The Knowledge Exchange Blog

The official blog of The Knowledge Exchange from Idox

A home for life? Developing lifetime neighbourhoods to support ageing well in place

aerial view architecture autumn cars

Photo by Pixabay on Pexels.com

The UK population is ageing. A 2019 report from AgeUK using data from the ONS highlighted that there are nearly 12 million (11,989,322) people aged 65 and above in the UK of which: 5.4 million people are aged 75+, 1.6 million are aged 85+, over 500,000 people are 90+ (579,776) and 14,430 are centenarians. By 2030, one in five people in the UK (21.8%) will be aged 65 or over, 6.8% will be aged 75+ and 3.2% will be aged 85+.

Allowing people to live well in old age in their own homes is something which housebuilders and planners are giving increasing thought to, both from a wellbeing perspective for residents, and a financial perspective for services, including the NHS and social care. The creation of “lifetime neighbourhoods” – spaces where people can live well from birth to retirement – brings together a number of elements: providing easy access to services; creating physical spaces which are suitable for people with disabilities and mobility issues to navigate; and allowing people to maintain those social and community ties which are associated with wellbeing, which can sometimes be lost with forced moves to residential care or a prolonged stay in hospital.

Homes for life

Building homes that are suitable for an ageing population is an important first step in creating lifetime neighbourhoods. However, planners and developers are starting to realise that one size doesn’t necessarily fit all when it comes to housing for older people. As with the general population, older people are not a homogenous group, and while some may need the support provided by extra care or sheltered housing projects, or may need single-storey open plan living to accommodate mobility aids or telecare packages, others simply want to live in a space which enables them to live comfortably in a community which suits their needs in terms of location and availability of services.

Designing and building a range of different housing types, which includes single-storey homes, extra care and sheltered housing, as well as stock which is suitable for people looking to downsize, is a key part of the development of effective lifetime neighbourhoods. This can free up larger family homes for people with children to move into and ensure that people are not kept unnecessarily in hospital because housing cannot be adapted to meet changing needs. A 2014 Age UK report showed that the scarcity of suitable and affordable retirement housing is a barrier to downsizing, highlighting that retirement housing makes up just 5-6% of all older people’s housing. Now groups like the Housing Made for Everyone coalition (HoME) are calling on the government to make all new homes accessible and adaptable as standard to help meet growing need in the future.

Social infrastructure such as libraries, community centres, local shops and good transport links are also a key aspect to planning effective lifetime neighbourhoods, as is ensuring accessibility of services such as GP appointments. Effective infrastructure planning can help enable the whole community, not just older people to feel connected to their local area, both physically and socially which can really help to support the idea of lifetime neighbourhoods and enable people to live well regardless of age.

Preventing loneliness and isolation in older age

Preventing loneliness and isolation in old age by creating spaces which facilitate engagement and encourage people to have positive social interactions is important to ensure that everyone within the community feels respected, involved and appreciated. However, the challenges are different depending on the nature of the community in question. In rural areas, social isolation can be compounded by a lack of appropriate transport infrastructure or the removal of key services at a local level in favour of “hubs” which are often located in towns and cities; in urban areas, loneliness can be exacerbated by the chaotic, hostile or intimidating environment that living in a densely populated area can have, a flip side to the benefits of density.

Ambition for ageing is a programme which aims to discover what works in reducing social isolation by taking an asset based approach to creating age friendly communities. Asset based approaches seek to identify the strengths and the abilities of people and communities, rather than their deficits. The asset based approach to creating age friendly neighbourhoods also seeks to use the experiences and  attributes that all members of the community have to help make the community better. To create effective age friendly neighbourhoods older people need to have opportunities to participate and feel that they are making a positive contribution.

A space for all ages

While much of the research and literature on lifetime neighbourhoods focuses on older people, it is also important to ensure that spaces meet the needs of all groups in the community, including children and young people and people with disabilities. Creating places which balance the needs of all groups within the community is an important consideration for planners.

The physical environment can be as important as the built environment and infrastructure development when it comes to developing lifetime neighbourhoods. Spaces which make use of natural and green infrastructure with lots of green and open public spaces have been shown to help improve mental health and wellbeing, as well as encouraging people of all ages to be more active. A number of design factors such as good paving, effective street lighting and easy access to seating and public toilets make neighbourhoods accessible to older people and people with impairments. Poor design can ‘disable’ people in their immediate environment and act as a barrier to participation in local activities.

adult affection baby child

Photo by Pixabay on Pexels.com

Final thoughts

For lifetime neighbourhoods to be successful, it is necessary that there is access to a range of appropriate housing options. In addition, the planning of public, open and green spaces, availability of transport links and local community infrastructure like libraries, police stations and local shops are all vitally important to ensure communities can thrive.

It is clear that while there is demand for more suitable housing for people in older age, the location and type of housing being built must also meet the needs and expectations of older residents, including good connections to local infrastructure, and safe accommodation. Projects which bring a range of ages together can be effective in strengthening community cohesion, can help challenge stereotypes and can reduce feelings of loneliness and isolation. Collectively these different elements feed into the creation of lifetime neighbourhoods which can support people to live well into retirement and beyond.


Further reading: more articles from our blog

Follow us on Twitter to see what topics are interesting our research team.

‘Digital prescribing’ – could tech provide the solution to loneliness in older people?

Notruf und Hilfe für Rentner und Kranke

The number of over-50s experiencing loneliness could reach two million by 2026. This compares to around 1.4 million in 2016/7 – a 49% increase in 10 years.

It has also been estimated that around 1.5 million people aged 50 and over are ‘chronically lonely.’

With an ageing population and increasing life expectancy, it would seem likely that loneliness among older people is set to continue; unless something significant is done. According to Age UK, tackling loneliness requires more than social activities. A new report from Vodafone suggests technology could be the answer.

Impact

The impact of loneliness in older people can be immense, not only for the older people themselves but for those around them. It can also put strain on the NHS, employers and organisations providing support to people who are lonely; and have a negative impact on growth and living standards.

Research has suggested that those experiencing social isolation and loneliness are at increased risk of developing health conditions such as dementia and depression, as well as increased risk of mortality. The damaging health effect of loneliness has been shown to be comparable to smoking 15 cigarettes a day. Older people who are lonely are therefore more likely to use health services than those who are never lonely.

The economic impact is also significant. It has been estimated that increases in service usage create a cost to the public sector of an average £12,000 per person over the medium term (15 years). Vodafone’s report suggests that loneliness has a £1 billion a year impact on public services. It has also been found to cost employers £2.5 billion per year.

How tech can ease the burden

According to Vodafone, “new technologies are a key part of the solution” alongside more traditional public and community services. Two key routes through which technology can be used to reduce loneliness are highlighted:

  • by supporting older people to remain independent in their home and community; and
  • maintaining and building networks and contacts.

From wearable devices and touchscreens to personal robots that act as the eyes, ears and voice of people unable to present physically, these are all highlighted as viable and positive uses of tech to ease the burden of loneliness. And there are already a number of examples of innovative use of technology that can benefit older people.

1024px-AV1

No Isolation AV1 robot. Image by Mats Hartvig Abrahamsen, via CC BY-SA 4.0

Good practice examples

One such example is Vodafone’s smart wearable wristband, the V-SOS Band, which supports independent living while also increasing the wearer’s safety. It can directly alert family members via their phone if the wearer needs help. It also uses fall detection technology so that families can be alerted automatically if the wearer falls either in the home or when they are out.

Kraydel is another example. Its smart TV-top hub links elderly people to their carers or family members, through their TV screens, helping people be more independent and remain in their own homes for longer as well as helping them be more socially connected. It provides for user-friendly video calling via the TV and can help people return home from hospital earlier. Via connection to the cloud, the device interprets the data it receives to build up a picture of the user’s daily activities, health and wellbeing. It issues medicine and diary reminders, and alerts caregivers if it sees something amiss, or identifies potential risk.

Although aimed at children, No Isolation’s AV1 – a smart robot designed to reduce the risks of children and young adults with long-term illness becoming socially isolated – demonstrates the positive impact innovative technology can have on social isolation and loneliness. The robot avatar, with its 360 degree camera, acts as the child’s eyes, ears and voice in the classroom or at other events, keeping children closely involved with school and in touch with their friends.

Of course, loneliness is particularly prevalent among people who don’t use smart technology such as smart phones and tablets, one of the reasons cited by Kraydel for using the TV – probably the most familiar and widely used screen globally. This issue also led No Isolation to develop KOMP, a communication device for seniors that requires no prior digital skills. It enables users to receive photos, messages and video calls from their children and grandchildren, operated by one single button.

Another new project recently launched in Sweden – considered one of the world’s loneliest countries – uses a unique conversational artificial intelligence which enables older people to capture life stories for future generations while providing companionship. Memory Lane works with Google Voice Assistant and is able to hold meaningful conversations in as human a way as possible. A pilot test showed that the software “instantly sparked intimate conversations” and led to stories that hadn’t been told before.

Final thoughts

With a significant number of older people lacking confidence in their ability to use technology for essential online activities, support for digital skills is obviously still important. In response to this issue, Vodafone has launched free masterclasses across the UK, as part of a programme called TechConnect.

Many of the above innovative examples bypass the traditional barriers to realising the potential of technology in reducing loneliness as most:

  • don’t rely on older people engaging directly with the technology; and
  • are based on mobile technology that can be constantly connected, whether inside or outside the home.

However, there is still the issue of awareness of such technologies and their accessibility to older people. The Vodafone report suggests that access could be improved through social and digital prescribing and revitalising support for independent living, and calls for a challenge fund to support innovation. It is suggested that these innovative ideas are just the start and that combined action is needed from across all levels of government, business and community groups, amongst others.

Perhaps if such action is taken to address existing barriers, we will see a reverse in the loneliness trend over the next 10 years.


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

Is technology really the answer to social isolation and loneliness?

Old man sitting on a benchBy Steven McGinty

As we head towards Christmas, the media is filled with images of families coming together and enjoying the festivities. However, the reality is that many people will not be spending the Christmas period with loved ones, and will be spending the festive season alone.

In April, Future Cities Catapult produced a report into the impact of social isolation and loneliness. They highlight that those experiencing social isolation and loneliness have an increased likelihood of developing health conditions such as dementia (1.9 times more likely) and depression (3.4 times more likely). In addition, there is a 26% increased risk of mortality.

The report also included findings from the Mormont Review, highlighting that in emergency situations social networks have a significant impact on recovery.

Individuals who are socially isolated are between two and five times more likely than those who have strong social ties to die prematurely. Social networks have a larger impact on the risk of mortality than on the risk of developing disease, in the sense it is not so much that social networks stop you from getting ill, but that they help you to recover when you get ill.

It’s this substantial impact on people lives’ – and the costs to the health service – which has led to many public bodies looking for ways to tackle social isolation and loneliness.

Technology-based interventions, in particular, are some of the most innovative approaches to addressing the issue that affects over half of all people aged 75 and over who live alone, as well as increasing numbers of young people. Below we’ve outlined some of the most interesting examples.

CogniWin

CogniWin provides support and motivation for older people to stay active and in employment by providing smart assistance and well-being guidance. It helps people to adapt cognitively with their work tasks through their interactions with a system (which collects information using an intelligent mouse and eye tracking software). A virtual Adaptive Support and Learning Assistant then provides feedback, which helps the older person adapt their working lifestyle or have the confidence to take up a part-time job or become a volunteer.

Casserole Club

Casserole Club is a social enterprise that brings together people who enjoy cooking and who often share extra portions with those who may not be able to cook for themselves. Founded by FutureGov and designed in partnership with four local authorities, the service uses its website to allow volunteers to sign up and search for diners in their area (most of which, are over 80 years old). Overall, there are 4,000 cooks nationwide, and 80% of diners highlight that they wouldn’t have much social contact without the Casserole Club.

Family in Touch (FIT) Prototype

The Family in Touch (FIT) prototype was developed by a team of Canadian researchers who noticed that elderly people in care homes and retirement communities often touched photographs in an attempt to connect with family members. Based on this, the team created a touch screen photo frame which sent a message to a relative to say that they were thinking of them. The relative was then able to record a video message, which could be viewed by the elderly person in the photo frame. It was found that elderly people appreciated the simple design and tactile user experience.

Final thoughts

These are just some of the innovative tools being used to tackle social isolation and loneliness. And although technology is not the whole solution, it can certainly provide new opportunities for projects seeking to provide friendship and support to those who feel disconnected.

Individually, we can also make a difference. Even just making a phone call to an elderly relative, sending a message to an old friend, or visiting a neighbour, can brighten up someone’s day.


The Knowledge Exchange provides information services to local authorities, public agencies, research consultancies and commercial organisations across the UK. Follow us on Twitter to see what developments in policy and practice are interesting our research team. 

“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.”



If you enjoyed this article, you may also find these blog posts of interest:

Buurtzorg: reinventing district nursing in Scotland

Buurtzorg roughly translates from its native Dutch as “neighbourhood care”. The model, used extensively in the Netherlands, has attracted international attention as a novel way to deliver community based nursing programmes. Its positive reputation and recorded successes in areas of Holland are attributed to its innovative use of locally-based and locally-aware nursing teams to deliver high-quality person-centred, but low-cost, care.

Seeking to improve core health outcomes

In the Netherlands, Buurtzorg was designed to engage three key health priorities:

  • Health promotion
  • Effective management of conditions (in a community setting)
  • Disease prevention

It focused particularly on the elderly, those who move regularly between hospital and home, and those with long term, constant care illnesses. It has also been used with patients with progressive illnesses such as dementia, with some nurses within the teams being given training to become dementia specialists where appropriate.

The model includes the following key elements:

  1. Holistic and personalised care – where assessments of need are integrated into and form the foundation of agreed care plans
  2. Mapping networks of informal care, and assessing ways to involve these networks in treatment plans
  3. Identifying other formal carers and organisations who provide care services and coordinate their input
  4. Taking steps to support the client in his/her own environment
  5. Promoting self-care and independence on the part of patients.

A number of studies of pilot sites across the UK and beyond have identified the positives and some challenges of applying the Buurtzorg model in different contexts. Some of these are outlined in the table below.

Applying the model in Scotland

In a Scottish context, the model has been applied in a number of areas, with the initial pilots making way for a wider roll out of adaptations of the model. In March 2017, as part of a wider research project, nurses and management staff from NHS boards across Scotland met in Perth to discuss learning and exchange best practice around how the model could be adapted and further rolled out in the future.

It highlighted the different stages that many Buurtzorg areas were at in their roll out, with some like Aberdeen and the Borders far more established than Argyll, who were at the time only in the earliest stages of their Buurtzorg journey. The research and learning event gave practitioners the opportunity to engage and further cement both formal and informal learning networks, which have been identified as key to the success of the Buurtzorg model both in the UK and elsewhere.

The importance of information sharing and informal learning

Rolling out the model in test sites highlighted the importance of planning and learning, and of creating a strong sense of trust between practitioners and NHS management, but also between the Buurtzorg nurses and their service users and other professionals. This change in mindset regarding ways of working, and a change in the chain of accountability was something, which, according to those practitioners who attended the Perth event, many sites have found to be a significant barrier to effective implementation.

However it was also highlighted that promoting and facilitating the creation of formal and informal learning networks and learning spaces can be an effective way to generate conversation about best practice as well as allaying some fears that may persist regarding working culture and approaches, including partnership working with other agencies and understanding risk in the working environment.

In Scotland, approaches have varied, from encouraging nursing teams to create videos and then post them to an online forum, employing more formal training plans to incorporate multiple agencies and ensure that everyone is “singing from the same hymn sheet”, or holding informal drop-in or open space events where staff are supported in their role and given advice to alleviate and find potential solutions to issues.

Practitioners also highlighted that it is important to provide a space where teams can examine what did not work well, and why. Learning from mistakes can often be as beneficial as learning from good practice, as these can provide insights into issue management and resolution as well as how to implement the programme effectively.

It is also clear from feedback, that while a strong core network of nurses and other community based practitioners is vital to the success of Buurtzorg care models, the back team support is also just as important. Creating efficient and streamlined processes leaves nursing teams free to care for patients and allows them more time to develop and deliver the person-centred care which is a key element of the Buurtzorg model.

Final thoughts

Learning from the experiences of the trial projects in Scotland has provided invaluable insights on how the model can be applied and some of the challenges that can be encountered because of the differing context. This knowledge can then be used to shelter and steer newer projects away from danger areas toward best practice and innovative collaborative working. Applying Buurtzorg in Scotland gives the potential to create and implement new models of holistic person-centred care, where practitioners with local and specialist knowledge interact at a local level with other care providers, join up approaches and create a better care experience for service users.

Follow us on Twitter to see what developments health, social and community care are interesting our research team.

If you enjoyed this blog, you may also be interested in our other articles on health care and reablement care

 

Working longer – the reality ‘behind the headlines’

Senior businessman in office working on laptop

By Heather Cameron

With no shortage of headlines highlighting the record employment rate in the UK, and the increasing number of older workers widely reported, it may seem that the outlook for the ageing workforce is a rosy one. But do these headlines hide the reality?

Recent analysis from Age UK argues that the headline employment rate doesn’t tell the whole story about working longer, “making it an insufficient – and even misleading – tool for public policy decision-making”.

The statistics

The most recent official figures show that the employment rate (the proportion of people aged from 16 to 64 who are in work) is the joint highest since comparable records began in 1971, at 74.8%, while the unemployment rate is the joint lowest since 1975.

Data also shows that the employment rate for people aged 65 and over has indeed increased since the 2008 recession. It is currently at 10.4%, up from 7.3% in 2008.

Age UK has also recognised the increase in employment rates for older people, noting that, in fact, the older the age group, the greater the increase in employment. However, the average number of hours worked has declined since the recession, indicating a more complex and perhaps less reassuring situation than the one portrayed in the media.

The biggest drop was for 50-54 year old men, whose average hours declined by 29%. For men aged 60-64, the average number of hours declined by 8 hours (over 22%), while women aged 50-54 experienced a fall of 18%.

The only age group not to see a decline was women aged 60-64, which is likely to be as a result of the raising of the State Pension age.

Choice or necessity?

The change in the State Pension age was justified on the grounds that it gave people more choice and more scope to continue working if they wished to.

A recent CIPD survey found that the most common reason for wanting to work past 65 is that employees believe it will help keep them mentally fit, followed by wanting to be able to earn a sufficient income to continue to do the things they enjoy.

As Age UK suggests, it may be that the reduction in working hours is a good sign if it is due to older workers choosing to wind down their hours, maybe to enable them to juggle other responsibilities such as caring for their grandchildren, while still earning a wage.

However, the research suggests it may be less through choice and more as a result of the changing labour market such as increasing underemployment (working less hours than they would choose to) or increasing insecure working practices driven by the rise in self-employment and the ‘gig economy’.

As it is likely working fewer hours will mean less income, this could be a cause for concern since it will be more difficult for older workers to maintain their standard of living until they meet the State Pension age and for them to save enough for retirement.

Another issue highlighted by the CIPD, is that most employees don’t believe their organisations are prepared to meet the needs of the over 65s, suggesting that there is a need for employers to also review their practices in terms of managing older workers.

Final thoughts

It is clear that while, for some, choosing to work beyond the traditional retirement age will be a lifestyle choice, for many it will be a necessity. Any substantial reduction in working hours for these older workers could consequently pose a real issue.

It would therefore make sense for policy makers to heed the warning from Age UK not to rely on the headline rate of employment for older workers, and rather look beyond it to the reality of many struggling to get and keep the secure, well paid jobs they want and need.


If you enjoyed reading this, you may be interested in reading our previous post on the pros and cons of the gig economy.

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

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.”


‘Olderpreneurs’ – the new generation of start-ups?

Senior Man on Laptop_Fotolia_61314537_XXL.jpg

By Heather Cameron

Entrepreneurs are often portrayed as bright young things launching start-ups, but does the reality of start-up demographics paint a different picture?

Changing demographics

The UK has certainly witnessed a boom in young entrepreneurship in recent years – the number of under-35s starting businesses in the UK rose by more than 70% between 2006 and 2014.

However, recent research suggests that the boom in young entrepreneurs may be waning. According to research commissioned by Google earlier this year, the majority of young people are “not interested” in starting a business, with four out of five young people surveyed saying they would rather work for a well-established company. Particular concerns were also highlighted over risk and instability.

The UK is, however, still ranked in the top 10 countries with the most favourable conditions for entrepreneurs to start and scale new businesses. And official data suggests that the UK continues to see record numbers of business start-ups, exceeding 600,000 in 2015, up on the previous two years.

So if it isn’t the younger generation heading up this record number, who is it?

‘Olderpreneurs’

Despite media coverage of the entrepreneurial spirit of the younger generation, the average age of an entrepreneur in the UK has actually been estimated at 47.

And according to the latest data from the Global Entrepreneurship Monitor (GEM), the most notable increase in entrepreneurial activity has been amongst the over 50 age group.

Referred to as ‘olderpreneurs’, this group could arguably be the new start-up generation.

There has been a 46.5% increase in freelancers over 50 since 2008, an age group that accounts for 72% of all self-employed people. According to official statistics there are around 1.8 million self-employed people over the age of 50 in the UK.

With an ageing population that is also becoming healthier, perhaps this shouldn’t be such a surprise.

Motivations

Motivations for people starting up their own businesses include redundancy, retirement, family circumstances, growing older and life stage milestones.

As life expectancy increases, many don’t want to give up work at the traditional retirement age, as they still lead active lives. Retirement has been cited as an ‘important tipping point’ for some, with the main motivation not to make money or grow their business, but rather something to keep them occupied or earn some extra money while doing something relatively easy.

The introduction of pension freedoms last year has also led to more over 50s using their pensions to fund new business ventures. The over 55s cashed in more than £4.7billion of their pensions in the first six months after pension freedoms were introduced.

Economic impact

And such activity is good news for the economy. It has been suggested that if the employment rate of 50-64 year olds matched that of the 35-49 age group, the UK economy could be boosted by £88 billion.

Older entrepreneurs have also been shown to be more successful than their younger counterparts. It has been highlighted that businesses run by owner-managers over 50 drive up revenues at their companies three-and-a-half times faster than GDP growth – 11.5% compared with 3.1%.

And older entrepreneurs create jobs at a rate more than seven times faster than the UK economic average.

It has also been suggested by the Prince’s Initiative for Mature Enterprise (PRIME) that start-up failure rates in this age bracket are remarkably low. It recently revealed that 95% of its members were still in business a year or more after starting up, compared to the national average of just 66%.

Final thoughts

A significant percentage of the UK population is past retirement age. And the number of people aged 50 to State Pension age is expected to rise by 3.2 million, while the number aged 16 to 49 will have reduced by 200,000 over the next 10 years.

As a result, keeping this group economically engaged surely has to be a priority.


If you found this article interesting, you may also like to read our previous articles on entrepreneurship and self-employment

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

%d bloggers like this: