Living Well in Old Age International Perspectives by iem58695


									  Living Well in Old Age
International Perspectives

     Maria S. Parsons
      Lead Advisor
§   An ageing world

§   What does it mean to live well in old age?

§   Living well with dementia: National Dementia
    Strategy for England

§   The role of design in prevention and early
    Ageing: shaping the 21st century
Age not synonymous with
disability but a third of people
aged over 50 live with life limiting
health conditions

Population ageing, urbanization
and climate change are global
trends that together comprise
major forces shaping the 21st
              Population ageing

2000:600 million people aged 65+
2025:1.2 billion
2050: 2 billion
2010: 64% live in the developing world
By 2025: 80%
Ageing societies
         The challenges of longevity
§   Japan, Italy & Sth Korea- world&s oldest populations
§   Me1ico 3 China&s ageing populations accelerate after
§   In almost every country, the proportion of people aged
    60 +years is growing faster than any other age group
§   Rapid pace of aging in the less developed countries will
    require them to adjust much faster than has been
    necessary in more developed countries
§   Competing demands for resources and recession mean
    human society will be restructured as we are compelled
    to find new ways of living, working and caring for one
           Old age as social burden

Problematised & pathologised
older people stigmatised
& marginalised in many societies
             Living well in old age

§   Common issues & differences between
    developed & developing countries
§   Health care ( access and lifestyles)
§   Care systems
§   State&s role in welfare 9 funding
§   Generational solidarity (support for families and
    individuals caring for older people)
§   Income security
§   Employment/ education/meaningful occupation
§   Sustainable homes and communities
§   Political inclusion and citizenship
    Not just developing countries
Long life is a indicator of good health and the gap in life
expectancy & quality of life between many people in
de:eloping and de:eloped countries shrin;ing<<.but
inequalities remain

?All but the richest Aritons are dying early and suffering
years of ill health because of "unfair and unjust"
inequalities. The richest live seven years longer than the
poorest and enCoy an e1tra DE years of good health&F

Professor Sir Michael Marmot of University
College London, 2010
         Fair Society, Healthy Lives
Create and develop healthy and sustainable places and

Fully integrate the planning, transport, housing,
environmental and health systems to address the
social determinants of health in each locality.

Strategic Review of Health Inequalities In England
post 2010 (The Marmot Review)

Housing as key to prevention
Lifetime Homes, Lifetime Neighbourhoods: A National Strategy for
Housing In An Ageing Society 2008
International ageing research agendas
   §   Healthy/active ageing
   §   Biological determinants
   §   Physical, mental & social functioning
   §   Care systems
   §   Family, kin and community
   §   Economic security
   §   Quality of Life
   §   Built environments
   §   Technology
   §   Social participation and integration
   §   Macro-societal change & development
   §   Policy processes and evaluation

   International Plan for Action on Ageing 2002 (Madrid)
   WHO and research in countries around the world<<..
       Researchers and funders

 National Governments and regional organisations

National Institutes    University Research Centres

Funding Councils KT-Equal Trusts    Voluntary Sector

International inter government agencies        NGOs

Development banks   Pharmaceuticals.   Private sector
Translational research: good practice


               Older people
                as USERS


        Practice Products Buildings
        Age friendly neighbourhoods
§   Neighbourhoods are often age unfriendly
§   Inclusive Design for Getting Outdoors research
§   EPSRC funded project at Oxford Brookes University
§   How do older people with dementia navigate localities?
§   Aims: Create a more inclusive environment & enhance &
    extend the active participation of older people, particularly
    those with dementia, in society
§   De:eloped into I&d Lo
§   Involving older people as research partners
§   Producing design guidance ( including Town Planning)
§   Developing new methods and tools
§   International partners
Dementia: past joys, present problems
                       Dementia in the UK
§     2008 estimated 700,000 people with dementia
§     2021 just over 1,700,000 (38% increase)
§     68% over 80
§     MNO Alzheimer&s disease
§     66.5% live in the community
§     36.5% in care homes
§     36% of estimated £18 billion costs of care borne by
§     No cure: Need to understand dementia as a disability

    Alzheimer&s Disease International RADIS estimates that there are
    currently 30 million people with dementia in the world, with 4.6 million
    new cases annually (one new case every 7 seconds)
  Living Well with Dementia: National Dementia Strategy ( England)
Raising awareness                          Early                                 Living
and understanding                      diagnosis                           well with
                                           and                                   dementia
O1 public information campaign
                      O2 memory services

                             O3 information for people with dementia and carers

                                 O4 continuity of support for people with dementia and carers

                                       O5 peer support for people with dementia and carers

                                                  O6 improved community personal support


                                                      O8 improved care in general hospitals

                                                           O9 improved intermediate care for dementia

                                                                  O10 housing including telecare
                                                                              O11 improved care home care

                                                                                        O12 improved EOLC

                                         making the change

O13 workforce competencies, development and training
O14 joint local commissioning strategy and world class commissioning
O15 performance monitoring and evaluation including inspection
O16 research
Most older people want to li:e ?at home&

§   Age in place
§   Choice and information
§   Flexible with scope for
    continuing everyday life
§   Unobtrusive support for
§   Low tech/high tech
§   Homely & comfortable
Why can&t a care home be more li;e a
            coffee shop?
                              Think of the priorities for YOU
                              in making a decision about
                              where your want to spend
                              your old age

Quality has improved      &
but care homes are
still ?the last resortT

Care Providers from
the UK plan to build in
India and China
            Healing environments?
l   Hospitals associated with poor outcomes for many older
l   Health of people with dementia worsened: they spent
    much longer in hospital after a fall, hip replacement
    infection or stroke
l   Noisy clinical environments, confusing signage, poor
    lighting and décor contributes to anxiety and isolation
       Design for living well in old age
§   Design for the highest level of disability
§   Life span flexible housing
§   Reflect culture of community
§   Preserve dignity & self worth
§   Promote choice and control
§   Address inequality
§   Universal and inclusive transport & communication
§   Bear in mind you are designing for
    a largely female ageing population<<the world o:er

Thank you for listening:

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