Housing needs in deinstitutionalisation

Housing is one of the most important needs to address in the process of DI and developing community care. Besides providing the shelter from the atmospheric adversities, the housing provides many important functions in people’s lives. A house or a flat is a place where people can construct their identities (by choice of living arrangements, furniture, decoration etc. and by forming relationships, family by co-residents), it is an important place of social activities, a place to invite people and be invited to and it is a place of intimacy and privacy as well. It is also a place to store one’s belongings (a personal museum) and an important item in constructing a formal virtual reality and contractual power – a place of permanent address (Flaker et al. 2013).

In deinstitutionalisation, issue of housing is one of the most important practical questions: where will people going out of an institution live. The question is burning since many of the residents have lost their homes and for many the housing problems were crucial moment in becoming a resident of the institutions. A little number has a property, but needs to be renovated or adapted for use. Some would like to return to their families, but conditions (be it material or social – broken relationships) hardly permit this. Even if there were premises available most of the residents would need support in the issues related to having a home. They would need support in maintenance of a flat or a house, in developing and maintaining privacy and intimacy, in choosing eventual flat mates and handling the relationship with them. Above all, in order to have a home, they would need a secure tenure (or ownership) in order to exert the right of having a home of one’s own (Flaker et al. 2013).

Housing needs

Need of secure tenure

Support in maintenance and housework

Adapting the house for personal requirements

Choice of co-residents or living alone

Need for privacy and intimacy, but also to be able to host friends and acquaintances

Need of permanent address

Need for temporary accommodation – transition period, training and rehabilitation, respite, crisis accommodation

Possibility for new forms of cohabitation (shared household, housing communities and cooperatives)

Source: Flaker et al., 2013.

For users that are not residents of institutions picture is more favourable. According to UNDP research ( 5-7) majority of disabled people have decent housing conditions. Majority lives in homes with three or more rooms, however, especially in urban areas (31 % as opposed to 12%) live in accommodation that has two rooms or less. Mostly they live in owned accommodation (research does not specify whether it is owned by a person with disability or their family), however there is a margin of respondents (6-17 %) who do not specify the nature of the accommodation ownership or would not answer the question of the number of rooms (2-7 %). This indicates that there might be housing problems for something like 5-10 % of people who are labelled with disability. Therefore, we can assume that there is about 1000 or more people who have problems with housing. This number is probably larger if we include the people who have inappropriate housing (poor conditions, arrangements not suiting their disability, living with people they do not want to live with or have problems with neighbours[1]).

For other groups of vulnerable people the proportions could be worse. It is known that mental health problems can be connected with housing issues (as cause or a consequence of mental distress). For old people in general housing problem is not so big, often there are cases that old people have more than plenty living space. However, there are some who live in bad condition, are evicted or cannot maintain their accommodation.

For the people in need who at the moment do not reside in the institutions access to housing is of virtual importance in the perspective of independent living. Most of those family members who believe that a person with disabilities can live independently consider that besides the employment housing is needed (UNDP N: 52).

We can conclude that housing needs are among the most important if not the most important to address in the process of DI. Most of the residents of the institutions would need new housing arrangements, a big number (almost all) of would be ex-residents will need some input in arranging accommodation either in their families or their property. For a relatively small proportion, but still substantial number of people in need of care and support access to secure accommodation would alleviate their distress and provide possibilities of independent living. A very rough estimate is that there will be needed a housing stock of more than 2000 units in Macedonia.

To come to the better and more precise assessment of needs in numbers but also in type of housing needs more research and investigation is needed that will estimate existing housing stock owned by users and services, circumstances of accommodation of the residents and community services user, preferable and appropriate housing arrangements, support needed to maintain the accommodation, and the needs regarding the use of flats or houses. This should also include the accessibility issues and the possibilities for use of assistive technologies.

Claimer: This blog is intended as a part of Situation Analysis and Assessment/ Evaluation Report of Implementation of National Strategy on Deinstitutionalisation 2008-2018 which will be soon presented to the public within the EU framework project Technical assistance support for the deinstitutionalization process in social sector.   

Reference

Flaker, Vito, Vera Grebenc, Tadeja Kodele, Jana Mali & Mojca Urek (2013) 'Where do you live? - Housing and long-term care (Kje živiš? - Nastanitev in dolgotrajna oskrba)', Dialogue in Praxis, Volume 2 (15), Issue 1—2 (24—25), 2013, pp. 111—132

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[1] Persons with disabilities are the most discriminated against in the provision of adequate housing and their inclusion in the community. 27% of the responders stated that they would not like as a neighbour person with intellectual disability; while people with physical disabilities are more acceptable as neighbours than those with intellectual disabilities. See publication: Naumovska Vojnovska A. Grozdanova E. Kasumi A. Kikerekova T. Sajkovska B. Stamenkovska Z, Stojanovik V., Trenchevska J., Useinova I., Fakovikl N., Cvetkovska S., “Guidelines for implementation of the national strategy for equal opportunities and non-discrimination base on ethnic age, disability and gender”, British Council in Macedonia, 2013, p. 25, http://www.britishcouncil.mk/sites/britishcouncil.mk/files/vodic_nsen_mk.pdf quoted in  ANED SP: 21