The Mental Health Needs of People Living in Extra Care Housing

Extra care housing (very sheltered housing/housing with care) is promoted as the best way of providing long-term support for older people. What happens to people if they develop dementia or other mental health problems in these settings is less clear. While promising ‘a home for life’, the reality is that many have to move on to more dependent care facilities if they experience significant problems. This paper reports data from 268 residents in ten extra care housing schemes who were judged by staff teams as being at risk from exclusion because of mental health problems. The sample included three large village
schemes (greater than 170 residents) that had opened in the
last five years as well as three medium schemes (60–80
residents) and four smaller schemes (under 50 residents). The overall incidence of dementia and depression was difficult to ascertain from records and from staff reports. Formal diagnosis varied substantially across schemes and staff estimates of diagnosis were variable also. Formal assessment of those residents that staff identified as being most at risk, however, showed that they had similar profiles on the Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Bristol Activities of Daily Living Schedule (BADLS) and Barthel Inventory, regardless of the size of scheme they lived in. Those
in larger village schemes were more likely to share their
apartment with a spouse but the majority of people identified as being most vulnerable lived alone. These findings imply that there is a need to take a proactive approach to people’s mental health in extra care housing in order to be serious about maintaining a good quality of life for all within housing schemes.