Abstract

One of the great achievements of modern society is the ever-increasing life expectancy of the World population. People do not only live longer, they also do so in better health than before. The ageing of society is a positive yet challenging phenomenon. According to the Organisation for Economic Co-operation and Development (OECD),1 the population share of those of 65 years old is expected to climb to 25.1% in 2050 in its member states. Cities are home to 43.2% of this older population. Understanding the relationship between population ageing and urban change and developing supportive urban communities are major issues for public policy.2 Older citizens are a precious resource, but in order to tap into their full potential for continued human development, our cities must ensure their inclusion and full access to urban spaces, structures and services.3 Therefore, cities are called upon to complement the efforts of national governments to address the consequences of the unprecedented demographic shift.1 But, what exactly makes a city age-friendly, and allows some older people to thrive and others, to find it hard to cope with struggles of daily life?
Age-friendly cities
When talking about urban ageing, and thinking about septuagenarians, octogenarians and nonagenarians, and their high age, it is perhaps nice to consider the age of cities themselves. Our home towns of Eindhoven and Wrocław got city rights in 1232 and 1262, respectively. The Hague never had historical city rights, but existed as a de facto city in mediaeval times and was granted honorific city rights in 1806 and 1810. This makes these cities young on a historical scale. The first great civilizations and their cities emerged around 3000 BC in the river valleys of Mesopotamia, India, China and Egypt. Given this age-old history of cities, cities and ageing are a seemingly perfect combination.
But is that really so, and are urban environments best for an ageing population? Cities, generally have more and better resources and offer greater opportunities than rural communities. In an opinion piece in The Guardian, the question was posed if cities are best for an ageing population,4 stating that ‘for an ageing society to function there needs to be a movement back to the cities – but cities need to be adapted and designed with this in mind. Cities don't always seem the most old-age friendly of places’. Cities may be the best possible environment for older people, if they under a cycle of continuous reinvention and adaptation to make them suit the needs of an older population. Such an approach encompasses a plethora of solutions, but to a large extent it is the built environment that makes a city, together with its inhabitants. So, what makes the city age-friendly, or a place for older people to thrive? Plouffe and Kalache3 describe the efforts of the World Health Organization (WHO) to engage and assist cities to become more ‘age-friendly’, through the Global Age-Friendly Cities Guide. An age-friendly city should ideally be inclusive and offer opportunities, not just be friendly, too for all the people living in the city. The concept itself is rooted in Lawton and Nahemow’s ecological perspective, which articulated the dynamic interplay between individual adaptation and environmental alteration to maintain optimal functioning in older age.3 The WHO project proposed that an age-friendly city is one that promotes active ageing and optimises opportunities for health, participation and security, in order to enhance quality of life as people age.3 The features of age-friendly cities were determined in eight domains of urban life,3 namely outdoor spaces and buildings; transportation; housing; social participation; respect and social inclusion; civic participation and employment; communication and information and community support and health services.
Ageing societies pose diverse challenges, such as redesigning infrastructure and urban development patterns, social isolation, lack of accessibility and housing affordability.1 All the aforementioned challenges are related to the indoor and built environment. Imagine the business potential for professionals with a background in one of these fields. There are many opportunities that society can benefit from, including new developments in technology and innovation, market approaches to retrofit existing housing facilities that allow older people to maintain or regain their autonomy, and the organisation of services for older people by older people in voluntary networks.1 Also, many of these opportunities may require support from policies, which means that policy makers are increasingly engaging in work related to the ageing of society in the broadest sense of the term, instead of just care support and pension schemes. The OECD recons that policies for ageing societies should be seen as a way to build for the future.1 In our context, this may literally mean build!
Building places and neighbourhoods for an ageing population
What does it mean when a city’s population is ageing for the built environment and urban planning? How can related services meet the needs of the ever-diversifying urban population and who are the stakeholders responsible for providing these services? First of all, many cities are known for high real-estate prices and a high demand for residential space. This implies that one may need to design and develop small dwellings for older people who are less affluent and have difficulty paying the rent or find it hard to obtain a mortgage as they no longer actively participate in a work life after retirement. But the lack of space and financial means is not the main driver for small dwellings: it is the fact that the growing number of older people are, in fact, single-person households, made up of people who have been single all of their lives (without having any offspring), or who divorced or became widowed.
Instead of building smaller homes and apartments, larger dwellings could accommodate multiple tenants at the same time, such as in the 1980s television hit series The Golden Girls. Think of group living with like-minded people, with friends or old acquaintances, who share similar interests. Having bonds with co-residents and other people is known to contribute to a sense of home among nursing home residents, and probably the same is true for people living in the community. The Dutch ThuisHuisProject5 initiative is an example of such a trend of people living together on a voluntary basis. In a Thuishuis home, five to seven people live under one roof, and each of the occupants have about 40 m2 of private space which they can decorate according to their personal preferences. Occupants share a kitchen, one communal living room, guest rooms and a garden. Living together could also be an effective strategy to combat feelings of loneliness among older people. The beauty of this arrangement is that social housing associations can help provide such spaces to live, as well as private investors and people with financial resources themselves. Imagine the opportunities for people who want to live together in terms of shared resources, cooking and eating together, keeping an eye and helping a fellow occupant to when he or she falls ill. Again, people who have found themselves divorced or widowed may find it attractive to start living together and the same goes for people who have always been single but miss the interaction with others that they used to have when still employed or active in organisations. For many people, it seems like an ideal: to live together with like-minded people. This notion goes even further in multicultural urban environments, where we have witnessed the emergence of housing facilities for older people with a comparable cultural, ethnic, social or religious background. Many of the world’s large cities have a multicultural and multi-ethnic build-up of their societies, and each of the groups have their own needs and preferences in terms of housing and interaction with each other. Community building is about stimulating the sense of belonging and sense of community among older people, and between generations, as well as about promoting social connectedness within urban environments. Cities are important sites for building social networks but can also trigger marginalisation and social exclusion. There are many methods for social engagement available to practitioners.
Age-friendly cities also include barrier-free buildings, including a large number of home modifications that are available to adapt dwellings.6,7 Easy-access and single-level dwellings are needed to house the growing group of older people, who may be at a higher risk of reduced mobility and who are prone to falls. Again, age-friendly architecture can help: as accessible dwellings are also a blessing for young parents with prams; and this should not where it ends. When talking about accessibility of buildings and homes, one should also consider the concept of ‘egressability’. Are people able to leave a building in case of calamities? Such events include fires or being taken away on a stretcher by an ambulance worker, or in extreme and terminal cases, in a coffin upon death. Less extreme examples of mobility are found in public transport with accessible busses that take people from A to B, outdoor seats for people to take a rest, public toilets and even adjusted sidewalks that are accessible for people using wheelchairs and wheeled walkers, and again, for young parents with prams. For instance, inner cities that are easy to reach by public transportation, have sufficient seats to take a rest, public toilets and a place to enjoy a cup of coffee, may be inviting to older clients to spend cash while shopping.
Many facilities and elements of urban design have an impact on walkability of neighbourhoods. Access to public services, better commutes and proximity to other people and places make neighbourhoods happier, healthier and more sustainable. In order to make cities more age-friendly, there is a need to undertake actions in improving urban walkability conditions, as they are strongly related with quality of life of citizens.8 And the outdoor environment can be a place where people meet, with fitting adaptations for the local climate. When going to Mediterranean countries, one can see older people sitting together on public benches and have a chat about life, and in the Caribbean, one can see people enjoy a game of dominoes. Also, when the weather does not permit outdoor activities, the indoor environment should be comfortable for older people, too. Urban planning challenges include an even and accessible distribution of services, including shops and health centres, which do not require large distances to travel.
We cannot discuss urban ageing without acknowledging the increase in the number of people with dementia. These people need legible and familiar indoor and outdoor environments.6 Such spaces are also beneficial to the community as a whole. Interesting examples come from The Netherlands and Belgium, where the Dementia-friendly Municipalities initiative provides programmes for raising awareness among people about dementia and make services more accessible through training. As you can see, a unilateral focus on just home modifications would mean that the city is a place less rich, less inclusive and less accessible to the older people.
Sustainable urban ageing with the use of technology
We have discussed the so-called ageing-related transition in the built environment in the context of urban ageing. Let us not forget that there is also the energy transition in the built environment. These two transitions require a lot of effort from various stakeholders but are not necessarily two worlds apart. The construction of comfortable and accessible dwellings for older people goes together with an increasing need for energy-efficient and sustainable housing.9 The European Commission’s ‘Clean Energy for All Europeans’10 proposals include measures to improve the energy efficiency in the built environment in the light of a clean energy transition. There are several measures aimed at protecting the most vulnerable consumers, for instance, in the light of energy poverty. Home energy monitors and automated energy systems can be installed in dwellings of older people in order to help save energy.
Apart from aspects of energy conservation and poverty, discussions need to be held about the potential consequences of weather extremes and climate change to the most vulnerable groups in our societies. There are already many actions undertaken in the field of adaptation to climate change and mitigating its negative effects. There are many ‘do-it-yourself’ solutions and actions that can be done by citizens themselves. Local activities, which are spread around the city, may play a significant role in facing problems relating to the urban heat island effect, air pollution or urban floods and the potential risks these environmental issues pose to older people in relation to emergency preparedness. We need more public awareness among people for their roles and responsibilities for a shared urban living environment. There are rather well-known approaches on how to include citizens as local experts in order to identify issues and suggest actions in plans and policies for urban adaptation to climate change.11 If we face the problems of a changing climate and age-friendly cities in an integrated manner, we will see significant connection between these issues. Therefore, in a way, adapting cities to climate change may result in an improvement of the quality of life of older people and make cities more sustainable in socio-environmental aspects.
Here, urban populations can be the front runners in the use of technology in order to cope with the aforementioned transitions. Older people living in an urban city are more likely than rural ones to use many devices.12 Technology is often seen as a solution for sustainable urban ageing in a smart city, which also includes smart home technologies to support well-being, independence and the provision of health care services. The engineering communities, including the readers of Indoor and Built Environment, have an important role to play in the transition towards sustainable, inclusive and healthy urban ageing on a national and global scale. A strong belief in the positive effects that technology, design and engineering have on the continuous development and well-being of mankind can help boost innovations in this direction.
Footnotes
Authors’ contribution
Joost van Hoof is the main contributor for this article. Jan Krzysztof Kazak was responsible for aspects concerning urban walkability and climate change actions.
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
