Title:برنامه ریزی برای جمعیت سالخورده

۲۰۱۱-۰۲-۱۷ ارائه دهندگان: Leonard F. Heumann، Jacques Gourguechon، Elizabeth H. Tyler این وب‌کست فقط برای مشاهده در دسترس است، برای اعتبارات AICP CM قابل استفاده نیست. با بازنشستگی نسل بیبی بومر و ورود بخش بزرگی از جمعیت به سن سالمندی، برنامه‌ریزان مجموعه‌ای از خواسته‌های جدید برای برنامه‌ریزی جوامع و تحولاتی دارند که به این تغییرات جمعیتی رسیدگی می‌کنند. در این جلسه دو شهرساز برجسته که تجربه عملی و پژوهشی گسترده ای در زمینه برنامه ریزی و اسکان جمعیت سالمندان دارند، حضور دارند. آقای Gourguechon به معنای پیر شدن، مسائل کلیشه ای و سن گرایی، یافتن هدف و معنا در زندگی با افزایش سن، و نیازهای ویژه سالمندان برای مسکن، ترتیبات زندگی، امنیت عمومی، آموزش و تحرک خواهد پرداخت. آمارها و مطالعات مربوط به جمعیت‌شناختی، اقتصادی و مراقبت‌های بهداشتی مورد بحث قرار خواهد گرفت و ابتکاراتی که برنامه‌ریزان می‌توانند برای کاهش نگرانی‌های محدودیت‌های عملکردی و کیفیت زندگی دنبال کنند، شناسایی خواهند شد. پروفسور هیومن بر نقش برنامه ریزی شهری در ارائه مراقبت کافی برای سالمندان و پیامدهای مربوط به جمعیت شناسی خدمات، استانداردهای زندگی و ارائه دهندگان مراقبت تمرکز خواهد کرد. او در مورد طیف وسیعی از مدل‌های تخصصی محله و مسکن که برای سازگاری با جمعیت سالمندان ایجاد شده‌اند، از جمله شرکت‌های توسعه جامعه، اشکال مختلف کمک در خانه، و مدل سرپرست محله که می‌تواند به نظارت و مراقبت از سالمندان در جامعه کمک کند، بحث خواهد کرد. هر دو سخنران به نقش مهمی که برنامه ریزان باید در این تغییر اجتماعی مهم ایفا کنند، خواهند پرداخت.

قسمتي از متن فيلم: Is going to be featuring two quite prominent urban planners both from Illinois would have extensive practical and a research experience in planning for and housing the elderly population Jacques Gorga Shawn will address what it means to grow old the issues of stereotyping and ageism finding purpose

And meaning in life as we age and the special needs of the elderly for housing living arrangements public safety education and mobility professor human will be focusing on the role of urban planning and providing sufficient care for senior adults and implications for the service demographics standards of

Living and care providers he will be discussing a range of specialized neighborhood and housing models that have been developed to accommodate two senior population including Community Development Corporation different forms of home health and the neighborhood warden model which can help the monitor and care for seniors in the community

Most speakers will just the important role that planners have to play in the significant societal change if I could tell you a little bit now about the speakers Jacques Gorga Shawn aicp is a founding principal and serves as president of Camaros limited a planning consulting firm in Chicago Illinois he

Has a bachelor’s from Michigan State University and economics and a master’s in city and regional planning from the Illinois Institute of Technology recently he’s been focused on human investment planning which considers the human side of the city equation he’s completed human investment plans for pueblo colorado in kansas city missouri

His interest in planning issues for our aging population sprung from his involvement in human investment planning Jacque has long been active in apa activities he was formerly president of the Illinois chapter and currently serves on the National APA legislative and policy committee he’s a regular speaker at section state and national

Planning conferences Jacques is a senior fellow at the chatak Institute for metropolitan development at the Paul University in this role he offers training sessions to community planning officials and workshops for working planners and DePaul University students it’s also an adjunct assistant professor college agriculture and sorry architecture at illinois institute of technology when

Human is a professor emeritus of Urban and Regional Planning and psychology at the University of Illinois at urbana-champaign he holds a PhD in city planning from the University of Pennsylvania and a master’s in urban planning and bachelors of architecture boat from the University of California at Berkeley he said co-author co-editor

Of a number of important books that pertain to the topic including empowering frail elderly people opportunities and impediments in housing health and supports service delivery housing for the elderly planning and policy formulation in Western Europe and North America Aging in Place with dignity international solutions related to low-income and frail elderly people

Managing care risk and responsibility the challenge of the 21st century the aging and disabled population grows and diversifies and the 1988 1990 90 surveys of section 202 housing for the elderly and handicapped I do have some introductory remarks that I’d like to kick us off today with and I do have a

Personal story this is me here at work if the city of Urbana in our conference room busy at work is a city planner and as a community development director i work in planning as well as our grants programs and building safety and just a full range of gamut and I do have a

Personal experience I myself am a young boomer in good health thank goodness but I’m part of what has been known as a sandwich generation where I have um taken care of my children at the same time as I’ve taken care of the older generation this is my mother Natalie

Tyler and she lived from 1928 to 2008 and this was taken just them just a few months before she passed away and my mother Natalie had a stroke a major stroke in 2001 and as you can see she was in a wheelchair and she had a very high need and I was

For those seven years pircher provider and chauffeur had limited resources so I found that I was in the unique position of becoming a service consumer as well as a service provider and I began to see my job as a planner and my role of the city through a whole different ones and

As I work to assist my mother with her needs through those years so for example of players and caretakers as well would become interested in senior services and we certainly took advantage of those in urbana housing choices became important affordable housing choices for people with these needs for elderly people with

These needs walkability we had a wheelchair and that really took a whole new way to look at the city and to get around accessibility to transit our local transit district has a DA rides on demand and this allowed my mother to retain an independent lifestyle even with the high needs the quality of

Medical services the safety fire employees and emergency response and the things that do in the community cultural and recreational offerings just seeing through a whole new lens in that role and at the job at the office I also began to see my regular test in a different light as well and I think

These are some things that planners can do and lace-up planners can help in doing site plan reviews to really check those sidewalk connections and to make sure that there’s transit access and reviewing subdivisions to ensure that those road connections can be there both now and in the future and to resist the

Request for reductions of sidewalk connectivity even things like street lighting to think again about what the demands are for people with failing eyesight on joining here there were challenges as well look at the zoning ordinances to ensure that there is a no discriminatory language we and our ordinance said daycare centers for

Children but we did not provide for adult day care centers and I felt very strongly that we needed to provide at least that same level of permissions for adult day care mixed use can be very important with reduced mobility that you can have both housing and commercial

Services within a small spatial area I did mention that I work as well and building safety and I’m complying with a DA requirements you know diligently connecting that access in our community we have a visit ability requirement for housing units where there’s any kind of City assistance requiring that there d0

Step entrances and adaptability of the units and visit ability for people with mobility needs also on the programming end I I saw our programs and a new light we do have seen your grants that we provide to seniors in the community to say fix the furnace and emergency

Something of that nature we have access grants and these allow for we modeling a home to provide for disabled access we provide whole house rehabilitation many times this will be for elderly people seeking to stay in their home and be able to make those modifications another

Service we provide which I saw an all new light was our neighborhood cleanup and all these are are used with our CDBG or Block Grant funds and in our biannual neighborhood cleanups we do pick up for seniors and I think that’s very important in keeping the house safe and

Clear of excess materials and furnishings and finally each year we do have social service grants at the city and you know once again we look to have priorities and and hope to always have provisions for the elderly as part of those priorities and this is just an

Example of a visible structure you can see there’s no steps and there’s a way to design and to require structures of this of this sort and here are some examples of those small access grants that we provide the city and it helps people stay in their homes and to be safe and then

Here’s our our neighborhood cleanup just showing twice a year it’s amazing what we see each time so I think with our two speakers today we are really going to learn more and more and and get connected and Jacques is going to be able to help us first understand what it

Is to plan for the elderly and the aging and then Len is going to tell us how to proceed so at this point I am going to turn this over to Jacques Gorga Shawn you’re full thank you very much we are now going to be hearing from Jacques and

I will be taking over the presentation so just give me a second to do that okay Jacques I think we’re ready I’m on okay thank you and thank everybody for attending this is a fascinating topic for me and I hope you’ll find it interesting as well because Libby said I

Got interested in this by actually doing human investment planning for our number of cities which in and of itself is an interesting topic that we’re going to concentrate on the elderly is one of my qualifications for talking to you about this is that I fall into the age group

And so I’m learning how I’m supposed to be planning for myself as we tackle this problem but okay jennifer and I have to coordinate we apologize for that but I have to tell everyone to change the slides and she will do that so let’s go the second one well the question is what

Does it mean to be old the elderly are now easily can live 20 to 30 years past the magic age of 65 65 got put in place some years ago i’m not quite sure how but certainly with the longevity and advances in health care people live a

Very long time past the age of 65 much more so than our parents our grandparents did and in fact if the elderly are now considered actually to have two phases of it the young old and the oldest of the old and they really are a very two different parts of life

But the we consider planning for an aging population we have to consider this 20 to 30 year phase of life a wide range of physical and mental conditions definitely change society unfortunately has stereotyping about elderly people and discrimination against them I’m sorry to say housing and living arrangements do the lennons going to

Talk about and like some of those specialties areas of the housing needs and living arrangements I’ll allude to as well love you shock shock I’m going to interrupt you for just a moment so your audio quality is a little bit inconsistent it sounds like maybe the

Microphone is a little bit too close to you so I’m getting a little bit of scratching noise okay is that better yes thank you sorry everybody so I’ve been very concerned about the idea of socialization or isolation of how people when they’re in their elder years are in different kinds of family arrangements

And can easily get isolated and the need for socialization with among their family friends and with the community and with community that support is very important so those are the kinds of things that I see is important for planners to consider in an aging population so next slide so while we act

Our age then some of my favorites so is looking at you know the stereotyping of people who are old I saw BB King and Muskegon Michigan a couple years ago he’s now 83 and still touring a hundred days a year and I understand that Betty White who is 88 just started a new

Sitcom can you believe that Ringo Starr is going to be 70 years old as well as Dylan and Paul Simon these are all people that were young just a couple of weeks ago it seemed to me how about these young people I think my favorite

Is Raquel Welch she is 70 years old can you believe that that really speaks to the power of cosmetic surgery I guess and of course my favorite singer Aretha Franklin is going to be 70 as well as Jill Biden so there’s all kinds of people that are

Very active and vital people in this world who you know fall into this this notion of being elder Americans it time marches on the current life expectancy is 78 medical advances and if we take care of ourselves that’s supposed to go up to 81 for men and 84 for women women

Always live longer and will continue to do so but there’s nobody who’s over 65 get can do all the things they did at 2442 and we also have to face the fact that half the people over 65 have some kind of chronic health condition and a

Lot of people over over 65 have some sort of functional limitation something they can’t do for which makes daily living difficult and they need help for now again the over 65 thing has to be considered in light of that many people from 65 to 75 or even older are very

Active and very healthy and a lot of the problems occur as people get beyond 75 so that’s all this this idea of a single group of people that are over 65 it’s really faulty now who’s this well let me introduce you to olive Emily Jones she’s my new granddaughter she’s a month old

Today and her life expectancy is a hundred years and some people say it might be a hundred and ten years so the idea of how we plan for a society which is going to have people living that long is really a continuing dynamic that we’re all going to have to deal with so

Goodbye alum so who are the elder Americans let’s see who they are there’s a study that was done by the federal interagency forum on Aging was about six or seven federal depart did a wonderful job and you can all look it up under that name federal interagency forum and the things that I

Looked at were population economic health status health care risk behaviors they cover a lot of areas but it gives it’s a great single place to get a lot of believable data on on what is going on in the elderly population so it’s one of the fastest growing cohorts of the

Population if not the fastest they’re thirteen percent of Americans are now over 65 in 20 years that will grow to 20 percent of course it’s very uneven there’s a suburban Georgia County the only has three percent of their people at are over 65 and and many places in

The Midwest have older populations much more older much older than the rest of the country look at the lower statistics twenty-one percent of people over 65 of college degrees it’s a huge difference from again our parents and grandparents generation that you have an educated group of people who have a lot to

Contribute America is relatively young and Japan the current elderly population of account for twenty two percent and by 2015 its projected to be fully a third of their society will be over 65 and that will cause in Europe has also got an older population some people who

Projected Italy will be as old as Japan by the by the year 2050 that America will stay relatively young in terms of developed countries around the world in terms of economics older Americans have become wealthier i think that there’s some stereotype that older people are poverty-stricken and that’s really not

The case the net worth of at least white households that are over 65 averages around 280,000 a lot of that as in real estate and the big real estate runoffs during the 90s the decade of 2000 created a lot of wealth for people I think what we really

Have to be cognizant of is the huge inequities that remain that the white household average net worth is six times the average black and Hispanic households and while low income and below poverty in the elderly group have dropped significantly it’s still a thirty-six percent of those households but there’s money in the elderly

Population and that money often can be used to provide services that they need living arrangements are are different from when you’re young although the idea of a family is changing very quickly all across the Democrat Democrat landscape but if you look at the two areas that I’ve highlighted and look at the marital

Status of men which is much much higher than women partly that they stay married until they die and when they die two women are widows but the difference in percentages are very high and it puts limited at this thing to disadvantage in kerrville maybe not maybe they don’t

Want to live with none i don’t know but in terms of living alone it’s almost double forty percent of women in less than twenty percent of men live alone and to the degree that alone means lonely that’s a tough situation it doesn’t always mean that of course but

It’s something that as planets we need to be cognizant of health status this is all people are tough and I think this is great bit here there these are self reports people are asking how has your help and as you can see there are 77 percent of people in the white race say

That their health is good to excellent once they’re over 85 it’s still sixty-eight percent I was somewhat lower for black and and span populations but they have less access to healthcare but but basically people are aches and pains and arthritis and whatever else is going on report that

Their health is good to excellent and they want to be full participants in the society that we live in on the other side of the coin this is a very sensitive one for me because I fall into the area of someone having hearing impairment if forty-two percent of men

And thirty percent of women can’t hear well and that is it is the most prominent disability in the United States of being hearing impaired vision is somewhat less that people don’t see as well as when they’re older either and these have big ramifications on on the way we arrange our environments for them

You know I think I mentioned early on that some half of the people had some type of chronic health condition but people are living longer and longevity is expected to go up but we’re not as good as some other countries and and many of the European countries and Scandinavian countries have much greater

Longevity or somewhat greater but people have arthritis in a high degree forty percent of men and fifty-five percent of women that’s a huge amount you don’t move as fast when you have arthritis these issues of mobility and safety all relate to these kinds of issues cancer heart disease and perhaps most important

Again a problem that is occurring across all the age cohorts is obesity and obesity is an important problem that affects the elderly as well as younger people I think when this startled me as much as anything but if you look at the degree of mental health issues particularly anxiety

Fifty-eight percent of women and fifty-three percent of men are suffering from anxiety that’s a terrible number and it seems to me that there ought to be ways that we can arrange our our environment in a way that at least help people worry less than they worry about

A lot of different things which we’ll see in a minute but be when over half of elderly people are suffering from anxiety and then another 10 and 18 / % respectively are suffering from depression these are serious things that have to be looked into we all know the

Drug costs have gone through the roof for the average person over 65 in 2006 it was over fifteen thousand dollars I hate to guess what it is now but we’re a pull society and these are issues that the elderly have to deal with functional limitations this was also early on we

Noticed that that some forty two percent have some kind of functional limitation there’s two different types the more serious our activities of daily living we have to get dressed eat walk use a toilet and so on me I aedes our views on the phone preparing your own meal

Stopping managing money and doing that kind of thing and actually people who are on Medicare who are over 65 there’s a relatively small percentage are struck by this when you really are have difficulty with the adl’s you end up in special housing for that and confined to

A facility but thank god that’s not a huge percentage of people the percent has been declining these percentages of people that are not able to do this have been declining for both men and women and that’s good news the bad news is were not fit we mentioned obesity but

The some basic measures of physical activity that a huge percent of women were not able to do these some basic thing bending over or doing I don’t know what they are actually but a set of of simple physical exercise and this is going to have a big impact ord

Already as a big impact on our on our help if you look at the rates of obesity forty percent of men over 65 thirty-five percent of women if you look at an FF on the rise it really begins to go up in 1988 and it goes up for both people that

Are 65 to 74 and over 75 going up for both men and women and is an important health concern so is it our job to think about these things well this is the question I’ve been asking myself as I got into the human investment planning angle and I answered that by saying well

If our job as planners is to deal with the quality of life then this is a big part of the quality of life that we not only have to look at how we are organized subdivisions how we are going to its neighborhoods where we put the

Pipes in the ground and all of that kind of stuff but also the quality of life the people are living in different stages of their life and that’s Jim Ross over there I think he felt the same way but he knew that cities were fun so the

Planning of deck comes for elderly as I see them are protect their well-being to do things that can support well-being make sure they have housing that they are ability to age in place and this is if there was ever a goal that there was a uniform of Grima nani it’s that

Elderly people want to age in place it remember anything else about this that’s what they want they need mobility in order to keep independence and to be active they need socialization opportunities and their public safety concerns well well being elderly worry about it being able to take care of themselves being

Independent they also worried about losing your memory and that certainly is understandable they want to have meaningful things to do they want to be able to have a lot of friends or have good friends and have access to them they need facilities that are designed for for their needs their use their

Functional limitations and so on diet nutrition support exercises crucial to meant both mental and physical health and longevity and we want to be able to facilitate the engagement of older residents not only to help them but to get them to help us and two-way street

Here so all of these things have to do with well being and as Libby gave our introduction that there are all kinds of ways within cities and in governments that can support these types of things this lady is 90 years old can you believe that and she isn’t planning that

Sign she’s doing the splits along that that sign and it’s so flexible it’s unbelievable but exercise and nutrition are are crucial where and what kinds of facilities are really suitable for the elderly in your community housing we’re going to have 48 to 60 million households in the elderly category

That’s a lot of different kinds of housing there’s a range of housing needs again ninety percent of people want to age in place that means they want to stay in their own house there’s all types of supportive housing from senior Independent Living to senior communities to assisted living and me I think that

Various types of housing and the various economic arrangements and financing for that housing are going to be something that planners will be dealing with increasingly and Len is going to talk more about that in the second part of this presentation well the vast majority want to stay in

Their homes and threats to that our safety issues chronic health problems that elderly may have cognition issues memory problems and so on and they’re staying in their home alone you got the possible problem of isolation and resulting depression so one of the things we want to look at is how to

Reduce or neutralize some of these threats one of the interesting things that i came across is that there’s a whole new category of people called certified agent play specialists and there are a few towns that have made arrangements with companies that offer these services because it is actually

Much more efficient to keep people in their own homes than it is to have special housing and if in the most part and that’s what people want to do so that this isn’t it may be a new thing that’s coming along the idea of technology providing monitoring ability

For people that might be living along to protect them against Falls or other types of things when they’re when they are living alone if don’t let some via call upon also increases the ability to agent place well people have to get around unfortunately at people who are

Over 65 or over 60 actually suffer fight tell these from traffic accidents that double the rate of people that are under 60 now part of that is because they’re frail and don’t survive bad accidents but also mostly if they’re not mobile enough they’re not agile enough to avoid

A lot of these things and so this is something that planners really need to pay attention to and the arterial roads are particularly dangerous they’re wider traffic’s moving faster they need to have time to get across and a lot of the kinds of things that we all have been

Paying attention to over the last few years Complete Streets and so on these types of policies are good for the elderly well this is an area that close to my heart that old people drive and in fact in 20 years 25 percent of the drivers

And the highway be over 65 we need to make sure that the driving environment is responsive to Pete letter over 65 to the fact that they do have sensory limitations maybe they need larger road signs wider lanes kind of runs right up against the notion of Road diets which

Helps elderly in a different direction but very often people outlive their ability to drive in fact every year 600,000 have their drivers license taken away from them if they have to stop driving they need alternative means to get around and if they don’t have that it’s a one of the biggest reasons that

People go into isolation and get depressed there’s a program to program for everything in this country but one call supplemental transportation program there’s an exchange of ideas most of these are non governmental but their community related to provide alternative modes of mobility people that lose their

Ability to drive and and many of us are going to be faced so you just try to take my driver’s license away we’ll see how far you get with that and the ability to the desire to be able to move I mean i think is depicted in in these

These little carts that are now running around that people they can’t drive will get in these carts and i saw one of these on a four-lane federal highway just a couple of days ago with big semi tractor-trailers passing by and lots of traffic and it just amazing so mobility

And land use Smart Growth principles work really well for the elderly just they do for kids and they allow us to have transit communities we’re going to be able to support transit pedestrian access through mixed use strategies again there’s all a lot of this Livie talked

About but it’s all true that the new notions about how to arrange our cities and arrange our living areas are particularly important for the elderly population now in New York State they’ve begun to pick up on the idea of safe streets for kids or safe streets to get

To school to look at safe streets for seniors to get to places where seniors go or just to create crossings on arterioles and places that are dangerous and a whole set of standards are available so make make it possible for the elderly to be safer in crossing

Streets now I’m not going to go through all of these because we have a time limit but they’re they’re very logical engineering and design mechanisms that all of us can look up and a lot a lot of the problem comes on right turns people elderly people step into the crosswalk a

Driver makes a right turn right into them they can’t see them and so there are ways of timing street lights and so on to reduce that effect there’s some of the time signals are three feet per second give people time to get across that intersection make sure the markings

Are highly visible if you have advanced op art stop those cars well behind the pedestrian cross and repair people old people tend to trip and fall and when they fall a break bones and these keeping your curbs and our ramps in good repair is critical so what about the

Socialization in your community most communities have senior centers well it does it have the facilities inside it meets the needs of the elderly what kind of programs does it have do we know this I mean planners can find out about these things how can these be improved

In many ways we’re messengers and we can find out what certain components of our population need and take those back to the community at large so get to know your senior citizens in your community find out what their issues are and what their problems are is there a calf

Program available are there alternative and demand response of transportation facilities available all these things are things that planners can take upon themselves to improve the lives of the quality of lives of their senior residents so the key concepts that I’d like to leave you with our the idea of

Aging in Place the need for mobility to think about dignity and the ability of people in their elderly years live with dignity and independence to support wellness both physical and mental to give them meaningful involvement to make sure they have connections and social opportunities with families and friends

Thank you very much for listening and remember being old isn’t so bad after all so appreciate your time make shock so at this point we are going to turn it over to win so I’m just going to take a second to make that change and while

We’re making that change we did have one question that came up Chuck what is an iadl and IA do is a instrument of activities of daily living like a telephone and a washing machine you watch a close it and so it’s a kind of a

New term for me as well and but the disabilities for it elderly is usually run on adl’s which are activities of daily living so you qualify a assisted living center or assisted living housing if you have four ADL’s that is you need help bathing or you need help taking

Your medication you need help dressing they’re generally 11 of these that have been it done five you have any four of those 11 and you qualify as a disabled person and are protected by the fair housing laws of the country but the IAB elzar our more normal thing can you wash your clothes

Can you cook your meals can you use a stove and its really the instrument of activities of daily living is what it stands for okay wonderful all right I’m going to turn it over to Len now ok hello everybody the I actually stands for independent independent independent

Activities of daily living it’s a way of measuring how independent the person can be and those the kinds of tests I’m I agree with everything that Jacques said the whole idea of Aging in Place is very central to what I have to say as well as the dignity of support services how they

Come to people and and what kind of quality of life they leave people with so I’m am I going to be in control of the changing ok do it ok I have a number of things I’m going to be focusing on there’s such diversity in the senior

Population that as a planner I want to first and foremost talk about the fact that baby boomers as of last year we’re going to be increasing the population of seniors for the next 25 years you they’re on I’m the senior population as you will see and and we just don’t know

How long it’s going to take to get back into a positive economy again seniors at the bottom one-third in income of the ones I’m going to be looking at statistics on and seniors with advancing frailties and seniors from minority communities and let me give you some

Summary goals right at the start here as well federal and state funds will be necessary for senior housing and community based services but the planning must be local to address population diversity unique local economies and unique local physical and social environments and we’ll talk more about that as we get going each

Community must assess need priorities with limited financial resources so empowering seniors and their family to take charge of maintaining independence to the margin of their ability becomes extremely important Aging in Place with dignity will be the preferred goal both of the weakened economy and for the senior quality of life traditional and

New planning tools zoning and building colleges you heard from both speakers need to become more flexible and focused at the same time we need less residential sprawls community-based services can reach the media efficiently greater neighborhood density that supports local services within easy access infill remodeling and retrofitting streets businesses and

Residences to be universally barrier-free and maintenance efficient allowing echo housing and co housing and group living options to fit within our zoning is going to be extremely important since the family is we the first line of support we need to look at those demographics and see if there

Really is family members our family members available 30 million households care for an adult over the age of 50 today that’s going to double 60 million in 25 years so this is something we all have to get used to and and live with most adults needing assisted living prefer extended family

Care fewer families among the poorest one-third can afford to care for a senior and this has gotten worse with the current recession lower-income families require both a gulf to work leaving no one at home to provide care even when they live close by if they live across town it often limits family

Support to just weekends dwindling numbers of support is also extremely important the Pooh a family support comes from the delves age 35 to 64 they are dwindling as the elderly are increasing projections for white populations from 1990 to 2050 show that in the most important group 35 to 44

They’re young and healthy enough to take care of Grandma that’s going to decline seventeen percent the 45 to 64 year olds who are also have to pale into that getting kind of frail that’s going to increase by thirty one percent but 65 plus population is going to increase by

Ninety-two percent for whites for african-american and Latino American populations this is even worse the age 35 to 64 increases slightly compared to the negative number for whites but we are absolutely going to be swamped families are when it comes to the growing population over 65 african-american 65 and up is going to

Increase two hundred forty four percent and Latino Americans above age 65 is going to increase 1085 percent so community-based service demographics become the next most important the next line of defense the next most preferred and efficient source of support is these community-based home visits there are three broad types

Health care services social services including the ADL and I ADL support and neighborhood and housing care and repair which is a little bit more rare in the United States but is rapidly growing and has the closest ties with urban planning provision must be coordinated and seamless across all three to maximize

Financial efficiency and senior quality of life today these three types of support our support our separated programs and funding strings with little or no coordination creating support gaps no client control of support with support resulting in senior loss of dignity remaining independence and quality of life this is going to be a

Very big political issue because we have these beasts domes in the federal government and as it streams down to the local government between health care social welfare and physical buildings and environment and we got to find some way for them to be coordinated many low-income minority seniors are

Themselves care providers one of the most startling statistics that we’ve been following over the last three sentences is a growing number of african-american and Latino seniors cannot conceive of the term retirement or becoming empty nesters and listen to the statistics 53.5 percent of minority households with children under the age

Of 18 and grandparents present there is no parents they are absent part of this is due to increasing use of drugs most often it’s grandma coping with their own aging and raising grandchildren the recession is not over for the minority and the poor and I can’t save

More strongly to much of the statistics in the news these days saying well we’ve dropped below ten percent unemployment and the and everything is now hunky-dory in hard-hit areas it is eighteen to twenty percent for the majority minority unemployment in the hardest hit areas can reach thirty-five percent it gets

Worse if you count house households with no member no number no member actively looking for work or working reduced hours with no benefits those aren’t included in the unemployment statistics so needed programs and including and starting with purpose-built housing seniors are the most diverse and dynamic age cord especially when we include

Their varied levels and range of functional independence they will need all forms of assistive living small board and care facilities large senior apartment complexes whole retirement communities even more nursing care facilities we have three major types of subsidized housing that can take on any one of the assisted living options we

Have public housing built by local housing authorities and sometimes managed by those housing authorities but for most part these days that is outsourced to the private sector nonprofit owned and managed section 202 housing that’s the oldest subsidized housing program for seniors going back to nineteen fifty eight and one of the

Most reliable privately built for profit developers who get tax shelters to make rents affordable and all three can get additional subsidies for assisted living services or they can build only for independent seniors needed programs and purpose-built housing the combination of these three provider types gives a great

Deal of housing diversity the problem is lack of funding this will get more serious as the percent of frail seniors seniors grow over the next 25 years the newest funding for the last two years have only gone to unclog the pipeline of request approved but never funded under the Bush

Administration backlogs predate the Bush administration the very popular section 202 program already had an 11 year waiting time to get into the average 202 facility when Bush came into office no one would alone a frail and low-income senior can wait that long community-based home help is in a greater demand than new affordable

Housing sixty-eight percent of seniors are homeowners and the majority want to age in place in a home and a neighborhood they know and love losing their home is seen as a loss of status identity and perceived independence and I mean perceived independence because sometimes their home can be an albatross

It can be so barrier loaded that it you actually lose independence this means where there is no family they will overwhelmingly prefer assistance with advancing failed to be community-based visiting services that come into their homes type 1 of this type of home help is social welfare home living assessments social workers or

Neighborhood planners trained to assess living environments one outcome is that it is in the best interest for the senior to move to a more affordable and supportive environment that is social workers and planners who come into the house see that they really shouldn’t be remaining there one reason is the home

Is too costly to maintain its mortgage its utilities its upkeep and so on another is the property it’s so substandard it must be abandoned and another one is that barriers to independent living are numerous and too costly to undertake renovations and finally the neighborhood itself can be so isolating and dangerous that the

Senior needs to leave the second is the care and repair home type many older homes and neighborhoods can be modified modernized and made more supportive the care and maintenance of senior residents and the care and maintenance of the housing environment can be linked and coordinated in ways that allow the

Senior to remain active and in charge of their housing to the margin of their interest and ability they can attend neighborhood improvement meetings and be involved in oversight of their own homes maintenance this takes special training managers who can evaluate both personal care and environmental care in ongoing

And dynamic ways in many places this type of house home help does not yet exist in this country the third is minimum wage home help these are the people who assist with adl’s and we’ve mentioned what all those are and in many places this type of critical critical

Affordable help is in short supply if not unavailable for the following reasons demand need has outstripped home helps supply and this can only get worse we have lost providers to do too withheld state funding and this has really been a big problem in Illinois we’ve had agencies that have had to go

Down because closed down because the state just didn’t come up with the money the minimum wage is just too low causing high turnover poor quality of help when we really need more caring and creative people added cost of travel time and gas prices have required eliminating services in widely dispersed seniors in

Low-density suburbs and rural and some home health is reluctant to go into high crime with center city areas the fourth type is skilled professional home help this group of home help includes nurses who monitor health conditions for seniors with chronic but manageable disabilities and oversee recovery of episodic injuries or

Illnesses it also includes various types of therapists such as speech and occupational therapy or small and large motor exercises and strength training it also includes social and psychological visits professional home helps can get too expensive when there is no travel economies the higher the density the closer clients live to one another the

Lower the travel costs of the professional services and the time it takes to get from one person to another neighborhood based coordination who can manage this complex in varied forms of assisted living while preserving client independence and dignity at the lowest possible price the closer to the resident both physically and personally

The higher the quality dignity and efficiency of the care neighborhood-based CDC’s many Development Corporation’s are one model that can do this and one that planners no well who are the Senior Care CDC’s they can be churches synagogues and mosques labor unions fraternal organizations and other nonprofit community-based providers they are often

The only ones willing and capable of organizing comprehensive care oversight in very low income neighborhoods there are ready a wide variety of senior assistant assistant CDC’s here is a representative list of these various models the neighborhood warden program age integrated cohousing shared housing or share a home echo housing and single

Agency comprehensive care management and consortium management of section 8 of section 202 Tax Credit bill housing with assisted living lots of examples out there but this does not add up to widespread coverage in local us communities most of these examples were invented in other countries and there are only a small

Scattering of examples in the u.s. there is only only time for one example for complete coverage I suggest you go to any of the three books listed here the warden concept is a new form of community-based care professional and coordinator now that title may give you the jitters but it was developed and

Widely available in Great Britain where the term warder refers to a chief prison administrator or then in British English refers to a wide variety of care coordinators who serve as family surrogates for example the college dorm warden serves as a parent surrogate to entering freshmen the warden in neighborhood resident from neighborhood

Resident seniors a neighborhood warden to seniors has training in two years of Community College programs in Social Work psychology nursing and building management they are mostly women who coordinate with the families of his senior and community-based services and act as an advocate and daughter surrogate to seniors who are aging in

Place in their own home or apartment the warden lives in the same neighborhood as the twenty to forty seniors they are assigned to depending on how independent or dependent their mix is she makes daily visits to some weekly visits to all provide some direct help but primarily monitors health changes and

Calls in and coordinate family and community based aid as needed wardens have proven to be very cost-effective by keeping visiting family and community services to a minimum making sure there is neither over or under caring while maintaining maximum privacy and dignity p for their charges in this way they

Keep the senior active and independent to the margin of the physical and emotional ability the role of urban planner is keeper comprehensive plan is we I want to end this modern-day urban and regional planning has tended to divide into two departments the department that authors and oversees the implementation of the comprehensive plan

Is one type two examples of this offices responsibilities when it comes to the elderly are of course zoning seeing to it that it’s flexible enough to accommodate the wide variety of housing with assisted and co living needed to age in place in conventional housing and avoid moving to assisted in

Institutional living as much as is desired and possible despite various frailties and disabilities a density of urban life is achieved that allows all of the activity of daily living that can occur to occur within each neighborhood holistic neighborhoods are a very big key to dealing with with the aging

Society within easy walking and biking infrequent light rail model senior mobile seniors should be able to get to shopping visiting friends dining out getting hair care attending religious services enjoying parks and recreation all of these kinds of things should be within easy barrier free access urban planning in the role of neighborhood

Service coordinator is also important neighborhood service offices make up the other planners they assess and improve the quality of neighborhood life this department could be the pivotal unit to coordinate the city senior service programs developing management models like the neighborhood Warden Service to monitor individuals support service and coordinating health social welfare and

Physical housing upkeep and retrofitting to form a felis Support Package aging seniors it can be argued that the physical aspects of the support plan is at the core affordable barrier-free easy maintenance living environments are the first step and even make it possible to postpone or minimize the need for health

And social service intervention for and that’s the end of my speech for additional information here again are those three books that I think speak to the subject the best full thanks so much land we have a number of questions that have been coming in so what I’m going to

Do is unmute all of our speakers I’ll just ask you to try to be quiet and then we will have the opportunity for more more dialogue now one of the things that was asked upfront and Lynn this question is for you is to explain what eco housing is or echo housing that you

Meant it okay it’s of the ones I list there it’s kind of the rarest but in some ways the most interesting because it’s had its run headlong into zoning ordinances that don’t fit with it it’s a way for families to bring grandma closer to them if the city actually owns a

Number of houses that portable there are not mobile homes because these have to be made barrier free but they can be put in the backyard with some foundation work and path work done to get in and out of it and this has been a real benefit but it has been difficult to

Maintain and monitor this because once they’ve got the house many families don’t want to ever give it this echo house in the backyard every give it up they just assume their teenager go and practice their guitar on that in that house after grandma dies or whatever but

It has tens to become an extension family great thanks for that explanation so while we’re brian has just added a comment and I’ll share this with the audience so his mother who’s 85 receives home health care services from the Veterans Administration home care program and he mentioned that he his

Mother was qualified for this because his dad was a deceased veteran and so he just wanted to share that for other families that have veterans that the Veterans Administration home care program is something that can be accessible and helpful to folks I agree it’s a good you’re eligible it’s worth

Tapping into so I’ll ask this question for the audience as a planner you know we obviously have a lot of stuff that’s on our plate if you were to advise a planner what are the three things that you think would be most important for a planning agency to be looking at and

Considering now the city of champaign where I’m on the Planning Commission just updated its it’s messed if the country has a plan and so much of what’s on the agenda for the next five years it fits in perfectly with an aging senior population we’re trying to green our our

Plans we’re trying to lessen our carbon footprint and we want to continue have growth at the local level but we’re talking much more about growth being in fill and retrofitting and and not continue sprawl out into the community and two of the things I mentioned were

That if we’re really going to be able to service the seniors and give them as much independence as possible we need higher density holistic neighborhoods that allow them to get within easy walking or biking or other means of communication of transportation in and around their neighborhood and take care

Of themselves to the to the limits of their abilities and these are the kinds of things that I think well together with with the whole coloring the carbon footprint of our cities and and probably where we should coordinate our thinking I got this is Jacques I certainly agree with lemon and

All those things I have been doing a lot of work and would have been called shrinking cities and I think that even in situations where cities have lost half our more their population that the idea of creating compact neighborhoods and neighborhoods that can function for the sport of all really important i

Think that the second thing would be issues that all the issues that surround the idea of energy and alternative energy i think that the next 20-30 years it’s going to be one of the biggest things we’re going to have to deal with and finally I don’t think urban America

Is going to ever really thrive without solving the education problem that planners issue I don’t know but it it certainly is is essential ingredient to making our city in our society successful in a in a global context yeah we have a good local example of that most places have a separate board of

Education so that it’s hard for the planner to be dictating these where they’re putting in schools champagne wants to move one of its two high schools to the absolute edge of the city which goes totally against what we want to put in what we have put in our

Comprehensive plan what what I see is happening though is I see that that Boards of Education and of the planning department are working a lot more closely than they have in the past and I think everybody understands it we have to coordinate with all these things now

We’re in the stake here and they’ll annoy where there are more separate taxing districts than any other city I think double the closest which is Pennsylvania but these things all have to be coordinated Park and Recreation everything and they all affect them the quality of life for seniors by where

They’re put and how they’re designed and so on so this all has to be coordinated and I think it’s our responsibility the planners to get everybody else on board including the health of social welfare folks good luck all right we you all have talked about aging in place and

That there’s a strong desire for people who want to age in place and want to be cared for in their home how do we balance that over the long term with the tons of people that we’re going to have they’re going to be aging is it really

Efficient to operate our cities with all these people being dispatched to care in individual homes and you know is there an alternative that we should be looking at okay I’ll take this first one of the other groups I mentioned was share a home and there are a lot of were only

Seniors in four bedroom houses whose children are gone from the community corporate America has moved in some other place their spouse has died and it’s much too much house for them to take care of let alone pay the the property taxes and everything else and this is one area is matchmaking people

And and then monitoring their living together and again we’re going to have to have zoning laws that allow that kind of living to occur not all cities and community municipality is allow that non related persons living that way but that’s one one solution to it well i

Think i read an article about that shared housing it was be a fairly large building in New York that where it was highly successful and the social interaction among the 15 or 20 people that were involved with really quite magnificent I think you know the question if you start to think about

Mathematically say well we have one person for 2,200 square feet of house is not very efficient that’s true and and I think that if we begin to build more desirable neighborhoods compact areas have been made neighborhoods or city centers or district whatever we want to call them that people will gravitate

Towards areas that give them the most advantages there’s a personal example my wife and I moved from a 2500 square-foot house to a 1500 square foot apartment and we like it much better because there’s less to take care of and we don’t need that space and we’re in a

Neighborhood that provides us with the kind of services and benefits that well we’re really looking for that that’s I think the key yet the other thing is I’ll do we don’t want to give up their house because they mean that means usually giving up their neighborhood as

Well and their church and and their their social group if we have these holistic neighborhoods and and they can give up their house so a younger family can live in but still stay in the neighborhood a small apartment building or some kind of small town houses that

Fit in with it with the design of the other houses could be infield in and and they would be more readily willing to move because there’s really staying in their cultural and social environment another one is as look into cohousing and this is often done at at the lead of younger people

Who want to share housing with a diverse group of people and and they often bring in a senior member and between them they trade their various skills the elderly person can help with babysitting and and can show people a lot of sewing and knitting skills and you have people who

Can do some of the heavy lifting in their apartment do some of the heavy shopping for them and it’s a win-win situation for everybody so there there are a whole slew of kind of infill things that we can do they’re not just physical infill they are social and

Cultural as well I you know I think some of the demographic trends are going to open up a lot of these kinds of options that we now think of G those are weird you know that’s not the way we’ve always done things but if you look at the

Percentage of people who are married in the American population with below fifty percent that the size of families and households quickly approaching two or less in a lot of particularly urban areas that we’re going to we’re going to find ourselves searching for different ways to arrange our living situations

Very quickly yeah and one of them one of those is to go back to the multi-generation house as well though where maybe the kids want to move into the lot back into the large house with their children with the grandchildren and and mom staying after dad has died

And you know the waltons idea is is the one that can work as well it’s good you know if we just use our imaginations and look at what we prize as quality of life we’re going to come up with a lot of different kinds of housing solutions and neighborhood solutions

Great yes we have lots of other questions so how do you see the dawning of the digital age affecting the lives of seniors in our future and that’s a question from Todd and I’ll just note for Todd that we do have a couple of upcoming sessions as part of the aging

Series that will be touching on issues of technology specifically but i’ll let our speakers go ahead and address that did you also say visual age or just technology digital age digital age digital digital that I remember that either yeah I didn’t hear a fine compare

Well yeah we don’t forget both of us are already in that age group but you know being an academic I started working on computers when they when it took a whole building to do something a computer that can fit on your fingernail could do today there are a lot of elderly who are

Scared to death I have a stepmother who for years I’ve tried to say can I give you this old this old computer so that we can email each other I otherwise I always have to call you but she says I leather your years alloys and there are

People who are not in the digital age and they don’t want to be there frayed to death of it and a lot of the things that we have done to bring into the home require too many skills for them to change temperatures to change different lighting gets very complicated for them

And very confusing and they end up maybe hurting themselves but their if the and I’ll say this if the not digital age but good but the technical age can can be brought in without them having to do a lot of work it’s amazing what you can keep in what would disabilities you

Can’t live alone with they now have toilets that a person as they sit on it in the morn it can take a blood urine camp specimen take it can check your heartbeat and it can send these things to the transfer station miles away and if they see some

Problems that get somebody out to the house real quickly so and they the individual elderly person doesn’t have to do a thing so there are ways that high-tech can can move in and make a big difference here but if they have to run it if the seniors have to literally know

How to use it including the way we were linked together here today and and it’s taken a lot of work among our three different locations but it works and we’re patient with it they just it’s just too alien well I think that you know I think since planners are

Future-oriented those of us who have had to learn how to use computers and all other kinds of magnificent pieces of equipment to make our living and those who are right behind us the baby boomers who already will bring to their senior years a knowledge about how to use this

Stuff will be in a better position to make use of it and to stay in communication and to be more cooperative with whatever kind of monitoring devices might develop over time so I think that on balance I would say that it’s going to have a benefit towards the notion of

Giving people more choices about how they want to live I we have a question here it seems that there are Popkin pockets of senior living in states like New Jersey which is where this person is from in Florida I don’t know of any cities that deliberately integrate living styles to mingle the younger

Population in the older population it seems to me that bringing the older people in and this person 64 would bring down a younger influx has that not been your experience or is is that not a consideration there’s both a American answer to this and a European answer to

This I we have built isolated elderly town’s new towns and they have their gated and and very little goes on between them and the outside world and even among them sun city and some of these other places out in Arizona I’ll pick a new different state have actually

You know force people out if they’re functional if their dependencies get to too heavy and these are kind of artificial in many many ways there are some very good retirement communities though and a lot of them are not in the United States there’s a Swedish example no but highly integrated with this

Community in fact they built a little low retirement community next to a new campus college campus and they have lots of activities that go on between the students and the seniors and I think that does make much more sense I’ll leave it at that I just tell a story

That came up earlier this month that a proposal to develop a 25-acre area fairly well devastated lanham southeast side of Chicago was put forward where no one under 40 could live in it was age restricted to under 40 if not just a householder that was nobody under 40

Could live in it and yeah the idea that somebody thought there would be a market for that type of housing in a fairly unsafe actually pretty unsafe neighborhood was you know a startling thing to me I kind of recoil against that type of thing that I think

That separating us as a community by ages is something that does tend to isolate people both particularly the elderly I think we have great role models in Japan and and Western Europe to look to as we continue to age it’s a whole different environment and and integrated the age groups is a natural

Thing now in these environments in many elementary schools they have adopted all the seniors in their surrounding neighborhood and they visit them on a regular basis the kids do I think you have to be in third grade or older help with little bit of cleaning in the house

And planting some plants or just visiting singing to them are showing their artwork to them bringing them into the school for Christmas plays or whatever it might happen to be and even putting up posters you know have you have you kissed your grandma lately or things like that we will get there and

And as an open society will do it creatively ultimately but we we have made mistakes already and we and one of the worst ones is segregating age groups hey next question granny flats get converted to rental units when granny dies how should planners deal with this should we care

What are your thoughts I know in public meetings for example that I’ve gone to everyone supports the idea of keeping the disabled child or the the senior citizen in the granny flat but they’re very concerned about a turnover in their neighborhood moving from primarily single family to a rental community so

What are some of the issues we might deal with that well grandest granny flats are the rental version of echo housing and both programs have this problem once a grandmother and her family younger family move in together and she has her own flat or own echo

House so she can have that privacy I have our own friends in but still be close to the family and have meals with them and do the projects with them and so on it gets very hard for the family to let go of that extra space when’s

Grandma dies and that’s the big fault in both both both programs I don’t know what you do about it I guess you have to police this more because the rights of other people are being you know ignore oven and actually this program is all that inexpensive and so it should go

Back to the city or whoever’s managing it once grandma dies but I don’t know how you do it I I don’t think it’s so bad to keep it because again if you look at demographic trends that we have a lot of people coming behind us who are going

To be a single person in single-person households who are not going to be able to afford that kind of standard housing we have I’m sorry I lived in evanston illinois for a very long time and you know Evans to know that it’s filled with big turn of the century the last

Century housing and it has a small institution in a call Northwestern University but I can’t tell you how many of those big housing had on their third floors one in two room little living units that were rented by students at Northwestern mean one house after another after another after another head

And you know Menem were legal but they were up there was a market demand for every one of those and yeah there there’s an issue where zoning is often responsive to the most conservative thinking rather than to kind of the reality of market demand the question is

Well we can’t let our neighborhood go to hell and and but I don’t think that’s necessarily occasional things I think that that we need need to look at different kinds of solutions for housing not only for the elderly but for single people disabled people people that are

Not in our standard for person family that essentially doesn’t exist anymore and you brought up a for-profit landlord into the into the model here and it that can be a element that solves everything I the landlord is not going to leave the small apartment empty and he’s going to

Know pretty much when grandma has died and we’ll start looking for either another grandma or looking for a student housing or whatever it can rent it as so maybe just all belongs in the private sector and that and it can then control itself and not in the public sector

Okay wonderful well we are now out of time I appreciate you all joining us today I learned some new things and I hope the rest of our audience did as well Jacques and Lynn and Libby thank you very much for sharing information that you have as you log out today you

Will receive a survey we just ask that you fill this out I will provide this feedback to our speakers and and so I’ll be following up by email with our speakers a copy of today’s presentation will be available at the Utah APA website so if you want to visit later

This afternoon we’ll have a copy of today’s presentation that will be up and available thank you all again and enjoy the rest of your afternoon okay Livie Lynn and Jacques I will just follow up by email with you later today thank you so much okay thank you very much thank

You when are you there I think he’s at oh yeah yeah disconnected huh yep okay well I’ll follow up with them personally thanks their help on everything and thank Corey for me as well okay will do thank you okay all right

ID: sg4zu1d4_xE
Time: 1344356083
Date: 2012-08-07 20:44:43
Duration: 01:27:20

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