Living in appropriate housing with timely access to health and social care services can result in measurably improved health status for older people and contribute to a greater sense of well-being, in addition to being financially sustainable. Older people are not a homogenous group and government policy recognises that varying levels of support, based on need, will be required by individuals to continue living in their own homes and communities, including care needs. Older people can choose housing that is appropriate and responsive to more complex needs, enable them to enjoy more active, healthy and socially connected lives and to age healthily and safely within their community.

Older people with chronic health conditions or disability, Older people with vulnerabilities

Health, Housing, Information and Communication, Long-term care, Transportation, Urban development

Government, Older People's Association, Academia, Health Care

Older people were consulted during the planning process

The joint policy statement on Housing Needs of an Ageing Population recognised that the provision of supports that enable older people to age in place are not delivered by any single agency, but by a multitude of agencies. This policy statement also recognised that housing needs and healthcare needs are often intrinsically linked and that poor housing, social isolation, and a lack of support co-ordination can lead to poor health outcomes for older people. The governance that was put in place for the Healthy Age Friendly Homes initiative is reflective of the need to have a multi-agency approach in designing and delivering a service intervention that seeks to address what is a very complex and multi-faceted problem, 'How do we enable ageing in place for older people with complex care needs?' The issues to be addressed are very broad and include health care needs, housing adaptation, sustainable energy solutions, support co-ordination, addressing loneliness and avoiding long-term care. The various partners on the programme all brought a level of expertise and experience that contributed to delivery of a very robust service solution to a very complex issue.

As of March 2022, the programme has had 1,175 referrals since commencement. Of these referrals, 757 assessments have been carried out, 958 home visits have taken place and 2,162 supports have been provided to older people in the areas of health, housing, community/social supports, and technology. In line with the Department of Public Expenditure and Reform’s Delivering for Our Public, five headline actions that focus on delivering better and more cost effective services to the public, the Healthy Age Friendly Homes is achieving these outcomes through a number of interventions including the innovative use of new technology and better data to reduce costs, while maintaining quality; involving the public in the design and delivery of services; improving communication and engagement with the public; and improving service quality and accessibility. Examples of the use of new technology include our digital assessment tool, case management systems and a multifunctional mapping tool to improve the service for the participant and enhance collaboration between existing services, which also meets the standards of Equity, Effectiveness and Efficiencies.

One of the key issues that needed to be addressed in the establishment of the programme was ensuring that it is aligned to core health and local authority services at a local level. This was addressed by joint information sharing events co-hosted by the national manager of the Age Friendly Homes initiative and the HSE representative on the national oversight group of the initiative. Through this process examples of good practice emerged such as the participation of the Healthy Age Friendly Homes local co-ordinators at Integrated Care Programme for Older People (ICPOP) multi-disciplinary team meetings where referrals to the initiative were discussed locally and appropriate channels of information sharing were established on cases where the two programmes were collaborating in addressing the needs of individual older people.

You can never communicate too much. Implementing a new initiative such as this requires extensive consultation and communication with key partners, particularly partners who will be involved in the day to day management of individual cases and supports. This is particularly relevant for agencies involved in issuing and accepting referrals for service, prioritising cases on the basis of need, and streamlining the communication process for the service user so that there is a single point of access for service and information sharing. Collaborative working is key when addressing complex issues such as in this case, housing options for older people that can facilitate ageing in place and a delay or prevention of admission to long-term care. Addressing the health and social care needs of older people with complex needs is not the sole responsibility of a national health service and there are many complex issues that are within the area of responsibility of multiple agencies, e.g. transportation, social connection, housing, social care supports.

The initiative was the result of a joint policy statement on the housing needs of older people from the Dept. of Health and the Dept. of Housing, Local Government and Heritage. The initiative is contributing to the Decade in that it is very closely aligned with two of the main objectives of the Decade; Age Friendly Environments; and Integrated Care. Government policy in Ireland, as demonstrated by the joint policy statement that led to the establishment of this initiative, is very much influenced by our own National Positive Ageing Strategy which also reflects strongly the objectives of the Decade. There is also a clear recognition through programmes such as the Age Friendly Programme that positive ageing and facilitating older people to age in place and live full and productive lives requires a multi- agency approach and this is reflected in the governance structure put in place to oversee the Healthy Age Friendly Homes initiative. In addition to this, through the Enhanced Community Care Fund Ireland has committed to the development of integrated care on a population basis across the country and one of the core target groups for this development of integrated care is older people. The Healthy Age Friendly Homes initiative is closely aligned to the aims and objectives of the Integrated Care Programme for Older People in that it plays a significant role in facilitating ageing in place across a continuum of an end to end integrated care service model for older people.