̽��ֱ�� of Cambridge - older people

Energy inefficiency and inability to downsize pose even bigger threat to low-income pensioners than loss of Winter Fuel Payments, study suggests

ta385 — Mon, 23 Sep 2024 09:32:48 +0000

̽��ֱ��study, published in Energy Research & Social Science, was completed shortly before the Winter Fuel Payment vote was taken, by researchers from the ̽��ֱ�� of Cambridge and Delft ̽��ֱ�� of Technology (TU Delft).

̽��ֱ��researchers raise particular concerns about the impact of the policy on pensioners with annual incomes of between £11,300–£15,000 for single pensioners and £17,300–£22,000 for couples.

Drawing on data from the English Housing Survey, which sampled nearly 12,000 households across all income groups, the study investigated how income, energy efficiency, home size, household type, and tenure status impacted on energy expenditure.

̽��ֱ��researchers found that an increase of £1 per year in income (after housing costs, tax and welfare payments) was associated with a marginal increase in heating spending of about one-tenth of a penny.

̽��ֱ��study also found that just a small energy efficiency improvement – a one-point increase in the SAP12 rating ( ̽��ֱ��Government's Standard Assessment Procedure for Energy Rating of Dwellings – had a major impact on households in energy poverty, offering an average reduction in annual heating costs of £21.59 per year.

Floor area also had an impact. ̽��ֱ��researchers found that a one square metre increase was associated with an annual increase in heating spend of £5.04 per year, for households facing energy poverty, making this the worst affected group. This compares with £4.18 per year for high-income households, £3.65 per year for low-income households, and £2.99 per year for very low-income households not in energy poverty.

“When low-income households receive more income, they generally spend a little more to warm their homes. But these households often have to spread any extra money they have across other essential needs including food,” said lead author, Dr Ray Galvin, affiliated with Cambridge Institute for Sustainability Leadership (CISL).

“A reduction in income like the loss of the Winter Fuel Payment could force low-income pensioners to cut back not only on heating but also on other basic necessities. This poses a significant risk to people who are particularly vulnerable to the effects of living in cold homes.”

Energy efficiency

Across all household types, the researchers found that the energy efficiency of the dwelling had by far the biggest impact on heating expenditure.

“ ̽��ֱ��most effective strategy to warm up the homes of people living energy poverty is to increase the energy performance of their dwellings,” said Professor Minna Sunikka-Blank, from Cambridge’s Department of Architecture.

Specifically, the authors advise that the SAP12 rating of homes need to be increased to at least 72.

Each increase in SAP12 energy efficiency rating corresponds to a reduction in heating costs of around £20 per year, meaning that for households in energy poverty, with an average SAP12 rating of 59.48, increasing the rating to the level of low-income households not in energy poverty, 71.45, could reduce heating costs by about £240 per year.

̽��ֱ��authors make clear that energy savings would not be sufficient to pay for these energy-efficiency upgrades. They would require targeted financial support.

Dr Galvin said: “Government and society may well find that these costs are paid back to the country through co-benefits of fewer days off work, longer lives and less strain on the health service.”

While this would not improve the finances of households in energy poverty as much as the direct monetary allowances such as the Winter Fuel Payment, it would, the authors argue, make a substantial, direct impact on cold, unhealthy homes.

Dr Galvin said: “There needs to be extra focus on developing policies for the long-term solution of retrofitting energy-inefficient homes. This can provide enduring reductions in energy bills while also improving thermal comfort. This approach may also align better with the goal of reducing carbon emissions and tackling climate change.”

Prof Minna Sunikka-Blank said: “Without retrofit initiatives, energy poverty will persist in the UK, because in low-income households immediate needs often take precedence over thermal comfort, even when incomes increase.”

Home size

̽��ֱ��study found that households in energy poverty have a 7.3% larger average floor area than low-income households not in energy poverty, and that floor area makes a substantial difference to heating energy costs (about half to two-thirds the impact that the SAP12 energy efficiency rating has).

Tijn Croon, from TU Delft said: “These findings suggest that inability to downsize may be a significant driver of energy poverty in the United Kingdom. Low-income households can save money and stay warmer living in smaller homes but downsizing is not always easy for older households whose dependants have left home and who find themselves with a large, older home that is very expensive to keep warm.”

One-person households spend less on heating

A surprising finding in the study is that across all income groups, one-person households tend to spend less on energy. And for households in energy poverty the reduction (£36.77 per year) was twice as large as for low-income households not in energy poverty (£15.65 per year).

Tijn Croon, from TU Delft, said: “This might suggest that many one-person households are able to control their energy consumption more strategically than a multi-person household can.”

Dr Galvin said: “Our study controlled for other factors so this is not just a case of low-income households living in smaller homes. Further research could survey one-person households to find out if they have skills and practices that could be transferred to multi-person households.”

Mitigating impact of Winter Fuel Payment cuts

̽��ֱ��authors suggest several potential solutions. Expanding Pension Credit eligibility to align with the government's low-income threshold would be the most comprehensive fix, though this may be financially unfeasible. Alternative measures could include a temporary application process for the Winter Fuel Payment for those just above the Pension Credit threshold or providing tax credits or rebates for low-income pensioners, which could be more easily managed since HMRC already holds income data.

While much attention has been given to the risk of energy poverty among pensioners, the authors also note that families with children and young adults are often equally vulnerable and may face even greater challenges in the housing market compared to pensioners.

̽��ֱ��authors are currently working on a follow-up research paper that will explore the recent reforms to the government’s Warm Home Discount scheme.

Reference

R. Galvin, M. Sunikka-Blank, T. Croon, ‘Juggling the Basics: How Much Does an Income Increase Affect Energy Spending of Low-Income Households in England?’, Energy Research & Social Science (2024). DOI: 10.1016/j.erss.2024.103766

̽��ֱ��UK Government’s policy to scrap Winter Fuel Payments could disproportionately affect low-income pensioners in England, new analysis suggests. But the same study argues that the energy inefficiency of homes and challenges involved in downsizing will have an even more harmful effect this winter.

Without retrofit initiatives, energy poverty will persist in the UK

Minna Sunikka-Blank

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Rooftops view from Totterdown to Bristol Centre

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Study identifies factors linked to dying comfortably for the very old

cjb250 — Thu, 05 Oct 2017 08:22:01 +0000

In a study published in the journal BMC Geriatrics, the researchers argue that their findings highlight the need to improve training in end-of-life care for all staff, in all settings, and in particular to address the current shortage of palliative care doctors in the NHS.

As life expectancy increases, so more and more people are dying at increasingly older ages, often affected by multiple conditions such as dementia, heart disease and cancer, which make their end-of-life care complicated. In the UK, in just a quarter of a century the proportion of deaths occurring at the age of 85 or older has risen steeply from around one in five in 1990 to almost half of all current deaths.

Older people living with dementia commonly report multiple symptoms as they approach the end-of-life, and if these symptoms are not adequately controlled, they may increase distress and worsen an individual’s quality of life.

While some people close to the end-of-life may prefer to die at home, only a minority of the ‘oldest old’ (those aged 85 years and above) actually die in their own homes. In the UK, fewer older people die in hospices or receive specialist palliative care at home than younger age groups, and the trend for older deaths is gradually moving away from death in hospital towards long-term care facilities.

Little is known about symptom control for ‘older old’ people or whether care in different settings enables them to die comfortably. To address this gap in our knowledge, researchers from the Cambridge Institute of Public Health examined the associations between factors potentially related to comfort during very old people’s final illness: physical and cognitive disability, place of care and transitions in their final illness, and place of death. This involved a retrospective analysis of data for 180 study participants aged between 79 and 107 years.

̽��ֱ��researchers found that just one in 10 participants died without symptoms of distress, pain, depression, and delirium or confusion, and most people had in fact experienced combinations of two or more of these symptoms. Of the treatable symptoms reported, pain was addressed in the majority, but only effectively for half of these; only a fraction of those with depression received treatment for their symptom.

Compared with people who died in hospital, the odds of being reported as having died comfortably were four times as high for people whose end-of-life care had been in a care home or who died at their usual address, whether that was their own home or a care home.

People living in the community who relied on formal services for support more than once a week, and people who were cared for at home during their final illness but then died in hospital, were less likely to have reportedly died comfortably.

“How we care for the oldest members of society towards the end of their lives is one of the big issues for societies across the world,” says Dr Jane Fleming from the Department of Public Health and Primary Care, the study’s first author. “ ̽��ֱ��UK is not the only country where an urgent review of the funding for older people’s long-term care is needed, along with commitments to staff training and development in this often undervalued sector.

“It’s heartening that the majority of very old people in our study, including those with dementia, appear to have been comfortable at the end-of-life, but we need to do more to ensure that everyone is able to die comfortably, wherever they are.”

̽��ֱ��authors of the study argue that it highlights the need to improve training in end-of-life care for all staff, at all levels and in all settings.

“Improving access to supportive and palliative care in the community should be a priority, otherwise staying at home may not always be the most comfortable setting for end-of-life care, and inadequacies of care may lead to admission before death in hospital,” adds co-author Dr Morag Farquhar, who is now based at the ̽��ֱ�� of East Anglia.

Contrary to public perceptions, the authors say their study demonstrates that good care homes can provide end-of-life care comparable to hospice care for the very old, enabling continuity of care from familiar staff who know their residents. However, they say, this needs recognising and supporting through valuing staff, providing access to training and improving links with primary and community healthcare providers.

“In the UK, we particularly need to address the current shortage of palliative care doctors in the NHS, where training numbers are not going up to match demand, but the shortage is even greater in developing countries,” says co-author Rowan Calloway.

“In the future, community care will be increasingly reliant on non-specialists, so it will be crucial that all members of the multi-disciplinary teams needed to support very frail older people near the end of their lives have good training in palliative and supportive care skills.”

̽��ֱ��study was supported by the Abbeyfield Society, Bupa Foundation, Medical Research Council, and the National Institute for Health Research Collaboration for Leadership in Applied Health and Care Cambridgeshire & Peterborough.

Reference
Fleming, J et al. Dying comfortably in very old age with or without dementia in different care settings – a representative "older old" population study. BMC Geriatrics; 26 Sept 2017; DOI: 10.1186/s12877-017-0605-2

Key findings and policy implications

̽��ֱ��Cambridge City over - 75s Cohort Study

Very old people are more likely to die comfortably if they die in a care home or at home, compared with dying in a hospital, suggests a new study from the ̽��ֱ�� of Cambridge. Yet while the overwhelming majority of very old people reported symptoms at the end of life such as distress, pain and depression, the study found that these were not always treated effectively.

How we care for the oldest members of society towards the end of their lives is one of the big issues for societies across the world

Jane Fleming

Sheila Sund

Rose by Pool

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Students invent new technology to improve later life

ta385 — Mon, 20 Jun 2016 09:30:00 +0000

As part of their Master of Research programme at the ̽��ֱ��’s EPSRC Centre for Doctoral Training in Sensor Technologies and Applications last year, the ten students were given 12 weeks to develop an integrated suite of wireless devices to enable family members and carers to monitor the wellbeing of an older person, remotely and with minimal invasion of privacy.

Details of the team’s breakthrough have just been published in ̽��ֱ��Royal Society’s Interface Focus journal.

According to ̽��ֱ��Royal Society for the Prevention of Accidents, around one in three adults aged over 65 who live at home will suffer at least one fall a year; and in 2009, in England and Wales alone, this age group accounted for 7,475 deaths as a result of an accident. Nevertheless, the vast majority of older people would still prefer to stay in their own homes until it is impossible for them to do so, rather than move into residential care.

Three million people in the UK are aged 80 or over, and the number of people aged over 85 is set to double in the next 20 years. With ageing populations placing increasing pressure on health services in the UK and many other countries, there is growing demand for assisted living technologies to enable older people to live independently and safely in their own homes for longer.

But as team member Oliver Bonner, an electronics engineer, explains:

“Existing monitoring devices are often too bulky, only perform one function and can’t be integrated because manufacturers don’t want their products used alongside those of rival brands. What we’ve done is develop an open platform so that anyone who invents an ingenious assistive device can bring that into the system and enhance what it can do for older people.”

̽��ֱ��interdisciplinary team – comprising engineers, chemists, biochemists, materials scientists and physicists – designed and incorporated five assistive devices into their sensor suite: a door sensor, power monitor, fall detector, general in-house sensor unit, and an on-person location-aware communications device. ̽��ֱ��group improved on existing devices, in part, by taking advantage of recent developments in 3D printing, printed circuit board production and electronics prototyping.

Josephine Hughes, who studied engineering as an undergraduate at Cambridge and is now pursuing a PhD in robotics, said:

“We’ve created a non-intrusive safety net that can be used to help older people live independently in their own homes for as long as possible while also connecting them with their friends and family. We had to ensure that older people would accept the system.”

To protect the privacy of older people, the in-house system uses motion and audio detectors to establish presence but no cameras or sound recording devices. Towards the end of the project, the team installed their sensor suite in the home of team member, Philip Mair, a biochemist. With kind permission from Mair’s flatmates, the group tested the system for two weeks and, to their relief, discovered that it was fully operational.

Extensive further testing would be required before the system could be commercialised but it has already attracted interest from potential investors and manufacturers.

Philip Mair said: “ ̽��ֱ��toughest part of the project was having to tear up our first proposal and start over again. Once we got into the development phase, we had to wait for our area of expertise to come into play but also pick up entirely new skills very quickly, in my case, programming.”

Professor Clemens Kaminski, Director of the Sensor CDT at Cambridge, said:

“ ̽��ֱ��sensor team challenge was a unique experience for all involved and what these students have achieved is astonishing. To devise a proposal, budget and work plan as well as build and demonstrate such a sophisticated system in such a short period is remarkable.

"Their sensor suite significantly outperforms any commercial solution currently available and the team has made a genuine contribution to society by sharing the advances which it has made. ̽��ֱ��experience will stay with them for the rest of their careers.”

All ten team members are now working on other projects as part of PhD research at Cambridge.

̽��ֱ�� ̽��ֱ�� is a world leader in the science and technology of sensing and myriad sensor technologies have been developed here, ranging from DNA sequencing to plastic transistors. ̽��ֱ��CDT in Sensor Technologies and Applications connects more than 100 academics from 20 departments and leading industries to provide a coordinated training programme and PhD experience to outstanding students from a large number of disciplines.

During the first year of the Sensor CDT studentship, which leads to the Master of Research qualification, students immediately begin to engage in sensor innovation through course work and experimental projects. ̽��ֱ��experience differs from that of a traditional, single-discipline PhD as students work across different Departments and undertake projects both individually and in teams. Students interact with industrial partners who are also pushing the boundaries of sensor innovation, and learn how to achieve radically new solutions to current and future sensor challenges.

A showcase event for Cambridge activities in the field is the Sensors 2016 conference (14 October 2016) which will host international speakers as well as the current CDT cohort, who will present the outcome of their own team challenge, focused on building a medical imaging device.

̽��ֱ��team:

James Manton; Omar Amjad; Josephine Hughes; Isabella Miele; Philip Mair; Tiesheng Wang; Oliver Bonner; Vitaly Levdik; Richard Hall; Géraldine Baekelandt.

Teaching team members: Prof Clemens F. Kaminski; Dr Oliver Hadeler; Dr Fernando da Cruz Vasconcellos; Dr Tanya Hutter.

A team of post-graduate students has published research with the potential to transform the lives of millions of older people around the world.

̽��ֱ��team has made a genuine contribution to society by sharing the advances which it has made. ̽��ֱ��experience will stay with them for the rest of their careers.

Professor Clemens Kaminski, Director of the Sensor CDT, Cambridge

Team members from Cambridge's EPSRC Centre for Doctoral Training in Sensor Technologies and Applications.

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