Housing for today and tomorrow's pensioners - why we need more choices

In Malta and Gozo we are currently really only providing one option for pensioners who can no longer cope in their own homes.

That choice is residential care. Government has also chosen to go for very high quality and standards in its latest residential homes - something we all applaud.

However, many older people fail in their own homes but do not require residential care. These people are either staying where they are, or in some cases moving into a residential home where they are costing too much for what they in reality require.

And although we hope that by building residential homes in the community, these will be part of the community, this is not usually the reality. Once people move into residential care, they do not move out, they tend to become more dependent rather than less and their contact with the community lessens drastically in most cases.

Even the private sector to date appears to be emulating the government model and opting for five-star hotel-type provision rather than a housing-based model of support.

In this way we are encouraging dependence and we are increasing costs. Many local councils appear to want "their own old people's home" and of course their vision is for more of the same...

If it is true that relative to our population we actually have enough bed spaces by established standards and if it is also true that there are waiting lists and unmet demand, isn't it time to explore and provide other models, such as housing based models of sheltered and retirement housing?

These are not simply my opinions based on some bedside reading or Internet searching. I worked in the field of housing and specialised in the field of housing and older people. I led a housing and care services department that managed over ten residential homes as well as scores of sheltered housing schemes and linked services.

We need a range of services for older people, and housing social services and health may need to come together to make it a reality.

There are basically three categories of sheltered housing.

Category 3. This is essentially the residential care home model we are providing locally. Sadly, we are still stuck with the idea of a hotel type living arrangement rather than a housing one so residents have at most a bedsit and usually a hotel room which is often shared.

I fail to understand why as you get older you can't still have your own bedroom, living room, kitchenette and bathroom but this model still eludes us here, even in the latest models being built currently

Category 2. Here you have a largish group of flatlets which are totally self-contained but where there are some communal facilities such as a common room or main kitchen and an assisted bathroom and also importantly a resident warden cum caretakes who provides the security that is so often needed. People not only feel vulnerable as they get older, they are. Even locally older people are often the target for criminals as recent cases have frighteningly shown

Category 1. Here you would normally have a group of flatlets which are earmarked for older people, which are fully accessible and which are often linked to a central alarm. Residents enjoy feeling secure, having a compact easy to run home as well as the benefit of generally quieter neighbours.

The Housing Authority is currently building a small Category 1 sheltered housing project in Floriana. We decided to make this project with smaller units as well as targetted only for older people. The location is ideal, in the heart of Floriana.

The flats will all have the use of a lift and the Department of Social Housing to whom we hand over these flats for allocation will, for once, have a number of one bed flats to allocate, something which is in desperately short supply considering that a third of the people on our housing waiting list (many of them older people) only require a one-bed flat.

Sheltered housing can be new build, as this one will be but it can be a conversion too. However for it to succeed some elements are of vital importance

Location

The first, as with all housing, but even more so with older people, is location. It is no good having a sheltered housing scheme wedged up some sharp hill, particularly if you are trying to encourage older people to go on living independent lives and maintaining their contact with the community.

Many sheltered housing schemes have become unpopular if they consisted of bedsits. As I said before, being old does not mean you want to eat, sleep and watch telly in one room. We need to raise our expectations of the housing needs of older people and stop putting them in cubicles.

Accessible services

Community services such as meals on wheels or home helps must be integrated into these developmets so that both housing and social services must own these developments and provide a seamless service.

Our new Care and Repair service has shown us how many older people live in inappropriate housing. Generally it is too large and too expensive to maintain. These older people (often women) are among our poorest citizens yet most of them are fiercely independent and wish to remain so.

Although through our service we can help them repair their homes this is not always an ideal long-term solution.

One hopes that both the public and private sectors will start building real housing schemes for older people, schemes which will make our senior citizens feel secure and independent while retaining their right to their own front door and their own key... something most of us cannot imagine being without..

The author, who is the chairman of the Housing Authority, was a lead adviser in the field of housing and older people in the UK and published a study on sheltered housing when she worked as a research associate for Kings College, London.