How to Improve Daily Life for Elders (and Everyone Else Too)
Monday, 21 September 2015
One of the most important people in the ageing “business” is Joseph F. Coughlin. He is the founder and director of the MIT Age Lab in Cambridge, Massachusetts, that since 1999 has been working to improve the quality of life for elders and their caregivers.
Working with governments, business and NGOs worldwide, the Age Lab exists to
”...invent new ideas and creatively translate technologies into practical solutions that improve people’s health and enable them to “do things” throughout the lifespan,” explains the website.
“Equal to the need for ideas and new technologies is the belief that innovations in how products are designed, services are delivered, or policies are implemented are of critical importance to our quality of life tomorrow.”
As Coughlin has said, “Old age is quite new.” Until well into the 20th century, few people lived much past 50 so there is little history about what old age is like and what is needed to navigate it.
Last week, CityLab, a website of The Atlantic, published a story reported by Amy Crawford about the Age Lab's work to make cities more habitable and friendly for old people.
At the Age Lab, Ms. Crawford was fitted out on the Lab's AGNES (Age Gain Now Empathy System) suit that simulates for young people the experience of being old: impaired vision, simulated arthritic hands, unsteady footing, weights to simulate muscle decline.
”After stumbling down a hallway,” writes Crawford, “I labor to open a stairwell door. A slight wave of panic arises as I think about how easy it would be to lose my footing and tumble down the concrete steps...
“The lab’s researchers...use the suit to test products and environments for age-friendliness, wearing AGNES around the lab’s busy Cambridge neighborhood and even down into the subway, which, it turns out, is a much more treacherous environment than the young and spry might believe.”
Coughlin says AGNES has been useful because
“'It gives you that ‘aha’ moment to feel the friction, the fatigue and the frustration of what it might feel like to be older, with multiple chronic conditions.'”
(You can see Coughlin show the AGNES suit in a TEDx video I published in a story about the suit four years ago.)
And so, one of the Age Lab's long-term, ongoing projects is to figure out how to make cities more age-friendly since in just 10 years, 25 percent of the population of the U.S. will be 60 and older.
Coughlin notes that autonomous robotic wheelchairs, home monitoring, self-driving cars and other technology innovations will eventually be useful, but they won't be here fast enough to help most people who are old now.
So the Age Lab is working with elders themselves to figure out how to make cities and towns work better for today.
It's important to work with elders because, says one Age Lab researcher,
”...older people often have concerns that conflict with the ideals of contemporary urbanism.
“'They have a very different kind of view,' she says. “We say, ‘Make the streets narrow to slow down traffic,’ but they’re worried about snow piling up and blocking their paths.
“'We want everyone to ride bikes, but they are afraid of bikes.' (Cyclists seem frighteningly quick and unpredictable, especially to people who came of age in a car-centric society like the United States, she explains.)"
As we used to say, Right on! I agree with the old folks on both of these issues.
Perhaps you have heard of the Age Friendly World Project from World Health Organization (WHO) and its worldwide network of Age Friendly Cities.
After a training class, I worked with the local Age Friendly group last year surveying retail businesses to rate them for their age friendliness. That is only one small aspect of what it takes to become certified an age-friendly city and it can take years to get there.
A lot of U.S. cities are actively committed to becoming age-friendly/age ready, but few have made it yet. Here is the AARP list of the ones that have made the commitment.
Amy Crawford's story is one of the best overviews I've seen of the kinds of things cities need to accomplish to be prepared for large numbers of elders ageing at home.
”Better lighting and more street-facing businesses would be a good start, [the same researcher] says, noting that older people are more concerned about their physical safety than younger people.
“Meanwhile, more benches and shade would help them cope with the fatigue that often prevents them from walking long distances. 'We need to be more aware of how much effort it takes for people to move,' she says. 'And if you think about older people, you keep everyone in mind.”
“Flashier ideas - like replacing Meals on Wheels with drone delivery, or building robots to care for the sick - might get more attention, but much of what we’ll need...is fairly simple and, in some ways, more difficult,” Crawford writes.
Joseph Coughlin wants to be clear that he is not talking about taking from the young to give to the old:
“The fact of the matter is, with any luck, all of us get to be old. So I don’t want us to be age-friendly. I want us to be age-ready. And then we’ll be ready for everyone.”
And don't forget. Any innovation that makes living in and getting around a city or town easier for old people is always – always – equally beneficial for people of every other age.
How is your city or town doing on being age ready?
What a great topic, Ronnie! Our city, Victoria, Canada, prides itself on being one of the most senior-friendly (don't you just hate that term!) cities in Canada. It is doing well, but could do more. I'll forward your article to some of the government people I know.
Posted by: Diane Dahli | Monday, 21 September 2015 at 06:03 AM
Great topic today. We do have a park designed for elders in a nearby town that my cousin (age 75) uses & likes very much. She said that it's always got some folks there with most of them there in the mornings. She likes it very much & says it's a nice break from the "Y" where she does her water exercises 3-4 times a week.
Of course our Ohio winters keep us indoors a good part of the year, but that's just another obstacle to tackle for those doing the research......with help, as well, from us elders.. Dee
Posted by: Dee | Monday, 21 September 2015 at 06:26 AM
New York City, is considered to be an "Age Friendly" city. There are elevators in subway stations and kneeling busses and plenty of vest pocket parks for people to sit in. However, these amenities do not extend to suburban or rural areas where public transportation stinks.
If you live on Long Island, or up here in Westchester Cty., the only way to get around is by car. Unfortunately, driving a regular motor vehicle is impossible for many older folks due to certain physical and financial limitations. And, while there are cabs, car services Paratransit and Uber, it's not the same as hopping in your own vehicle and going a couple of miles to the store whenever you want.
I would like to propose that motor vehicle regulations be revised so that low speed vehicles such as scooters and golf carts be allowed to operate on designated streets in special lanes like bike lanes. While many people can't operate a regular car, an electric golf cart type vehicle would be a good alternative.
Posted by: Bruce Cooper | Monday, 21 September 2015 at 07:44 AM
I particularly appreciate your last point. Any innovation that makes getting around and living in a city easier for some people is always going to make life more pleasant for everyone.
Case in point: curb cuts and ramps and elevators and 'kneeling' buses, designed to make a city handicapped-accessible for wheelchairs and walkers, are a great boon for young parents trying to manage a stroller. Handrails help anyone whose balance is unreliable, including toddlers and pregnant women. Shaded benches are just the civilized way to furnish a street; everyone benefits from being able to sit down for a bit on a hot day.
Nobody over the age of eleven wants to clamber over heaps of ice and snow, either. If more and more elders are aging in place, cities can't require each house owner to be responsible for shovelling the public sidewalk out front. Imagine if that same notion was applied to the roads! A liveable city needs a budget to keep sidewalks clear for pedestrians.
Posted by: Sylvia | Monday, 21 September 2015 at 08:09 AM
A good and informative article on a subject I care more and more about as I age (82) and become more limited in my ability to get around. What it raises for me, though, is yet another thing to say about "What took them so long?" Thirty plus years ago, my friends were introduced in a class in a study of geriatrics to a body suit, gadgets to limit sight and hearing, and weights to emulate old muscles. About 35 years ago, I took an adult ed class at the local community college, where we experienced the same things as a way to better understand handicaps, and also went out to lunch
with one person who was really blind, and the rest of us were experiencing deafness with ear plugs, blindness with blinders, legs tied together to handicap walking, and thick gloves to emulate arthritic hands. I now am familiar with all of those handicaps, but still have to be helped up steps to get in many buildings, handicapped restrooms with too-heavy doors, bars too high, toilet paper too low or too high, and latches that can and do lock me in because they are not appropriate for limited finger strength and agility. WHY has it taken so long? I despair of it ever being much different in my lifetime, if so little progress has been made to date.
Posted by: Lyn Burnstine | Monday, 21 September 2015 at 08:30 AM
A few blocks from my suburban home there's a little green belt with a creek trickling through it; it's a pleasant destination for a walk. However, it hasn't been developed as more than a mowed grassy area with a paved path. On a whim, I sent a note to the city suggesting that if there were a place there to sit, I and others like me could spend more time there. To my utter amazement, someone from the city called a few days later, discussed where I thought a bench should be located, and a week later "my" bench appeared under a large cottonwood tree, right where I'd imagined it. It's even painted my favorite color. One of the first things on my to-do list when I regain my health is to go sit on that bench. Often.
Posted by: PiedType | Monday, 21 September 2015 at 08:44 AM
The buzzword in city planning these days is "walkability." What these planners forget is that not everyone has the same walk-ability. If you are mobility impaired, limiting parking spaces to get people to walk or take public transportation does nothing for you.
My current city, McMinnville, OR just decided to put handicapped parking on the street in the downtown core. YAY, except the decided to put one space at each end to the block because that is where the current curb cuts are. Really? What if your destination is in the middle or at the other end of the block? Contrast the with Bend, OR that put 2 handicapped spaces in the middle of the block with new curb cuts there and at each end, cutting the walk to 1/2 block in any direction.
Ramping into buildings and between elevations with even low steps prevents falls like the one I took the other day when I missed a substandard step with no rail in a dimly lit restaurant. European styled handles, levers, rather than knobs make entrances and exits easier. The flip levers in bathroom stalls rather than tiny slide knobs, make using the lav easier for those of us with hand impairments.
Like Lyn, I remember the simulation suits from 30-35 years ago.
Posted by: Marcie | Monday, 21 September 2015 at 10:52 AM
I am with Lynne Burnstein. Your article about another study using a suit that simulates the infirmities of age just confirms the fact that study after study continue with ideas a-plenty and then it all hits a brick wall.
Several years ago people in Tucson were trying to get the planning commission to require that safety features be part of every new home built. I have a retired architect friend who was volunteering on the board and the suggestions were: ramps for wheelchairs, grab bars in the bathrooms, wider doors and halls that would accommodate wheelchairs, etc. It would only cost the builders a few hundred dollars more per house, but the SA Homebuilders Association killed the plans. Money always becomes the issue when push comes to shove.
Today my daughter will be buying and installing sliding glass door bars to the 4 sets of doors in my house. Someone tried to break into my house last night while we were sleeping. The would be thief had cut the front screen and peeled it back. Thank God for my daughter's German Shepherd or I am sure he would have been able to break the glass and crawl in without our knowledge.
Safety from violence is perhaps more important than other safety features because we become more vulnerable as we age.
Posted by: Darlene | Monday, 21 September 2015 at 11:05 AM
Thanks once again, Ronni, for the article. Your ability to focus on important things which impact all of us continues to be amazing. Your blog has become the first thing I read when I turn my computer on. I no longer go to the Oregonian first thing, or to Huffington or any of the other blogs and news sites I follow until I've read what you have to say for the day! And, it seems, I frequently quote something I've reading one of your articles.
Having been involved in building a new house with features designed to help me as I age has been a real eye opener for me. While planning boards slowly try to come into this era sometimes their rules and requirements are crazy making...as we've discovered in the building of our ADA comparable home.
We put grab bars in the obvious places and I now have a nice walk in/wheel in shower so I no longer have to step over the height of a tub as I did in my apartment and old house.
The big problem has been the ramp from hell that's been a year in the making. Just a simple ramp from ground level to my door..about 5 feet..has become a huge undertaking!
I wonder what happened to the era when a group of neighbors got together to build a ramp for an injured neighbor. This would no longer be allowed in Washington County, Oregon! The building inspector would come and put a big STOP WORK sign out and the poor wheelchair bound neighbor would end up out of luck.
Posted by: elle hayes | Monday, 21 September 2015 at 12:38 PM
Montreal has been flirting with the idea of heating the main shopping street, so no snow in winter.
Probably won't happen any time soon. Our infrastructure needs an overhaul, bridges, etc.
Also love Bruce's idea of electric golf carts to be driven on certain quiet streets.
Winter keeps many seniors inside.
Posted by: doctafill | Monday, 21 September 2015 at 02:31 PM
Such a welcome post, Ronni. I was actually surprised to learn that Houston is on the list of committed cities. I can attest it is NOT an age friendly city. But the enrollment date was just a year ago....and government wheels turn slowly....at the local level on up. Maybe it time it will be age friendly. Probably not in my lifetime, but one can hope.
Posted by: Fritzy Dean | Monday, 21 September 2015 at 04:27 PM
Darlene, it's very good to hear you're okay following a near break-in at your home. This would be a good project - for a city or town to assist elders in securing their homes and perhaps assist in putting in or replacing devices, such as levers or rails, etc., that allow easier and secure mobility with safety.
You've given me additional incentive to get a dog, too!
Posted by: Simone | Tuesday, 22 September 2015 at 06:51 AM
I'm appalled by how many doors in public places (including restrooms) are unreasonably hard to push open.
Maybe we should have stickers made that we could quietly put on any such door. I don't know what the sticker should say, but it would help call attention....
Posted by: Shelley | Tuesday, 22 September 2015 at 09:10 AM
Parts of Europe have heated sidewalks, they install them whenever they need repairs to that section. I live in an area that has little plows that do the walks and no, they don't work any better than having people do it themselves because ice is almost always left there, Here they clear roads first, the main ones, then feeder, then sidestreets, then sidewalks. By the time they get to the walks you have packed bits of snow often on top of black ice. I walk a lot compared to most suburban people and basically for 5 months a year, I walk on the road not the sidewalk as the latter is never safe.
I also wear YakTrax, for some reason elderly people do not use them. They are excellent for traction. My neighbour broke his hip last winter sliding down the driveway and I had warned him for years to get a pair of these. My main walking problem now is living in an area full of Coywolves and the community leaders think packs of wild dogs that are out in broad daylight and by the bus stop is fine, again because people who drive everywhere are safe and that's all that counts.
Posted by: Vera | Wednesday, 23 September 2015 at 08:09 AM