Ageing is one of life’s inescapable realities. We are all born into this earth, and as time goes by, we go through life’s different stages (infancy, childhood, adolescence, and adulthood) until we reach the stage that precedes death: old age. Old age is a natural part of life, and even though it is not without limitation (whether it is physical or mental), it is still a time for a person to continue living good, happy, and fulfilling lives.
Old People (OP) are not permanently disabled by age, nor should they ever be considered as a burden. Even though there are complications that spring with age (loss of motor skills; disability; disease), there are arrangements that can be made to enhance OP’s quality of life and make them feel that they are still valuable, that they are still useful, and more importantly, that they are still alive.
In searching for ways to make OP’s lives better there are two fronts that must be addressed simultaneously: housing and health care. OP needs to be healthy, this is undeniable, but they also need to live in a house that is specifically designed to accommodate their needs. Recognizing the need to take care of OP’s needs integrally, society itself started working in what today is referred to Assistive Technology.
Assistive Technology (AT), contrary to what most believe, is involved with more than simply developing devices that assist disabled individuals (such as walkers, canes, and wheelchairs). OP need houses that work for them, they need assistive devices (in case they suffer from any kind of disability), and they need specialized health care that can only be procured at home. This document assesses the opportunity that AT signifies for OP (and for the more than 10 million disabled individuals) living in the United Kingdom today. Specifically, the assessment considers possibilities in Adaptive Building (AB) and Home Health Care.
State of market
At present, more than three million OP (ages 65 and up) benefit from at least one publically funded program. These programs include: health care; social care; home care; home improvement/support; community alarm/telecare. Roughly 89% of OP living in the UK is currently living in general needs housing, and to make matter worse, during the next 25 years, it is estimated that 2.3 million OP will be 85 or older.
Evidently the market trend is towards an ageing population that will increasingly depend on publicly funded programs, unless a more efficient and economical alternative is developed. AT is the alternative that the market needs, and it is required in each of the following forms: adaptive building, assistive devices, and specialized home-based health care.
Today OP’s needs are underserved. Private insurance is costly and restricted to a select few. Public programs lack the necessary resources to righteously serve the country’s ageing population’s needs. Health care services are generally located in specialized centres and clinics; this requires OP to leave their own homes, which puts them at risk and is more costly. Furthermore, regular houses are ill equipped to satisfy the needs of OP (and disabled people too).
Based on this it becomes clear that OP and the disabled need help in adapting their houses so that they can be comfortable and safe. They also need specialized devices to help go away with their disabilities, and they need home-based health care. Current publically funded programs must be reassessed in order to meet the growing needs of OP. Correctly targeting and servicing the needs of this segment of the general population will surely increase efficiency and decrease costs.
According to research, a significant proportion of OP and disabled individuals live on their own (44% of OP using a wheelchair, for instance, live on their own). This is not a problem in itself, but what truly constitutes a problem is that at present more than half of those living independently are uncomfortable or unsatisfied with their current housing accommodations.
There are companies and organisations that offer adaptive architecture services (home remodelling in order to enhance the comfort and overall quality of life of OP and the disabled). There are also some government programs that assist OP and the disabled; these programs offer health care and housing assistance for OP and the disabled. Today home care is becoming the norm when it comes to health care services for OP and the disabled. Understandably, these segments of the population are more comfortable when they receive the care they need at their own homes. This alternative is available, and even though it is not substantially more economical than regular health care services, there are gains in terms of safety and commodity. There are organisations that assist OP in procuring health care services, and some government assistance programs offer this service to the general public. Efforts will need to continue, however, as this trend continues to increase (and with it the demand for specialized aid and home equipment).
There are several OP needs, especially in what concerns housing adaptability and health care that necessitates a more active involvement from Age UK. Building on the establishments of relationships with other organisations such as Lifetime Homes and Age UK, it would be possible to put together a catalogue home remodelling and home-based health care services/equipment. These services could go from home evaluations, remodelling appraisals, specialized equipment, and source funding advisory services.
Upon considering organisations that are currently providing service to old people and the physically/mentally disabled, it is important to mention Age UK. Age UK currently offers information on alternatives for adaptive home remodelling in order to accommodate the growing needs of OP. Alternatives that can be found on Age UK’s website include: ramps and landings (for OP using wheelchairs and walkers); door entry modifications; intercoms and cameras (in order to facilitate communications and visualization throughout the home); integral structural remodelling in order to facilitate movement inside the entire house, especially for OP and disabled individuals using assistive devices. Adding on to this, Age UK also offers information on alternatives in areas such as: home care services; safety precautions; security precautions; assistive devices. Age UK is also a third-party seller of specialized equipment (note: the current offering of specialized assistive equipment is limited).
Age UK also serves as member of The Foundation of Lifetime Homes and Neighbourhoods. This is an organisation dedicated to promote assistive housing designs in the United Kingdom. These designs (which incorporate 16 universal design criteria) offer remodelling possibilities that can make any home OP-friendly with minimal costs.
The Home Improvement Trust is an organisation that promotes safety, comfort, and independence for OP and the disabled. This organisation could be contacted in order to promote adaptive building designs that service OP’s needs. In obtaining advice regarding how best to proceed in targeting potential partners and establishing relations with them, Age UK could turn to the Centre for Accessible Environments (CAE). The CAE would truly be a valuable partner, as it is the leading association when it comes to designing homes and environments that are OP-friendly. Other organisations that could prove valuable partners for Age UK when promoting adaptive design include: Federation of Master Builders (FMB); Royal Institute of British Architects.
Patient.Co.Uk is one the most trusted medical resource websites for people living in the UK. It is a non-profit organisation that holds a complete catalogue of medical articles, guidelines, and most any information that might be required on a specific disease, disability, or physical condition.
Addressing Existing Service Inadequacy
It would be interesting to look into establishing partnerships with construction companies that specialize in adaptive building solutions; the company can do much in terms of promoting (and improving) adaptive housing designs and procuring tax abatements for OP and disabled individuals. A good way of getting into the adaptive building and remodelling business is to establish partnerships with small construction businesses. The organisation could capitalize from said partnerships in the procurement of home improvement supplies and specialized equipment for those who might prefer remodelling their homes themselves (without the help of a contractor). This could be an economically enticing endeavour that should definitely be studied in more depth (as could be starting a brand new homecare and homebuilding solutions company). This way, the organisation would be able to become fully self-sustainable; outside funding would not be a necessity for the organisation to function.
Moving on from adaptive building and remodelling, and moving into health services and health equipment (including specialized assistive devices such as walkers, oxygen tanks, gurneys, walkers, and canes), it must be said that this too constitutes a viable business opportunity. Today more and more OP are looking for quality home health care solutions, and taking into account that senior citizens are the fastest growing segment of the world population, looking into servicing their needs makes sense (from a purely business and financial viewpoint).
Now, even though it is true that government plans to build three million new homes by 2020, none of these homes takes into account the needs of the country’s ageing and disabled populations. 90% of the UK’s OP spend most of their time at home, so it is safe to say that demand for Adaptive building and remodelling will increase tremendously over the next few years (as will the demand for specialized home health care services and equipment).
Another valuable ally in this entire process would be Fairtrades, which is the leading trade union for home improvement contractors in the United Kingdom. Fairtrades could help Age UK by providing information about the market, and consolidating partnerships with contractors specialized in adaptive building or remodelling for disabled individuals and OP.
In looking into health services that could be offered to OP, the foremost associations to be approached should be the British Medical Association (BMA), the British Society of Rehabilitation Medicine (BSRM), and the United Kingdom Homecare Association (UKHCA). These three associations can be of great assistance, as they can provide medical centre directories, information regarding treatment options for OP and disabled individuals, information about specialized equipment producers, etc. If an endeavour in health services is undertaken, then it would be important to get in touch with the British Health care Trades Association (BHTA), which is the leading trading association in the health care services and equipment market, with over 400 company members in the UK.
It should be no problem for the organisation to partner up with, or buying, a small or mid-sized adaptive building solutions company (specializing in home construction and remodelling). Of course, the bulk of the investment would go into inventory, so as to secure that the company has the construction equipment (tools and materials) required to carry out such an activity. If, on the other hand, the decision were made to partner up with adaptive building solutions companies instead of buying one, investment would be much lower, as it would act simply as a consultant and intermediary between OP and those companies. Costs would stay down, as these companies usually carry their own catalogues and their websites (for those who have websites) already offer complete information on the kinds of home solutions offered to OP and disabled individuals. The organisation could then aspire to turn a profit from such an endeavour, either from the actual construction (in case the company owns the adaptive building solutions business), from consultations (which would comprise a full assessment of the client’s house, a recommendation, and an appraisal of costs), or commissions (obtained from partner contractors).
Likewise, the company could look into partnering up with (or buying outright) a small or mid-sized supplier of health care equipment. Here the investment would be directed towards the acquisition of the specialised equipment in order to have a complete catalogue to show to potential customers. Initially, the organisation would have a small offering of specialized equipment available, so it should not be hard (or expensive) to broaden this offering via partnership with other suppliers. Here, the organisation would continue to act as a third party seller of health care equipment, but to a greater extent. Income could be generating from this possible course of action, either from direct product sales (in case OP came and purchased health equipment), consultation fees (by assessing OP’s needs and making appropriate recommendations), or commissions (received from suppliers and other sellers, based on referrals and sales).
A third alternative would be to consider partnering up with a medical centre or a small clinic in order to secure effective treatment for OP at their homes. Here, the organisation would be able to generate income from commissions (based on referrals), or from consultation fees too. Buying a small clinic could also be a possibility, but this would require a more in-depth assessment in order to determine the viability of such an investment). If the investment were found to be viable, then the organisation could generate income from the offering of medical services (or health care services). In case it were to establish partnerships with suppliers and construction contractors, it could potentially minimize costs and maximize profits by signing exclusivity deals and getting significant discounts on all orders.
At present there are roughly 210 home improvement agencies in the UK. These agencies are all potential partners or subsidiaries for the organisation. Each of these agencies should be considered in order to make an objective, informed, and economically sound decision. As well, there are hundreds of health care facilities and hundreds of health care equipment suppliers across the United Kingdom. A comprehensive assessment of these companies in order to determine which ones fit the organisation’s mission, strategy, and budget.
The only way in which the proposed organisation would successful is through the meaningful participation for all organisational stakeholders. In other words, it is important for all stakeholders to be privy to certain factors that might take from the organisation’s objectives and efficiency. This becomes even more so important when considering that the organisation’s success will rely heavily on its ability to establish partnerships and cooperation agreements with other organisations already operating in the target market.
All things considered, it is important that all stakeholders are aware of the fact that a non-profit organisation’s complex structure may easily lead to inertial inefficiency, which may very well lead to permanent (and hidden) failure, which naturally entails full-scale inefficiency. Based on this, it becomes important for the development and implementation of proactive management models. As well, it is important for stakeholders to be aware of the fact that despite summarily important, efficiency may not necessarily be a prerequisite for continued operation. On this point, it is important to note, “non-profits have too many constraints attached to their market behaviour to compete with for-profit organisations in the same market”. Furthermore, it is important to stress “they have disadvantages in their ability raise capital, to introduce incentive schemes, and face the additional penalty of loss of legitimacy and decline in volunteer input”.
Participation, Information, and Evaluation
When talking a non-profit organisation, much like when talking about any other type of organisation, there are two aspects that must always be considered: information and evaluation. Given the complexity of a non-profit organisation’s structure, it is important to guarantee that multilateral (and effective) channels of communication are enabled at all times. On this point, it might be advisable to institute a simplified organisational structure, one that assimilates more of a horizontal structure (as opposed to a vertical structure).
As well, it is worth noting that evaluation, which is equivalent to organisational accountability, may also serve the purpose of enabling effective communication (and proliferation) of information. This being said, there are distinct aspects of accountability that may not only serve to potentiate participation (which naturally includes the proliferation of information throughout all of the organisation’s levels), but also the organisation’s own evaluation capacity:
Publication/disclosure of relevant information (annual reports; audits; 990s; Internet postings; etc.).
Compliance with legal and regulatory requirements.
Board oversight and overall corporate governance.
Peer accountability (best practice evaluations; self-regulation; on-field interviews).
Corporate values and ethics manual.
Conflict resolution (especially as it applies to possible, or potential, conflicts of interest).
Responsiveness to constituencies (including donors and volunteers).
After having finished the module, I have looked into the design of a non-profit organisation that aims to service the (housing) needs of old people (OP) and those who are disabled (physically and mentally). Specifically, the idea behind the proposed organisation has been to provide housing solutions that are founded on Adaptive Building (AB). Looking back on the process that ultimately resulted in this assignment, I must recognize that the first (and perhaps most important) thing that I learned is that non-profit organisations are fundamentally different (in more ways than one) from regular for-profit organisations. Based on this, I knew that the organisation that I planned on designing and developing could not follow a traditional organisational structure. Traditional for-profit organisations are concerned primarily with generating profits by selling their products/services to their target markets. Non-profit organisations are not focusing exclusively on generating profit. In fact, most non-profit organisations are more concerned with servicing their respective target markets, leaving considerations such as efficiency and profitability on a second plane.
I recognized that my proposed organisation would not focus on minimizing costs and maximizing profits. However, I also realized that such considerations (primarily efficiency) are important for an organisation to become self-sustainable. Non-profit organisations require funding in order to deliver on their mission and vision (as well as their objectives). Based on this premise, I attempted to propose a model that did not exclusively rely on external funding. In my attempt to making the organisation completely self-sustainable, I proposed a hybrid model that also included a for-profit segment (in terms of housing consultation and the sale of housing and medical appliances/equipment). This, I thought, was not a novel idea, but definitely one that many non-profit organisations fail to dawn upon (or capitalize upon).
Throughout the module I have learned that in any organisation it is important to guarantee effective channels of communication. I have also learned that information is exceedingly important for an organisation’s success, and so communication becomes even more important (as it is communication that allows for information to spill over all organisational levels). Recognizing the need for effective communication and information, especially in a market so large and potentially diverse, a simpler, more horizontal structure was offered. Horizontal organisational structures facilitate processes, including communications processes (thus allowing information to flow more freely and fluently throughout the entire organisation).
A fourth aspect that I learned must always be considered is accountability (which is equivalent to performance evaluation). Efficiency may not be the top priority for a non-profit organisation, but it is necessary (at least at a given minimum level) in order for the organisation to deliver on its objective(s). On this point I would like to mention that before taking this module, I was not very well versed on what an organisation’s Board of Directors actually did. After finalizing the module, however, I have learned that the board is instrumental in an organisation’s operations and overall performance. The board is the utmost authority in all matters pertaining to the organisation, including monitoring, evaluation, and accountability. Likewise, and touching back upon the aspects of communications and information, I would like to point out that in my opinion the organisation’s publications are very important in order to promote efficiency (as well as to enhance the organisation’s image).
Finally, and focusing on the chosen market, I would like to share some brief ideas. As society continues to age and as disability continues to be a reality (ever more resounding in the future as a greater part of the population is grouped into the OP category), there is an opportunity for home builders and health care suppliers to increase profits if they offer society what it will need (OP-friendly housing and integral home-based health care). Technological innovation can and one day will allow for the development of a universal design that enables economical, appealing, safe, and comfortable housing (one that benefits OP, disabled individuals, and the general population equally). As the needs of OP and disabled individuals are currently being underserviced, a valuable opportunity appears for businesses that manage to service those needs (be it through adaptive home solutions, home-based health care solutions, health care equipment, etc.