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Report of the Second International Expert Seminar
on Building Non-Handicapping Environments:
Renewal of Inner Cities

Prague, October 15-17, 1987

Download the Prague proceedings as a PDF file (420 KB)


Better Housing! Now!

Orvar Sthen, Linköping Regional Hospital, Sweden


When we discuss the renewal of inner cities we must bear in mind that we are discussing a very time-consuming process. The building of "non-handicapping environments" may well be a topic which concerns mainly the next generation. But it is possible even in the present to combine long-range and short-range ideas so as to give the present generation non-handicapping environments. I believe that it is very important for our seminar to find such solutions and this statement is a proposal for a short-range idea which can affect many old and disabled persons. It is feasible now and can be done at low cost.

The combination of long-range and short-range ideas is not only a way of giving the present generation some non-handicapping environments. If we start today by carrying out practical, low cost ideas which can be accomplished in a short period of time, we build at the same time a platform for discussions in our communities about further development of non-handicapping environments, which cost more, and take a longer time to realize. People always understand a need in the community better if they can watch practical results being achieved. The platform for discussion for further developments is built in people’s minds in this way. So if you really want a scheme for building non-handicapping environments I am convinced that you must include short-range ideas in this scheme - also for the psychological reasons I have mentioned here.

My statement "Better Housing! Now!" is based on many years of practical experience.

In Linköping, Sweden, we started modern, advanced home care in 1962. It meant that patients who normally would have been treated in institutions for long-term care, were instead sent back to their homes. We had patients who had lived in institutions for 20 years who were sent back to their homes and were able to cope if they received modern, advanced care. So we have had 25 years experience of such work and in our city we now have 150 patients, living in their homes instead of an institution.

What did this modern, advanced care give the patients?

They were entitled to home-visits by all the professionals they needed, including doctors, nurses, therapists of various kinds etc.

Their flats were renovated to suit their needs.

The patients were promised that they could return to the institution immediately if they wished. This was important for the patients’ confidence, but has not been used very often.
When we renovated the flats we put in the technical aids each patient required. We found that we could arrange the flat to suit the patient in almost all cases.

But we found that there was one deficiency which we could seldom alter. If the patient could not manage stairs we could only consider installation of a lift in the building. Installation of a lift is normally an expensive and time-consuming process. Many patients could not live in their flats on account of stairs and had to move to an institution. This meant that they had to give up most of their social network in the neighborhood.

In some such cases we received help from the municipal authorities in the following way. If a neighbor in the building wanted to exchange his ground-floor flat for the patient’s flat, this could be done. It was easy, cost the community nothing and allowed the patient to stay where he\she had a social network.

Why not systematize this idea? It could be done in several different ways. Here are two examples:

If the town has a housing office, the authorities could make it known that old and disabled people who cannot manage stairs to their flat are to be given priority for vacant ground-floor flats in their neighborhood, if the housing office gets their present flat in exchange. Landlords say that old people already try to get ground-floor flats. Most other tenants want to get flats on upper floors and an official announcement as mentioned above should not raise any objections from the general population.

Another method can be used in towns where no housing office exists. The authorities can make it known that they will organize the exchange of flats for old and disabled people who want ground-floor flats. People who have ground-floor flats should be invited directly to participate in this exchange. Probably many people living on the ground-floor would be interested. Upper floors are generally considered to be more attractive. Widows and widowers among senior citizens might be interested in getting smaller flats than the one in which they have lived with their spouse.
In my opinion it is obvious that the methods proposed here are easy to realize. They require only some administrative costs. They can be accomplished today. In Sweden between a quarter and a third of the adult population are either disabled or over the age of 65. This is firm evidence for the proposal’s importance. It is a matter of increased confidence for a large section of the population.

Few can have any objections to such a scheme and a greater part of the population would also, as a result, become more aware of the needs of old and disabled persons.

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