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  پرینتخانه » فيلم تاریخ انتشار : 07 آگوست 2012 - 19:38 | 41 بازدید | ارسال توسط :

فيلم: تأثیرات و فرصت های یک جمعیت سالمند

Title:تأثیرات و فرصت های یک جمعیت سالمند ۰۲-۱۱-۲۰۱۱ ارائه دهندگان: داگ بیچ، میمی رجنتین، پیت سچلر این وب‌کست فقط برای مشاهده در دسترس است، برای اعتبارات AICP CM قابل استفاده نیست. وبینار “تاثیرات و فرصت های یک جمعیت سالخورده” دنیای جدیدی را بررسی می کند که توسط تغییر جمعیتی لرزه ای ایجاد شده است که […]

Title:تأثیرات و فرصت های یک جمعیت سالمند

۰۲-۱۱-۲۰۱۱ ارائه دهندگان: داگ بیچ، میمی رجنتین، پیت سچلر این وب‌کست فقط برای مشاهده در دسترس است، برای اعتبارات AICP CM قابل استفاده نیست. وبینار “تاثیرات و فرصت های یک جمعیت سالخورده” دنیای جدیدی را بررسی می کند که توسط تغییر جمعیتی لرزه ای ایجاد شده است که از اول ژانویه ۲۰۱۱ آغاز می شود، زمانی که اولین نسل از بیبی بومر ۶۵ سالگی خود را جشن می گیرند. در طی ۲۰ سال آینده (۲۰۳۰) جمعیت سالمندان دو برابر خواهد شد و به ۷۱ میلیون نفر خواهد رسید و تا سال ۲۰۵۰، جمعیت سالمندان ما برابر با جوانان ما خواهد بود (۱۰۹,۰۹۰,۰۰۰ در مقابل ۱۰۹,۱۴۷,۰۰۰). تعداد زیادی از افراد که مسن می‌شوند، تقاضای بیشتری برای محله‌های قابل پیاده‌روی و توسعه‌های کاربری مختلط ایجاد می‌کند که مشاغل و خدمات مورد استفاده جمعیت مسن‌تر را در مجاورت محله‌های مسکونی قرار می‌دهد. جوامعی که استانداردهای طراحی جهانی را نیز در برنامه‌ریزی کلی و کدهای ساختمانی خود گنجانده‌اند نیز در موقعیت بهتری خواهند بود تا ساکنان خود را قادر سازند تا در جوامع بازنشستگی طبیعی “سالمند شوند” – در نتیجه تقاضا برای مراقبت‌های سازمانی با هزینه‌های بالا کاهش می‌یابد. تأثیر و فرصت های جمعیت سالخورده فراتر از برنامه ریزی شهری سنتی است و به سیاست های عمومی و برنامه ریزی استراتژیک گسترش می یابد. جمعیت ضعیف‌تر می‌تواند بر استفاده از خدمات سنتی دولتی مانند خدمات اضطراری ۹-۱-۱ تأثیر بگذارد، می‌تواند هزینه‌های زندان محلی را افزایش دهد و می‌تواند بازی Medicaid را که دولت‌های محلی مسئول آن هستند افزایش دهد. اگرچه چالش‌های مهمی وجود دارد که جوامع با جمعیتی که به طور فزاینده‌ای مسن‌تر با آن روبرو هستند، فرصت‌های فوق‌العاده‌ای وجود دارد که جمعیت بازنشستگان از جمله هسته قوی داوطلبان، جمعیتی با درآمد اختیاری و جمعیتی با تمایل به مشارکت به ارمغان می‌آورد.


قسمتي از متن فيلم: Kind of secured active adult you know retirement communities it’s really a very very small percentage of what the overall housing picture is most of these folks are living in conventional housing in in conventional suburban or traditional neighborhoods just like everyone else here’s some more numbers i think that the real takeaway here is

That single-family home owner is still the predominant number but there is some growth in multifamily rental and multifamily condo so when we think about sort of you know what are the needs realizing that kind of the age-restricted community is really an extraordinarily small part of the overall sector it really just comes down

To a lot of things that we that we talked about in the planning community about just how you make highly functional mixed-use places that have access to basic daily needs are highly walkable with calm traffic but just to realize that that there’s going to be a higher and higher percentage of folks

With diminished mobility skills similar in some ways to that of a child so I go back to that that that that grandparent grandchild sort of theme all of those rules that we’ve all learned in school and in our career are going to come home to bear it in a much more profound way

Over the next 20 years here’s an example this is actually close to where I grew up in Columbus Ohio I think this is a great example of an existing community that that that places a remarkable variety of services within a relatively small area if you look at the half mile

Radius in red you see a significant park in the middle you see a neighborhood shopping center right there off reading road in the middle there’s a there’s a regional mall a little bit to the north there’s a couple of different schools there’s a couple of different churches there’s a senior there’s a senior

Wellness facility that’s part of the north and road complex we just don’t build enough of this kind of mixture and more and we really need to focus on it particularly a new development here’s some of the activities that you see there so you’re seeing everything from you know huh Foods Market

Tremont pharmacy to the the senior wellness in the lower right places that are bikeable places where you’ve got the corner the corner cafe and that type of thing the challenge is you know we’ve built an awful awful lot of this and this just becomes harder and harder for

Folks to manage over time we’re seeing a lot more trend at least here in Florida but I’ve seen it in other parts of the country of the granny flat accessory unit type of development we’re even seeing a lot of what what you see here this is this is actually a reap arsal is

A shin in the traditional area of orlando that actually creates an entirely separate unit off the back of the house where the grandparents live so basically they have their own unit it’s a ground-floor unit there’s a loft on the second floor that’s mostly used for storage but this becomes a tandem lot

Parcel ization and it’s a fully functional home in the back of the property also sort of in the urban environment I know many of you are just familiar with you know sort of the fundamentals of of the benefits of mixed mixed housing and mixed price points and again this this idea that folks

Fundamentally would prefer to stay in their home or if not their homes stay in their community mixed-use places provide the best opportunity to do that and that can happen in kind of traditional neighborhoods where you look at the fabric in this image and you think about sort of where those neighborhoods come

Together in corridors that have the basic services that people need this is actually another road diet example this is in college park where we’re again sort of the nexus between calm to traffic creating a better main street retailing environment for the merchants and then setting up for mixed-use infill

Development all kind of adds up to a more livable place that actually is much more suitable for people again whether whether it’s a child or whether it’s a senior we work in some suburban areas and mainly mentioned Charlotte County earlier in the slideshow is a place in

Florida that has a very very high percentage of folks over 55 um we see a lot of development like this in Charlotte County where where this this image on the top Chelsea house is a retirement community but the infrastructure in that area is so limited that it’s virtually impossible

For for the folks that live here to access what is actually a wide variety of available services there’s a nearby grocery store there’s actually two small community hospitals there’s a number of doctors offices that are associated with those hospitals there’s a library or community center various other things

But in most cases that’s extremely difficult to even get around and access those things because of the form and so what we’re doing is we’re going in and actually helping them build a walkable infrastructure in some cases creating new streets and some crates is creating new mobility services whether those are

On bus circulators or what have you to help people actually get around and better manage a pretty unlivable environment right now in more urbanized areas we’re definitely seeing a trend towards the development of the the mixed-use medical district as an economic development tool but also as a

Setting for all manner of new forms of housing and then of course the various medical and non-medical services that go with on that type of development and we’ve looked at precedents in in Baltimore and Seattle and in Boston for these types of things when we think about congregate living facilities in

The urban environment and this is in Orlando I think what’s really critical that I didn’t fully appreciate so I started researching this is actually how much activity goes on between these facilities and the nearby churches the library and various other senior centers and retail opportunities it’s very

Important that these kind of programs to actually help people get around that these things exist because the function of going to church or going to the library or going somewhere to volunteer is really what keeps a lot of these people active another community forum that I’m sure

Many of you are familiar with is sort of the tmd traditional neighborhood design this has a lot of benefits it’s a great model to accommodate your goals of mixed use and mixed price point with a lot of access to services so i think this model is going to become more and more

Relevant over time this is baldwin park this is also in orlando what you see is just a lot of different price points to housing a lot of different types of housing and then great access to services within a within a walkable environment this is the town center there’s a grocery store there’s

Community centers and so forth and it is I’m relatively seamlessly tied into the Orlando on the street grid now when you compare something like Baldwin Park to sort of the age-restricted suburban community I had a chance to do some interviews with a number of um developers of these kinds of facilities

And surprisingly they were remarkably frank about the fact that um that you see the quote in the middle you know we don’t really address in home activity services health care we just assumed that his folks age the market will address people’s in-home healthcare needs it’s it’s that it was actually a

Little a little stunning to hear someone just come right out and say you know that that that there they realize they’re not really building something that addresses the real material needs of of people over 65 who generally think they’re 10 years younger than they are and then the other quote that this

Gentleman made that was interesting he said you know the only the only developer out there that really has the buying power to really try to provide those services as the villages the villages is a project that some of you not in Florida may not be familiar with

This is a huge land development north of Orlando south of gainesville it has about 73,000 residents and they have they have specifically designed this to be a very unique environment to provide thick activities recreation shopping retail to specifically serve this demographic with special solutions for security transportation access

Activities I would definitely on Google on the villages and I’ll see what comes up it’s actually a beautiful environment it’s it’s made to look like a like a small town you can see the image in the lower right golf carts definitely rule there’s a little bit of a critique about

The villages though that you know are they really providing services for folks that are having diminished skills or is it folks that really are still in excellent health excellent mobility there are a number of facilities nearby that that um address the needs of people who are who are starting to go through

Some sort of health condition but the villages itself is basically set up to be fairly active so I’m not sure that it’s the perfect solution for folks that are in a more diminished situation however as you can see these facilities are actually right nearby so I think

It’s a very interesting model for people to study the other thing about the villages that’s very interesting is they realized early in the game that if they were going to deliver an excellent experience and an excellent level of service for the folks that are living there they were going to need a very

Very high end onset of service providers and the only way to recruit a very very high end sort of service providers is going to be to develop some very very high end schools and a very high-end sense of community so that people actually would want to live near the

Villages in order to use that as an employment opportunity so the villages region has got excellent health care and educational facilities for the families and kids that are essentially supporting the services that go on in that community I’m almost done I think there’s just a couple of more things I

Wanted to share this is another concept of community and its really a virtual concept of community this is this is um The Beacon Hill ville this is a model in Boston and it’s it’s really it’s a non-profit grassroots essentially a concierge service where for a relatively small annual fees at

The top about you know less than a thousand dollars they will arrange for you all sorts of in-home services rides activities affinity or activity groups gardening grocery shopping it’s it’s a way for people to meet people in in a traditional environment as opposed to a created environment like the villages

This is a way to access that social activity and and interaction and physical services it’s sort of a concierge level which i think is actually very interesting you still have to pay for the services you may have to still pay for a ride but the concierge service will screen drivers and and

Require certain qualifications of them and then provide certain discounts to the people who are part of the Beacon Hill Village program which i think is advantageous to everyone here’s just kind of here’s kind of one more little anecdote on sort of these seniors and sort of their their level of activity

This is a this is a couple that I know personally they’re both in their 70s they’re highly active just as we said at the beginning they live in a mixed-use development which they live a couple of stories above super target they’re right down the street from a jason’s deli

They’ve got extra bedrooms where their grandkids can come in they’ve got access to all kinds of services in the development that they live in and they’ve got their retirement plan figured out they’re going to move to Spokane Washington which they visited 12 times it’s it’s an area here where again

You can see the proximity of things the the husband is actually a pastor and this is the church that you could provide some service out of so I think this idea of relocating to the extent that folks do relocated they’re looking for livable cities I’m like Portland

Oregon Boston etc so I think to kind of to kind of wrap up just some thoughts about kind of this the senior generation you know it really starts your ability to live a long and healthy life with a high quality of life really starts with with how you grow up

And and where you are as a child and and the kind of habits that you develop this this couple here certainly you can change your life midstream but but this kind of fitness and activity at this age you know probably traces back to when they were adults and even when they were

Kids and the kind of habits that they adopted and the livability of their community and their acts their access to opportunities to be healthy and the kind of cities that we make or the communities that we make where we think maybe about a high standard of living do

We all have the right car but really are we are we creating a place that has the kind of quality of life that promotes livability and promotes a healthy lifestyle that allows people to remain active well past age 65 so that so that it’s kind of the social interaction and

Joy of being retired and all the opportunities that affords you that people can take maximum advantage of that so that’s really the conclusion of my talk it’s really about choice flexibility having mixed generations within your developments or within your city thinking about principles of smart growth which are highly applicable and

Then thinking about things you can do as a planner to actually promote and reward types of development that will actually serve this incredibly growing group of people within the country that’s it I’m going to turn it over to Doug beach thank you alright it’s my name is Doug beach and I

Am the executive director of Lucia County Council on Aging I apologize for format some of these things have been reformatted on my computer so or by the computer so it doesn’t look quite right as an economist one of the things that’s particularly interesting with Pete slides is that many economists

Particularly economist looking at urban sprawl suggest that part of our problem is the fact that we’ve built too many highways and if you go ahead and look what’s happened with populations they’ve moved out of urban centers where actually they were walkable they did have access to activities to grocery

Stores and alike and we’ve moved into a completely different era particularly with this baby boomer population this slide is my introduction to aging and many of you probably are too young to remember this but this is the old people Sly I’m fine with this this is the old

People’s home in Lincoln County Ohio where I grew up this uh women down there I’ve probably in grade school and went down there to sing and as you can see the bottom is all boarded up and we went in there the seniors were the shovel they were trying to touch us and I

Remember being one of the more terrifying experiences I had up to that point my life but these were County homes they were working farms most of them seniors who didn’t have family and were too poor to take care of themselves would go to these County homes they

Would work on these farms until they weren’t able to in a sense of they go to bed to die remember that in the 50s and 60s the poverty rate and senior population was forty-three percent compared to now where it’s less than 10 so we had the advent of the older

Americans Act which creates programs like meals on wheels we had the advent of Medicare Medicaid which provides for services in nursing homes and the senior plight as i said is gone from a forty three percent poverty level to the point where we think of particular in florida’s seniors as our secret economic weapon

A 1999 study by local economists Hank fish kind estimates the diamond industry is Florida second largest economic sector the average floor retiree contributes nearly 2,000 more in taxes than they cost most of residential housing is owned by people 60 plus and for those of you that earn the political

Realm as I am seniors in last gubernatorial election or four thirty-one percent of the registered voters but 40 over forty percent of people have voted so nearly one in two were sixty plus so what’s the problem well a simple problem is all of you know in these statistics buried somewhere

Between 76 and 78 million baby boomers began to retire in 2008 pressures on Social Security pressures on Medicare pressures on Medicaid some people have called this an aging tsunami as for me I think of it as an opportunity to do some things a little differently 19 our 2004

Issue of roll call and we’ll call is one of the rags on Capitol Hill suggests that and these statistics are a little bit dated but suggest that we’re looking at a 72 trillion dollar unfunded mandate of that 62 trillion dollar due to increases in Medicare with the aging

Baby boomers and overt entry and due to social security so when we look at the whole issue particular in Florida we look at Florida communities in the first part of first car of our train in the engine of course is an aging population again we think of it as potential to do

The right thing and help the economy rather than create a train wreck this goes a little bit at some of the slides that beat Mimi showed us what we expect here in Florida actually this is nationwide that the senior population is essentially going to double between now

And 2030 the largest sort of fastest growing age cohort right now is 85 85 + population and we know a couple things about the 85 + population first of all somewhere between 45 the percent of those folks are going to need some help to stay in their homes

And the second thing we know is that somewhere between 35 and 45 percent of folks 85 + are going to have dementia in Florida it’s even more exaggerated what we’re showing here is that we expect the population increase twenty-seven percent between now and 2030 with sixty-six

Percent of that growth from the 65 plus population there are some folks here in Florida that have talked about decreasing the percentage of seniors you know getting more young people involved having industries that will attract more young people but i would suggest when you look at this slide that seniors are

The past present and future of florida the second car on the train of course is scarce funds and being an economist i have to show you some of these awful slides but trying to get a little feel for what exactly is going on these slides again are just a little bit dated

But i wanted to use some statistics that were before the great recession that we are in right now and i think they’re a little bit more applicable and give you a better feeling as to where we’re going if you look at that final column that fifth column we’re looking at

Entitlements as a percentage of total spending in the united states and the fifth column looks at percentage of total mandatory spending you’ll see that the top ten entitlements consume ninety percent of entitlement spending if you go to column 3 which starts with percent of federal outlays in fiscal year 2001

You’ll see that if you add up that whole column you see that entitlements account for nearly fifty four percent a little over fifty four percent of total spending in the United States now why is this so bad this slide goes into a little bit and what we’re trying to do

Is see what happens when we compare growth and entitlement spending to growth in GDP gross domestic product a couple of slides a couple of columns that are pickering interest column two shows over on time spending has increased well about the growth of GDP over the last 40 years two-point-eight percent for GDP

Which is the top row there compared to 4.2 percent 4.19 percent for entitlements if you go to column 5 looking strictly at nineteen seventy five to two thousand you’ll see that GDP has grown roughly two-point-six percent entitlements have grown at two-point-six percent so growing it at a similar rate

Of course this is before the baby boomers retire but if you look at Medicaid Medicaid is growing at nearly seven percent and medicare has grown at six and a half percent so two of the big drivers when we look at government debt is Medicaid and Medicare let’s bring

This home even a little bit more what this slide and it’s a slide about Florida comes out march two thousand nine and what this slide shows is that in the state of Florida the blind and disabled seniors blind and disabled again on the left are about twenty four percent of the Medicaid population

Twenty four percent of the Medicaid population we have twenty four percent of Medicaid population driving what is that sixty-three percent of the costs so any time we look at Medicaid reform you can’t look past the senior blind disabled population particularly seniors or nine percent driving twenty-two percent of cost blind disabled are

Fifteen percent driving forty-one percent of the cost as Mimi has made sure that i mentioned to you this comes down to the local level as well local county organizations are responsible for some medicaid hospital costs and in Orange County Medicaid expenses for Orange County have gone up from 5.7 I

Think that’s million in 2002 to over 13 million in 2010 Medicaid nursing home costs have up from this is the County Sheriff on a 1.1 million in 2002 to 1.5 million so these things are increasing at an increasing rate and then the last thing we like to talk about is the dependency

Ratio this slide shows what’s happened over the last 50 60 years dependency ratio in the 1950s there are roughly 16.1 workers to each retiree actually this is just retirees we’re not talking about kids when we talk about dependency here but it’s gone from 16.1 to 12 in

Two thousand is 3.4 workers 21 retiree and 2020 it’s going to be two point six workers to one retiree and in 20-30 2.2 workers to one retiree and what exactly does that mean well this is something i just threw together looking at the average monthly benefit from Social

Security the average wage in 2003 and the average contribution per wage earner in 2003 and as you can see when we have these different ratios we go from a positive situation in 2020 with 2.6 workers per beneficiary to strongly negative when we go to 2.0 workers per beneficiary so the train wreck is

Complete when we look at riding the train I want to talk about three things particularly a little bit about politics a little bit about economic growth and a little bit about reducing spending and hopefully increase tracks revenues now this is very very hard to to look at but

We talked about it a little bit earlier what you see here and this is for the US as a whole that older adults 65 plus constitute about 12.2 percent of the population it should be proclaimed two percent of registered voters yet in the 2002 election they were nearly twenty

Three percent of the folks so we’ve got 12 point two percent of the registered voters and representing point three percent of the people voted so if people really need in I want to need to get involved in these activities to understand how politicians thing as i said in the 2006 gubernatorial election

Seniors accounted for thirty-one percent of registered voters but nearly forty four percent of people voted so one and two thinking about this further clearly any change in entitlement programs it would be pretty hard giving this huge voting block all right now this is a whole bunch of squiggly lines which make

Very little sense but what I’ll say is that if you look at the baseline and this is what the Congressional Budget Office looks at they assume a two percent growth rate and they assume that seniors in the future are going to act like seniors today now Pete Nene’s

Slides clearly suggest that baby boomers haven’t acted like anything in their whole experience from birth why would they start acting like anything as they go into the next step and so what I suggest here is possibly looking at that bottom pink line that bottom pink line assumes a growth rate that’s more

Typical what we’ve seen in the last 30 or 40 years seems a growth rate closer to three percent compared to two percent with the MA baseline as the congressional budget office uses it also assumes that seniors aren’t going to be active that seniors been end up in

Nursing homes and so instead of having these programs Medicare Medicaid and Social Security at thirteen and a half percent of GDP it’s actually closer to nine clearly not where we want to be but not as bad as the doomsayers will will tell you that it is let’s skip this slide

What Mimi this is a slide that Mimi’s provided and what we’re sense of looking at here is public health implications of a number of things lack of geriatrician smaller worker to retiree issues things we’ve gone over here employee caregiver issues which I’ll talk a little bit about depression and mental health which

We’ll get into and so there are a whole bunch of issues they’re impacting seniors on a daily basis moreover when we look at growth and assistive technologies home health care innovations long-term care options I really think that that potential train wreck is actually a potential for us to

Do things in different ways than we’ve ever done before and move the economy forward rather than backward so what am I talking about suggestions come from the World Health Organization suggesting lifelong learning to increase the possibilities for older adults finding employment this Great Recession has really hit the senior population hard

You see a lot more senior staying in or place for a longer period of time which at the end will benefit Social Security Medicare and Medicaid promoting income security policies access to adequate health care early intervention and prevention and of course pension policies which will allow these seniors

To age in place all right this slide is an interesting slide in the sense that we’ve all heard particularly long term care insurance salesman say that over fifty percent of seniors are going to end up in a nursing home at some point in their life now the operative term is

At some point in their life and what’s this slide shows is that for Florida we have roughly 2.1 percent of seniors in nursing homes for extended period tag of stay and one point nine percent assisted living facilities so less than five percent are an institutional care the

Rest ninety percent are what we call well elders and they’re in the community and what we know is generally those nursing home stays are associated with a rehab stay from a hospital Medicare rehab stay what we want to do and what we know is that if we can increase the percentage

Of seniors well elders from 89.1 percent in this slide to 90.1 percent we can decrease Medicaid costs in the state of Florida somewhere between 500 and nine hundred million dollars one percent increase in percentage of well elders will decrease Medicaid costs somewhere between 500 and nine hundred million

Dollars when you have a 3.2 billion dollar deficit in your state budget decreasing Medicaid costs by nearly 1 billion of course is the right way to go so writing the train integrating medical and social services before illness illnesses that we think about particularly with seniors our hips heart

Depression diabetes Pete me me both have talked about hip fractures ninety-five percent of hip fractures among adults age 65 and older are caused by falls every eighteen sector seconds an older adult will fall in the United States heart disease is the number one killer of women the United States yet most of

The protocols used to treat heart disease in the United States are based upon white males in their 50s 60s and 70s so again the whole idea of figuring out ways to use social services to help with a couple of these illnesses the other two illnesses that we particularly are worried about is diabetes

Twenty-three percent increase in diabetes between 1990 mid 1990s and mid-2000s many of these folks are elderly many of it related to wait and then the last thing is depression twenty percent of older adults are depressed fifty percent of older adults in nursing homes are depressed I know many physicians think that depression is

Normal part of eight of aging it just isn’t and how we can treat depression to keep people involved in the community is essential to the things that we’re talking about this slide is one of me me sliding we kind of snuck it in there at the last minute but what we’re talking

About primarily with these illnesses is increasing the period of time when seniors are well decreasing the period time when they’re sick how we’re going to do this well the first thing we want to talk about is physical activity hips heart depression diabetes we know that exercise is a positive on each one of

Those illnesses again hips heart depression diabetes so we’re thinking first of all about exercise getting people up and moving and we’re thinking secondly about going to your doctor age appropriate number of times per year I like to use an analogy about my dad when before dad passed when I was growing up

We blew up one truck two cars two tractors and mom’s blown up another car since then and so the question always was what’s more important $35 oil change or a 3500 dollar engine same thing with human beings in most ways if we get things through early intervention we can

Often or a prevention we can often head it off at the at the door so to speak headed off at the pass and make seniors as well as anybody let them have a happier and healthier life for a longer period of time the second part of the activities that we’re talking about to

Fight hips heart depression and diabetes our intellectual activities there were a series of tests done by a guy by name of Snowden on some nuns in Kentucky and Tennessee carry out in the 1970s and what Snowden was able to show is that for those young nuns that were intellectually active during their

Lifetime even though they had Alzheimer’s disease by brain brain biopsy shown that they had Alzheimer’s disease even though they had Alzheimer’s disease when they died they didn’t show the symptoms when they were living for those nuns that weren’t intellectually active during their lifetime they showed all the symptoms of full-blown

Alzheimer’s disease so what we know is that if we keep people intellectually active doing different things than they are used to we can either do an end run around dementia or at least slow it down the last thing that we talked about in combating hips heart depression and diabetes is social activity

Putnam’s book Bowling Alone which I’m sure many of you have read he suggests that social isolationism is as difficult on a seniors health as smoking we also know that the frequent fliers and nursing homes in emergency rooms tend to be socially isolated seniors and as I suggested earlier 20 percentage seniors

Are depressed fifty percent of seniors in nursing homes are depressed the suicide rate and senior population in Florida and I think it bears out nationwide depending on what state you are is either number one or number two suicide rate of any age cohort in your various state so again hips art

Depression diabetes and physical intellectual and social activities so what are we talking about with respect to the types of these are examples of just some programs that help us get there this is a respite program based upon a Brookdale model in that we apply here in Volusia County and what we’re

Able to do is that if we can keep caregivers helping their loved ones for a longer period of time the statistics suggest that United States as a whole it costs over 50 for 650 billion dollars a year to replicate what caregivers do yeah caregivers tend to be under

Tremendous pressure and I like to talk about the three-legged stool of caregiving first leg of the stool is the out-of-state sister-in-law the calls mom every day to make sure she’s properly agitated the second leg of the stool if the second leg of the school is the

Aging expert when you ask them for help to take care of mom the person says well it’s your mother’s journey and you’re just along for the ride you say but it’s in my house and then third leg of the stool is when mom comes in once or twice

A week two or 3am says she absolutely needs oath emergency room and get her to the doctor the next morning she’s good enough to get a doctor next morning about grass ask her how she is and she says she’s fine and so then the doctor thinks you’re the one with dementia so

The bottom line is how can we keep these caregiver givers involved in there with their loved ones for longer period of time course respite programs tend to be the answer senior centers are the focal point for many of the activities we talk about senior centers provide a reason

For seniors to get up in the morning they provide that necessary socialization can provide the necessary physical activities and can provide the necessary intellectual activities and then the key for almost everything we talked about and people went into it quite extensively is transportation how do we get people connected with their

Communities I know that many of you remember the movie cocoon I would suggest that you go back and look at that movie because everybody thinks that movie was all about a bunch of pods coming down to some remote County and in western Florida and Don Ameche doing

Backflips off of a backboard but the fundamental issue in that community was the fact that the guy that owned the car was going blind and they were all afraid that they would be connected to the community anymore so transportation is often the biggest problem that we need

To solve but the most important problem in trying to keep senior socially intellectually and physically active and that’s my presentation ok wonderful our Mimi are we ready for QA yes we’re ready for questions and answers ok and I’ll be able to assist with that Mimi ok so the

First question comes from Michael he points out that all the photos showed in the different presentations they show nice flat communities Florida Central Ohio that sort of thing what about communities that have large changes in elevation seniors walking or biking is not really possible many living situations are isolated even those

Services may be close by how do you deal with those issues of elevation I guess I’ll jump in and start with that this is Pete I think in particularly you know a lot of those areas with a lot of elevation also correspond to snow and ice and all

The things that come with that I think I think it has to do in my mind maybe with a couple of things one is you know when possible erring on the side towards developments that allow for greater physical proximity just so that the fundamental difference between uses is

Less taking you know as much care as you can towards following all of the ad a sort of basics in terms of ramps and great change and having non-skid surfaces and all those types of things but also I think in those areas you know if it really is more difficult terrain

To traverse you really are leaning on developing systems that can provide bus transit service or circulator or like I mentioned with the with the Beacon Hill program in Boston the sort of concierge access to rides and those types of things so I think it becomes more of a community a community transportation

Function that can either be privately funded or can be funded through some sort of a medical I mentioned sort of the medical district model where you can get enough concentration of uses and density in a certain area you can actually start to create programs that can be fairly specialized there’s a

Program that actually here in Orlando started in Portland Maine this is doug beach called independent transportation network and it’s an arm and arm program and it’s volunteer-based where people actually can pay for their loved ones to get the transportation and at the end of the day they go ahead and they come to

The seniors door and help them get in the car and help them go to medical appointments or shopping appointments or whatever they need to be but there’s increasing number of transportation options again this one started in portland maine all over the united states we have a I am down here in Florida called

Volunteers in motion which is out of Brevard County rare they let volunteers drive or bart county vehicles to take cruisers or transportation services things transportation is extremely important one of the things we always try to do is figure out ways to integrate churches to the extent possible school systems and trying to

Look at the transportation issue because that’s the thousand pound gorilla or elephant or whatever you want to say that’s always in the room lurking and any type of senior services we do yeah I want to let me just jump in one more thought on the church question the the

Congregate care facilities that i visited you know on a sunday or on a weekend and then usually there’s a special night during the week often it’s a wednesday night when you have a small bus vehicle that within a very short distance can hit five or six congregate

Care facilities in 15 or 20 minutes because you’re in a little bit more integrated sort of traditional urban area and conversely when you’ve got a congregate care facility they can send a bus out to to a grocery store a library a church and a senior center within a

Very short drive that’s just highly functional and highly doable from a financial perspective when things get just exponentially spread out then the ability to provide those services becomes extremely difficult whether it’s a public service or a private entity providing the function thank you the next question is from Richard he wants

To know have you how have you responded when asked the question do you think Universal Design could be counterproductive by making things too convenient for the elderly whereas using stairs bending up and down walking longer distances or physical exercises indirectly forcing elderly to exercise I’m assuming a balance of both may be

Necessary and so what are your thoughts excellent question and actually as I’ve been thinking about this stuff over the last couple of months that that same thought has come into my mind as an example my father worked for about 35 years at Ohio State University and he

Worked on the fourth floor and he took the stairs to and from every day of his life and I’m a big believer in take the stairs you know and those types of thoughts about you know just daily exercise and everything what what I found is particularly my parents now and

They’re considering buying a second home they actually live in a ranch home now they definitely want a one-level home going forward you know because they’ve watched their parents go from 65 to 75 to 85 and the functional reality is is you do get to a point where the stairs

Just become impossible there is a universal design principle and it’s in the National Home Builders Association that if you have a multi-level house where maybe the bedrooms are above that you have a room on the ground floor that’s easily convertible to a bedroom and that’s a great retrofit solution the

Other comment I would make is it’s it’s it’s incredible to me a lot of the older homes I go into and I actually own an older home just how narrow some of the hallways are how cramped and difficult some of the bathrooms are and and so I think the concept of the universal

Design is that is that if we would just look at some very simple parameters sometimes it’s just an additional six inches here or orienting orienting a toilet or orienting a sink you know in a different way just makes it so much easier to circumnavigate and and those things I think pay material dividends

Down the line and my final thought on it is is I know a lot of folks that are sort of my age mid 40s then maybe doing some sort of modification of their home in some cases you might be redoing your kitchen for instance and and it’s it’s

It’s amazing to me actually some of the kitchen remodels for instance or bathroom remodels that I see done that that fundamentally got the room and yet at the end I know that there’s a spot in that design that is you know eight inches too tight or is a difficult is

Going to be a difficult scenario down the line and it wouldn’t really have been a big cost differential to think a little bit more subtly about how we deal with sinks or how we deal with clear passable areas and if I can just jump in we keep talking about falls prevention

And the reality is if you if you fall about seventy percent of the people that fallen break their hip they have their quality of life significantly impacted you know fifty percent will use a cane twenty percent will likely die within the year what Universal Design does is allows somebody who’s had a traumatic

Event be able to stay in their home my mom has a three-story house the bedrooms and the shower are on the third floor if something happens and she does fall she can’t live there anymore and so she can no longer live in the house that is comfortable for her and that situation

Happens very very quickly so it’s not something that you can plan for you’re automatically suddenly faced with oh my goodness what can I do with mom well but the fundamental question is an interesting one because universal do not design does not prevent you from doing what’s in your best self interest and

Clearly if you look at hips heart depression diabetes the only thing that we know that positively impacts all four of those diseases is exercise so whether you’re in a universal design area or whether you’re in in a rural area or wherever you are you should be out walking everyday jogging everyday or you

Know if you have a game limitations in a pool every day band exercises people need to get up and get moving next your fault okay how do we reconcile accessibility requirements and neo-traditional developments where raised foundation and steps leading to an inviting front porch or commonplace providing a second side access point

With a lot grade and accommodating ramps on a small lots can be very difficult so what are your ideas for Kenneth on that I I agree that this is actually a real problem and as an urban designer i really like homes and buildings that are off the ground I always sort of

Fundamentally feel like that the fundamental reason for having a house is to get off the ground and and so when I see a lot of homes that are that are sort of slab on grade it sort of runs counter to that but I think that that nevertheless it’s it’s actually

Important that we do maybe maybe at least in some portion of our development portfolio within a city that we actually do look at you know slab on grade and I think I think that when we’re in a tnd environment I think secondary entrances and rear entrances actually typically do

Set up as as being zero threshold situation so you know if you want to put the money into it you know essentially you can have steps on the front and zero threshold on the back where the car comes in or on the side but it is a

Challenge I mean I’m not I don’t have a clean answer for you on that but but it’s clear that if the only way to get into the house for the primary way to get into the house is with two or three steps then from the president then from

The viewpoint of a senior it’s a more difficult situation and you know certainly handrails and all those things help but it is more difficult and that’s the point you know at a minimum you need to have handrails absolutely door securely tied down either in that concrete or to that to that house so

People can at least have something grab on often what you’ll see is that the handrails are rickety and so not only great fall you fall taking the handrail with you so I’d lean to have those things lockdown I mean the best ones I’ve seen have got really substantial

Kind of wrought iron hand rails and they’re connected to a townhome kind of development and the whole dimension of the step is not very wide so you might even have handrails on both sides and and that sort of thing but it is it that is a challenge I don’t have a I don’t

Have a clean answer for for that okay um what can land use planners do to assist with community the community building aspects for seniors that’s from Natasha well I think one of the things that you know typically one thing that people have problems with is putting in

Grab bars and things like that so if there is some way to make many of these things more attractive that would certainly be helpful you know clearly Peaks suggestions early on that you have a design that will not only accommodate people that can get up and around but

What happens if 20 30 years from now they need either a walker or a wheelchair so having those types of accommodations I think but doing that early in the process rather than waiting to refurbish something when people may not have the money to do it I think just

To add a couple of things I think that I think that you can you can look at it sort of kind of passive kind of policy things that that generally promote mixed-use types of developments mixed price point development sort of inclusionary zoning you know types of practices into things that start to get

A little bit more proactive in terms of providing density bonuses or other other essentially incentives for things that actually facilitate either reinvestment in homes to adapt them to a universal condition or things that can directly benefit someone coming in trying to provide housing thing that is specifically geared towards um seniors

Or the ability to be adaptable for seniors and I also think that it’s important you know when you’re talking to developers to really talk about some of the different land uses commercial or office can include a lot of different things it can include doctors offices that have

To be close to residential facilities at a little corner store is really really important exercise companies that focus on older adults the yoga the Tai Chi the Qi Gong encouraging and dialoguing about business opportunities and uses that can be in close proximity to where seniors might live is really important and I

Think actually trying to trying to adopt a facilitation sort of attitude as opposed to a regulation attitude for certain key uses that may come into a neighborhood that could be you know for instance there’s you know there’s if there’s again a doctor’s office or a dentist or a grocery store you know

Finding ways to actually inset or at least streamline the process for those types of uses that start to build towards a mixed-use environment okay well we’re now out of time so I do have to draw things to a close i appreciate the questions a number of that those of

You who did ask questions for example about Norks and other kinds of aspects we will be hosting more of these webcasts coming up over the next month and so I’d encourage you to register for those as an opportunity to learn more about the details of planning for aging

I’d like to thank our speakers today you all did a wonderful job and will I will follow up via email with Mimi providing an evaluation of today’s event and for those of you that are leaving the webcast please remember to fill out your evaluation form on your way out thank

You all great thank you okay she is family and talk to us know what I’m going to do is I’m going to go ahead and close out the webcast because everybody’s leaving and I will just communicate by email after the fact away you need we would like to get a

Copy of a PDF of the presentation today so that I can guess that I was salad okay wonderful thank you thank you

ID: hAKoFiqDpUM
Time: 1344352086
Date: 2012-08-07 19:38:06
Duration: 00:54:58

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