“The quality of care in aged care facilities or retirement homes is as much about facilitating a homely experience and preservation of identity for the incoming resident, as the quality and cost of the physical environment alone”.
The ‘Great Australian Dream’ of owning your own home is a mindset embedded into Australian culture that we embody from a young age, achievable or otherwise. We grow up surrounded by this rhetoric and it sticks. It comes as no surprise that as people reach a stage in life where they require a certain level of support and care, they hold on tightly to the independence they associate with their home and strongly resist entering third party managed care. A recently published paper, ‘The Head, Heart and Housing’ (by Emily Millane, Per Capita Australia) suggests Australia’s housing policy has not adapted with societal changes or advances in life expectancy, and that, perhaps our social norms have also failed to adapt. The paper’s authors recommend a review of housing policy to include and recognise peoples desire to live in their own home as well as the latest in psychology research as it relates to the emotional impact of ‘leaving one’s home’.
‘The Head, Heart, and Housing’ paper goes on to note that policies directed towards funding retirees in Australia – particularly superannuation and the age pension – are modelled around home ownership and do not adequately accommodate those who do not own their homes outright, or those who rent. The authors call for policy to reflect that good housing provides the basis for health and quality of life. The real estate community knows the importance of managing these issues when facilitating the buying and selling homes, but is a stronger force at work in the elderly than other demographics?
This highlights that the quality of care in aged care facilities or retirement homes is as much about facilitating a homely experience and preservation of identity for the incoming resident, as the quality and cost of the physical environment alone. Clearly, the decision about what size, style or location is as much an emotional one as it is a financial one. For example, 92% of adults aged between 65 to 74 years express a wish to remain in their current homes as long as possible. Further, the older one gets, the stronger the desire to stay home even as their need for external assistance grows; 95% of those aged 75+ will remain at home until crisis arises or the decision to move is taken out of their control. Whilst 82% recognize that they may require assistance in caring for themselves, they maintain a position that they want to receive it in their own home without facing the emotional trauma of moving
In the context of later life, the family home is reflective of more than just bricks and mortar, it is an archive of memories and familiarity providing perceived safety and security to the resident. For the individual, staying in their own home is an expression of retaining control over one’s life and managing uncertainty at a time when their memory and other destabilising conditions start to present themselves. Ultimately, moving out of the home in these circumstances or selling up is the last chapter of independence and the start of a new dependency on health professionals and aged care facility providers.
The house, if they owned one is sold off or mortgaged to fund their entry into care. Older adults go to great lengths to show creativity in establishing solutions to remain in one’s place with deteriorating physical and cognitive abilities, showing a resistance, or some may say a stubbornness, to move when loved ones are seeking to initiate a transition for their own safety.
Major gaps in our knowledge about the optimal process and reasoning for downsizing remain. A more person-centred approach building from the experiences of older adults undergoing this major late life transition is required to truly understand the effects of downsizing on the elderly in the community.
From a real estate perspective, homes vacated by the elderly community are often needed to be quickly sold, but not before much needed renovation or repair beforehand. The ‘once’ home owner entering an aged care facility, and their loved ones, are often in an emotional state and coming to terms with the need for aged care. With a primary focus on preserving or managing the independence and health of the resident. Quickly creating liquidity or accessing the equity in their family home to fund the incoming resident’s financial obligations to an aged care facilities bond requirements, rather than finessing the maximising of the house sale price.
Importantly, for many older Australians, the decision to move is unexpected with only 20% of persons aged 65 and above having anticipated a move 2 years earlier (according to Health and Retirement Survey data reports from Sergeant & Ekerdt, 2008). Two of the strongest independent predictors of housing relocation in later life are preceded by an acute health event from a stroke or hip fracture, with the decision often taken away from the individual suffering the condition4. Regardless of whether or not an older adult moves into a supported living environment, the overall picture is that older adults prefer to age in place.
Downsizing has commonly been represented as a practical affair; with a focus narrowly on a review of what is retained in terms of material possessions and treasures that one could not live without. The truth is that for many older people, the decision one way or another to downsize is less about material possessions and more about the people, places, activities, memories and events associated with a home and maintaining the independence that matters the most.
Finally, true quality care shows an appreciation of this attachment to the home for a resident, and good providers not only recognise it but train their staff to support residents through the adjustment period. Families who have experienced the transition into care with a loved one know it all too well also. Regardless of whether the person entering care is a home owner or not, more recognition around the sensitivities of a residents’ drive to preserve their identity despite what may seem as though much of it is left behind.
Circling back, the real estate community can play a key role in understanding these ‘softer’ but important issues when encountering families or homeowners where the home requires selling to facilitate the move of an elderly family member into a facility. This way we will be better prepared for those enduring this significant life changing event and maybe we can prevent the ‘Great Australian Dream’ from becoming an ‘Elderly Australians Nightmare’.