Retirement homes with room for some independence

Where do you go when the house becomes too much for you? Richard Thomson examines the options

THE traditional solution to the simple problem of a retirement home is to sell the family house, buy a bungalow or some other modest residence, and invest the spare capital. Undoubtedly this is not only the simplest but by far the cheapest kind of accommodation in old age. Expenses are kept to a minimum, there is no mortgage, and there is a wad of money in the bank to supplement the pension.

Increasingly, however, people are coming to see the limitation of the traditional solution. In particular, these bungalows have little provision for disabled or even slightly less agile old folk, and there is often little serious medical back-up nearby specifically designed for old people.

This, of course, can become a worry as people live longer and grow infirm or lose partners. Self-reliance is all very well until illness or loneliness makes it impractical.

At the other end of the scale from self-reliance is the traditional option of an old people's home - institutions that provide a bedroom, communal lounge and basic services such as meals and laundry. Companies such as Takare and Quality Care Homes have sites throughout the UK, but most others cater for the local community and attract custom by word of mouth. Organisations such as Age Concern also provide information on what is available.

Halfway between these two solutions is sheltered housing, a concept that was pioneered in Britain during the 1980s by McCarthy & Stone, which claims around 70 per cent of the market. A typical development has 20 to 50 flats designed for old people, with features including emergency bells and video door monitors. A house manager lives on site to look after the place and keep an eye on residents. The developments are often close to town centres to reduce the need for driving, and most of the people who live in them have moved only 10 or 15 miles from their old homes.

"A one- or two-bedrom flat would cost around pounds 63,000 for a lease of 125 years," says Matthew Thorn, finance director of McCarthy & Stone.

Additional bills come to another pounds 1,000 a year. The buyers then own the flat as they would any other kind of property. "Our residents have to be over the age of 55 or 60, and 80 per cent of them are women, many of whom have lost their husbands. The flats provide an intermediate environment for people who feel the pressure of living in their own home is too much."

"But," says Thorn, "our units are not nursing homes and we do not arrange communal meals." The problem, of course, is that if people get frail they have to move out again and into some other accommodation that provides more medical care.

"Close care" is increasingly available as an attractively flexible solution to this problem. Anglia Secure Homes, for example, has a development at Little Holland Hall in Essex of 26 apartments, where communal dining is provided and three levels of medical service are available. "People want independence, but with medical care laid on," says Paul Edmondson, an executive with the company. "You can use it as a hotel or, very nearly, as a nursing home. Each service has a price and you can buy what you want. That way, you don't pay for what you don't need." The simple tariff of basic cleaning, laundry and food is pounds 120 a week. A slightly fuller version of the same is pounds 154 a week, and nursing attention of a similar standard to a nursing home costs pounds 240 a week. This is on top of the cost of buying the apartment - pounds 80,000 to pounds 100,000.

Anglia recognises that selling the old family house can be a problem. Consequently, it allows residents to rent their apartments at pounds 3,000 to pounds 4,000 a year with the option to buy later. The rental option may also be more attractive to older people who do not want to use up all their capital, perhaps reserving it for medical spending.

The cost of full nursing home accommodation is expensive, even if it may only last a short time. "At our nursing homes, the average age is 85 and people only stay nine or 10 months," says Nick Dhansa, the chief executive of Associated Nursing. The cost of even that short residence could be up to pounds 17,000.

"We also provide home care for serious cases, but that would cost pounds 200 per week. Because of the economies of scale we can achieve at our nursing homes, it is cheaper to move there if you are very ill."