Report of the Third International Expert Seminar
on Building Non-Handicapping Environments:
Accessibility Issues in Developing Countries

Tokyo, September 10, 1988

Housing Programs for Old Persons in Rural Communities of Japan

Hiroko Ogawa, Shizuoka University, Oya, Japan

Housing Conditions of Old Persons in Rural Communities

In rural communities of Japan, almost all old persons live in extensive but old houses of their own. Many of them have been living there from the time they were born or married and have been deeply attached to the community, so they hope to live there until they die. Figure 1 shows an example of a house where an old couple lives in a rural community; the mountain district in Hiroshima Prefecture. There is a heavy snowfall and a lack of good communication faciliies. The couple can not drive a car and it takes two hours on foot from their house to the nearest bus stop. They own a wooden house which is very depreciated having been built in 1942. The total space of this main house is about 100 m2. The approach of this house is not very accessible as the high threshold is rather hard to cross. There is a kitchen in the unfloored part of the main house. Between the heights of the floored and the unfloored parts there is about 50 centimeters difference and the toilet and the bathroom are apart from the main house.

Housing Programs for the Elderly in Rural Communities

From 1970, housing programs for old persons began in some prefectures which have some regions with heavy snowfall and lack of good communication facilities (Figure 2). These programs are modifications of public housing or old-people’s homes and they are mainly managed by the section of welfare in the municipality. The representative programs are "Independent Housing for the Single Elderly Person", "Inexpensive Dormitories for Old Persons" in Hokkaido Prefecture and "Small-Scale Old People’s Homes" in Hiroshima Prefecture.

"Independent Housing for The Single Senior Citizen" in Hokkaido Prefecture

As single persons had not been able to live in the public housing until the amendment of Public Housing Act in 1980, in Hokkaido Prefecture, the "Independent Housing for The Single Senior Citizen" program was begun in 1970. (Figure 1,2,3, Table 1,2) Half the number of the units under the program were located near other facilities for old persons (Table 1). The facility is usually a one-storied apartment house with 6-12 units. The total floor space of a private unit is about 22.9 m2 on the average.

Table 1 Facilities adjacent to housing for old persons

	Independent housing (16)	dormitory (22)	old people’s home (8)
community center for old persons	5	4	0
nursing home	3	0	1

Table 2 Service staff (multiple answers)

	none	caretaker	housemother social worker	not clear	neighbor	a resident visiting live-in
independent housing (16)	2	5	2	7	2	0
dormitory (24)	0	0	0	1	22	2
old people’s home (8)	0	1	1	8	0	0

There is also a private kitchen, toilet and doorway in the majority of these programs (Figure 3,4). In addition, as shown in Figure 4, there are provisions for some security and convenience in old persons’s daily life with this program. But in respect to supporting services for the old residents’ independent living, this program is the lowest level of the three (Table 2).

"Inexpensive Dormitory for Old Persons" in Hokkaido Prefecture

This program is intended for senior citizens who do not want to enter the old people’s home established in the other municipality and are on the independent level but not able to cook their own meals. Even now in Japan, an old people’s home whose capacity is below 50, can not be established under the Old People’s Welfare Act. Thus, in some municipalities with a smaller population, this program has been suitably applied. This program began in 1973. The dormitory is usually a one-storied apartment house with six units. The total floor space of a private unit is about 14.0 m2 on the average with the use of a common toilet and kitchen (Figure 3). An example of how this program is to be used by elderly is shown in Figure 5. In the "Inexpensive Dormitory for Old Persons" programs, live-in helpers are arranged who provide meals and emergency measures for the residents (Table 2 and Figure 4,5,6)

"Small Scale Old People’s Home" in Hiroshima Prefecture

This program is intended for single senior citizens who live in regions with heavy snowfall or lack of good communication facilities, to share the housing located conveniently at least in winter. This program began in 1978 and has been extended to Shimane prefecure. It offers a one-storied apartment house with 6 units. The total floor space of a private unit is about 21.7 m2. on the average, with private kitchen and toilet (Figure 3,6). In this program, there is no meal service, but the residents can receive social workers’ visiting services (Table 2).

Conclusion

Housing programs for old persons in rural communities of Japan have been inaugurated by some municipalities since 1970. The architectural or planning features of these representative programs are as follows. In a private unit, the floor space is very small and in some cases without private kitchen and toilet. Accessibility is still an unsolved problem. On the other hand, live-in housemothers, social worker’s visiting service, meal service and other services in the housing programs assist the residents’ independent living.

Akio Hagita, Department of Architecture and Building Sciences, Yokohama National University and Yasumasa Tochigi, Architect

Introduction Housing protects humans from the elements and allows for such activities as sleeping, resting, bathing, excretion, eating, dressing which are indispensable for living and provides a place for daily life. Housing ensures one’s privacy and serves as a foundation to form personality and character. It serves as a place to raise a family and is a basis of society, for it facilitates human relations. Thus, housing protects life and functions as an important basis for living, family, society and culture.

What are the housing conditions of persons with disabilities? In 1959, the Law for the Welfare of Physically Disabled Persons was enacted which favored social welfare institutions rather than community housing. In 1961, the system of Family Rehabilitation Loans was adopted. In 1967, by the amendment of the Public Housing Act, special housing for physically disabled persons was legislated and the foundation of so-called "wheelchair housing" was laid. But this type of housing accepts only disabled persons who have acquired ADL (activities of daily living) independence or have a family which provides these services for them. We had to wait until 1980 for the single disabled person to enter public housing, when the Public Housing Act was amended. However, there has been no change in the eligibility of tenants who still must be capable of ADL. The policy of the administrative agencies applies even today stating "a single disabled person who needs care all the time" can not be a candidate of public housing and has to live in a social welfare institution. Therefore persons with disabilities, especially with extensive disabilities, are forced to enter an instituion or live under family protection. To cope with this severe reality a new type of housing which disabled persons themselves created and enforced has been realized, that is "Housing with Atendant Care for Disabled Persons". This type of housing "enables disabled persons to live in the community as ordinary citizens and to overcome many handicaps that they encounter ".

The History of "Housing with Attendant Care for Disabled Persons" There is a long history of struggle for "Housing with Attendant Care for Disabled Persons". Meeting the demand of disabled persons’ organizations centered on Tokyo Aoi-shiba. The Tokyo Meropolitan Government held the first study meeting on "Housing with Attendant Care" on July 19th, 1976 and issued the "Plan of Establishing Housing with Attendant Care". In July of 1981, the Tokyo Government founded Tokyo Metropolitan Hachiohji Independent Living Home of Tokyo Colony, Social Welfare Juridical Person. This home is the very first "Housing with Atendant Care" project established by the public and run by a private organization.

In Yokohama City, the "Association for Supporting Disabled People at Home of Yokohama City" established an "Examination Committee on Group Homes" in September 1983 and issued their report in April 1984. Prior to the formulation of a system by Yokohama City, the group home "Fureai Seikatsu no Le" was founded in November 1984. The report "Disabled Persons’ Group Home Provisions of Yokohama City" was presented in August 1985 and "Fureai Seikatsu no Ie" was adopted as an experimental project in October the same year. In Kanagawa Prefecture the Examination Committee on "Fundamental Problems in Housing with Attendant Care" was started and under the interim report of the Committee "Housing with Attendant Care" projects were started in Hiratsuka City, Fujisawa City and Sagamihara City as experimental projects in 1986.

In Hokkaido Prefecture the disability group, Sapporo Ichigo Kai, had tried experimental housing for independent living in 1978 and requested the administration to build "Housing with Attendant Care" based on the belief that persons with disabilities can live independently in the community. In 1985, the government of Hokkaido issued the report "Concerning the Promotion of Disabled Persons’ Living Independence" and as a consequence of the report, "Hokkaido Municipal Housing for Severely Physically Disabled Persons" was founded. It is the first "Housing with Attendant Care" special purpose housing project in the Second Class Public Housing Program and is considered a model project.

In addition to the above projects, there are various practices for "Housing with Attendant Care", for example, building living quarers next to a sheltered workshop (Hinraku-ryo Nagasaki Prefecture 1987), building public housing within the site of social welfare institution (Iwamisawa City, Hokkaido, Public Housing for Households with Severely Physically Disabled Persons 1977), a training center where disabled people acquire independent living skills (Life Training Center, Yamaguchi Prefecture 1975), transiional apartments and a guesthouse with attendant care. In addition, there are many projects where housing is built or modified adapted to disabled persons. There are also projects under way to establish care systems for disabled and old persons in the community.

Case Studies of "Housing with Attendant Care for Disabled Persons"

The following are actual examples of "Housing with Attendant Care for Disabled Persons". Significance and Limitations of "Housing with Attendant Care" Having overcome various difficulties through trial and error, "Housing with Attendant Care for Disabled Persons" has been coninued as follows:

• The purpose of the scheme is to enable disabled persons to lead an ordinary life in the community apart from their parents. Through that experience, persons with disabilities acquire independent living skills.
• The concept of disabled persons living through their own will and choice can be applied to existing social welfare institutions offering a possibility to change institutions as a place for living.
• The establishment of services such as health care, community-based personal assistance, transportation and income supplements to enable disabled person to live independently will poentially change the present community into a more democratic one by integrating persons with disabilities.

Existing "Housing with Attendant Care" projects encounter various obstacles.

• Because of their weak financial basis some "Housing with Attendant Care" projects have not secured enough living space which makes privacy difficult.
• The weak financial basis also precludes personal assistance in sufficient quantity. In this way, occupants have to rely on volunteers. Their daily life is always threatened and they have to lower their quality of life.
• Housing design is not well adapted to the needs of persons with disability causing daily inconveniences.
• Since there are no training courses in the existing rehabilitaion system to teach independent living skills to people already living in the community, "Housing with Attendant Care" has to take over that role. Originally, "Housing with Attendant Care" was a place for living but now it also has to be a place for training. Since projects are notoriously understaffed, training tends to be insufficient.

• to insure that the independent living housing projects that are being built are designed with good consideration of the needs of disabled persons.
• to establish community-based personal assistance schemes which take into account the various needs of disabled persons.
• to establish training courses for the acquisition of independent living skills in order to facilitate living in the community.
• to provide income security which is the foundation to leading a life as an ordinary citizen.
• to establish various independent living support systems such as health care, transportation and independent living counselling.

"Housing with Attendant Care" is the first important step to establish these comprehensive systems.

Kei Adachi and Hyoichiro Araki, Department of Architecture, Kansai University, Osaka, Japan

I would like to present a few pilot projects in Japan’s public housing complexes. Japan is facing a rapidly aging population structure. During the last decade many social and housing policies for old and disabled persons have been implemented by the central and local governments to cope with this increasing population group. However, some programs in public housing development have not always been successful due to lack of coordination in integrating both special housing and supportive services at a community level. Therefore, a new housing policy is expected that puts more emphasis on the community care concept introduced by Scandinavian and British housing policies.

Segregation is slowly becoming integration and conventional instiutional care is being turned into community based services. Figure 1 illustrates the transition. This concept encourages old and disabled people to live independently in the community as long as possible. The recognition of the importance of supporting housing with a service network has brought us new trends in the provision of living environments for old and disabled persons at the neighborhood level. In the following, leading examples to coordinate public housing and supportive service by the cities of Itami and Kobe will be introduced and discussed.

The Itami City Public Housing and Welfare Area Figure 2 shows the site plan of this project. The site of the Itami City project is about two hectares and located in the existing residential community close to the public nursery and elementary school. It is also adjacent to various community facilities and public housing. There are new projects for public housing consisting of three-storey buildings where the first and second floors are designated for senior citizens and the third floor is for multi-family units. Also, across the river is a half-way nursing home, a senior citizen center and a medical clinic. Some of these projects under construction will be built this year and next year. Since this is a local government low-rise project, the budget is too small to allow for elevators. Buildings will be connected with pedestrian walkways and ramps.

On the west side of the creek there are, again, units for old persons on the first and second floors and family units on the third floor. The 16 specialized units for old persons on the first and second floor are integrated with the 8 multi-family units on the third floor with ramps within the building. (Figure 3) In the units there are recessed bathtubs for easy access, hand rails, sliding doors, an emergency alarm system and floors without the traditional Japanese split level. Supportive services for senior citizens such as home help, home nursing and 24 hour emergency calls are available.

Persons needing extensive assistance can live in the two-storey half-way nursing home which is under construction. It is located near a hospital, a nursing home and residential housing. The facility is intended for persons who require intermediate nursing care on a short term basis and are expected to return to their homes with supportive rehabilitation services and in-home support services. (Figure 4) The nursing home will also include a day care center. From here home helpers will be sent to persons requiring these services for living independently in their homes. On the first floor of the nursing home there is a rehabilitation area with special bathing equipment. On the second floor there are about 14 rooms. Each room has four beds providing space for altogether about 50 people who can live in the half-way nursing home.

There will also be a three-storey senior citizens’ building of post-modern design, with construction due to begin this year. It is inended as a base for old persons and will contain various leisure and cultural activities. Nearby a placement center is planned for employment opportunities. On the first floor of the senior citizen center there will be a restaurant and lounge with various types of social activities. Many of the first floor rooms are designed for social interaction in the community and for cross-generation contact.

Kobe City Public Housing The next project I would like to describe is a public housing complex in Kobe City. Kobe has developed a model program in public housing projects which offers community-based services to cope with the aging society. The Uozaki Housing Project is located in an urban industrial area. The population of old persons here is higher than in any other part of the city. The project is considered as a leading example for an urban renewal project which has not severed social relationships in the neighborhood but has, in fact, strengthened them. Figure 5 shows the Uozaki Housing site plan.

In the complex there will be a meeting center that is intended to promote community care in a school district. (Figure 6) The facility will serve not only residents but also visitors from the neighborhood. It has a reasonable capacity as a community welfare center for volunteer support services such as meal delivery and home health. There will be 16 specialized units out of a total of 56 housing units. They are for old and disabled persons. In the units the living room can be extended to a tatami-mat room which may be used for social activities such as communal dining. Throughout the complex barrier-free design has been employed.

Conclusion Although these projects have just started in Japan, they are expected to promote public awareness and community welfare. These residential units together with the community-based facilities and supportive services can make independent or semi-dependent living in the community possible.

References Kei Adachi and Hyoichiro Araki, Public Housing Basic Proposal (Nakano jutaku kihon keikaku), Itami City, Construction Department, January 1988.

___________________________, Happy Town Planning (Shiawase no machizuhuri) , Kobe City, Welfare Department, 1985.

Questions and Answers

Q.: So far this afternoon we have seen examples of projects for housing exclusively for the old and disabled population. My quesion is, what are the obstacles in Japan to building truly integrated housing that is accessible to all regardless of whether they are disabled or not? What are the institutional, financial or other obstacles to truly integrated housing?

A.: In public housing, the budget is too limited to build specialized and accessible units. It is quite difficult to make all housing units totally accessible to old and disabled persons. So basically, the projects we are showing are designed for old and disabled persons only on the first and perhaps second floor.

Q.: In Sweden, we have had building laws that stipulate accessibility in all regular multi-family housing since 1977. For example, my wife and I live in a regular apartment in a regular building without any special facilities except for electric door openers that have been added afterwards. Studies have shown that the additional expense as a result of the law in 1977 that stipulated the inclusion of elevators, etc. in the entire production of new multi-family housing was less than 1 per cent over what ordinary housing without these accessibility features would have cost.

Satochi Kose and Michiko Nakaohji, Building Research Institute, Tsukuba, Japan

Introduction

As a key government organization, the Ministry of Construction has tried to implement various policy measures in promoting the supply of dwelling units that are suited to the needs of old persons. The measures include construction of public housing through local governments and the HUDC (Housing and Urban Development Corporation). Some of the measures date back as early as 1964, when general design guidelines for purpose-built units for old persons were issued. Several other guidelines followed.

New Policy Trends for Housing Old Persons

In 1985, the Advisory Council on Housing and Land Policy compiled its report "Basic Policy on Housing and Housing Lots in the Changing Society" within which measures to cope with housing problems in the aging society were included. The report emphasized that the needs of old persons in maintaining their life style should be met by the following:

• larger dwelling units to enable living with children’s family,
• provision of paired units and neighborhood units,
• provision of specially designed housing through the public and private sector for old persons who do not live with their children,
• maximization of senior citizens’ opportunities for social and cultural activities through proper design of housing areas and the provision of necessary facilities within easy reach,
• development and application of design guidelines for senior citizens’ dwellings that compensate the decreasing abilities of old persons,
• promotion of housing for persons with disabilities.

Another policy measure are the so-called "Silver Housing Projects" which are planned in cooperation with the welfare department of local governments. This program was originally intended as a joint policy implementation with the Ministry of Health and Welfare. The program aims at supporting independent old persons, physically by design and socially by a care-taker, a so-called "life support adviser".

The two programs are new trends toward a more comprehensive policy on housing senior citizens, because previous measures were restricted to supplying housing units.

The third measure is the implementation of the "Five-Year Development Project of Housing for The Aging Society" by the Building Research Institute which started in April 1987. The project aims at the establishment of design guidelines for dwellings, urban environment, housing schemes, etc. It is also designed to propose possible policy measures related to solutions of the problem. One possible goal is reported elsewhere.

Measures for Housing Old Persons: Historical Development and Present Status

Currently implemented policy measures for housing senior citizens are summarized in Table 1. The following is a brief explanation of these main measures .

Table 1 Current Policy Measures for Housing Old Persons.

	Independent	Living with family	Living next door
Public housing	Special purpose-built units Special units for independent dwellers	Specially designed dwelling units Larger dwelling units	Paired units
HUDC housing	Priority allotment Movement to more suitable units	Priority allotment Larger dwelling units	(Paired units)
HLC financial	Preferential interest rates Larger loans	Preferential interest rates	Preferential interest rates

Public Housing by Local Governments

In 1964, the Ministry of Construction issued a memorandum "Public Housing Units for Old Persons" which emphasized the following points:

• site selection in order to assist the life style of old persons,
• geographical and social integration of housing for senior citizens with other households,
• bungalows or ground floor apartments as dwellings,
• design details adapted to the needs of old persons,
• inclusion of senior citizens in the use of all facilities.

A typical plan of dwelling units for old persons living with their children’s family is given in Figure 1. They differ from ordinary units in that the room for the old parent(s) has a smaller kitchen sink and a separate entrance, since the unit is situated on the ground floor. However, there is only one bathroom and toilet.

An example of paired units is provided in Figure 2. The smaller unit is for senior citizens. A standard unit for an ordinary family is located next door. Presently the two units are not necessarily situated side by side. They are sometimes located on different floors.

An example of a recent development in line with the "Silver Housing Project" is now being constructed in Kobe City. Containing a special nursing home and a day care center in the lower floors, the building has 31 dwelling units for independent old persons and a housing unit for the so-called "life support adviser". The floor area of the unit for a single old person is 35 m2 with two rooms and a kitchen, the unit for a couple is 48 m2 with two rooms and a dining-kitchen. The "life support adviser" will check periodically the safety and health of the senior citizens, help in case of need, act as a consultant of daily living and assist them to live a better life. The facilities and services provided by the day care center such as meal preparation, bathing, rehabilitation and by the special nursing home (for short stays) are easily accessible.

An additional example is provided by another public housing scheme in Kobe City. The aim of this scheme is to establish a "happy town to live in" and various design features for the benefit of old persons have been incorporated in the dwelling units as shown in Figure 3. These include low, apron-height bathtub; grab bars for toilet and bath; no split level between tatami-matted room, dining kitchen and corridor; and emergency-call bell. Height differences are eliminated and ramps are used around buildings . The assembly rooms in the housing complex are specially designed.

A third example is called "Silver-Pia Project" provided by the Tokyo Metropolitan Government. This scheme is very similar to "Silver Housing" projects. Figs. 4 and 5 show the plan of the dwelling units, the former for a single senior citizen, the latter for a couple. Various design considerations are also included in the units. Some of the specific features are indicated in the plan.

HUDC (Housing and Urban Development Corporation) Housing In 1972, the HUDC (at that time the Japan Housing Corporation) started to provide "paired units" and a priority allotment of these units to families with old or disabled persons. The "paired units", however, were unpopular because of higher rental costs, stricter contract terms and potential difficulties when moving out after the death of the old family member(s). The scheme was therefore abandoned in 1974.

Since 1985, HUDC has tried to place old persons and their children’s families in the same apartment complex as a way of supporting life in the neighborhood. Specially designed dwelling units for seniors and persons with disabilities are also being constructed as well as larger units that allow the old and their children’s family to live together in the same units. The following design considerations are to facilitate better living conditions for old persons:

• hand rails for stairs in the hallways leading to the apartment,
• ramps3, shallower stairs and curb cuts,
• elimination of stairs on route from street to apartment

• Senior citizens and the children’s family live in the same unit.
• They live next door.
• They live in the neighborhood.

Figure 7 shows paired dwelling units. They are connected by a fire resistant steel door in the wall. The way the door is used defines the relationship between the two families: they can live completely separate or can live together. Design considerations are the same as in the previous example. In addition, water, gas and electricity meters are independently installed.

A recent development is the installation of home security systems in dwelling units for senior citizens which are connected to the children’s unit. As for living in the neighborhood, the units for senior citizens are 48 m2 in width, accessible by elevator, with provisions for larger bathtubs, grab bars in bath and toilet, heating and hot water supply and no split-floor levels.

Renovation measures for existing rental units (on the ground floor in particular) include: improvement of kitchen; improvement of bath (lessening height differences, provision of grab bars); improvement of toilet (heated seat, grab bars); and installing internal communication phones.

Concluding Remarks: Future Needs The design of ordinary dwelling units poses a problem, because old persons can not be excluded as possible tenants of such units. As tenants get older, new needs arise. In the future it is unlikely that the Japanese economy will be as prosperous as it is now. This means that we have to start to prepare for the future immediately. One possible solution would be an adjustable dwelling unit which can easily be renovated according to the changing needs as the dwellers grow older and develop different and /or additional requirements on detailed design in and around dwellings . This subject is also being investigated in our "Five-Year Project on Housing for The Aging Society". The result will be design guidelines which will be applicable as minimum design standards to private sector as well as public sector housing. The guidelines are anticipated to be used in the loan conditions of the Japan Housing Loan Corporation. Its loan schemes have been quite effective in upgrading the quality of Japanese dwellings and will continue to be so as our aging population increases.