Euro-China UPC: Optimising care delivery models to support ageing-in-place: towards autonomy, affordability and financial sustainability - ODESSA

Population ageing has been recognised for some time in European countries like UK and France. However, this has been acknowledged in China only recently but with more urgency due to the tremendous population size and predicted growth; China will have 64 older people for every 100 workers by 2025. China presents what is, in effect, a different ageing trajectory from European countries, and has unique characteristics shaped by its distinct historical, cultural, economic and political contexts. Recent demographic changes and significant economic transformations have led China to move from a traditional familial dominated elder system of care in which older people are being cared for by the extended family structure, to one which seeks to be based on efficient and sustainable social care support. The importance of building up a long-term care system to adequately and sensitively serve the diverse needs of ageing individuals appears however, self-evident for both Europe and China. In both settings, there is a persistently increasing trend for older people to choose to live independently in their own home (ageing-in-place). In Europe, care provision is being shifted to accommodate this trend, though it is acknowledged that this shift will require investment for homes that provide for independent or semi-independent living and that in doing so, can meet the range of later life physical needs. However, it is probable that targeted investment in adaptation for improved levels of accessibility and in specialised and/or supported housing for older people to live independently for longer in their own homes can lead to substantial cost savings in associated health and long-term care.

This research will attempt to contribute to the processes for meeting older people's needs in terms of these changes by exploring the relationships between living arrangement, living environment and the design of care delivery from technological, financial, political and social perspectives. Taking account of the factors that impact on the different ways in which older people in China, UK and France see care delivery, this proposal will build a common framework for the study of care delivery mechanisms and options available to older people that includes consideration of the role of cultural, socio-economic and welfare system dimensions. This will allow scenario building and in-depth comparative analyses among the three partner countries.

The study will use a mixed-method design, combining data mining and in-depth analysis, robust measures of the quality of the built environment, together with a participative action research approach to generate the engagement of key stakeholders and a range of qualitative data. It has six work packages which will be conducted in parallel in the three partner countries. The research will provide comparative studies and a synthesis that will inform recommendations to benefit China and Europe.

The study will help understand ageing-in-place in the three countries and will identify common features for integrated care under different policy and society circumstances. It will examine the potential of such models, their impact on improvement to the care of older people and finance implications. The involvement of academic and non-academic stakeholders will strengthen the methods, reach and impact of this research.

It is the aim of this research to translate its findings as quickly as possible. This activity of translating research into action is something which the project team has rich experience in undertaking, as evidenced through projects such as Bridging Research in Ageing and ICT Development - BRAID, Assessing Needs of Care in European Nations - ANCIEN, Survey on Old People of Tsinghua, Development and Social Significance of Facilities for The Elderly, Understanding the Diversity of PPP Practices around the World, and networks such as Cogworks, Housing LIN and the EU-Asia Network of Competence Enhancement on Public-Private Partnerships.

A range of guidelines will be produced by the research detailing how the built environment relating to housing design should be adapted, in addition to social and health care delivery guidelines, to meet the needs of older people and their families, and sustainable mechanisms to afford age-friendly housing. This information will be of direct benefit to policy makers, social and health care and housing providers who are in the position to modify and update policy recommendations relating to programmes of care delivery and design of homes and their affordability. In addition to policy makers, the recommendations produced will be of direct benefit to practitioners. Practitioners will use evidence generated by the project to inform the future planning, design, construction and management of home settings. Older people who have a good appreciation of ability to understand the value of good design of the built environment and, in particular, affordability and accessibility to decent housing will be in the position to impact further on the study through providing their future engagement and opinion. Their feedback and comments will be invaluable in terms of being able to influence policy and practice having evidence-based research at hand.

Through the subsequent change in both the domestic environment and in how social and health care is both managed and delivered within it, older people who desire to age-in-place will benefit through an improved living experience in terms of an environment that better meets their needs and promotes and improves their quality of life. They will have access to home settings that are more inclusive and that are able to facilitate increased mobility, autonomy, social connectivity and physical activity.

The project will create in a locality within each country setting, a replicable process of community engagement for understanding, through experiential account and social network datasets, the effect of formal and informal network connections of the local older population. This will provide a basis for demonstrating the value of network oriented social care models as part of a framework of social care development and a way of enabling the impact for of the project's wider activity on participants to be captured and to complement testimonials and other forms of feedback from the stakeholders and user associations involved with the research - all of whom will be provided with the opportunity to comment on the study's findings and recommendations.

As a result of the adoption of the study findings, older people will have access to a supportive environment that will facilitate a personalised care delivery, improved mobility and enhanced participation in social and physical activity. As a direct result, it is anticipated that carer burden will be reduced.

Researchers and academics within the study will benefit through their development of increased levels of multidisciplinary knowledge and the creation of a shared language through their involvement with the multidisciplinary work plan within the research. The working structure of the research project will provide an opportunity for those from all domains within the study to work together and hence gain a further insight into a number of new areas of work and multicultural awareness.