05 Jul 2021
Our population is getting older – testament to advances in medicine, technology and living standards over the last century. It is estimated that the number of people aged 60 and over in Scotland will increase by 27 percent by 2043 and those aged 80 plus will have increased by 77 percent.
While many people are living well in later life, ageing does increase the prevalence of conditions like dementia. There are currently around 90,000 people living with dementia in Scotland and this number is expected to increase significantly. Around two thirds of people with dementia are living at home, not in a specialist care home.
We know that the vast majority of people want to remain independent, living in their own home or in the community. That might mean staying in their current home with aids, adaptations and support if required, or a planned move to a different home that better suits their needs. For example, a more accessible or ground floor home or somewhere closer to family or other support networks.
Realising the impact that the current pandemic has had on people with dementia and their families, the Scottish Government published an Action Plan setting out how they will continue to support people with dementia and their carers through the pandemic and beyond. This includes a commitment to ensure people are supported to live well at home and maintain vital connections with their communities.
“We will work with health and social care partnerships to enhance integrated and co-ordinated support for people with dementia to live well and safely in their own home, connected to their local community, for as long as possible and to minimise hospital admissions – and do more to support those with dementia who live alone. As part of this we will spread learning from the local whole-system dementia care approach being tested in Inverclyde.”
In order to support this work, the Scottish Government invited Ashley Campbell of CIH Scotland and Lesley Palmer of DSDC, University of Stirling to co-chair a new National Housing and Dementia Forum, bringing together practitioners, academics and people with dementia to explore how we can better support people to live well with dementia. The Forum will gather examples of what is working well and could be replicated in the short to medium term and make recommendations for longer term policy changes, reporting to the Scottish Government in 2022.
The Forum will meet four times this year with additional evidence sessions exploring four key themes:
The first evidence session and Forum meeting took place in May focussing on whether people with dementia are able to access the right type of home or have their current home adapted to meet their needs.
We heard that the process for getting adaptations is complex. Different funding streams and means testing can result in unequal access to potentially life changing support.
Self Directed Support, where people are given control of a budget to choose their own services, is intended to empower people and allow them to make personal choices about their care. However, this option is not often taken up by people with dementia meaning that they might not always get support that has been tailored to their needs.
There are some good examples of specialist housing for people living with dementia, but they are few and far between and are very expensive to develop and maintain – we need to fucus more on making all mainstream housing more dementia friendly.
But our initial discussions didn’t just focus on negatives, some promising connections were made between organisations and practical ideas on how we can improve things quickly were shared – by ensuring people get advice about housing when they are first diagnosed with dementia and making sure that dementia friendly design is the norm and not the exception when new homes are being designed and built.
But perhaps one of the simplest and most important things we can all do, in our professional and personal lives, is talk about getting older. We shouldn’t be waiting until getting a dementia diagnosis before thinking about whether our homes will meet our needs in the future. As a society, we need to become more comfortable with these conversations to make sure that we can all plan to live well as we get older.
We are looking forward to further evidence sessions and keeping you updated on our progress throughout the year.
Ashley is the policy and practice manager at CIH Scotland and Lesley is the chief architect at the University of Stirling’s Dementia Services Development Centre.