1. Older people: health, environment and living arrangements Report of a scoping study Liz Cairncross and Janet Askham Oxford Brookes University and the Picker Institute Report of a scoping study Liz Cairncross and Janet Askham Oxford Brookes University and the Picker Institute

2. The Research Project A scoping study of previous research and policy A scoping study of previous research and policy Aiming to review the fields of interest relating to older people common to the Departments of Health, Work and Pensions and Communities and Local Government (as it is now) Aiming to review the fields of interest relating to older people common to the Departments of Health, Work and Pensions and Communities and Local Government (as it is now) Main research questions: Main research questions: - what factors contribute most significantly to the maintenance of independence in later life? - how can older people best be supported to remain independent? A scoping study of previous research and policy A scoping study of previous research and policy Aiming to review the fields of interest relating to older people common to the Departments of Health, Work and Pensions and Communities and Local Government (as it is now) Aiming to review the fields of interest relating to older people common to the Departments of Health, Work and Pensions and Communities and Local Government (as it is now) Main research questions: Main research questions: - what factors contribute most significantly to the maintenance of independence in later life? - how can older people best be supported to remain independent?

3. Topics covered in the scoping study Housing/type of domicile Housing/type of domicile Neighbourhood Neighbourhood Community Community Social networks Social networks Social support and care Social support and care Health and healthcare Health and healthcare Economic well-being Economic well-being Housing/type of domicile Housing/type of domicile Neighbourhood Neighbourhood Community Community Social networks Social networks Social support and care Social support and care Health and healthcare Health and healthcare Economic well-being Economic well-being

4. This presentation Focus on issues for the future of older people’s living arrangements and independent living Focus on issues for the future of older people’s living arrangements and independent living Acknowledge the complex meaning of ‘independence’. Acknowledge the complex meaning of ‘independence’. Focus on issues for the future of older people’s living arrangements and independent living Focus on issues for the future of older people’s living arrangements and independent living Acknowledge the complex meaning of ‘independence’. Acknowledge the complex meaning of ‘independence’.

5. Factors identified as contributing to sense of independence and well-being include: - interdependence - safe/comfortable home & neighbourhood - being close to friends and amenities - being able to take part in social activities, keeping busy, getting out and about - paying for new expenses - getting independent advice and information - health and healthy living. - interdependence - safe/comfortable home & neighbourhood - being close to friends and amenities - being able to take part in social activities, keeping busy, getting out and about - paying for new expenses - getting independent advice and information - health and healthy living.

6. Some key issues for the future: I DIVERSITY of the older population The diversity of older people and inequalities between them will increase. For example: The diversity of older people and inequalities between them will increase. For example: -young old and old old -black and ethnic minorities -income and tenure -lifestyle and belief The diversity of older people and inequalities between them will increase. For example: The diversity of older people and inequalities between them will increase. For example: -young old and old old -black and ethnic minorities -income and tenure -lifestyle and belief

7. II BALANCE between promotion of active old age and preparation for a possible less active period Old age is not an inevitably downward progression towards dependence Old age is not an inevitably downward progression towards dependence Treatments now available for many previously disabling conditions Treatments now available for many previously disabling conditions But denial of the possibility of disability etc has never been seen as the best way of preparing for late old age. But denial of the possibility of disability etc has never been seen as the best way of preparing for late old age. Old age is not an inevitably downward progression towards dependence Old age is not an inevitably downward progression towards dependence Treatments now available for many previously disabling conditions Treatments now available for many previously disabling conditions But denial of the possibility of disability etc has never been seen as the best way of preparing for late old age. But denial of the possibility of disability etc has never been seen as the best way of preparing for late old age.

8. III Importance of TRUST in controlling own social and health care Current policy emphasis on choice, control and individual budgets Current policy emphasis on choice, control and individual budgets But in an increasingly less-trusting society there is a need for independent and trusted sources of advice and information But in an increasingly less-trusting society there is a need for independent and trusted sources of advice and information For example, how can we most effectively provide financial information, advice and help to older people, which may directly or indirectly promote their health and well-being? For example, how can we most effectively provide financial information, advice and help to older people, which may directly or indirectly promote their health and well-being? Current policy emphasis on choice, control and individual budgets Current policy emphasis on choice, control and individual budgets But in an increasingly less-trusting society there is a need for independent and trusted sources of advice and information But in an increasingly less-trusting society there is a need for independent and trusted sources of advice and information For example, how can we most effectively provide financial information, advice and help to older people, which may directly or indirectly promote their health and well-being? For example, how can we most effectively provide financial information, advice and help to older people, which may directly or indirectly promote their health and well-being?

9. IV Towards promotion of interdependence in the COMMUNITY/social networks Communities are changing: Communities are changing: - decline in physical community infrastructure/facilities - rise of new communities: age-segregated, communities of interest, faith, virtual. What interventions might help to minimise social exclusion? For example, neighbourhood networks, healthy living centres, support schemes run by older people, transport and road safety, reduced fear of crime? What interventions might help to minimise social exclusion? For example, neighbourhood networks, healthy living centres, support schemes run by older people, transport and road safety, reduced fear of crime? Communities are changing: Communities are changing: - decline in physical community infrastructure/facilities - rise of new communities: age-segregated, communities of interest, faith, virtual. What interventions might help to minimise social exclusion? For example, neighbourhood networks, healthy living centres, support schemes run by older people, transport and road safety, reduced fear of crime? What interventions might help to minimise social exclusion? For example, neighbourhood networks, healthy living centres, support schemes run by older people, transport and road safety, reduced fear of crime?

10. Some concluding themes We know a good deal about the links between well-being and housing, environment, economic circumstances, social networks. We know a good deal about the links between well-being and housing, environment, economic circumstances, social networks. There are still huge gaps in our knowledge – some of which are even growing because we are asking new questions and because our circumstances are changing: There are still huge gaps in our knowledge – some of which are even growing because we are asking new questions and because our circumstances are changing: -very old people -older men -excluded groups e.g people with learning disabilities, prisoners We know a good deal about the links between well-being and housing, environment, economic circumstances, social networks. We know a good deal about the links between well-being and housing, environment, economic circumstances, social networks. There are still huge gaps in our knowledge – some of which are even growing because we are asking new questions and because our circumstances are changing: There are still huge gaps in our knowledge – some of which are even growing because we are asking new questions and because our circumstances are changing: -very old people -older men -excluded groups e.g people with learning disabilities, prisoners