Review| Volume 99, P92-97, May 2017

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Care homes: The developing ideology of a homelike place to live


      • The concept of ‘home’ is dynamic, complex and highly individual.
      • Scottish quality indicators state that residential/nursing care for older people should provide a homely environment.
      • There are tensions between creating a homely environment and the requirement to meet other standards of care, such as Health and Safety.


      This paper reports on part of a doctoral study which explored stakeholder perceptions of the importance of a homelike environment in a care home and which factors contributed to this. The changes in institutional care for older people have evolved from being a ‘warehouse’ type of environment for those too poor, too mad, too sick and too unloved, to a place where older people in need of care can spend their days in safety, in a ‘homely’ environment. Such an environment is one of the quality indicators of care home provision. Yet defining what ‘homeliness’ means is fraught with difficulties. This article presents a narrative literature review on the concept of ‘home’ and the common measures taken to address homeliness in a care home setting. The results show that although the word ‘homely’ is used with the presumption of a shared understanding, the concept is elusive and highly subjective. Given that long-term care now provides homes for an increasingly wide range of age groups and individuals with increasingly diverse backgrounds and personal histories, is a shared viewpoint on homeliness possible? Indeed, is it ever possible to make an institution homely?


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        • Peace S.
        • Kellaher L.
        • Willocks D.
        Re-Evaluating Residential Care.
        Open University Press, Buckingham1997
        • Rybczynski W.
        Home: A Short History of an Idea.
        Viking, Penguin, USA1986
        • Ausserhoffer D.
        • Deschodt M.
        • De geest S.
        • van Achterberg T.
        • Meyer G.
        • Verbeek H.
        • Sjetne I.S.
        • Malinowska-Lipień I.
        • Griffiths P.
        • Schlüter W.
        • Ellen M.
        • Engberg S.
        “There's no place like home”. A scoping review on the impact of homelike residential care models on resident-, family-, and staff-related outcomes.
        J. Am. Med. Directors Assoc. 2016; (Available:’There's%20no%20place%20like%20home’%20PUBLISHED.pdf)
        • Popham C.
        • Orrell M.
        What matters for people with dementia in care homes? Ageing and mental health.
        Ageing Ment. Health. 2012; 16: 181-188
        • Yeo M.
        • Heshmati A.
        Healthy residential environments for the elderly.
        J. Hous. Elder. 2014; 28: 1-20
        • Teka A.
        • Adamek M.E.
        “We prefer greeting rather than eating:” life in an elder care center in Ethiopia.
        J. Cross Cult. Gerontol. 2014; 29: 389-404
        • Bishop C.E.
        • Stone R.
        Implications for policy: the nursing home as least restrictive environment.
        Gerontologist. 2014; 54: S98-S103
        • Dai H.
        Care for whom: diverse institutional orientations of non-governmental elder homes in contemporary China.
        Br. J. Soc. Work. 2014; 44: 1914-1933
        • Guo J.
        • Mu L.
        Residential care for elders in China: the private sector as a solution?.
        Soc. Dev. Issues. 2015; 37: 11-24
        • Lundgren E.
        Homelike housing for elderly people? Materialized ideology.
        Hous. Theory Soc. 2000; 17: 109-120
        • Calkins M.
        Evidence-based long-term care design.
        NeuroRehabilitation. 2009; 25: 145-154
        • Grant-Savela S.
        Care Setting Configuration and Size.
        2010 (Available: (10.07.12))
        • Garcia-Mira R.
        • Uzzel D.L.
        • Real J.E.
        • Romay J.
        Chapter 1: Introduction.
        in: Garcia-Mira R. Uzzel D.L. Real J.E. Romay J. Housing, Space and Quality of Life. Ashgate, Aldershot2005
        • Sinha S.P.
        • Nayyer P.
        Crowding effects of density and personal space requirements among older people: the impact of self-control and social support.
        J. Soc. Psychol. 2000; 140: 721-728
        • Van Haitsma K.
        • Curyto C.
        • Calkins M.
        • Sapertsein A.
        The environmental design lexicon for dementia care, final report of grant IIRG-00-2058 funded by Alzheimer's Association, Polisher Research Institute, North Wales, PA. Cited in: Calkins, M. (2009) Evidence-based long-term care design.
        NeuroRehabilitation. 2004; 25: 145-154
        • Miles M.
        After the public realm: spaces of representation, transition and plurality.
        J. Art Des. Educ. 2000; 19 (Available: (08.04.11)): 253-261
        • Mowl G.
        • Pain R.
        • Talbot C.
        The ageing body and the homespace.
        Area. 2000; 32: 189-197
        • Varley A.
        A place like this? Stories of dementia, home, and the self.
        Environ. Plan. D: Soc. Space. 2008; 26 (Available: (30.11.10)): 47-67
        • De Witt L.
        • Ploeg J.
        • Black M.
        Living on the threshold: the spatial experience of living alone with dementia.
        Dementia. 2009; 8 (Available: (30.11.10)): 263-291
        • Danes S.
        Creating an environment for community.
        Alzheimer's Care Q. 2002; 3: 61-66
        • Joseph A.
        • Zimring C.
        Where active older adults walk: understanding the factors related to path choice for walking among active retirement community residents.
        Environ. Behav. 2007; 39: 75-105
        • Rowles G.D.
        Place in occupational science: a life course perspective on the role of environmental context in the quest for meaning.
        J. Occup. Sci. 2008; 15: 127-135
        • Edwards H.
        • Courtney M.
        • Spencer L.
        Consumer expectations of residential aged care: reflections on the literature.
        Int. J. Nurs. Pract. 2003; 9 (Available: (30.11.10)): 70-77
        • Cook G.
        Older people actively reconstruct their life in a care home.
        Int. J. Older People Nurs. 2008; 3: 270-273
        • Reed J.
        • Cook G.
        • Sullivan A.
        • Burridge C.
        Making a move: care-home residents’ experiences of relocation.
        Ageing Soc. 2003; 23 (Available: (30.11.10)): 225-241
        • Nolan M.
        • Walker G.
        • Nolan J.
        • Williams S.
        • Poland F.
        • Curran M.
        • Kent B.C.
        Entry to care: positive choice or fait accompli? Developing a more proactive nursing response to the needs of older people and their carers.
        J. Adv. Nurs. 1996; 24: 265-274
        • Leith K.
        Home is where the heart is…or is it?” A phenomenological exploration of the meaning of home for older women in congregate housing.
        J. Aging Stud. 2006; 20 (Available: (30.11.10)): 317-333
        • Parker C.
        • Barnes S.
        • Mckee K.
        • Morgan K.
        Quality of life and building design in residential and nursing homes for older people.
        Ageing Soc. 2004; 24: 941-962
        • Perrit M.R.
        • McCune E.D.
        • McCune S.L.
        Empirical findings suggest recommendations for carpet pattern and texture.
        Alzheimers Care Q. 2005; 6: 300-305
        • Dickinson J.I.
        • Shroyer J.L.
        • Elias J.W.
        • Hutton J.T.
        • Gentry G.M.
        The effect of selected residential carpet and pad on the balance of healthy older adults.
        Environ. Behav. 2001; 33 (Available: (31.10.10)): 279-295
        • Bradshaw S.A.
        • Playford E.D.
        • Riazi A.
        Living well in care homes: a systematic review of qualitative studies.
        Age Ageing. 2012; 41: 1-12
        • Hauge S.
        • Heggen K.
        The nursing home as a home: a field study of residents’ daily life in the common living rooms.
        J. Clin. Nurs. 2008; 17: 460-467
        • Robertson L.
        • Fitzgerald R.
        The conceptualisation of residential home environments: implications for occupational therapy.
        Br. J. Occup. Therapy. 2010; 73: 170-177
        • Fitzgerald R.
        • Robertson L.
        Inhabiting the places and non-places of a home: a case study from New Zealand.
        Sites: J. Soc. Anthropol. Cult. Stud. 2006; 3: 48-71
        • Cutler L.J.
        • Kane R.A.
        As great as all outdoors: a study of outdoor spaces as a neglected resource for nursing home residents.
        J. Hous. Elder. 2005; 19: 29-48
        • Bengtsson A.
        • Carlsson G.
        Outdoor environments at three nursing homes: focus group interviews with staff.
        J. Hous. Elder. 2005; 19 (Available: (08.04.11)): 49-69
        • Cross L.T.
        Predicting individuals’ preferences in outdoor environments: development of a method.
        Architecture. 2003; 46 (Available: papers pdf/full paper_048.pdf (07.06.12)): 1-9
        • Stigsdotter U.A.
        • Grahn P.
        What makes a garden a healing garden?.
        J. Ther. Horticult. 2002; 13: 60-69
        • Lipsedge K.
        A place of refuge, seduction or danger? The representation of the Ivy Summer-House in Samuel Richardson's Clarissa”.
        J. Des. History. 2006; 19 (Available: (08.04.11)): 185-196
        • Januarius J.
        Feeling at home: interiors, domesticity and the everyday life of Belgian Limburg miners in the 1950's.
        Home Cult. 2009; 6: 43-70
        • Araujo A.
        Repetition, pattern, and the domestic: notes on the relationship between pattern and home-making.
        Textile: J. Cloth Cult. 2010; 8: 180-201
        • Olesen B.B.
        Ethnic objects in domestic interiors: space, atmosphere and the making of home.
        Home Cult. 2010; 7 (Available: (08.04.11)): 25-41
        • Lees-Maffei G.
        Introduction: professionalization as a focus in interior design history.
        J. Des. History. 2008; 21 (Available: (08.04.11)): 1-18
        • Murphy K.
        • Shea O.
        • Cooney E.A.
        Quality of life for older people living in long-stay settings in Ireland.
        J. Clin. Nurs. 2007; 16 (Available: (08.04.11)): 2167-2177
        • Rice C.
        Bear cottage.
        Archit. Aust. 2002; 91 (Available: (08.04.11)): 66-70
        • British Standards Institute
        BS8300: Design of Buildings and their Approaches to Meet the Need of Disabled People – Code of Practice.
        British Standards Institute, London2009
        • Sparke P.
        Studying the modern home.
        J. Archit. 2004; 9 (Available:||D404A21C5BB053405B1A640AFFD44AE3 (08.04.11)): 413-417
        • Cipriani J.
        • Kreider M.
        • Sapulak K.
        • Jacobson M.
        • Skrypski M.
        • Sprau K.
        Understanding object attachment and meaning for nursing home residents: an exploratory study, including implications for occupational therapy.
        Phys. Occup. Therapy Geriatr. 2009; 27 (Available: (08.04.11)): 405-422
        • Olin E.
        • Jansson B.R.
        Common areas in group homes: arenas for different interests?.
        Eur. J. Soc. Work. 2008; 11 (Available:||D404A21C5BB053405B1A640AFFD44AE3 (08.04.11)): 251-265
        • Nagy J.W.
        Kitchens that help residents re-establish home.
        Alzheimers Care Q. 2002; 3 (Available: (08.04.11)): 74-77
        • Morgan-Brown M.
        • Newton R.
        • Ormerod M.
        Engaging life in two Irish nursing home units for people with dementia: quantitative comparisons before and after implementing household environments.
        Aging Ment. Health. 2013; 17 (Available: (30.06.14)): 57-65
        • McDaniel J.H.
        • Hunt A.
        • Hackes B.
        • Pope J.F.
        Impact of dining room environment on nutritional intake of Alzheimer's residents: a case study.
        Am. J. Alzheimers Dis. Other Demen. 2001; 16 (Available: (08.04.11)): 297-302
        • Rybczynski W.
        The Most Beautiful House in the World.
        Viking Penguin, New York1989
        • Bachelard G.
        The Poetics of Space.
        Beacon Press, Boston1994
        • Peace S.
        • Holland C.
        Homely residential care: a contradiction in terms?.
        J. Soc. Policy. 2001; 30: 393-410
        • Webster H.
        Bourdieu for Architects.
        Routledge, Oxon2010
        • Heathcote E.
        The Meaning of Home.
        Frances Lincoln Ltd., London2012
        • Australian Government
        Aged Care Act.
        Australian Government, Canberra1997 (Available: (15.05.12))
        • Burton E.
        • Sheehan B.
        Care-home environments and well-being: identifying the design features that most affect older residents.
        J. Archit. Plan. Res. 2010; 27: 237-256
        • Dybvik T.K.
        • Gjengedal E.
        • Lykkeslet E.
        At the mercy of others for better or worse.
        Scand. J. Caring Sci. 2014; 28: 537-543