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Why we need to talk about ageing in place

13 October 2015 Author: Victoria Pinoncely

The first day of October marked the United Nations (UN) celebrating the International Day of Older Persons.  UN Secretary General Ban Ki-moon stated for the occasion that “making cities inclusive of older persons means generating opportunities for their economic and social participation in accessible and safe environments. It also means providing affordable housing as well as the health and social services needed to support ageing in place." This resonated with the theme of the latest RTPI South East conference in Brighton on Planning for an Ageing Population, a theme the RTPI considered in its RTPI Planning Horizons papers Future-Proofing Society and Promoting Healthy Cities.

Ageing is one of the key demographic transitions we are facing. In the UK, by the mid-2030s, there will be over 16 million older people (i.e. aged 65 and over), nearly 3 million of them over 85. By 2061 more than a quarter of UK residents will be aged 65 and over. This will have social implications and economic implications, yet a House of Lords report has suggested that the UK is ‘woefully underprepared’ for this.

For instance the economically active’ age group (people between 16 and 64 years old) will have to support a greater number of older people; by 2037 to the ratio of working age people and those of state retirement age will fall to 2.7 from the current 3.2. Health and social care costs will rise significantly as well as social services more generally and pensions, as older people are more likely to have a long-term condition such as diabetes, dementia or asthma (sixty per cent over 65 years old in the UK report having a long-term condition) and disability. As the older population increases, the number of older people with a long–term condition is expected to rise from three million to 18 million by 2025. Treating those with long -term conditions accounts for 70% of the total health and care budget, over £70 billion every year. This will also build greater pressure on local authorities.

The most proactive approach to addressing these issues lies in prevention by creating environments which promote active and healthy ageing, helping to improve people’s quality of life but also reducing pressures on public services. However, planning and physical environments (beyond housing) are rarely mentioned in government ageing strategies, or reports on ageing – despite it being potentially a key area for our response as a society. Age-friendly environments are shown to be a key factor in ensuring active, healthy ageing, and mobility, as shown in this WHO illustration:

Older Ages Influence WHO

 Source: WHO

According to the WHO Global Age-Friendly Cities guide, “the city’s landscape, buildings, transportation system, and housing contribute to confident mobility, healthy behaviours, social participation, and self-determination, or, conversely, to fearful isolation, inactivity, and social exclusion.” Policy decisions should be based on determinants of active ageing, and this includes physical accessibility, proximity, security, affordability, and inclusiveness as important characteristics.

Housing also plays an important role, as many of the chronic health conditions experienced by older people have a causal link to, or are exacerbated by, particular housing conditions; falls in houses are a major cause of care needs and hospitalisation. Yet the National Housing Federation estimates that 8m over-55s are living in houses that will become unsuitable for them as they grow older, and suggested that around 100,000 new homes need to be built specifically for older people to meet the demands of an aging population. Although the National Planning Policy Framework identifies duties for councils to meet housing demands for elderly people based on demographic trends, many new developments are not filling the gap, which means that older people looking to downsize or move into more appropriate accommodation as their personal circumstances change may struggle to find an appropriate property. The Planning Advisory Service has released a case study of proactive councils when it comes to meeting the need for older people’s housing.

Where housing is located will also be crucial (our Location of Development project will be looking at the implications of this).  Access to services and jobs is more difficult for older people who may not be able to drive or are in a situation of dependency to be driven. The Elderly Accommodation Counsel (EAC) residents consultation shows the importance of location and being close to shops and public transport for older people. Older people can become vulnerable through a lack of transport, services, facilities, opportunities for social engagement and fear of crime in their area; social isolation and persistent loneliness, particularly in later life, have a huge impact on people’s health and wellbeing and can lead to physical and mental health issues. According to Age UK, more than a million people over the age of 65 in the UK report feeling lonely often or always and a similar number of people report feeling trapped at home. In addition, it can be very hard to care for older people – both social care and medical care – when housing is thinly distributed across a rural or peri-urban environment.

Research on the effect of the built environment on mobility in older people indicated that mobility is associated with land use patterns, for example densities and land-use mixes that provide proximity to destinations such as shops and parks. By contrast, low-density areas are shown to be negatively associated with walking as areas of this sort often have poor accessibility and great reliance on car travel. Access to public transport, local amenities and diverse retail outlets can encourage individuals to remain engaged with their local community, and having green spaces is an important age-friendly features of urban environments.

Ensuring healthy ageing requires a different emphasis on enablement and possibilities beyond the discussion on pressure and costs. An ageing population presents an opportunity to rethink and redesign our communities in a way that is inclusive and better for all. Older people in the UK contribute an estimated £61bn to the economy through employment, volunteering and caring, but many feel unrecognised: an overwhelming 92% of respondents to survey don’t feel older people’s skills, knowledge and experience are valued and harnessed by society. In planning strategies, we need to refer to older people not only in terms of (adapted) housing but in broader terms, considering people as workers, consumers, residents, community activists and thus thinking about broader issues such as health, retail, employment, transport and community facilities provision, in order to tap into the potential older people represent for our societies.

Victoria Pinoncely

Victoria Pinoncely

Research Officer, RTPI - @vpinoncely