Pathways into long-term care accommodation in Britain: common aspects, differences and policy implications

Population ageing is a global challenge, and understanding the dynamics of living arrangements in later life and their implications for the design of appropriate housing and long-term care is a critical policy issue. This paper investigates the dynamics of living arrangements amongst people aged 65 years old and over between 1991 and 2008, focussing on two types of accommodation: sheltered accommodation and residential care. The empirical research examines the rates and determinants of moving into sheltered accommodation and institutional care, using all 18 waves of the British Household Survey data and a discrete-time logistic regression model in order to model the probability of entering each type of accommodation. The paper shows that the factors associated with each of the two transitions in later life are different; for example age, health and marital status are significant determinants of an older person’s move into residential care, while the move into sheltered accommodation is in addition associated with an older person’s housing tenure and highest educational qualification. Such results indicate that the two kinds of transition may be more prevalent in different stages of the latter part of the life course, and have crucial implications for the design of future social care provision.