Age-specific housing and care for low to moderate income older people

Aims and questions This report presents the final findings of a national, interdisciplinary research project into age-specific housing for lower-income older Australians. The key research aim addressed in this report is to assess Australia's current age-specific housing market and its potential growth among low to moderate income older people, in order to develop effective policy strategies for the provision of age-specific housing for this disadvantaged group. This project examines the increasing demand for age-appropriate and affordable housing that can adequately encompass the care needs of older people with low to moderate incomes, the housing types and options currently available to lower-income older people, and future trends and policy strategies that may emerge in answer to this demand. The research questions that direct this project are as follows: A. What is the nature of the age-specific housing market in Australia at present? A1. What is the range of age-specific housing and care options currently available within the housing market in Australia? A2. What are the financial models associated with the various age-specific housing and care options? A3. What is the likely size of the market at present and in future decades? A4. What are the demographic characteristics of older consumers and to what extent are these variations significant in terms of housing, location, income and care types? B. What factors have influenced the provision of particular types of age-specific housing products? B1. What makes age-specific housing options attractive/unattractive to older persons/providers? B2. How do the financial models associated with the various options facilitate or constrain choice among low to moderate income older people? B3. To what extent do the current legislative and policy frameworks hinder or support the range of age-specific housing options currently available? C. What factors are shaping the market growth of particular types of age-specific housing? C1. Should policies and regulations be modified to create more suitable age-specific housing options and, if so, what changes should be made? C2. What impact would these changes have over time? Background The need for some form of care and assistance increases markedly as people move into older age cohorts, particularly for those aged 85 years and over (Productivity Commission 2008). This has necessitated the development of housing models targeted specifically towards older people and their particular housing and care requirements. However, older people without savings and with minimal or no superannuation earnings have minimal capacity to cover any increase in housing and living costs that may arise from a move to more age-appropriate housing, particularly if they are not homeowners (Morris 2007, 2009 and affordability thus becomes a key issue. The provision of aged care involves many different organisations, governance arrangements, funding instruments, accommodation types and providers, and the costs associated with service provision are highly variable (Productivity Commission 2008). While the number of age-specific housing providers around Australia has increased steadily over recent decades, particularly in the retirement village sector and 'Over 55's community' models, the legislative and policy framework for government interaction and regulation of these housing types is undeveloped and fragmented, and the research evidence base to underpin policy development is sparse. Methodology This research project was divided into five methodological stages: Stage 1: a literature review and policy review of the Australian age-specific housing market. Stage 2: a quantitative profile of the housing market and its consumers. Stage 3: a questionnaire survey of age-specific housing providers and older residents of age-specific housing. Stage 4: 107 qualitative interviews with older people in age-specific housing, housing providers, and key policy stakeholders. Stage 5: public engagement via a public forum and the publishing of at least one peer reviewed academic article relating to this research. Trend analysis This analysis of trends from the Australian Bureau of Statistics (ABS) Census demonstrates the dramatic ageing of the Australian population in the first half of the 21st century, and particularly over the next 20 years (2011-31) as the baby boomer cohort ages. This is likely to be accompanied by a steady decline in outright home ownership, dramatic increase in owner-purchasers, and increasing polarity between higher and lower-income older Australians. This will potentially impact on the demand for more affordable housing options, including the kind of low to moderate income age-specific developments addressed in this report, as older Australians seek to down-price to discharge mortgages and thereby reduce housing costs. Provider perspectives The perspectives of providers of age-specific housing were garnered via an online survey and semi-structured interviews with selected providers of key housing types. Age-specific housing providers are extremely diverse in terms of their scale and focus, their motivation, i.e. for-profit and not-for-profit, and their attitude and approach to care service provision. A number of other key issues emerged, such as: Much of the current supply of age-specific housing is quite old and not particularly suitable for older consumers. The sector experiences the normal frustrations of developers who have to navigate the planning system and communities resistant to change. The regulatory system is complex, and while regulation is needed to protect consumers, inappropriate regulation may both reduce the ability of the sector to innovate as well as discourage potential providers. Many not-for-profit providers are pursuing a strategy of letting their market initiatives subsidise their initiatives for lower-income households. There is considerable activity in the rental market with some targeting of lower-income households but demand in this area is also considerable and providers are struggling to keep up. Residents perspectives Residents were surveyed using an online and paper-based questionnaire, and in depth semi structured interviews were conducted. The survey highlighted the great range of housing and dwelling types available in the age-specific housing sector and the vast differences that exist between them, particularly the differences between the market and subsidised accommodation. It revealed that many residents experienced considerable difficulty in finding appropriate housing, particularly when they required subsidised housing or when they lived in a regional location. Many survey respondents raised concerns with the level of maintenance in some stock, highlighting the large variation in the quality of age specific housing and the varying age of the stock. It also emerged respondents actively sought out age-friendly design features, such as hob free showers. Large numbers of survey respondents had entered market-based housing after sale of the family home. However, with declining rates of homeownership, this situation is likely to change significantly in the future. Targeted interviews with residents of age-specific housing indicated that declining health and a desire for a supportive and secure environment with less physical demands were major reasons for moving to age-specific housing. High quality age-specific housing that included a component of care services was in high demand from consumers. Many residents reported long waiting lists for appropriate housing. Financially, older people who had been homeowners before transitioning to age-specific housing had greater choice and were better able to afford higher cost housing options such as retirement village accommodation. Older people with a lower income and asset level often had restricted options in age-specific housing, particularly those who had a history of marginal and insecure housing. The provision of care services was highly variable between housing types