Seniors and other long term support needs

Common themes

The concept of a PIE was first fully formulated primarily in the context of homelessness services in the UK and the earlier accounts of a PIE tended to use the language, and the examples, from that field. For many, it is still largely identified with that area.

But it has long been acknowledged that the roots of the PIE concept are both deeper and wider, for example with the expansion of supported accommodation for all vulnerable adults that came, in the UK, with the Supporting People programme.

Included in this were supported (or 'sheltered') accommodation for senior citizens and others; and accommodation with support for those with physical disabilities, learning difficulties, and long term mental health problems.


Widening the frame

The expanded PIEs 2.0 framework was our attempt to encompass this wider scope within the same overall model (HERE); and in recent years, we have seen a growing range of accommodation-based services coming to the PIElink for fresh ideas on creating more holistic supports.

There are many other sites* where those involved with these communities may find a far wider range of support models and examples to help them, including many that will stress the role of housing in creating a sense of community.

Here therefore we are interested in how far the wider PIEs framework has some value in long term support needs, whether in specialist or in general needs housing.


Is this as useful here?

As part of the 2022 lunchtime forums programme, we had several discussions on PIEs in general needs housing; and with the Housing First programme still developing, we would be keen to hear from these and any more specialist services now exploring this framework, particularly in the context of long term needs.

For the moment, we begin here with one specific example only of a service that would probably not have thought of itself as a PIE. In the Ann Arbor hospice, we find a building, a staff team and an approach in which everything was done, with care, to ease the minds and the conflicts not just of the residents, but also, crucially, their families.

Rather than seeing ethical issues and dilemmas as an inconvenience, interfering with their proper task of clinical care, they saw them as the psychological essence of what they were dealing with. The Ann Arbor hospice staff then heard of, and chose to enter, a local open competition for schools, a 'Super Bowl', run by the Philosophy Department of the local university (of Michigan) on the quality of discussions on ethics. They won.


  • Just in the UK, for example, we would recommend the Housing LIN (the 'Learning and Improvement Network') ; hact - the Housing Associations Charitable Trust; and Erosh - the Emerging Role of Sheltered Accommodation.




Further background reading, listening and viewing

Other useful material and links

The Housing LIN :  HERE

Hact - the Housing Associations Charitable Trust : HERE

EROSH  - the Emerging Role of Sheltered Accommodation : HERE

On conversations in end of life care NIHR research)  : HERE


PIElink pages

Is the PIE evolving? : HERE

A single framework : HERE

PIEs in general needs housing : HERE


Library items

Public health and social housing - a natural alliance? : HERE

Making small practical changes for dementia friendly environments : (HERE)

Hospice care as applied ethics - values-based practice in Ann Arbor : HERE

A very brief history of PIEs : HERE