Ageing in place - are we there yet?

What home modifications are most needed and what is the scale of the need?

Image: Bench Accounting - Unsplash

The benefits of ageing-in-place have long been recognised by governments and advocacy groups. These range from the comfort of familiarity, continued independence, a connection to the local community and cost savings associated with residential care. An objective of renovating one’s home at any stage of life is to continue in residence, while adjusting to new circumstances – be that children leaving the family home or increasing difficulty with everyday tasks due to ageing. Government-sponsored home modifications schemes for older persons and/or people with disability are in existence worldwide, including Australia. However, firm empirical data on what home modifications are most needed, and the scale of need is fragmented and largely unavailable to policy makers and researchers.

In Victoria, the Home Renovation Service scheme, provided by Archicentre on behalf of the State Government from 1998 to 2016, conducted up to 4,500 visits annually, at the request of residents, to assess their homes for age- or disability related modifications. People visited were generally older persons (over 60) with age-related mobility issues, or age-related health conditions affecting mobility. Houses visited had often been the family home where children had been raised and hence the remaining occupant (frequently an elderly mother/ grandmother) desired to stay.  This article presents a brief case study of 50 reports.

The home modification reports analysed for this case study show that housing in which older people live (in Melbourne’s western suburbs at least) contain significant barriers to the goal of ageing in place. Houses visited were mostly 25 – 75 years old, built long before the advent of accessible housing guidelines such as ‘Livable Housing Australia’, the NDIS, and current advocacy efforts being pursued through the Australian Building Codes Board (ABCB). Mostly detached, single storey, timber framed and floored, almost all the visited houses have a raised doorsill and/or step at the front door (typically 300-600mm above ground level). Having two doors to negotiate, i.e. front door and screen door, the latter with fiddly handles and locks is very common. More than half have projecting windowsills and/or awnings, or the meter box, obstructing access to and around the front entry. Bathrooms, in line with housing style and age, are typically small and mostly without a toilet which is often several rooms away. Having the shower over bath is far too common - with level-entry showers very rare. Bathrooms have insufficient door widths and/or clearances, and easy-to-use lever doorhandles rare. Space for dressing, manoeuvring, or providing assistance is mostly insufficient. Hard to use tapware and switches are common. Grabrails are rarely in existence; with towel rails often (dangerously) being used instead, and floor finishes are invariably not anti-slip. Issues affecting health and safety, and repair and maintenance concerns, were identified at most locations.

So, for ‘ageing-in-place’ to be a reality it is evident that a significant amount of work, encompassing both accessibility and housing condition issues, is required. Initial analysis of this sample of Home Renovation Service reports and the extensive experience of the project team indicate that the accessibility issues noted are endemic to Australia’s existing housing stock. This is particularly problematic given that 35.9% of Australia’s 8.9 million households include a person with disability, 12.5% of Australians under 65 live with disability compared to 50.7% of those 65 and over and 2 in 5 people with disability are 65 or older (AND 2019 [1]). But if, in line with government policy and their own desires, older Australians wish to age-in-place where will assistance come from, in what form, and how much is enough? The issues identified in the case study indicate that retrofitting will be difficult, and thereby costly, particularly if all that is necessary is undertaken. Self-financing home renovations will not be an option for many, and so some form of national scheme will be required. Cooperation, collaboration, and a clear recognition of the emotional, physical, and economic cost-benefit of ageing in place will be needed to rebuild Australia’s housing stock to better accommodate all inhabitants throughout life.

Funding has been provided by Melbourne Disability Institute (MDI) to undertake a research project led by Dr Andrew Martel of the University of Melbourne’s Melbourne School of Design (MSD) entitled Accessing the Home: Collecting and Analyzing the reports from 17 years of Victoria’s Home Renovation Scheme. Project team: Dr Andrew Martel – Lead Investigator, Mary Ann Jackson, Access Consultant, Planner, Architect and Saumya Kaushik, Architect. Currently approximately 10,000 Home Services reports have been collected.

[Source: Mary Ann Jackson, FRAIA, Managing Director, Accessibility Specialist, Architect, Planner & Access Consultant, Visionary Design Development Pty Ltd,]