The Knowledge Exchange Blog

The official blog of The Knowledge Exchange from Idox

“A new journey”: creating a dementia-friendly public transport system

People diagnosed with dementia can live independently for many years – in fact, 1 in 3 people with dementia are still able to drive safely.  However, as the disease progresses, people with dementia must eventually stop driving.  Public transport can be a good alternative to driving for those in the early stages of dementia, enabling them to stay connected with their families, friends and local communities, and provide access to healthcare.

Indeed, the provision of easily accessible public transport options is a key aspect of dementia-friendly communities.  It is difficult to overstate its importance:

“If I didn’t have coping strategies to remain independent and mobile I’d be very lonely and soon sink into depression. Travel brings normality to an often abnormal life” Wendy Mitchell, recording a Dementia Diary for Upstream

However, the challenges faced by people with dementia mean that travelling by public transport can be daunting.  This is because dementia affects more than just memory.  Environments that are noisy and busy can be extremely disorientating for people with dementia, particularly when there are added time-sensitive elements such as bus or train times.

People with dementia often lose the confidence to travel.  They may experience difficulties purchasing the correct tickets, become confused by different fares or travel options, or feel hurried or pressured.  They may feel anxious or unsafe, for example, when becoming separated from their luggage or they may have a fear of becoming lost, or getting off at the wrong stop/station.

In addition to the cognitive, emotional and sensory challenges faced by people with dementia when travelling, there are a number of additional barriers.  These include:

  • Difficulties with journey planning
  • The use of fast changing technology which can exclude certain groups of people
  • A lack of service integration
  • Staff with limited awareness of the needs of people with dementia
  • Poor, inconsistent or confusing signage – or unclear rules regarding reserved seats/spaces

Policy and practice

The UK has set out the goal of becoming the best country in the world for people with dementia by 2020.  It has made some significant steps forward – currently, there are now over 200 communities working towards becoming ‘dementia friendly’.

In regards to transport improvements specifically, earlier this year, the Bus Services Act gained royal assent in England.  The Act provides powers to ensure that buses make both audible and visual announcements about the route and the next stop.  These reminders can help to reassure people with dementia.  The government has committed to work alongside the bus industry, passengers and disability groups to develop the policy further.

The government is also currently consulting on a draft ‘Accessibility Action Plan’, which addresses the barriers faced by people with disabilities using public transport, including a focus on hidden disabilities, such as dementia.  It also commits to updating existing guidance on ‘inclusive mobility’ to incorporate current knowledge and understanding of the needs of those with hidden disabilities such as dementia.

Involving people with dementia in service design

Involving people with dementia in the design of services can help to ensure that their needs are addressed.  Upstream is a project that does just that.  It helps to give people living with dementia across Scotland a voice in the design of future mobility services.

Projects have involved visiting various groups in the Western Isles to learn about the challenges of island transport, workshops to gather insights about travel with Dementia Friendly East Lothian and the North Berwick Coastal Area Partnership; and developing training programmes in conjunction with transport providers.  They have produced a report of their work so far.

Use of technology

The expansion of real time audio and visual information as set out in the Bus Services Act provides a good example of where technology can be used to make transport more accessible for people with dementia and other disabilities.

Other ways in which technology may help include the expansion of live departure boards at bus stops and increasing the use of journey planners – either online or via the telephone.  Apps may also have the potential to help organise shared modes of transport for groups of people in rural areas, and in the future, driverless cars may offer an additional transport option for people living with dementia.

Improved awareness of dementia among travel staff

Improving awareness of dementia among transport staff, and developing training programmes on how to respond to the needs of passengers with dementia, is another key way in which services can be improved.

For example, East Anglia Trains, has worked with the Dementia Society to deliver a dementia-awareness training pilot for staff at four of its stations, and plans to roll this out to all East Anglia staff. Arriva Rail Northern has also announced funding to develop the Bentham Line from Leeds to Lancaster and Morecambe as a ‘centre of excellence’ for people with dementia.

Transport assistance cards are another example of possible ways to improve transport for people with dementia. These cards record details of an individual’s needs so that the individual can show the card privately to the driver or other travel staff as a means of asking for extra assistance. Many individual transport operators and local authorities across the country already issue such cards.  Standardising these schemes across the UK may be one way to help improve people’s confidence when using public transport.

Future developments

While these initiatives are making a significant impact, there is still much to do.  If the growing number of people living with dementia are to maintain their independence, then it is essential that transport services become more dementia-friendly. Bringing together the shared knowledge and experiences of those living with dementia, and the skills and experience of professionals involved in the design and delivery of transport services will help to create a more inclusive, person-centred public transport system.

Dr Joy Watson, an ambassador for the Alzheimer’s Society who herself has been diagnosed with dementia, sets out an admirable goal:

A diagnosis of dementia is not the end of the road, but the beginning of a new journey.  Some people need a little more help to take the first steps, and if I can contribute to them living well, then my mission is fulfilled.”


If more than one in three homeowners are interested in downsizing, why aren’t they making the move?

 

According to Savills estate agents, about 90,000 people over the age of 65 in the UK downsize to smaller homes each year. On the face of it, that’s a substantial number, but it still leaves more than three million houses under-occupied.

With an ageing population and a serious housing shortage, government at local and national levels is looking for ways to encourage older people to downsize their accommodation so that more family-sized housing is made available.

Benefits of downsizing

Everyone needs good housing, but as people grow older their homes become especially important as places where they can feel safe, independent and comfortable. Downsizing from larger properties can offer significant benefits to older people:

  • Smaller homes can be easier to heat and have lower utility bills.
  • People downsizing to sheltered housing can retain their independence, while having access to support when it’s needed.
  • Smaller homes are easier to manage and cheaper to maintain.
  • People moving into specialised retirement accommodation can experience improvements in their health and wellbeing.

Enabling people to remain in their own homes may also alleviate the pressures on the country’s social care system – pressures that are likely to intensify as the population age rises.

Downsizing barriers

While there are attractions to downsizing, important factors are putting off large numbers of people from moving to a smaller home. Some may feel too confined in a smaller space, experience problems storing their possessions, or miss having a large garden. Others may feel that they’ve taken a long time to climb the property ladder, and want to enjoy the home they have spent a lifetime working to achieve.

But for those who do want to move, downsizing can be expensive.  It may release equity, but some households find the costs of moving – notably stamp duty – may cancel out the financial benefits. And although lower maintenance costs can be a major reason for downsizing, older people moving into apartments may find that costs for maintenance and factoring, may be higher than in a standard family home.

Downsizing: the real story

A 2016 report by the International Longevity Centre (ILC) explored the experiences and expectations of people downsizing from under-occupied housing later in life. The report found that one in three homeowners over 55 are considering or expect to consider downsizing. However, while demand for downsizing is substantial, the reality is a different story:

“In many ways, the older generation is stuck in its current housing, which has resulted in the UK having one of the lowest moving rates amongst its older population compared to other developed countries.”

The study echoed the findings from a 2014 Age UK report which showed that the scarcity of suitable and affordable retirement housing was a barrier to downsizing:

“At the moment, retirement housing makes up just 5-6% of all older people’s housing. Research indicates that many more older people might consider downsizing if alternatives were available, although not just retirement housing schemes.”

The Age UK report noted that, based on demographic trends, specialist retirement housing would need to increase by between 35 and 75% just to keep pace with demand. The report also pointed to poor access standards and cramped accommodation in some sheltered housing schemes as downsizing deterrents.

Alternative approaches

The Scottish Government’s strategy for housing for older people, published in 2011, supports downsizing, and highlights Highland Council’s scheme as an example of good practice. In association with local housing associations, the council has provided financial and practical incentives to support older people wishing to move because their homes are too large for their needs.

Another approach, popular in Scandinavia and the Netherlands, is co-housing, which offers older residents a balance between independence and community life. Co-housing schemes are run totally by the residents, offering support when needed to those who live there, while respecting their dignity and independence.

In the Netherlands, there are now more than 200 co-housing communities. Successive governments there have supported co-housing because it has had such positive impacts on demand for health and social care services.

In April, the UK’s first co-housing project for older women opened in Barnet, north London. One of the scheme’s proponents, Maria Brenton, believes that it will be a model for similar projects:

“One of our purposes is to promote the idea of senior co-housing. Now we have shown the way, we are a living, breathing example, it will encourage people enormously.”

Final thoughts

As the ILC report notes, the policy debate on housing in the UK has focused almost completely on first-time buyers. However, with more than three million homeowners aged 55 or over open to the idea of downsizing, the impact of freeing up large numbers of family homes could be significant. Before that happens, the under-supply of affordable homes meeting the particular needs of older residents needs to be addressed:

“Fundamentally, the notion of downsizing in later life should be about choice rather than obligation. It therefore becomes clear that if we were to develop the right policy environment, we can enhance the choices available to people in later life, encouraging downsizing and creating a more dynamic housing market.”



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Moving stories: how poetry is carrying the message about mobility challenges facing older people

All too often, valuable results from research reports receive an initial burst of publicity before being shelved and then largely forgotten.  But one project has been keeping its research in the public eye by taking its findings onto the streets.

A three-year study led by researchers at the University of York’s Centre for Housing Policy has been investigating the links between mobility and well-being among older people. The “Co-motion” project has been working with older people in York, Leeds and Hexham to explore how changes in their lives, such as losing sight, becoming a carer and starting to use a mobility scooter, have affected their mobility.

Poetry in Motion

One innovative strand of the project involved a six-month collaboration between the researchers and the award-winning poet, Anna Woodford. Anna has written a series of poems that reflect on the travel challenges of older and disabled people. In keeping with the spirit of the Co-Motion project, the poems have themselves become mobile. Earlier this year, buses serving passengers in and around the city of York began displaying Anna’s poems.

The Co-Motion project leader, Dr Mark Bevan, from the Centre for Housing Policy, explained that one of the key messages emerging from the research was the need to raise awareness among service providers and the wider public about the diverse travel needs of people later in life.

“The aim of Poetry in Motion is to encourage people to think differently about how they travel and the needs of others.”

The research findings provided inspiration for Anna Woodford: “Many of the things that older and disabled people find difficult are often very simple daily travel actions that most of us don’t even think twice about. Parking your car on the pavement instead of fully on the road or using priority seating on public transport, are just some of the things study participants cited as being a challenge.”

Future plans, future poems

First York, which provides public transport services in York, was happy to showcase Anna’s poetry as part of the project. Rachel Benn, Business Delivery Manager at First York, said: “We are proud to support our local communities, and when we heard about this project, we were keen to help raise awareness of this important research.”

The Co-Motion project is one of seven Design for Well-being projects looking at ageing and mobility in the built environment, funded by the Engineering and Physical Sciences Research Council (EPSRC), the Economic and Social Research Council (ESRC) and the Arts and Humanities Research Council (AHRC).

There are now plans for an exhibition of the Co-Motion poems at York Explore library and at Newcastle City library in autumn 2017, and it’s also hoped that the project will expand to look at people living with mental health issues.

Transport and art collaborations

Poetry in Motion is in keeping with a strong tradition of the arts and public transport working hand-in-hand.  For over thirty years, passengers on the London Underground have been able to enjoy a range of poems showcased in Tube train carriages across London. The success of the programme has inspired similar initiatives across the world.

Meanwhile, in China, a London-based artist has taken the art and transport theme even further. Mira Calix created a moving museum on a bus, enabling passengers to take in sonic and visual art installations as part of their journey.

And in New York City, photographs by the American artist Andres Serrano have appeared in subway stations to highlight the existence of homeless people on the streets. Although Andres doesn’t see himself as a crusader, he hopes that his images will make people stop and think.

I feel like it’s enough for me to just bring it to your attention, and then after that it’s up to you to decide what to do with it.”

Final thoughts

Public art can be appreciated on different levels – for its own sake, and to provoke reflections about its deeper meanings.  The work of Anna Woodford, Andres Serrano and many other artists enables the travelling public to look with new eyes on the challenges facing vulnerable people, such as the elderly, the disabled and the homeless.

A poem or a photograph, a painting or a story might not change the world, or even an individual. But if it causes people to pay attention, and to reflect on how it makes them feel, the artwork will have done its job.


Follow us on Twitter to see what developments in transport, mobility, the arts and wellbeing are interesting our research team.

Helping people with dementia to live well through good urban design

Earlier this year, the Royal Town Planning Institute (RTPI) published their first practice note on how good planning can play a stronger role in the creation of better environments for people living with dementia.

It summarises good practice guidance from Oxford Brookes University, the Alzheimer’s Society and the Scottish Government, among others.

Living with dementia

According to the Alzheimer’s Society, there are currently around 850,000 people living with some form of dementia in the UK.  Although the risk of developing dementia increases with age, it is not just a disease of the elderly.  There are currently around 40,000 people with dementia in the UK under the age of 65.

The vast majority of cases of dementia cannot be cured. However, there is a lot that can be done to enable someone with dementia to live well with the condition. Many people with dementia can continue lead active, healthy lives for years after diagnosis.  Even most elderly people with mild to moderate dementia can continue to live in their own homes.

The importance of good urban design

Evidence has shown that well-planned, enabling environments can have a substantial impact on the quality of life of someone living with dementia and their ability to retain their independence for longer.

For example, being within easy walking distance of shops and other local amenities can help people with dementia to remain physically active and encourages social interaction.

Having access to green space and nature also has particular benefits, including better mood, memory and communication and improved concentration.

Key characteristics of a dementia-friendly environment

Drawing on the principles set out in ‘Neighbourhoods for Life’, the RTPI advises that urban environments should be:

  • Familiar – functions of places and buildings made obvious, any changes are small scale and incremental;
  • Legible – a hierarchy of street types, which are short and fairly narrow. Clear signage;
  • Distinctive – including a variety of landmarks and a variety of practical features, e.g. trees and street furniture;
  • Accessible – access to amenities such as shops, doctor’s, post offices and banks within easy, safe and comfortable walking distances (5-10 minutes). Obvious, easy to use entrances that conform to disabled access regulations;
  • Comfortable – open space is well defined with public toilets, seating, shelter and good lighting. Background and traffic noise minimised through planting and fencing. Minimal street clutter;
  • Safe – wide, flat and non-slip footpaths, avoid creating dark shadows or bright glare.

Dementia-friendly communities

In addition to specific guidance on how to improve the urban environment, the RTPI practice note also highlights the crucial role of planners in the creation of ‘Dementia Friendly Communities’.

This is a recognition process, which publicly acknowledges communities for their work towards becoming dementia friendly.  It aims to involve the entire community, from local authorities and health boards to local shops, in the creation of communities that support the needs of people with dementia.

There are 10 key areas of focus.  Those particularly relevant to planning include:

  • shaping communities around the needs and aspirations of people with dementia;
  • the provision of accessible community activities;
  • supporting people to live in their own home for longer;
  • the provision of consistent and reliable transport options; and
  • ensuring the physical environment is accessible and easy to navigate.

There are currently over 200 communities across the UK working towards recognition as dementia-friendly.  Dementia Friendly East Lothian and the Dementia Friendly Kirriemuir Project are two such examples.

Local government policy

By 2025, it is estimated that the number of people diagnosed with dementia will rise to over one million.  Significant under diagnosis means that the number of people who experience dementia may be even higher.

However, the RTPI report that at present few local authorities have made explicit reference to dementia in their adopted local plans.

Worcestershire County Council and Plymouth City Council are notable exceptions:

  • Plymouth have set out their ambition to become a ‘dementia friendly city’ in its current local plan; and
  • Worcestershire are currently developing a draft Planning for Health Supplementary Planning Document that covers age-friendly environments and dementia.

A beneficial environment for all

While these are important first steps towards the greater recognition of the role of planning in supporting people with dementia, it is imperative that planning explicitly for dementia becomes the rule, rather than the exception.

Not only will this benefit people with dementia and reduce healthcare costs, it may also benefit the wider community, including young families, people with disabilities, and older people.

As the RTPI rightly state, “environments that are easy for people to access, understand, use and enjoy are beneficial to everyone, not just older people with dementia.”


Planning for an ageing population: designing age-friendly environments

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In the UK, increased life expectancy means that people can expect to live longer than ever before.  While this is clearly good news – and has a number of potential economic benefits – the shift in demographic structure towards an increasingly elderly population has a number of significant implications.

Following Wednesday’s blog post on the implications for planning of the ageing society, today we highlight some of the ways in which planners can help support the creation of age-friendly environments by influencing the design of the urban environment, transport, housing and the wider community and neighbourhood.

The importance of an age-friendly environment

Age-friendly environments are underpinned by three key factors:

  • Safety
  • Accessibility
  • Mobility

Such environments impact positively upon the quality of life of older people by enabling and encouraging physical activity and social connection.  This in turn has a beneficial impact upon their physical and mental health, and helps to tackle social exclusion – which can be a particular problem among older people.

Conversely, as the World Health Organisation (WHO) notes, poor design can have a negative impact:

“older people who live in an unsafe environment or areas with multiple physical barriers are less likely to get out and therefore more prone to isolation, depression, reduced fitness and increased mobility problems”

Creating an age-friendly environment

There are a number of areas in which planners may have an influence on the provision of age friendly environments:

  • the design of the urban environment
  • supporting appropriate transport options
  • the provision of age-appropriate housing
  • adequate neighbourhood and community facilities

Urban environment

In terms of the urban environment, green spaces are an integral aspect of age friendly environments.  Access to green spaces supports the physical activity of older people, makes a positive contribution to their health and wellbeing, and provides opportunities for social interaction.

Research has found that green spaces that are poorly maintained, perceived as unsafe, or contain potential hazards resulting from the shared use of parks and walkways are less likely to be used by older people.  Suggestions for improvement include the creation of small, quieter, contained green spaces and improved park maintenance.

Paths, streets and pedestrian areas are also a key planning consideration. Older people have greater reliance on pedestrian travel and are more likely to be physically active in areas that are pedestrian friendly.  The perception of safety also influences use – therefore, lighting and road safety measures can help to enhance this.

Adequate public toilet provision will also become an increasingly important issue.  Recent cutbacks have resulted in many public toilets being closed – in their review of public toilet provision in the UK Help the Aged noted that provision was sporadic. They found that the majority of older people had experienced difficulties in finding a public toilet, and even when toilets were found, they were often closed.

Transport needs

Responding to the transport needs of different groups will also present a key challenge. For example, an analysis of major European cities  by the Arup engineering consultancy found that older people typically make fewer journeys, use private cars less, public transport more (trams and buses in particular) and walk more.  In addition to this, older people’s typical walking speed – as well as the average length of walking trips – were lower than younger people’s patterns.  These differences must be considered when designing age-friendly environments.

The growing population of older people in rural and semi-rural areas, and the reliance on cars in areas with limited public transport options were also identified by Arup as important issues.

Age-appropriate housing

There will be increased demand for age-appropriate housing that meets the needs of older people as the population ages. People are likely to have longer periods of retirement and possibly longer periods of ill-health. As noted by the Future of an Ageing Population Project, unsuitable housing can damage individual wellbeing and increase costs for the NHS.

In order to meet demand, it will be necessary to both adapt existing housing stock, as well as ensure that new housing can adapt to people’s changing needs as they age.  Age-appropriate housing that supports independent living can reduce demand on health and care services, and positively enhance the lives of older people.

Thinking ‘beyond the building’

There is also a need to think ‘beyond the building’. It is thought that interventions that improve homes are likely to be less effective without similar improvements in the neighbourhood.  The ability to socialise and to access services is considered to be particularly important.

Therefore, planning for the provision of local shops and other community facilities such as GP surgeries, post offices and libraries, in tandem with an increased focus on walkable neighbourhoods and public transport provision, will help older people to be physically active and more independent.

Raising awareness

Despite a pressing need for action, the provision of age friendly infrastructure in the UK has been constrained by a lack of resources, and assigned a relatively low priority.  However, there is growing recognition of the need to raise awareness of the potential effects of the ageing population and its implications for the design of cities, towns and villages across the UK.

Planning departments cannot address these implications in isolation.  However, for their part, knowing and understanding the potential implications of the UK’s ageing population is a positive step towards the creation of a successful age-friendly built environment.


For further information, you may be interested in our other blog posts on the creation of age-friendly towns and cities and the economic opportunities presented by an ageing society.

We have also published two members-only briefings on Ageing, transport and mobility and Meeting the housing needs of older people.

Planning for an ageing population: some key considerations

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On average, the UK’s population is becoming older and living longer, healthier lives.  This is due to historically low fertility rates and reduced mortality rates.  Between 2014 and 2039, the government predicts that over 70% of UK population growth will be in the over 60 age group. Although this trend is partially countered by migration, by 2037 there will be 1.42 million more households headed by someone aged 85 or over.

The implications of population ageing for society are so complex and far reaching that they are impossible to fully predict. However, a key priority is the provision of age-friendly environments.  This is where local government, and planning departments in particular, have a crucial role to play.

In this blog post – the first of two on the implications of population ageing for planning – we highlight some key areas for consideration.

Some areas will be more affected than others

While headline-grabbing statistics paint a very clear picture of the significant growth in the number of older people that is predicted, often they obscure the subtleties of the way in which population ageing will occur across the UK.

In reality, it is likely that population ageing will not occur equally in all areas of the UK.  The degree to which some local authorities – and therefore planning departments – will be affected varies considerably.

The impact of population ageing is measured by a ‘dependency ratio’ – the number of people aged over 65 for every person between 16 and 64.

Recent research has found that coastal localities are likely to have higher dependency ratios than urban areas.  Urban areas will, however, experience a larger overall number of older people.

Dependency ratios will vary considerably between local authorities.  On average, it is predicted that by 2036, there will be over four people aged over 65 for every 10 people aged between 16-64.  However, local figures are likely to vary – from just over 1 in 10 in Tower Hamlets, up to 8 in 10 in West Somerset.

You can see how your own area is likely to change in an interactive map created as part of the Future of an Ageing Population Project.

Differences between the ‘young old’ and ‘older old’

And while there is awareness of the growth in the overall numbers of ‘older people’, another complexity is that ‘older people’ are not a homogenous group. 

As life expectancy increases, the differences between different age groups become more significant.  For example, there are variations in the needs, tastes and lifestyles between the ‘older old’, i.e. those aged over 80, and the ‘young old’ who are just approaching retirement age.

Some planning departments are already taking this into consideration.  Northumberland County Council – who have a higher than average number of older people within their population – use a three phase definition as part of their strategy to prepare for the ageing population. They categorise ‘older people’ into three distinct groups: older workers; ‘third agers’; and older people in need of care.

Understanding social impact and interpretation

The physical environment is commonly understood to be a ‘societal context’ in which ageing occurs.  This is reflected in the term ‘physical-social environment’ – it suggests that there is no physical environment without social interpretation.

However, recent research has found that while planners were reasonably aware of the physical needs of older people, they were less aware of the social and economic contexts of older people’s lives.  This included the links between wellbeing and attractive environments, green space, activity and health, and the positive impact of place attractiveness on social interaction.

Related to this, older people’s social interpretation of the built environment – including the importance of place meanings, memories and attachments ­– is likely to become an increasingly important consideration for planners.  As too is the potential effect of redevelopment on older people – which may include feelings of insecurity and alienation, disorientation, loss of independence, and social exclusion.

Involving older people in the planning system

How to effectively involve older people in the planning system in an increasingly technology-dependent age will pose a number of challenges.

Planners will need to think creatively about options for engagement.  Increasingly, social media platforms and other online media have been used to engage with users.  However, these technologies may not be readily accessible or easily used by older people due to a lack of technological skills or access to the internet.

Older people may also need certain adaptations to support them to become involved – either online or in person – if they have physical or other disabilities.

Negative assumptions about technology’s usefulness held by some older people may need to be challenged or worked around.

Supporting healthy and happy lives

There is no way to fully predict the impact that population ageing will have across all sections of society.  Developing our understanding of the way in which the built environment can help to support and enable older people to live happy and healthy lives – and the implications of this for planning towns and cities across the UK – is increasingly important.

In our next blog post we will look at some of the ways in which planners can help support the creation of age-friendly environments through their influence on the design of the urban environment, transport, housing and the wider community and neighbourhood.


For further information, you may be interested in our other blog posts on the creation of age-friendly towns and cities and the economic opportunities presented by an ageing society.

Planning for later life … where does retirement housing fit in strategic planning?

Rural_Urban Landscape_iStock_000004526499MediumHow does the planning system recognise and reflect the needs of different social groups for housing and amenities? And how should planning respond to current demographic trends? You would assume that these questions would be central concerns of strategic planning and local plan creation, given the long-term view that these processes require. Arguably however, statutory land-use planning has actually been relatively indifferent to the specific needs of age.

Planning around the ‘nuclear family’ norm

The regulation of land use and development is informed by broad strategic assumptions regarding economic, demographic and social changes.  And in addressing the provision of housing, the tendency has been to meet the needs of the ‘nuclear’ family. Other groups, such as the young, the unemployed, the socially excluded and those in ‘later life’, tend to be accommodated at the margins or by default. This is often satisfied through the planned provision of social and educational facilities, rather than being driven by the aspiration for a fully integrated society.

Planning and housing policy interconnect in the UK in a complex and confused way. Housing shortages, the lack of affordable housing, an aggressive geographical divide, widespread social exclusion, the rise of ‘generation rent’ and dysfunctional housebuilding practices all coexist as problems which planning policy is expected to solve.

Meanwhile the realities of 21st century life – such as the fragmentation of extended families due to employment opportunities and longer life expectancy – is creating a market for appropriate housing for older people. Planning for retirement housing has been described as the UK’s next housing crisis.

Planning for retirement housing

Research has pointed to demand for retirement housing increasing as older people (especially those with income, wealth, social networks and health) seek more appropriate accommodation for their later lives. And left to market forces, those in later life compete with first-time buyers for smaller properties.

Failure to downsize can exacerbate wider housing market pressures and create very real psychological and health costs for individuals. Planning has a role here – as shown by a recent Demos study demonstrating how better design of retirement accommodation can help to address the blight of loneliness in later life.

A recent report by Anchor – a not-for-profit provider of housing and care for older people – highlights the issues created by the absence of appropriate retirement housing provision. They argue for a National Task Force on retirement housing; exemption from stamp duty for retirement homes; and reform of the planning system (in England) to remove current disincentives to constructing appropriate numbers of retirement houses.

In terms of changes to planning, they suggest that local planning targets for retirement housing be introduced in local plans; that retirement homes projects be exempt from planning obligation provisions and that eligibility for the Community Infrastructure Levy be reviewed; and that retirement housing should be given the same priority status as affordable housing in development plans.

Similarly, a new All Party Parliamentary Group report on housing and care for older people, published in June this year, calls for a significant change in the focus of Government policy away from concentrating simply on support for first time buyers.

Planning as a symptom or the cause

We’ve written before on this blog about the need for planning to address the need for lifetime homes and age-friendly neighbourhoods. There’s also a lot of research going on into how housing and communities can be planned and designed to assist people with dementia.

Not everyone enjoys later life in the same way and there are considerable discrepancies and inequalities evident – often reflecting earlier life chances. While the planning system has a role to play in addressing these issues, we must recognise that it is a symptom of a wider failure to confront the needs of older life within society. There is a need for a respectful national conversation about how we address the public (social) and private realities of the modern economy.


This blog draws on an article by Professor Greg Lloyd (Ulster University & Wageningen University) published in Scottish Planning and Environmental Law Journal: Greg Lloyd (2016) Planning for later life. SPEL 175, pp50-51

Follow us on Twitter to see what developments in public and social policy are interesting our research team.

Read our other related blogs:

Social prescribing – just what the doctor ordered?

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By Heather Cameron

It is widely acknowledged that wider social, economic and environmental factors have a significant influence on health and wellbeing. According to recent research only 20% of health outcomes are attributable to clinical care and the quality of care while socioeconomic factors account for 40%.

With increasing pressures on GPs and lengthy waiting times a real issue for many, particularly those with mental health conditions, social prescribing could represent a real way forward.

The government clearly recognised the importance of social prescribing in its new deal for GPs announced earlier this year, which made a commitment to make social prescribing a normal part of the job.

In response to a recent Ask-a-Researcher request for information on different approaches in social prescribing and evidence of what works in the UK, it was interesting to find that despite the recognition of potential value, there has been little evaluation of social prescribing schemes to date.

Much of the material found focused on specific interventions and small-scale pilots and discussion around implementation. A new review of community referral schemes published by University College London (UCL) is therefore a welcome addition to the evidence base as it provides definitions, models and notable examples of social prescribing schemes and assesses the means by which and the extent to which these schemes have been evaluated.

So what is social prescribing?

Social prescribing means linking patients with non-medical treatment, whether it is social or physical, within their community.

A number of schemes already exist and have included a variety of prescribed activities such as arts and creative activities, physical activity, learning and volunteering opportunities, self-care and support with finance, benefits, housing and employment.

Often these schemes are delivered by voluntary, community and faith sector organisations with detailed knowledge of local communities and how best to meet the needs of certain groups.

Social and economic benefits

Despite a lack of robust evidence, our investigation uncovered a number of documents looking at the social prescribing model and the outcomes it can lead to. Positive outcomes repeatedly highlighted include:

  • improved health and wellbeing;
  • reduced demand on hospital resources;
  • cost savings; and
  • reduced social isolation.

According to the UCL report, the benefits have been particularly pronounced for marginalised groups such as mental health service-users and older adults at risk of social isolation.

A recent evaluation of the social and economic impact of the Rotherham Social Prescribing Pilot found that after 3-4 months, 83% of patients had experienced positive change in at least one outcome area. These outcomes included improved mental and physical health, feeling less lonely and socially isolated, becoming more independent, and accessing a wider range of welfare benefit entitlements.

The evaluation also reported that there were reductions in patients’ use of hospital services, including reductions of up to a fifth in the number of outpatient stays, accident and emergency attendances and outpatient appointments. The return on investment for the NHS was 50 pence for each pound invested.

Similarly, the Institute for Public Policy Research (IPPR) has recently argued that empowering patients improves their health outcomes and could save money by supporting them to manage their condition themselves.

IPPR suggests that if empowering care models such as social prescribing were adopted much more widely throughout the NHS we would have a system that focused on the social determinants of health not just the symptoms, providing people with personalised and integrated care, that focused on capabilities not just needs, and that strengthened people’s relationships with one another.

Partnership working

With a continued policy focus on integrated services and increased personalisation, social prescribing would seem to make sense. In addition to providing a means to alternative support, it could also be instrumental in strengthening community-professional partnerships and cross-collaboration among health, social and other services.

The New Local Government Network (NLGN) recently examined good practice in collaboration between local authorities, housing associations and the health sector, with Doncaster Social Prescribing highlighted as an example of successful partnership working. Of the 200 referrals made through this project, only 3 were known to local authority and health and wellbeing officers, showing that the work of social prescribing identified individuals who had otherwise slipped through the net.

And with the prospect of an ageing population and the health challenges this brings, a growing number of people could benefit from community-based support.

As Chair of Arts Council England, Sir Peter Bazalgette, notes “social prescribing is an idea whose time has come”.

Follow us on Twitter to see what developments in policy and practice are interesting our research team.

Further reading: if you liked this blog post, you might also want to read Heather’s earlier post on the health and wellbeing benefits of investing in public art.

 (Older) people power: the economic opportunities of an ageing society

By James Carson

Responding to a recent Ask-a-Researcher request for information about Britain’s ageing population, I found that an online search generated a discouraging set of headlines:

“Ageing UK population will increase strain on public spending”

“UK faces ‘debt timebomb’ from ageing population”

“UK woefully underprepared for ageing society”

Further down the list was something more positive:

“Britain’s retiring workers have never had it so good. As well as being among the last workers to benefit from generous final salary pensions, many older people have housing wealth, having got on to the property ladder long before the boom that has priced out many younger buyers. And thanks to new pension freedoms, which came into force in April, the over-55s can now withdraw money from their pension funds.”

If anything, this article from The Guardian was a little too upbeat – there was no mention of the tens of thousands of older people enduring fuel poverty.

But the story does highlight the growing market which older consumers represent for products and services.

The demographic trends

In many developed countries, ageing populations are being driven by two demographic trends: a declining birth rate due to women having fewer children than in previous generations; and increasing numbers of people living longer, thanks to improvements in diet and medicine.

The global population aged 60 or over is projected to more than triple by 2050, reaching approximately 2 billion people. In the UK, the number of people aged 65 and over is expected to increase from 10.3 million in 2010 to 16.9 million by 2035.

Harnessing the economic opportunities from an ageing population

Surveys of household income and expenditure have reported that older people devote a greater proportion of their total expenditure to necessities, such as food and drink, housing, fuel and power. Luxury items related to recreation and culture are also areas of significant expenditure for older households.

With the abolition of the default retirement age, many older people are continuing to lead productive working lives, and have financial security. The STUC recently published a report highlighting the potential economic contribution of women over 50 to the economy, although noting that they are often ignored in labour market and economic policy.

In 2011, a report for the Centre for Local Economic Strategies (CLES) suggested that harnessing the spend of older people will be increasingly important for both the private and public sectors.

The research pointed to ways in which an ageing society might affect the economy:

  • Changes in housing needs may provide opportunities for developers and the construction industry to explore new types of housing provision to support older people.
  • Retired people, such as former business managers, may be interested in setting up their own business, or investing in local enterprises.
  • More retired people may become interested in playing a wider role in the community through voluntary work, something that may become even more important as public services are cut back.
  • Older people will also be increasingly important to the labour market, and there are opportunities to explore how their experience and skills can be best used.

Earlier this year, a report from the International Longevity Centre-UK also highlighted the importance of design and technology in responding to the needs of older people, and outlined what needs to happen in order for new technologies to live up to their full potential. Among the recommendations:

  • Ensuring homes meet lifetime homes standards and neighbourhoods adopt age friendly guidelines.
  • Tackling digital exclusion to ensure older people maximise the benefits of new technology.
  • Providing more evidence on what works to help designers, marketers and retailers understand the potential economic return of targeting older consumers.

The report provided some examples of innovative technologies that could make a significant difference to the lives of older people, including:

  • a kettle which monitors blood pressure;
  • lights which adapt to the level of daylight in a room;
  • driverless cars;
  • a secure platform enabling the management of bank accounts, bills and pensions through one simple portal.

The ageing population presents challenges for government, business and society in general. However, growth in this section of the population also brings with it emerging economic opportunities. That’s something worth remembering on this International Day of Older Persons.


 

Follow us on Twitter to see what developments in public and social policy are interesting our research team.

Enjoy this article? Read our other recent blogs on policy relating to older people:

Shedding light on a serious issue: how Men’s Sheds are tackling social exclusion

by Stacey Dingwall

Promoting awareness of health and social issues among men, and particularly older men, has always been a tricky challenge. According to research, the longstanding stereotype of men who actively avoid visiting the doctor is true: significant numbers of older men may be experiencing loneliness and isolation due to their reluctance to join clubs for older people, a fact which may explain why suicide rates are higher among middle-aged and older (white) men.

One initiative that has tried to tackle this issue is the Men’s Sheds movement, which originated in Australia in the 1990s after concerns were raised over the lack of opportunities for older men to socialise and discuss any issues they were having with their peers. This led to the emergence of numerous Men’s Sheds across the country, in the form of workshops where men could come together to engage in traditional shed-orientated activities such as woodwork, as well as form new social connections and access health information.

The benefits of Men’s Sheds

Evaluations of Men’s Sheds have identified a range of benefits for the men who participate in them, as well as for the wider community. Older men and social activity: a scoping review of Men’s Sheds and other gendered interventions published in Ageing and Society in April 2015 identified a range of positive effects of the initiative on older men, particularly in terms of improvements in their mental health and wellbeing status. While limited evidence was found of a positive impact on the men’s physical health, the review did find that belonging to a Men’s Shed provided participants with both a personal and social sense of accomplishment – through learning and sharing skills and contributing to their local community – as well as a sense of purpose, through social engagement with their peers which enabled opportunities for fun and camaraderie.

Men’s Sheds in the UK

Between 2010 and 2012, Age UK ran a ‘Men in Sheds’ pilot project, initially limited to Kendal, Bildworth and South London. The popularity of the pilot saw it covered in the national press and other ‘Men in Sheds’ projects soon opened in other areas, with one participant expressing his regret that the initiative had not been established in his area years ago.

In 2013, the UK Men’s Sheds Association was launched. They provide information on how to start a new Men’s Shed, or develop an existing organisation, and have helped form regional networks of Sheds.

One of these networks is in Glasgow, which is now home to the Glasgow Area Men’s Sheds (GAMS) group. We spoke to current GAMS secretary Charlie, who became involved in Men’s Sheds after illness led to him experiencing unemployment and social isolation. After coming across the UK Men’s Sheds Association website, he met up with six other men who were also interested in starting a Shed in Glasgow. Fast forward a year, and there are now at least six separate Sheds in the Glasgow area, at which Charlie estimates there are around 80 regular attendees. For Charlie personally, involvement with Men’s Sheds has allowed him to “build a portfolio of work experience, gain possible references, meet new people, go to new places and do new things”.

Charlie also pointed to research published by the Joint Improvement Team (JIT) in February 2015 which highlights the rapid spread of Men’s Sheds throughout Scotland over the last two years, with Sheds now in 18 of the country’s 32 local authority areas. The report also looks at the development paths of Men’s Sheds, as well as drawing out lessons for other community capacity building initiatives and outlining the local and community support needed to develop a Shed.

What about the women!

According to GAMS, the question of why the Sheds are men-only affairs is a common one. Their response is that “Men’s Sheds address specifically male issues involving male social isolation, men’s health both physical and psychological, re-defining of masculinity in modern society […] women have much more and highly developed socialising group opportunities”.

As well as highlighting a tendency towards loneliness among older men, research has also indicated another trend – the decline of men’s social networks as they age, particularly after the death of a partner. Thus, the importance of Men’s Sheds in “promoting social engagement and healthy, active ageing among older men” is perfectly demonstrated.


The Idox Information Service can give you access to a wealth of further information on active and healthy ageing. To find out more on how to become a member, contact us.

Further reading:

The experiences of older male adults throughout their involvement in a community programme for men, IN Ageing and Society, Vol 35 No 3 Mar 2015, pp531-551

Tackling men’s health: implementation of a male health service in a rugby stadium setting, IN Community Practitioner, Vol 84 No 4 Apr 2011, pp29-32

One hundred not out: resilience and active ageing

Active ageing: live longer and prosper – realising the benefits of extended healthy life expectancy and ‘disability compression’ in Europe

Ageing, health and innovation: policy reforms to facilitate health and active ageing in OECD countries

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