Age-friendly environments: global trends and where is Central and Eastern Europe? EAST Workshop Budapest, 10 -11 June 2016 Zsuzsa Széman Maria Tróbert Semmelweis University
Demographic and urbanisation trends by 2050 q. WORLD 50+ 65+ Population of world in cities WHO, 2005, Global Age-friendly Cities -32 cities , Guide (2007) 34% 22% 70%
Elder-friendly approach qenvironment, qsocial /welfare, societal follow up/ action, implemantation researches, secondary analysis proper urban planning e. g adequate urban environment financial sources experts/knowledge
East Canada, Quebec region 177 settlements Ottawa Pedestrian Signal Technology Snow Go Program Snow Go Assistant Program Low income/handicapped Snow Angel market principle social civil /neighbours
Quebec region, Ottawa q. Community Connect Training q. Gatekeeper model Isolated older people Mapping needs Listen to older people Fulfil needs Social department of local government Volunteers
Canada: West, British Columbia q 2007 -2010: 30 cities Vancouver: „Elder-friendly Action Plan 2013 -2015” (60+) Ø improve health state and well-being Ø decrease/eliminate social inequalities by action program Ø services for active and healthy Ø built environment Ø safety and emergency Ø education/training Ø Awareness Elaborated by: seniors, carers, family carers of demented people, NGOs, local decision makers
Canada: Mid - Manibota region q. Research: since late 90 s v Centre on Aging, University of Manitoba new concept research on age-friendliness projects mapping elder-friendly plans 2013 more than 100 age-friendly settlements 1/3 below 1000 - rural region
Manibota: age-friendly rural settlements Meaning and practice 1. Built environment and transport 2. Social participation 3. Information
1. Built environment and transport Ø Alteration Environment: e. g. set up public WC, obstacle-free public environment/public building, increase green areas, better lighting Involving market actors e. g. convince shop owners to let the public use the WC Transport logistics
2. Social participation a) whole community Ø e. g. recreation/health prevention for everybody, Ø parties, Ø social gatherings for all age groups, b) only for older age groups: Ø e. g. mapping older people at social risk, Ø visits, Ø drive training, Ø swimming training, Ø innovative projects by involving them
3. Information For whole community Øsocial, health, cultural, services Øsafety Ø emergency Only for older generations Ø elder-friendly/current events
Main pillars of age-friendly environment Ø research Ø ICT development – long distances, bad weather Ø tertiary education Ø communication between different actors Ø volunteers, older people Ø financial support Ø good examples - widespread Ø focus: ageing society Ø aim to prevent social exclusion
USA Similar trends Similar tools Research E. g. University of Wisconsin, Institute on Ageing and Environment 2015: age-friendly − 24 states − 47 cities − New York City BUT Sun City 26% 65+ Ø built for older people, different approach
Australia By 2051 85 + 6% 15 -64 67% Science/research + policy Elder-friendly environment Ø Urban Ø Isolated areas (57% in 2002)
To elaborate: HOW? Planning Øwhole community Øolder people q. Tasmania Positive Ageing Plan, 2006 -2011 Positive Ageing Plan, 2012 – 2016
Pillars of Positive Ageing Plan 1. Health 2. Social 3. Community
Health Øhealth state Øfinancial situation Ø personal characteristics Ø gender Øtime spent alone
2. Social Øfamily relations Øsocial network Ørelations with carer
3. Community Ø social capital Ø information on social/community events Ø available services Ø improve services Ø allowance, benefit Ø improve access to transport Ø prevention of discrimination Ø tailored services Ø development of infrastructure
QUEENSLAND qbig region qcooperation with Tasmania qadaptation of approach, good examples
Australia: Research Many researches from 2000 s One result e. g. correlation between time spent away from home and subjective „being active” Source Aird, Rosemary L - Buys, Laurie (2015): Active Aging: Exploration into Self-Ratings of "Being Active, " Out-of-Home Physical Activity, and Participation among Older Australian Adults Living in Four Different Settings. Journal of aging research 2015 (9): 501823
Japan: age-friendly criteria 1971 : city for the youth but old now Very rapid ageing city should follow, adapt to changes Øphysical Øduring lifetime Øin life of family Øin styles of generations Øhabits of generation
To achieve age-friendly environment Øageing-friendly planning, Ødecision making, Ø financing, ØResearch Ødevelopment/ICT, Ømobilisation of family resources
China Mainland China Ø family role, special culture Ø ageing persons should remain with their family Hong Kong Ø joint families - living together Singapore Ø Planning 3 generations living together China: special feature: different culture, role of family
India, Sri Lanka: age-friendly environment: different meaning India, Delhi § poverty- poor infrastructure-crime police: mapping older people at risk, telephone register Sri Lanka Cataracts - Eye Camps for Older People monks –temple- urge participation in screening New dimension of age-friendly environment: religion
Dublin Declaration on Age-Friendly Cities and Communities in Europe 2013 e. g. 10 European cities – research q Change of climate increasing morbidity (older people) o age friendly environment more green areas decrease negative trends. increase social cohesion, strengthen intergenerational and inner generational, community
Ireland 2008 e. g. Louth county program a great place to grow old 2013 national program, Age-friendly Ireland (15 cities) 2014 smaller towns as well: Cavan Age Friendly Town Initiative Age Friendly Cities & Counties Programme AIM: country where it is nice to be getting old.
Western, Northern Europe e. g. UK, Germany, Sweden, Finland, Netherlands similar trends
Central and Eastern Europe lagging behind EU initiative: 2008 -2012 „Q-AGEING (Q-AGEING - Quality Ageing in an Urban Environment) Slovenia, Maribor Italy, Treviso province, Genoa Poland, Sopot, Hungary, Budapest (XI district) Germany
Elder-friendly House Model (EF) 2003 -2005 AIM: Keep independence in home environment Co-operation NGO/ idea – ministerial financing Target group 75 + with home care recipients q Tailor-made obstacle-free home environment q different regions q different types of houses
Methodology Survey 150 40% of falls – obstacles in the flat Subsample Alteration Follow-up New sample 50 20 20 30
Help needed Rating: 2, 25 -2, 7 (1 -3 scale ) bathing, moving in flat, cooking, heavy and easy home work, cleaning Ø alteration 20 first phase 30 second phase
Bathroom: problem 1 high bath, no grips
Bathroom: Solution 1 Shower tray, grips, moved washing machine
Bathroom: problem 2 High bath, obstacles
Bathroom: solution 2 Shower cabin, moved wash basin
Bathroom: problem 3, special Elderly owner insists on bath
Bathroom: solution 3, special Step and grips Felmérés:
Dissemination of model Tender – financed by ministry 2700 applicants ¼ approved Target group: older people over 65 + receiving social services
Spatial differences Potential for prevention of social exclusion Hungary: 19 counties 52% of applications from poorest 3 counties Northern Eastern (Szabolcs) Northern (Borsod) Eastern . 29% 12% 11%
Bielefelder Model (BM) 1996 aim: keep independent life - ensure social integration integrated service among LTC recipients Bielefeld region, 40 residential districts cooperation: emplamenting by 7 nursing services, 5 housing associations 2013 -12 residential areas, 442 households
Characteristics I TARGET GROUPS: older people with LTC older people with migrants background demented people other cohorts with LTC need
Characteristics II SCOPE qlink between health-social care qfee for services HELPERS qmobilisation –volunteers q. Neighbours q. Other cohorts
Bielefelder Model COMPLEX CARE
Living space Service provider • Establishment • Alteration Adaptation Carenursing Provider Authoritie s Municipality • Personal needs • Free choice • Payment/fee based on need • Community services • Programs • Volunteers
Similarities between the two models Aim: keep independence Obstacle-free environment Person-tailored care, alteration Regional Co-operation with others NGO –important role Roots of innovation: long history Intervention Social integration
Differences Elder-friendly House Bielefelder Model Safe home environment, preventing falls 65+ Households: 756 Home environment Financing: public Environment with complex care Other cohorts Households: 442 Special environment Financing: other sources Rural settlements Poor region Poor economic situation q Social integration
Present state of art q. Social innovation in Central Europe q. Catching up
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