Age-friendly housing - navigating through a complex multi-regime environment

Abstract

Demographic change poses significant challenges for housing and healthcare, that deems current practices as uncontainable. Reforms in long-term care resulted in the closure of institutional residences, like nursing and care homes, which made new forms of housing including care services - necessary. Age-friendly housing as an envisioned solution for older adults to live at home independently as long as possible, can facilitate a transition of these sectors. Alterations in the home environment in the spatial, physical, and technological sense are used to facilitate longer independence at home. Age-friendly housing solutions as a response to the challenges of demographic change, are trying to facilitate older persons to live independently at home, as long as their health and care needs are met. Applying the multi- system approach, based on the multi-level perspective, this study develops an integrated framework capturing the dynamics of three sectors: housing, healthcare and ICT by exploring local initiatives and its system interactions. A focus is put on determining the constellation of actors, and the niche-regime interactions. This study developed an integrated framework that captures the dynamics from three sectors: housing, healthcare and ICT. The multi-level perspective (MLP) is useful to capture the transition processes of one sector, however understanding the involvement of three sectors, the multi-system approach is used, to advance from the MLP. Local initiatives are explored in a variety of contexts, to determine the multi-system interactions. A qualitative approach in form of a multi-case (n=10) design performing semi-structured interviews (n=18) is conducted. The analysis is performed on three levels: the individual case, groups of similar cases, and all the case together. The cases embody various configurations of actors and strategies. Three directions among the cases are identified based on the solution and the related vision: new living concepts, home modifications, and integrated solutions. A set of cases are found to develop new solutions without being hampered by the healthcare regime, while others that try to alter healthcare practices found resistance. To accomplish radical innovation in healthcare there is a need for the involvement of actors coming from housing and ICT. This study contributed to the understanding of the multi-system approach by investigating the multi-system interactions in relation to the emerging domain of age-friendly housing. Multiple socio-technical systems have to be included to truly understand complex transitions. In the future, age-friendly housing could either constitute multiple transitions, or form a new regime on its own.