The New Middle Age

The Possible: In the most recent HAPPI [Housing our Ageing Population: Panel for Innovation] report, you talk about “extended middle age” rather than retirement or old age. What characterizes that stage of life?

Richard Best: I think there’s a general feeling that three score years and ten just doesn’t work any more. Life expectancy is now into the 80s for men as well as women, and you don’t really classify yourself as old, and don’t like being classified as old, even if you’re in your late 70s. So we’ve got this period of relatively good health that runs from the mid-50s to the late 70s. Perhaps we’re slightly more creaky, but we’re not ready for residential care.

More people in their 80s and 90s will need the care element to be added in and that may mean moving to a specialist establishment. But I think that the ideal is a design for people in extended middle age that actually lasts until you’re 100.

TP: How do you reconcile the idea of downsizing with the desire for familiar surroundings?

RB: We know that loads of people, something like 6.8 million in the UK, have expressed an interest in the concept of downsizing, but we also know that when people do move, they prefer to move within three miles. As we are still only building occasionally for this particular group, most people won’t have something on their doorstep and they’re going to be much more resistant to moving. It’s only when we have a plentiful supply that downsizing will really take off.

TP: You also talk about “rightsizing” rather than downsizing …

RB: Quite often people are worried that downsizing means moving from a three-bedroom house with a garden to a bedsitter or a one-bedroom flat, and they are not going to move if it means giving up too much space. But if you don’t need the upstairs, a well-designed two-bedroom apartment is the equivalent of a three-bedroom house. So you are moving to less square feet, but you’re not going down in the world in terms of quality.

TP: Where in the world is getting this type of housing right?

RB: It’s very irritating that other countries are well ahead of the UK on this. In America, they have continuing care communities that will see you through from the bungalow to the care element if you need it. And in terms of it being the norm for people to move in extended middle age, then it’s our neighbours — Scandinavia, the Netherlands, Germany — who are well ahead. But there are still large parts of the world where the ageing population doesn’t feature as a big issue for housebuilders and developers. They haven’t picked up on the fact that this is an international phenomenon.

TP: Are there universal factors to good housing design for this age group?

RB: The basic design, how it feels to be inside, these are universals. The HAPPI Design Guides are about space, light — terribly important when you’re older — and accessibility. Another universal is that, whereas housing for young people is for people who aren’t there very much, the elderly occupier is there all the time. They are going to spend nearly all their waking hours in that place, so it’s got to be good and it’s got to be different from the bog standard product that, sadly, we’re quite used to for younger people.

TP: Soon there will be a proportionally larger number of people needing care and a smaller workforce to look after them. How can better housing help to meet that economic challenge?

RB: It’s really incredibly important. On the health and social care side, there are more and more stories of people who are in hospital and cannot be discharged because their home is totally unsuitable. So we have people stuck in hospital, costing £340 for 24 hours. It is simply wasted money. Then you’ve got people who have accidents in these homes — if you fall and fracture a hip, that’s going to cost the NHS something like £8,000. And if you can’t afford to heat a badly insulated older property, you’re going to get winter diseases. You can list 101 ways in which the home can be the cause of people requiring health and social care services, all of which are entirely avoidable.

And underpinning that are mental health factors, because so many older people are isolated. If they’re in a place with others in the same boat, they get mutual support, they get companionship.

TP: So is communal space important?

RB: I’m not very keen on retirement housing having a lot of institutional ingredients. I find it’s better for people to entertain in their own homes. There might be a club room for occasions when everyone gets together, but I see that as a catalyst for socializing separately, which is a more real interaction.

The housing association I chaired, 16 of our schemes have cinemas in them, and in retrospect I think that’s a waste of time. If five of you want to watch something together, someone’s probably got a DVD player. It would have been better to spend the money on giving people another couple of square metres, or better storage facilities. A continental practice is to have “cages” where, when you downsize, you put that huge sofa that you’re never going to sit on again but can’t bear to get rid of. Psychologically, that seems to be important.

Lord Richard Best is head of the UK’s HAPPI panel on housing for older people