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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