What works in long-term care? Housing with support and care

This report is part of the “What works in long-term care?” project promoted by IVÀLUA and the Barcelona Provincial Council (Diputació de Barcelona), with the support of the Taula d’entitats del Tercer Sector Social de Catalunya (Third Social Sector Platform of Catalonia) and La Confederació (an employers’ association representing non-profit organisations providing social care services). The project aims to improve the design and implementation of long-term care policies and services by collecting, filtering, and presenting the available scientific evidence in an accessible way.

In the current context of demographic change and the crises occurring in both the care system and in housing, there are new models emerging for people with support needs. These intermediate resources aim to enable people to live autonomously and in the community, while offering them the adaptations and support that they need.

These models focus on the concept of a home, where support and care services are provided, guaranteeing a stable place of residence while fostering socialization. In addition, depending on the group in question, these models avoid institutionalization or facilitates deinstitutionalization. Unlike the hospital-like design of traditional care homes, these housing units, which are promoted both by the public sector and the social economy sector, focus on the right of residents to an independent and community-based life in a respectful setting. In this type of housing, support and care are not the end goal: they are instead a means of guaranteeing people’s quality of life and autonomy.

The aim of this review is to build a knowledge base on assisted living facilities and to compile the evidence available in the best possible way, to determine what works and what does not. This review connects several different areas, since this type of housing is presented as a solution for several groups: older adults, people with dementia, people with disabilities, and people with mental health problems. Although supported housing options have their specific characteristics for each of the groups, the differences between them are not explored in depth. This review will focus on the aspects they have in common: avoiding institutionalization or promoting deinstitutionalization, fostering autonomy, community integration, and improving quality of life for people with care needs.