

terms of a person’s immediate living environment and the broader neighbourhood or community

environments into which they move. Moving in later life because of housing environment needs suggests

that if given more opportunities and appropriate information, older people would be in a better position to

College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, SA2 8PP, UK

make more deliberated and planned choices about moving, to ensure that their housing environment ‘fits’

with their changing needs.

Funder: The Office of the Chief Social Research Officer (OCSRO) for the National Surveys Secondary

Analysis Programme, Welsh Assembly Government, Wales

Ageing in place: a French-British comparison of adaptations to housing environments

Swansea Researcher: Dr. Sarah Hillcoat- Nallétamby (Lead)

Research Team: Dr. Jim Ogg, Sylvie Renaut, Prof. Catherine Bonvalet

Introduction

Taking France and Great Britain as comparative contexts and with a particular focus on Wales, this research

project aimed to highlight housing policy provisions in each country relating to housing adaptations which

had been designed to help older people live independently in their own homes.

Methodology

The project adopted a mixed-method approach involving analysis of survey data for the population of

individuals aged 75+ in each country (2002 English Longitudinal Study on Ageing; Welsh 2004 Living in

Wales survey; French 1999 survey Handicap, Incapacité, Dépendance); qualitative interviews with housing

adaptation service providers, their older clients, and government-level policy makers concerned with

housing; a critical analysis of strategic policy documents relating to housing and ageing policies.

Results

Older people in England, Wales and France share similar demographic profiles, although the proportions

renting their accommodation from the social housing sector is lower in France. The overall trend in each

country is a gradual increase in the proportions of households with adaptations (grab rails, adapted

bathrooms) with increasing age, although the majority of older households do not have these facilities. Each

country shares similar problems regarding the implementation of housing adaptations and improvements

including: significant regional variations; implementation dependent on local-level service provider

capacities to respond to demand; the degree of local authority commitment to promoting housing-related

preventive-based measures. Each country also recognised certain issues relating to the provision of housing

adaptation services, notably: service user difficulties in accessing information; complexities in the number

and types of services offered, as well as in sources of funding or financial assistance; significant regional

and local variations in service provisions; service providers’ difficulties in demonstrating the preventive value

of housing adaptations and of obtaining funding support for preventive interventions (e.g. installing a walk-

in shower before someone has an accident); acknowledgment by service users and providers that even

minor adaptations can have a very positive, life-changing impact upon older people’s quality of life.

College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, SA2 8PP, UK

Conclusion

In each country context, the question of how to house an older population in decent and affordable

accommodation seems only recently to have come to the fore, and presents a particular challenge in terms

of adapting existing housing stock. Governments in each national context need to facilitate preventive

approaches with regard to the provision of housing adaptations for older people.

Funder: France’s Mission de la Recherche – MiRe/DRESS, Direction de la recherche, des études, de

l’évaluation et des statistiques, Ministere de la Santé, de la Jeunesse et des Sports, Paris

Grey and Pleasant Land?: An Interdisciplinary Exploration of the Connectivity of Older People in Rural Civic

Society.

Swansea Researchers: Prof. Vanessa Burholt, Prof. Judith Phillips

Research Team: Catherine Hennessey (Lead), University of Plymouth (UoP) Ray Jones (UoP), Andrew

Phippen (UoP), Inocencio Maramba (UoP), Jill Pooler (UoP), George Giarchi (UoP), Fraser Reid (UoP),

Robin Means, University of the West of England (UWE), Graham Parkhurst, (UWE), Iain Biggs (UWE), Nigel

Curry (UWE), Charles Musselwhite (UWE), Simon Evans (UWE), Thomas Abba (UWE), Kip Jones, University

of Bournemouth (UB), Kate Galvin (UB), Les Todres (UB), Rosie Read (UB), Yvette Staelens (UB), Peter

Howard (UB), Liisa Rohumma (UB), Paul Milbourne, University of Cardiff, Lee-Ann Fenge (UB), Norah

Keating, University of Alberta

Introduction

This project brings together an interdisciplinary team of gerontological researchers and rural experts from

five universities in South West England and Wales to examine the connectivity of older people living in rural

areas in civic society. At the heart of this is an exploration of their voluntary collective action around shared

interests, purposes and values such as formal and informal associations and community groups. Growing

older in contemporary rural Britain is experienced against a backdrop of issues such as incomer group

pressures, minority group citizenship, gentrification and changes in land use, all of which have implications

for ageing identities, attachment to place and participation in community life. Indeed, far from reflecting the

popular and literary representations of the timeless ‘rural idyll’ the landscapes and populations of many

rural areas in the UK are in a state of flux, with significant implications for the quality of life of older people.

The 3-year research programme will address the following principal questions in relation to the

circumstances and experiences of civic inclusion among older rural people:

· How and in what ways are older people connected to civic society in rural settings in England and Wales?

· What is the impact of this connectivity on older people’s quality of life in rural areas?

· How is later life experienced across diverse rural contexts and within subgroups of older people?

· How can novel interdisciplinary approaches be used to capture and disseminate evidence about older

people’s participation in and contributions to rural civic society, i.e., as a source of rural community capital?

College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, SA2 8PP, UK

The research programme employs methods and perspectives from across the arts and humanities, transport

studies, the social and geographic sciences and informatics to examine key aspects of older people’s

inclusion in and contributions to the life of their rural communities from a positive ageing paradigm. It also

offers innovative approaches to engaging stakeholders in rural ageing in the framing, dissemination and

use of the research findings to support an ‘opportunity dialogue’ regarding the impact of demographic

ageing in rural areas. The objectives of the research related to the research questions stated above are

investigated through seven coordinated work packages.

Funder: ESRC grant number RES-353-25-001

The closure of care homes for older people in Wales: Prevalence, process and impact

Swansea Researchers: Prof. Vanessa Burholt (Lead), Prof. Judith Phillips

Research Team: Sarah Stone (Deputy Commissioner for Older People in Wales)

Care home closure is often the subject of media coverage and can be an extremely emotional topic for

those that are affected. The closure of care homes is highly relevant because of the impact of relocation on

the health and well being of older people. This project replicates a study conducted in England. It uses a

variety of methods to investigate care home closure in the last year including analysis of data collected by

the Care and Social Services Inspectorate Wales (CSSIW); telephone interviews with CCSIW inspectors and

(ex)managers/owners; analysis of local authorities protocols. The project extends the research conducted in

England to look at outcomes for those involved in the closure of care homes and will undertake in-depth

interviews (before and after relocation) with providers, older residents, relatives and carers during the

closure of four different care homes in Wales. The project will:

- Identify issues associated with closures of care homes in Wales

- Identify areas where the process of closure departs from Welsh Assembly guidance

- Provide examples of good practice which could be used in further guidance

- Identify the impact of particular processes of closure on the well-being of older people, their relatives and

carers

Funder: Wales Office of Research and Development for Health and Social Care scheme: SC09/09.