The slides from the first in a series of three seminars from ILC-UK and Age UK on Community Matters - are our communities ready for ageing?
Full details here: http://www.ilcuk.org.uk/index.php/events/community_matters_are_our_communities_ready_for_ageing_getting_out_and_abou
Enjoy Night ≽ 8448380779 ≼ Call Girls In Gurgaon Sector 46 (Gurgaon)
'Getting out and about' A Community Matters seminar from ILC-UK and Age UK
1. Community Matters – are our
communities ready for ageing?
Seminar 1: ‘Getting out and about’
Tuesday 11th March
This event is kindly supported by Age UK
#communitymatters
6. Community Matters: are our communities
ready for ageing: Getting out and about
Setting the scene – where are we now and
where do we want to be
Dr Charles Musselwhite
Associate Professor/Reader in Gerontology
c.b.a.musselwhite@swansea.ac.uk
www.drcharliemuss.com
7. A reduction in mobility can result in an increase in
isolation, loneliness and depression and an overall a poorer
quality of life. (Fonda, et al., 2001; Ling and Mannion, 1995; Schlag, et al., 1996)
8. More miles driven per person
Source: DfT (2002, 2006, 2010)
Older people are more healthy
and active as a cohort than ever
before and as such are also
more mobile (Tomassini,
2004).
Increasing hypermobile society,
where services, shops, work
and families are increasingly
dispersed
Increasingly reliant on the car
Growth in % licence holders over 70 years
0
500
1000
1500
2000
2500
3000
3500
4000
4500
1995/97 1998/00 2002 2005 2010 2011 2012
Milesdriven/person/yearGB
Miles driven GB
60-69
70+
All ages
+77%
+37%
-8%
-
10
20
30
40
50
60
70
80
90
% of GB licence holders over 70
female
male
9. W-H
• Especially by car
Source: Musselwhite, C. and Haddad, H. (2010). Mobility, accessibility and quality of later life. Quality in Ageing and Older Adults. 11(1), 25-37.
PRIMARY MOBILITY NEEDS
Practical/utilitarian Needs
e.g. get from A to B as safely, reliably, cheaply and comfortably as
possible.
SECONDARY MOBILITY NEEDS
Social/affective Needs
e.g. The need for independence, control, to be seen as normal.
Linked to status, roles, identity, self-esteem. Impression management
On giving-up driving this level of needs is adversely affected
Isolation, no longer part of society, no longer feel normal
TERTIARY MOBILITY NEEDS
Aesthetic Needs
e.g. The need for the journey itself for relaxation, visit nature, use and
test cognitive skills
A reduction in mobility can result in an increase in
isolation, loneliness and depression and an overall a
poorer quality of life.
On giving-up driving this level of needs is adversely affected
Not so easy to ask for discretionary travel
On giving-up driving –
this level of need is usually met
friends
accessible transport
public transport
teleshopping?
“Well Dorothy and David from
number 3 take me shopping
every week, we all go, we have
a bit of a time of it you
know, it’s a kind of outing. I
never expected that. ”
(Female, gave-up driving at 80)
“It’s hard to explain I suppose.
You just don’t seem like you
belong. I suppose yes there are
feelings that you might be
ready for the scrapheap now.
The first step to it, you know”
(Male, given-up driving at 76)
“You can’t ask other people
to take you out for “a
drive”. They’d think you’d
lost their senses. Anyway
they have got better things
to be doing with their
time, then ferrying me about
just for the sake, like”
(female, gave-up driving at 80)
10. Traditional Categorisation of Trip
Purposes
10/
“Essential”
Tourist“Discretionary”
Travel for Utility
• Time wasted: to be
minimised
• Distance to be overcome
• Destination-focussed
• Routine
• Often Essential, Productive
Travel for Tourism
• Novel
• Enriching
• Less destination focussed
Economic
Priority
Economic
Priority
12. To consider...
• Therefore in general terms, the more complex road environments are, the higher the
accident involvement for older drivers.
• „Self-explaining‟ roads which include perceptual cues are needed e.g.
• “This is a „quick win‟ area, in which many of the benefits are likely to extend
beyond older drivers to the rest of the driving population”. (Box et al., 2011)
• To help older people stay driving later on in their life, should we design an
infrastructure to help them be safe?
– Would it be a safer environment for everyone? 12
Change the infrastructure
Self-explaining roads
13. Dashboard sign display (with user prioritisation)
Head-up sign display (with user prioritisation)
Head-up display of current vehicle speed
Audible speed cue (driving speed)
Audible warning when reach actual speed
limit
Intelligent Speed Adaptation
GLARE AND LUMINANCE
Night vision enhancement
Head-up display
Dashboard display
EXTERNAL DISTRACTIONS
MAINTAINING A CONSTANT SPEED
Change the vehicle
Increase the automation?
Musselwhite, C. and Haddad, H. (2008). Prolonging safe driving through technology. Final Report. UWE
14. Change the law: Restrict driving
Re-take driving test
Stricter medical test
No to extra tests
Other than for prompting
Self-regulation?
Works well, but the future with working
later? More car centric society?
Grabowski et al
(2004)
USA – Vision tests, road tests, more
frequent licence renewals, in
person renewals no difference
Langford et al (2008) Victoria (no age controls)
and
New South Wales
(medical assessment 80+
and on road test 85+)
No sig diffs for older or other
road users
Mitchell (2008) Across Europe lowest fatality rates for this age
group occur in two of the
countries (UK and the
Netherlands) with more relaxed
procedures
Siren and Meng
(2012)
introduction of age-
based cognitive
screening starting from
the age of 70 in
Denmark in May 2006,
in a population-based
study.
Whilst collision rates for car
drivers did not significantly
change across any age group.
the collision rate for older
vulnerable road users in the
post-implementation period
increased significantly: by 38%.
Langford et al.,
(2004).
In Sydney (where there
is mandatory assessment
from 80 years onwards)
and Melbourne (in which
there are no age-based
controls)
older drivers in Sydney (with
age-based controls) had higher
collision risks per licence and
per times spent driving than
those in Melbourne (who had
no controls).
15. Change the driver
Education:
Improves self-awareness
Training, education
Feedback from others, the environment, cars
But how aware are you in wider
social context?
Who would want to be educated?
Who would bear the cost?
Who would attend?
Age discrimination?
How to improve self-awareness
Cognitive tests
On-road tests
Classroom/group work
Role of ADIs
Physiological test?
Cognitive tests
On-road tests
Do the courses work?
Evidence?
How would the evidence look?
Course
Must allow self-reflection
Must allow chance for fail
Must encourage strategies to adopt to help self-
regulation
Must provide help with alternatives
Involve Forum of Mobility Centres
Look for champions and leaders
AA Drive Tech
Wessex DriveAbility
Musselwhite, C.B.A. (2010). The role of education and training in
helping older people to travel after the cessation of
driving International Journal of Education and Ageing 1(2) , 197-212
Musselwhite, C. (2011) Successfully giving up driving for older
people. Discussion Paper. International Longevity Centre - UK.
17. Multimodal
Re-engage in immediate
locale
Literal Potential Virtual Imaginative
Successful at giving-up driving
Plan in advance
Trial and error
Support of family and friends
“I’ve re-discovered my local
area. Which is great. I forgot
what the village has to offer.
In fact I think it is better than
a few years ago. But not
using the car has forced me
to use more local things.”
(female, aged 75)
“The bus out is a
real bit of fun. I go
on it with friends...
and we have a day
out” (female, aged
70)
Musselwhite, C.B.A. and Shergold, I. (2013). Examining the process of driving cessation in later life. European Journal of Ageing. 10(2), 89-100
18. • Bus use
• Unprecedented cuts in services
• Growth of community transport
Issues:-
• Must communicate the benefits of
free bus pass
– Wider economic and social benefits
to individuals and society
– Need to map return on investment
• Quality of service
• For aesthetic purposes – just
getting out and about
Formal information
Alternative transport provided locally
Timetable of buses
Location of bus stops
Walking area
Real time information
Informal information
Does the bus leave when it says it does?
Ease of carrying shopping/luggage on a
bus?
Ease of getting a seat on a bus?
State of the pavements for walking?
Provision of benches, formalised crossing
areas, toilets etc.
Feeling of safety using transport/walking?
Attitude of bus driver
Musselwhite, C.B.A. (2010). The
role of education and training in
helping older people to travel after
the cessation of
driving International Journal of
Education and Ageing 1(2) , 197-
212
19. It is estimated there are around 300,000 mobility-scooter
users in the UK
(DfT, 2010c).
Very positively received by users as they help maintain
freedom and independence (e.g Barham et al., 2006;
DfT, 2010c; Steyn and Chan, 2008).
Issues:-
Who uses them?
Insurance and safety?
But do they replace walking and effect health?
Thoreux (2011) perform worse than non-users.
The role of mobility scooters
20. DfT Minimum crossing
speed 1.22m/s (88% not
walking fast enough!)
Walking
TERTIARY TRAVEL NEEDS
Aesthetic Needs
Pleasantness/desirability of neighbourhood
open spaces (trees, plants, waterscapes)
SECONDARY TRAVEL NEEDS
Social Needs
A place to make a statement and interact e.g.
suitable spaces to socialize. Inter-generational
community important
PRIMARY TRAVEL NEEDS
Practical Needs
Large, open, un-crowded, low level of noise. Lack of
nuisance.
Well maintained paths for movement. Facilities and
amenities.
Only 11% walk as fast or faster than DfT recommendations for pedestrian crossing time
Only 6% of females
Faster if higher socio-economic background, healthy and confident
Agrees with previous research (Asher et al., 2012, Newton and Omerod, 2007).
fear of not being quick enough to cross the road is known to restrict people leaving the home or limit their accessibility when out and
about (IDGO 2013; Lord et al., 2010; Zijlstra, 2007).
Make streets attractive
Musselwhite, C.B.A. (2014). Environment-person interactions enabling walking in later
life Proceedings of the 46th Annual UTSG Conference, Transport Operations
Research Group, Newcastle University, 6th January
22. • Transport is more than just A to B
• Provision beyond the car must reflect diverse patterns of travel and individual need.
• How to help break the giving-up driving = poorer health and wellbeing correlation
• Integration: within travel training, within provision and services.
• Multimodality from a young age.
• Increasing need to prove mobility is important (and the wider economic and social
benefits).
• Future:
– Novel solutions. ITN America.
– Re-inventing existing solutions: Taxis/cycling
– Milton Keynes Pods
– Nature of working later? Health and fitness of society? Falling out of love with the car? Will we even
have cars?
– Role of Virtual mobility?
24. Getting Out and About:
where are we now and
where do we want to be?
Catharine Ward Thompson
Professor of Landscape Architecture
Director of OPENspace Research Centre
The research centre for inclusive
access to outdoor environments
26. Mobility, Mood and
Place (MMP) explores
how places can be
designed
collaboratively to make
mobility
easy, enjoyable and
meaningful for older
people.
28. Evidence: What we know
• The pedestrian experience is vitally important to older
people, who are most often on foot when out and about.
• Poor quality environments are seen as increasing falls risks and
can exacerbate the challenges of socio-economic deprivation and
social isolation
• A supportive environment – one that makes it easy and enjoyable
to get outdoors – is associated with a range of physical, mental
and social well being outcomes
• Living within 10 minutes’ walk of a pleasant local park, and
having easy and enjoyable routes to get there, makes a big
difference to likely levels of walking and satisfaction with life
• People living in care homes are very much less likely to get
outdoors than those living in their own homes
• Physical exercise has a more beneficial effect on older people in
delaying brain shrinkage than ‘mental exercise’
• Older people’s wellbeing is enhanced by having an accessible
outdoor space and a green view.
30. Gaps in research and policy
• What level of environmental quality in the residential
street, park or local neighbourhood is sufficient – good enough to
support health and quality of life for older people?
• Can environmental improvements alone be demonstrated to
increase levels of outdoor activity in older people? If so, what
kind?
• Does outdoor activity per se reduce social isolation as well as
enhance physical and mental health?
• What are the positive qualities/assets that encourage people to
go out, remain active, and give them pleasure into very old age?
• What levels and types of public lighting might make a difference
to older people’s outdoor access at night? Is this a sensible
strategy to pursue or a waste of investment?
• What is a minimum acceptable standard of residential open
space provision to ensure opportunities for wellbeing are
maximized into very old age?
31. Image courtesy of Sustrans
Five things that might fix some of these issues
32. Image courtesy of Sustrans
Five things that might fix some of these issues
1 Rationalise the planning system so that non-mandatory features
such as open space/green space don’t ‘slip through the cracks’
and get lost. An appropriate minimum standard of access to
green space might be based on the Accessible Natural
Greenspace Standard (ANGSt)
2 Recognising the physical and mental health benefits of access to
green space, place a mandatory requirement for residents in care
homes to have access to gardens and assistance to enjoy them.
3 Recognising the health benefits of access to green space, place
spending on green space under the umbrella of health and so
ringfence it. It requires a commitment to recurrent spend.
4 Place a mandatory requirement on private developers to provide
suitable green space in housing developments on-site.
5 Create a set of national standards for road crossings
incorporating types, siting, and maintenance with a mandatory
requirement on local authorities to adhere to such standards.
33. Sophie Handler
Research and Planning Officer
Age-Friendly Manchester
Chair
RIBA working group on Ageing
This event is kindly supported by Age UK
#communitymatters
34. Getting Out and About in older age
What do we know?
1. the ‘amplification of impact’
the disproportionately disabling impact of obstructive, urban
environments on older people
2. ‘alienation’ from urban surroundings
> cities structured to meet needs of a working age demographic
> the vital but often neglected role of older people in planning and
design processes
> the less visible impact of urban environments on people’s identity,
sense of self and belonging in older age
3. the inherent value of public spaces
the value of spaces that can be used, shared and appropriated
(even in older age)
35. What are the gaps in research and policy that we need to fill?
1. Scale and sustainability
developing sustainable policies that connect city-wide programmes to
the fine grain of community-led initiatives – in ways that support older
people in getting out and about over the long-term
2. Developing policies that think beyond the physical
what kinds of programmes, policies and initiatives might be developed
together with older people to support and encourage older people to
feel more confident in getting out and about?
3. Alternative forms of urban design practice
what can we learn from creative, relational forms of design practice
in encouraging older people to ‘lay claim’ to their urban surroundings?
36. If you were a minister, what are the five things you would do fix some of
these issues?
1. Encourage original urban research
work with funding councils to support innovative and creative inter-disciplinary
practice-led research and collaborations
2. Champion best practice
promote and disseminate best practice on creating age-inclusive spaces – to
inform and animate public debate
3. Support Local Authorities
support programmes and initiatives that share learning between cities across
the UK (develop a learning infrastructure and resource for local authorities
across the UK)
4. Engage Professional Bodies
work with professional bodies to build an ageing lense into professional
standards and practice
5. Promote integrated Age-Friendly Cities approach
sponsor programme development of Age-Friendly Cities and Communities
(based on the integrated WHO approach)
37. Dr C.G.B. "Kit“ Mitchell
Co-chair
Transportation Research Board's
Committee on Accessible Transportation
and Mobility
This event is kindly supported by Age UK
#communitymatters
38. Mobility – what we know
• As we age, we make fewer journeys;
•
• The reduction is almost wholly due to
fewer car driver journeys;
• Older people are more than average
likely to live in low density areas;
•
• By age 80, about 10% of male and
20% of female drivers will have
surrendered their licence.
39. Trips per year for men and women
in Great Britain 2011-12
Men WomenCar driver
Car passenger
Other Walk
Bus
-
200
400
600
800
1,000
1,200
40-
49
50-
54
55-
59
60-
64
65-
69
70-
74
75-
79
80-
84
85+
Journeysperyear.
Age group
0
200
400
600
800
1,000
1,200
40-4950-5455-5960-6465-6970-7475-7980-8485+
40. 0
5
10
15
20
25
30
35
40
10 100 1,000 10,000
Percentageofretirementage.
Population density people per sq.km.
PERCENTAGE POPULATION RETIRED
GREAT BRITAIN 2008
41. 0
5
10
15
20
25
30
35
40
50 55 60 65 70 75 80 85 90
Reductioninlicenceholdingfrom.
peakforcohort.
Age
PERCENTAGE OF CAR DRIVERS WHOSE
LICENCE HAS LAPSED
Men
Women
42. Mobility – what we do not know
• What we can do to help older women
continue to drive safely and without
stress, at least locally;
•
• How to encourage older people to
settle in areas where they will not be
wholly car dependent;
43. Mobility – suggestions for Minister
• Require drivers over 70 to submit an
optician’s certificate with licence
renewal;
•
• Encourage and support local authority
schemes for older driver voluntary
checks;
• Study the US guidelines for highway
design for older drivers, to introduce
appropriate sections here.
47. Community Matters – are our
communities ready for ageing?
Seminar 1: ‘Getting out and about’
Tuesday 11th March
This event is kindly supported by Age UK
#communitymatters
Hinweis der Redaktion
However, our current project is focusing on the positive – what is it about getting outdoors that makes things enjoyable and meaningful, reinforcing the benefits and reducing anxiety?In particular, what might be the environments that are ‘restorative’, that help people cope better with busy streets, for example, when they do have to encounter them? Alertness vs relaxation.
The pedestrian experience is vitally important to older people, who are most often on foot when out and about. For the many who find it difficult to get around, it is often due to the poor design, provision, installation or upkeep of neighbourhood features, especially footways. Lesser-quality environments are often considered by older people to pose an increased falls risk, especially by those with vision, mobility or other impairments. They can heighten fears about crime, nuisance and traffic and make going outdoors less enticing; reinforcing feelings of loneliness or entrenching the challenges of socio-economic deprivation. Inconsistency, e.g. between types of road crossing and tactile paving, can make older people uncertain about features that are designed to be enabling.If older people live in an environment that makes it easy and enjoyable for them to go outdoors (i.e. a supportive environment), they are more likely to spend a longer time outdoors, be more physically active and more satisfied with life. They are twice as likely to achieve the recommended levels of healthy walking.Living within 10 minutes’ walk of a local park, and having good quality paths on the way to the park, are associated with up to twice the odds of undertaking 2.5 hours of walking per week. Living within 10 minute’s walk of the local park is associated with over twice the odds of being satisfied with life, and pleasantness of this local open space, as well as safety, are also associated with nearly twice the odds of satisfaction with life.People living in their own home are almost 3 times (1/0.34) more likely than people living in shelter/care home to attain 5 hour or more of total outdoor time/week.Recent research into the Lothian Birth Cohort found that people aged over 70 who took regular exercise showed less brain shrinkage over a three-year period than those who did little exercise. The Edinburgh team used MRI scans to measure the volume of brain tissue and the volume and health of the brain’s white matter in almost 700 people. The research supports the view that physical exercise has a more beneficial effect than “mental exercise.”In 21stC. developments, residential outdoor space (ROS) tends to be less green than it was pre-2000. The levels of such space in the rising number of homes built for older people is below average. Older people’s wellbeing is enhanced by having an accessible outdoor space or a green view, and the more types of residential open space, whether owned or shared, the greater older people’s satisfaction is likely to be. Front gardens, in particular, are valued as a place for social interaction. Some of the positive effects of residential open space on wellbeing actually appear to strengthen as people age.
What level of environmental quality in the residential street or local neighbourhood is sufficient to support healthy activity levels or quality of life for older people?What kinds of environmental improvements can be demonstrated to increase levels of outdoor activity in older people? Does outdoor activity per se reduce social isolation as well as enhance physical and mental health?Removing barriers is necessary but not sufficient to increase mobility. We need to understand the positive qualities that encourage people to go out, remain active, and give them pleasure into very old age. How can we ensure people have access to emotionally positive and meaningful places throughout their lives and especially into very old age?What is a minimum acceptable standard of residential open space provision to ensure opportunities for wellbeing are maximized into very old age? Do views of green space or nature matter as much (or more) than access to such spaces outdoors?What levels and types of public lighting might make a difference to older people’s outdoor access at night? Is this a sensible strategy to pursue or a waste of investment, given many older people’s reluctance to go out at night in any case?One challenge in current times is that so much decision-making is now devolved down to authorities, rather than legislated for at national level. This is not such a challenge when funding is adequate, but the current squeeze on local government funding means that authorities struggle to know how to carry out just their statutory duties. Areas that are non-mandatory end up at the bottom of the pile in terms of attention or investment.
1 - Rationalise the planning system. We have national planning guidance, National planning policies, Strategic plans, Regional Spatial strategies and Local plans. In all of these different areas non mandatory features such as open space/green space can slip through the cracks and get lost. e.g. Housing can involve By Design – Urban Design in the Planning System: Towards Better Practice, DETR, 2000.Safer Places – the Planning System and Crime Prevention, ODPM, 2004.Planning and Access for Disabled People: A Good Practice Guide, ODPM, 2005.Better Places to Live By Design: A Companion Guide to PPG3, DTLR, 2001.Secured by Design, see www.securedbydesign.comBuilding for Life Standards, see www.buildingforlife.orgDesign Quality Indicator toolkit, see www.dqi.org.uk/DQIForthcoming Manual for Streets Guidance (DfT/Communities and Local Government).See Preparing Design Codes – A Practice Manual, Communities and Local Government 2006. 2 – Recognising the physical and mental health benefits of access to green space place a mandatory requirement for residents in care homes to have access to gardens. 3 – Recognising the health benefits of access to green space place spending on green space under the umbrella of health and so ringfence it. 4 - Place a mandatory requirement on private developers to provide suitable green space in housing developments on-site. England - Planning policy states that all private developments over 10 houses must incorporate open space. However, in exceptional circumstances, which are not stipulated, the space provided may be an off-site piece of land. In addition there is no stipulation in the guidance that the open space be suitable to the development. There is nothing to stop the open space being merely a grassed area tacked onto the development as an afterthought.http://www.gov.uk/government/uploads/system/uploads/attachment_data/file/6077/2116950.pdf Scotland - Designing Streets: A Policy Statement for Scotland, changed the emphasis of guidance on street design towards place-making. However, while planning applications for residential developments may be expected to confirm with these principles on open space provision within the design of new residential development there is no legal requirement to do so. Some developments may be passed if developers contribute to an off-site piece of open space.http://www.scotland.gov.uk/Resource/Doc/307126/0096540.pdf 5 – Create a set of national standards for road crossings incorporating types, siting, and maintenance with a mandatory requirement on local authorities to adhere to such standards.
