Abstract

Objectives: Enabling and optimising older adults’ capability to age “in-place” in their own home and community are key long-term care policy imperatives. In this light, housing can play a key role in the prevention, maintenance, and enabling of older adults’ psychosocial and physical well-being, and in turn, facilitating ageing in place. A pilot “AIP” project has been implemented in 11 public housing estates in Hong Kong since 2014 to promote aging in place of their elderly residents. The project provides estate-based “one stop” health and social care services for elderly tenants. Each estates is stationed with a social worker and some estates also have tailored elderly apartment units and a lounge designed for older adults. This housing model is akin to the Naturally Occurring Retirement Community Supportive Service Programs (NORC-SSP model) that aimed to promote ageing in place by facilitating partnerships among stakeholders including elderly residents, service providers, and estate managers, and by fostering neighbours’ capacity of mutual help. We conducted a four year longitudinal study to (1) evaluate the overall effect of this pilot project on psychosocial outcomes among elderly tenants; and (2) examine the ageing-in-place intention of the elderly tenants under the AIP project.

Methods: We interviewed 2,000 older residents of 12 public rental estates annually between 2014 and 2017, including 11 estates that implemented with the pilot AIP project and one estate without the program as a control group. We collected demographic, physical health, cognitive heath, quality of life, use of health care services, and their intention to age in place from them.

Results: Older people living in estates with AIP project increased the use of community care services, participated more frequently in active ageing activities, and had better cognitive health and mental health than those in the control estate. They also reported fewer falls and fewer use of accident and emergency services than those in the control estates. More elders in the estates with AIP project preferred to live at home even if their health deteriorated to a point that they can no longer living in the community without support.

Conclusions: Elders in estates with AIP pilot projects should more willingness to age in place and reported better outcomes than those in the control estates. Since more than 40% of elders in Hong Kong are living in public rental housing estates, the positive results indicates that a NORC-SSP type model may help lower the impact of rapid population aging on the long term care system.