Oct 30, 2020

Aged care isn’t working, but we can create neighbourhoods to support healthy ageing in place

In 2020, the coronavirus pandemic has exposed issues and inequities across society. How we plan for ageing populations and older people is one critical issue that has been neglected for decades. Fresher-faced youth and families have become the demographic focus of increasingly short-term electoral cycles, reinforcing a deep-seated prejudice against ageing and older people.

If Gandhi is right, and the true measure of a society can be found in how we treat the most vulnerable, then Australia has a lot to learn from the 683 deaths from COVID-19 in residential aged care this year. Australia needs a radical shift to policies that better support ageing in place — that is, in their own homes — rather than relying so heavily on underfunded and poorly resourced residential aged care.

Residential aged care populations are growing, with 70% of facilities located in major cities and 30% in regional areas. These facilities and current policies are failing our older people as identified by the current Royal Commission into Aged Care. Reform is needed now.

However, residential aged care is only part of the problem of failing to plan adequately for ageing. Neoliberal policies have turned the ageing population into a growing consumer market while filial piety or family caring becomes rarer as economic and social pressures on working families (their adult children) become greater.

Older women are particularly vulnerable. In 2007, 75% of women aged over 70 had no superannuation (with superannuation beginning in the 1980s). Two-thirds of residents in aged care were women.

Being age-friendly makes cities more liveable

We need to shift the conversation on ageing to healthy ageing and creating environments that better support ageing in place. Age-friendly places aren’t just good for older people. They also support the needs of children, people with a disability and everyone else in a community.

In recent research we looked at how the World Health Organisation’s Global Age-Friendly Cities Guide can be applied in local planning. The aim was to develop practical tools to help policymakers and planners assess the age-friendliness of local neighbourhoods. This included the use of spatial indicators to measure the eight domains of the Age-Friendly Cities framework.

Spatial indicators investigating the relationship between health and place are created using geographic information systems (GIS) to map the presence of features within a local area. We have suggested key indicators that can be created and mapped using desktop analysis to understand how age-friendly local spaces are.

Table of key indicators for assessing age-friendly cities

Author provided

One of the most striking features is that many of these suggested measures are important for everyone living locally and not just older people. Examples include good walkability, public open spaces, public transport, affordable housing, local services, cafes, doctors and internet connectivity. Others are age-specific such as in-home aged care.

Most importantly, all of these factors are essential ingredients of healthy and liveable communities. Together, they support better health and well-being outcomes for all. We have mapped many of the suggested measures of age-friendly communities in the Australian Urban Observatory.

The use of additional technology such as sensor and robot technology should also be considered in future community and housing design, but this depends on household internet access. That can be a problem, particularly in regional and remote areas where populations are ageing rapidly and fewer aged-care places are available.

Some of these indicators might not necessarily be feasible for all regional and rural communities. Many regional communities have reduced access to services. However, these indicators still provide an important starting point for discussions with diverse rural older people about what is important and what constitutes reasonable access within their community.

If we have learnt anything from this difficult year, then post-COVID recovery must include a broader approach to ageing that extends beyond residential aged care to a focus on healthy ageing. That means better support for people to age in place.

Age-friendly communities enable older people to continue to make significant economic and social contributions to families and communities. However, this can’t occur unless local places plan for all ages and abilities from the beginning.


This story was originally published on The Conversation by:
Melanie Davern, Senior Research Fellow, Director Australian Urban Observatory, Deputy Director (Acting) Centre for Urban Research, RMIT University
Geoffrey Woolcock, Senior Research Fellow (Regional Community Development), Strategic Research Projects, University of Southern Queensland
Kathleen Brasher, Assistant Lecturer, Charles Sturt University; and
Rachel Winterton, Senior Research Fellow, John Richards Centre for Rural Ageing Research, La Trobe University

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  1. What a lot of intellectual rubbish! 70% of aged care residents have dementia, how in hell does a bus stop 400 metres away or any of that other nonsense make their lives better!
    All this crap about kitchens and ensuite etc… people just don’t understand dementia. These poor folk don’t recognise their kids, can’t recognise their room, can’t toilet, eat etc.
    Scandalous that someone paid for that information.

    1. Anton, I think it would be good to broaden your perspective. What makes you look at this article from the point of view of people living with dementia only? This article includes overall suggestions of services aged people require to function well and happily in their own homes and own communities. The support needs of aged people in this category is far less than those living with dementia who require high care, but ard also aging. This applies to those living in care or being cared for by family members. The very issues addressed in this article are greatly important for people of all ages and abilities to be able to function well in our communities. The one area I would love to see addressed in this “neighbourhood” concept is to foster and enable a greater social interaction between community members of all ages, whether old or young. Whatever our age we can all benefit from this mix of generations. One fine example of how this can work magnificently was the ABC series ” Old People’s Home for Four Year Olds”.
      The benefits across the board ranging from the very young to the very old was heart-warming and showed how well mixing the generations socially can bring amazing changes to the lives of us all. I hope you are able to access the necessary support for the situation you expressed concern about. I enjoy this forum as a way of reaching out to others and challenging us to look beyond the square. As an aging person living alone, all the suggestions contained in this article resonated with me.

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