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Planning and design for an ageing population: Coursework for Re-thinking aging

Currently, I am participating in an massive online open course (MOOC) from the University of Melbourne on the topic of Re-thinking aging:  are we prepared to live longer?

The free course is offered through Coursera; it started the last week in April and runs for 5 weeks. You can read more about the course and sign up for future offerings at: https://www.coursera.org/learn/ageing/home/welcome

We were encouraged to keep a journal or blog about our journey through the course, particularly to note where our opinions and ideas have changed from the beginning of the course to the end. I thought this would be a great opportunity to share the course information and my opinions with you – a little something different than my usual posts 🙂 As such, this will be a work in progress over the next 5 weeks.

Week 3:  Planning and designing for an ageing population

Week 3 of the course highlights the planning and design principles for an age-friendly environment for housing, retirement communities and health care settings.

Q. What might an age-friendly city look like?

A. I imagine an age-friendly city to have wide, smooth walkways, low curbs with walkways that have lights long enough for you to actually get across. I imagine good public transportation with busses/trains/metros that accommodate handicap access (such as busses that can lower so that the step in is not so high). Buildings will have easy to read and understand signage, stairs, ramps and elevators, wide doorways and hallways, good lighting that doesn’t cause glare against floors. I also imagine plenty of public space for enjoyment, such as park benches, green areas, recreation and activity areas for people of all ages. I imagine grocery stores and shops that have areas or benches for customers to rest and even socialize, large print signs, shelves that are not too high or too low and wide aisles. I also imagine shops that are dementia-friendly, meaning they have undergone training and know how to accommodate customers with cognitive problems in an effective manner. I also imagine a society of people living there who are helpful, patient, engaged with each other, social and active, and who actively break down ageist stereotypes that older adults can’t work or contribute to society.

If you are interested, check out my post on a platform to crowd-source age-friendly areas.

Age-CAP is a cross-platform smart phone application which aims to create a crowd-sourced database of age-friendly locations. It consists of survey-style forms which allow users to quickly rate the age-friendliness of a location or service. The criteria for rating was developed using the World Health Organization’s Global Network of Age-friendly Cities guidelines and age-friendly community initiatives in North American cities.

https://doctordementia.com/2015/03/19/america-and-age-friendly-communities/

Q. What adjectives might you use to describe your ideal community for ageing-well in?

A. Adjectives I would use are:  intergenerational, open, accommodating, social, health-promoting, and I want to also use another learner’s adjective of adaptive.

I found it interesting that this section of the lectures highlighted the World Health Organization’s principles for age-friendly cities, which I focused on in my internship there when I worked on incorporating eHealth into the Age-friendly Cities Guidelines.

I also have an article on age-friendly shopping!

Q. How to design homes for the future (as far as making homes more flexible and agile)?

A. A major element will be to incorporate the wants and needs of the population and consider a life-long approach to the design. Elements of Universal Design and modular scalability will increase the ease of use of the home space and it’s ability to adapt to the user.

Q. Why do people choose to stay in houses?

A. I rephrased the question a bit (from Why do people choose to stay in their houses longer than they should?) – it’s not necessarily about people staying in their houses longer than they should, but about why they choose to stay there when it is no longer functional for them or safe. But, really, the topic is on attachment to place, which is a normal (and healthy) psychological experience which is encouraged. People choose to stay in their homes because they are their homes – the place where they have had their family grow up, where their friends come to visit, their neighborhood and community, they know the layout and the surroundings are familiar. They are attached to their homes and the things that their homes represent to them (stability, family, independence, style, choice, etc.).

One link that was given during the presentation, which I would like to share here, is for Lifetime Homes (http://www.lifetimehomes.org.uk/). Created by a group of housing experts, they provide 16 criteria which can be applied to (usually new) homes in order to meet the Lifetime Home Standard. Their goal is to ensure homes are inclusive and accessible.

Q. Do you see future healthcare settings evolving into a type of Maggie Centre? A smaller scale setting (similar to a large house) that is not institutional in any way, but designed to create a sense of familiarity and comfort for patients and families.

A. I think this is a great idea, for both the individuals and for the care workforce. These are more along the lines of the types of places where people want to be treated – not a large institution that is so sterile and treating large numbers of people. Something more personal, more comfortable, a place to foster emotional, psychological and social health as well as physical/biological health.

With these being less institutional, I wonder if that means that staff have more relaxed requirements for workflows. In particular, I am thinking of the potential of spaces like Maggie’s Centres to treat more people in long-term care and in palliative care, rather than them needing to move into large institutions like care homes. If there is a reduced need for highly trained staff (for example, those who would be cooking meals, tending the garden, cleaning, leading activities, general house managers, etc.), this could help to alleviate the burden caused by the lack of health professionals available. I could envision this as a small-scale commune-type living arrangement, where skilled nursing care is not the main priority of living there, but the social and emotional care of those around you.

I was really excited to learn about the concept of Maggie Centres. I was also surprised that I hadn’t heard of them before, having interests and experience in both palliative/hospice care and dementia care.

Maggie Keswick Jencks was an author on landscape architecture and had advanced cancer for several ears. She used her experiences as a patient to design (and start a movement) for patient care centers. It was a way of re-thinking hospital-like care settings, especially for people who are spending a significant amount of time living in them. The idea is to have a smaller, more home-like setting with a kitchen, dining area, living room and separate bedrooms, outdoor spaces and more of the familiar comforts of home. They are more domestic than institutional.

Initiated in the UK in the 1990s, Maggie’s Centres are now found all over the world, and each has it’s own unique design and different elements of home life. Some have art in a museum-like fashion, similar to how some would have art displayed in their homes. Some have gardens, ponds and other outdoor areas to enjoy. But all of them center on the concept of using the physical space to both support and uplift people.

Some pictures of the unique design used in Maggie’s Centres:

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Maggie’s Glasgow

 

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Maggie’s Manchester

 

Maggie’s Hong Kong

 

Read more about Maggie’s Centres and find out where they are located here:  https://www.maggiescentres.org/

In the lecture video, they also mentioned a center using elements of Maggie’s Centres, designed by NORD architects out of Copenhagen, and a cancer treatment center here in Copenhagen. Again, I was surprised I had not heard of Maggie’s before and that there was one right here in my city! I couldn’t find it on the Maggie’s website, but did find it through NORD. Take a look at the cool (and quite Danish) design:

 

 

Q. Do you think the role of technology in residential aged care will help residents get the care they need? What about the care they prefer?

A. I definitely think that technology can help to provide quality, efficient, personalized care. Much of this is through benefits to organization and administration of care – more accurate and timely health records, early warnings for drug interactions, more efficiency in the provision of care when it is needed, better billing/discharge/prescription distributions, etc.

For the individuals, there are personal and assistive technologies, such as digital calendars to help with the structure of the day, communication and socialization enhancement through video messaging or interactive technology (like Paro the robotic seal), sensors in floors (especially bathrooms) to detect falls and alert help immediately, wearable technologies which can detect all kinds of early symptoms and enhance personalized care (heart rhythm monitors, medication patches, bio-sensing bandages, gait monitors).

For the care that most people prefer, it involves a human touch, including empathy, compassion, respect and dignity. The goal of using technology in care is never to substitute the trained human professionals, but to enhance their ability to provide the human aspects of care. An easy way to imagine this is to think that all the scheduling, billing, and reporting can be done automatically (and more accurately) through technology so the nursing staff have more time to be with the people.

If you are interested, you can read some articles from my blog on the topic of gerontechnology.

My review of the Danish Nursing Home of the Future (with pictures!): https://doctordementia.com/2015/04/14/review-nursing-home-of-the-future-fremtidensplejehjem/

About iPads and custom apps for older adults in Japan: https://doctordementia.com/2015/05/18/ipads-and-custom-apps-connect-older-adults-in-japan/

The future of robot caregivers:  https://doctordementia.com/2015/02/19/the-future-of-robot-caregivers/

That wraps up Week 3 of the course. Now, I would really enjoy your opinions and insights in the comments, please share what you think!

 

 

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