Second World Assembly on Ageing Madrid, Spain 8 -12 April 2002
Providing a safe and enabling environment
The living environment for older people becomes tremendously important as they age, and families and older persons are often confronted with painful or expensive choices. Homes that were wonderful for a young family can prove to be an obstacle course for an older person.
An adult child in the "sandwich" generation, caring for a parent and children at the same time, very likely spends time worrying about the parent just as they once worried about their toddler when out of sight. What if mom falls down the stairs? What if dad trips on his way to the kitchen? What if mom gets stuck behind her walker in a small bathroom? Can she safely get to the kitchen and get herself food? Is the food accessible? Can she reach the glasses? Will someone check on her? What if that someone should be delayed, or prevented from coming? What to do when the kitchen and the bathroom and the bedroom are on different floors? Buy a new house? Build on another room? If these questions - and their answers - seem irrelevant today, they will probably take on real meaning for almost everyone, someday in the not-too-distant future. While this particular set of questions may be more pertinent for the lucky more wealthy humans living in developed countries, and other questions more relevant in "human settlements" in much of Africa and Asia, some issues are universal.
Adequate housing and a safe and enabling environment is a basic need when it comes to older people - and their children. It can make all the difference in quality of life. Today, with the rapid ageing of the population that is now restructuring human society around the world, it is a particularly timely subject.
Why does housing matter so much?
The social costs of population ageing have been a source of concern for planners and experts for at least the last 30 years, certainly since the first World Assembly on Ageing took place in 1982 in Vienna. But at that time, the concern was with population
ageing in developed, wealthy countries. Today, the concern is the much more rapid process of ageing taking place now in developing countries, where access to the most basic services - such as toilets, clean water and garbage collection - are not available to large segments of the population, many of whom live in precarious and unhealthy circumstances in informal "squatter" settlements that have sprung up around major cities in the developing world. The pace of population ageing that is expected to take place in those cities - which will become the mega-cities of the 21st century - will be truly astonishing.
As people age from young older to older old and oldest, disabilities become much more common, and mobility, and consequently access, become more and more limited. At the same time, it is important to remember - and very easy to forget - that, as people age, they also become more diverse in terms of abilities, health, participation, and other types of activity.
In 1999, to get a better idea of the living circumstances of older people with low incomes, the United Nations Human Settlements Programme (UN-Habitat) undertook a study in cooperation with the Institute of Public Administration. At that time, projections by the UN Population Division indicated that the share of older persons living in urban areas would increase by a factor of 16, from 56 million in 1998 to 908 million in 2050, or to one-fourth of the total urban population. In this study, the older residents who were interviewed expressed their concerns, identified changes they would like to see implemented and services they would like to have provided, and made suggestions on how such changes could be brought about. In the most basic way, the information gathered was not surprising.
Many older persons living in squatter settlements were unhappy with their homes. They complained about the inadequate size, poor construction and unhealthy surroundings in which they lived. But those in good health said that they would definitely improve their homes - if only provided with affordable and secure tenure, and with small low-interest loans to buy building materials. Convenient and affordable access to health clinics and hospitals was also a high priority, and for those who could not get to health facilities, home visits by people appropriately trained in geriatrics were very desirable.
A common concern was personal safety. Most of the older persons said they wanted protection - from crime, from social discrimination, from traffic - and from many other hazards. They also wanted basic things, such as an adequate water supply; solid waste and sewage disposal; access to their homes by road or path; and electricity, telephones and fuels at affordable costs. They wanted air and water pollution and hazardous wastes reduced or eliminated. Finally, they wanted safer housing sites, that ere not located on steep slopes or in wet areas.
Another common desire was for more social contacts within the community. Those interviewed suggested community centres or elder centres for social contacts, recreation, counselling and minor health care. Also wanted: opportunities to participate in community affairs, employment, education and training services for those able to work, and more opportunities for inter-generational contacts.
Active ageing and ageing in place
Two complementary concepts are often used today when designing and implementing policies for providing a safe and enabling environment for older persons: active ageing and ageing in place.
Active ageing means what it says: remaining active as one grows older. People who continue to be productive members of society and contribute to the economy have better health, live longer and have a higher quality of life. National and local policies can go a long way to help to provide opportunities and support to individuals to age more actively. There are a number of policy choices that can be effective and that are cross-cutting in terms of the involvement of UN agencies, programmes and departments. Some of the most important are:
· Provide opportunities for and encourage lifelong learning, particularly to keep older persons abreast of technological changes and changes in work and skills;
· Create conditions that allow older persons to remain involved in mainstream activities of society, such as transportation to shopping, voting, or public entertainment;
· Make affordable and effective medical interventions, such as hip replacements and cataract surgery, more readily available.
· Make public transportation accessible to older people who may have some disabilities.
Just as more active older people have a higher quality of life, they are also more independent and better able to finance their own needs.
Ageing in place is more specific to adequate housing and a safe and enabling environment. Older people who wish to do so should be enabled to remain in their own homes and environments as long as possible. Institutional arrangements, such as long-term care, should be avoided or delayed as long as possible. Appropriate improvements to housing, such as changes in design and easier access to services, can do a lot to sustain the activity level of older people, and thereby reduce their dependency.
But the physical environment is not all that is important. Ageing-in-place policies should also include social integration as a fundamental and necessary element. It is crucial that older people be supported and encouraged to continue their participation in the social and economic life of their communities. For active ageing and its healthful consequences to be achieved, social integration should be given equal importance as surroundings that are safe and easy to navigate. At the same time, it is also important that the implementation of ageing-in-place policies does not limit the options available to older people or their families. Sometimes the best option may mean moving - to a more convenient dwelling and/or renting, sharing, or selling homes that may have become impractical or burdensome.
The fundamental challenge to all stakeholders, particularly governments and local authorities, is to develop strategies and actions that will result in more sustainable human settlements. More cohesive societies and improved citizen participation in decision-making processes are mutually reinforcing. In today's urban age, sustainable cities are the ultimate goal - not only for older people, but for everyone.
UN-Habitat has long included the issue of ageing and older persons among its diverse activities working with vulnerable groups and human settlements development. In 1982, prompted by the World Assembly on Ageing held in Vienna that year, the Centre produced the report: Human Settlements and Ageing. A second publication in 1993 incorporated the findings of recent global research, in particular case studies prepared for the cities of Ottawa, Canada and Madras, India. The publication, Improving the quality of life of the elderly and disabled people in human settlements, carefully analyzed the living conditions of these groups and made detailed recommendations for action, particularly at the local level.
To contribute to the International Year of Older Persons and to the preparations for the Second World Assembly on Ageing, UN-Habitat and the International Council for Caring Communities (ICCC) continue to undertake activities aimed at raising awareness, deepening the understanding of the implications of ageing and indentifying more effective ways to address the needs of older persons. Through this partnership, successful events have been organized in several cities in Eastern and Central Europe and as parallel events to sessions of the Commission on Social Development at United Nations Headquarters in New York.
For further information, please contact:
United Nations Human Settlements Programme
UN Department of Public Information
Tel: (212) 963-0499
Published by the United Nations Department of Public Information DPI/2264 March 2002Back to Table of Contents