Elixir of life

Miriam Bernard is professor of social gerontology and
director of postgraduate studies at the School of Social Relations,
Keele University. For the past 20 years, her research interests
have mainly been in developing new and healthy lifestyles in later
life, and she has a long-standing interest in women’s lives as they
age. 

Retirement communities are increasingly promoted as a positive
alternative to traditional forms of residential and nursing home
care and the Supporting People programme regards them as suitable
for fit and frail older people. However, although the number of
British retirement communities is growing, we know comparatively
little about how they function.

Between 2000 and 2003, a team at Keele University explored what
it was like to live and work in the new Berryhill Retirement
Village in Stoke on Trent.(1)  A multi-method, participatory action
research approach was adopted in which the close involvement of
participants was key.

The village is in a working-class area that is below the
national average for health and well-being. The building has 148
rented flats along a series of internal “streets”. Residents either
live independently or receive one of four levels of support, which
stop short of full-time nursing care. There is a social club,
activities, a range of on-site facilities, monthly street meetings,
a monthly village news-sheet and an in-house television service.
Residents also volunteer their services in various roles within and
beyond the village.

At the start of the study, the village accommodated 159 people
older than 55. The population was all white and women outnumbered
men by two to one. Eight in 10 women lived alone, three in five
were widowed and one in four were married. Half the men were
married or cohabiting and half were widowed and living alone. Nine
in 10 respondents had left school at or before they were 15.
Three-quarters had been employed in manual occupations. Staff work
variable hours but cover the village 24 hours a day, 365 days a
year. A key worker system operates for all residents.

Concerns about one’s own or one’s partner’s health were the main
reasons for moving to Berryhill. Three out of four residents had a
limiting long-standing illness but they functioned better
physically than their peers with such a condition outside the
village. And levels of functioning were maintained over the study
period. More respondents expected their physical, rather than their
mental health to worsen, and one in five was worried that their
health might affect whether the village would be a home for
life.

Residents spoke positively about opportunities for maintaining
health within the village, but those with significant physical or
mental health problems felt they were more limited. About one-third
of residents receive support and most rate it very highly. Nine in
10 respondents were confident that support would be available at
Berryhill if they needed it, but some expressed concern over its
affordability both now and in the future.

Opportunities for participation and involvement were key to
developing a new kind of lifestyle at the village. For women in
particular, and for people who needed staff support to attend
activities, the safety and security offered by having them on-site
was particularly valued. Keeping fit was the most important
activity and organised trips were popular. Volunteering played a
big part in village life and regular street meetings offered
opportunities for involvement in decision-making, which helped
improve self-esteem and self-confidence.

Residents said they felt younger inside and thought they looked
younger. There were no differences on this between men and women,
and physical appearance and the use of aids such as wheelchairs
were often poor indicators of how people felt on the inside.

The mixing of generations could lead to tensions around, for
example, different tastes in music. There were also fears about how
the outside world saw Berryhill. Some stakeholders viewed it as
exclusively for “old” people or for those who had “given up” and
could no longer cope. But family and professionals perceived it as
a safe environment and remarked on how residents seemed to have a
greater sense of self-confidence.

The study suggests that retirement communities do not have to be
planned and developed just with middle class professional retired
people in mind. But we highlight a number of challenges.
First, the word “retirement” sits uneasily with an ethos of active
participation. Residents pointed out that using the phrase
“retirement community” or “retirement village” often meant that
they and their families had certain expectations of Berryhill: that
people would be “looked after” as if they were in a retirement
home. It can also affect the perceptions of people outside who may
see these communities as places for (frail) old people.

Second, with an age span of 40 years, what most seems to
characterise these developments is the diversity of the people who
are attracted to live there. Three factors are important: the
different age groups and generations within such a community; the
gender dimension whereby women’s needs seem to be well catered for
in contrast to older men’s needs; and the spectrum of “wellness”
that exists and how this is viewed and handled by residents
themselves, staff and helping professionals. Developers,
policymakers and practitioners need to embrace a more nuanced
approach that takes account of people’s histories, personalities
and expectations.

Third, although Berryhill staff (except the newest recruits) are
trained to NVQ Level 2 as a minimum, staff in similar environments
are often not especially well qualified or well trained. Our study
reinforced the need for training and support, including about how
one relates to older people, communication and information-giving
skills. Dealing with mental health needs, death and bereavement,
group motivation and facilitation skills, and conflict management
techniques were also identified. If they are to work, retirement
communities require a considerable investment in training and staff
time beyond the instrumental, task-oriented activities of their
daily jobs.

Finally, a particular challenge is to articulate the extent to
which such communities should encourage people to join them; and
how far they should be self-contained and security conscious.
Although residents at Berryhill were keen to maintain links with
family and friends, at the same time they emphasised how living in
such an environment was important in lifting the emotional and
physical burden from families.

This study suggests that retirement communities can provide
environments in which to age well and develop a new lifestyle. Yet
there remain many challenges to all involved: to residents
themselves, whose values, attitudes and beliefs can lead to
tensions; to staff, who may struggle to respond to the changing
needs of the individual and the community as a whole; to developers
and managers, who have to balance the benefits of increased
facilities and activities offered through larger communities with
the needs of more vulnerable individuals; and, of course, to
policymakers, who must judge how best to incorporate such
developments into strategies that promote health and well-being in
older age.

Abstract:

This article reports on the findings of a three-year
participatory action research study exploring what it was like to
live and work in the Berryhill Retirement Village in Stoke on
Trent, which was developed by The ExtraCare Charitable Trust and
Touchstone Housing Association. Funded by the Community Fund (now
the Big Lottery Fund), the study suggests that Berryhill works well
for many. However, there were persistent challenges for all
involved.

Reference:

(1) Miriam Bernard, Bernadette Bartlam, Simon
Biggs and Julius Sim, New Lifestyles in Old Age: Health, Identity
and Well-being in Berryhill Retirement Village, The Policy Press,
2004, price £14.99, ISBN 1 86134620 4. E-mail: direct.orders@marston.co.uk

Further Reading:

• K Croucher, N Please and M Bevan, Living at Hartrigg Oaks:
  Residents’ Views of the UK’s First Continuing Care Retirement
  Community, Joseph Rowntree Foundation, 2003.
• Office of the Deputy Prime Minister, Supporting People, ODPM,
  2003.
• S Peace and C Holland (eds), Inclusive Housing in an Ageing
  Society: Innovative Approaches, The Policy Press, 2001.
• K Sumner (ed), Our Homes, Our Lives: Choice in Later Life
  Living Arrangements, Centre for Policy on Ageing, 2002.

contact the author:

m.bernard@appsoc.keele.ac.uk