Title:جوامع دوستدار سالمندی

۲۰۱۱-۰۲-۲۳ ارائه دهندگان: آماندا لنینگ، جانا لینوت این وب‌کست فقط برای مشاهده در دسترس است، برای اعتبارات AICP CM قابل استفاده نیست. سال ۲۰۱۱ آغاز بازنشستگی و افزایش جمعیت بیش از ۶۵ نفر به ۷۰٫۳ میلیون نفر تا سال ۲۰۳۰ است. سالخوردگی آمریکا فرصتی خارق‌العاده برای بررسی انتقادی محیط ساخته شده از دیدگاه افراد مسن با هدف ایجاد آن است. جوامعی که فرد می تواند عمر یا سن خود را در محل سپری کند. این وبینار که توسط بخش تمرین خصوصی ارائه شده است، راه‌هایی را بررسی می‌کند که از طریق آنها می‌توانیم محیط ساخته شده را در جوامع خود تغییر دهیم تا نیازهای جامعه سالخورده را برآورده کنیم و جوامع خود را دوستدار سالمندی کنیم. موضوعات تحت پوشش عبارتند از: بررسی سیاست‌ها و برنامه‌های محلی دوستدار سالمندی در منطقه خلیج سانفرانسیسکو، استراتژی‌هایی مانند خیابان‌های کامل، و توسعه جوامع بازنشستگی طبیعی (NORCs)

قسمتي از متن فيلم: Eating friendly communities is sponsored by the APA private parts division and it’s really tied into a divisions constable initiative the divisions council is a component of APA and it’s comprised of 20 what we call divisions and these divisions are really professional peers affinity groups around urban design technology and in

Our case it’s private planning or private practice I have also identified the website for the divisions Council initiative it’s on Aging and livable communities the goal of this initiative is really to provide a robust information and data base an opportunity for planners to be able to help in the

Transformation and the creation of communities that are livable for all and so by providing these resources it will help planners people interested in improving their communities to be able to address the aging of the baby boomers and the aging what I call aging tsunami as you can tell I’m from Hawaii and the

Aging tsunami is really the doubling of the older population by 2030 from about 34 million to over 70 million I’m Ramona Malay he and I’m the chair of the private practice division and I’m your moderator today and we have some really wonderful speakers my first speaker is a

May Amanda leinen she is currently an ni a post doctoral fellow at the University of Michigan School of Social Work this past May she received her PhD from the University of California Berkeley where she did a dissertation focused on local government policies and programs that can help older adults age in place

Amanda will give us really the foundation of why we should create aging friendly communities and really what is the impact of community and older adults and she’ll also talk about her survey of local of very local governments and some of the community aging initiatives across the united states jana lino aicp is the

Senior strategic policy advisor at AARP where she works at the Public Policy Institute and her research focuses on transportation and livable communities for most recent research and project management activities resulted in publications entitled planning Complete Streets for an aging America road safety for all lessons from Western Europe and

Policy options to improve specialized transportation part your employment with AARP she was a director of transportation planning for the Northern Virginia Transportation Commission where she designed and managed a groundbreaking study on the linkage between land use and the mobility of older adults she also represents AARP in the National Center for senior

Transportation and America walks steering committees and she serves on the legislative committee on the Virginia chapter of American Planning Association and Jonah will really focus on some community examples that interface between land use and transportation to try to provide planners with some ideas of what’s going on in transit oriented development or T

Of these Complete Streets accessory doing units visit ability and universal design and should also give it some innovations that are occurring in terms of human services transportation before turning it over to Amanda I want to provide you with some very basic federal resources that are available one is

Aging in place it’s a cityscape vol.12 and it really focuses on affordable housing and supportive services based on a symposium that was held creating aging friendly communities by the CDC healthy aging Network is a wonderful online interactive conference with the purpose of helping to build capacity for change in regards to creating a

Friendly communities and finally the federal interagency form an aging has a annual publication the latest is older Americans 2008 key indicators of will mean and what I like about it is that it has a number of reports it reflects over 12 national data as systems it talks about the federal partners that are

Involved in aging and the websites that are available to support this again I really want to thank both of our speakers and also do a little plug for the private practice division and this is the web address for the product practice division we’re also going to be taking questions as Jennifer’s to bed

After Jonna our last speaker I want to thank you very much for for participating today let me now transfer the speaker over to Amanda great thank you Amanda you’re now ready to go okay well thank you so much for mona and i am very happy to be participating in this

Webinar today again my name is Amanda lemming I’m a postdoctoral fellow at university michigan school of social work I’m really bringing the Social Work perspective and also the researcher perspectives my presentation today so what I’m going to talk about is first I want to talk about the background and

Significance of this idea of creating more aging summer communities so what do we mean by aging friendly communities why do I think this is important and what impact would just have an older adults so what is the research evidence for some of these cases to the physical

And social environment and then I want to go couple of samples first as i mentioned i did a survey of Bay Area local government looking at different changes for the physical and social environment and other prevent prevent a couple results from that survey and then when the more certain works

Perspective I’m going to present some results of different types of community aging initiatives that are mostly on the nonprofit side but for what else is happening in communities across the country to make them more aging family and I duendes very quickly acknowledge the support of refuse for these different projects including the MetLife

Foundation Hartford doctoral fellows program HUD Society for social work and research and particularly a nice charlack at the UC Berkeley School of Social Welfare who is involved in both of the research projects that i’ll be presenting today so a growing number of international national state and local initiatives are started working to make

Communities more aging friendly examples include the World Health Organization’s age friendly cities initiatives the visiting nurse service of New York’s advantage initiative and for a and partners for liberal communities Aging in Place initiative and the robert wood johnson foundation community partnerships for older adults I mean in

My work with Andy Charlotte you defined an aging from the community as having five characteristics the first is continuity so individuals can continue to pursue and enjoy lifelong interest and activity the second is compensation supports are available to help individuals with disabilities need their basic health and social needs third is

Challenged older adults can develop new sources of fulfillment and engagement connection which are opportunities to develop and maintain meaningful interpersonal relationships and then contribution which are opportunities to participate in and have an impact upon the social environment using the physical and social environments that better meet the needs of older adults or

Making our communities more aging friendly is the potential solution to three interrelated problems including demographic changes inadequate long-term care and the desire to age in place so first in terms of demographic changes we’re seeing a dramatic increase in c % and number of people who are 65 and

Older so for example in 1900 about 4.1 percent for 3.1 million people were 55 and older in the united states by 2000 this had grown to thirteen percent 438 million people and by 2050 this will be twenty percent 488 million people important is being driven by lower fertility rates for example in 1800

People had about seven to eight children on average and that’s it’s around to today this is also driven by the aging of the baby boom generation the 80 million people born between 1946 and 1964 and then there’s also increased longevity people are living longer than ever before right now average life

Expectancy is 77 and it’s the lead it will reach about 87 years by 2050 in addition the need for long-term care assistance is possibly increasing so the 85 and older population increased by three hundred fifty percent over the past century and this group is currently the fastest growing segment of the US

Population they’re expected to grow from four million in 2002 19 million by 2050 and this is particularly important because the incidence of functional and cognitive impairment increases with age so for example people 85 and older have a much higher risk for dementia and almost half of people 85 and older have

Difficulty walking compared to about eighteen percent of those between the ages of 65 and 74 we’ve also seen the baby boomers are showing signs of reversals and improvements in health that we’ve seen in recent generations of older adults so for example adults who were ages 40 to 59 between 1997 and 2006

That an increase in obesity diabetes and cardiovascular geez compared to adults in this age group in the 1980s and early 1990s another problem is long-term care in the United States so long term care here is characterized first by unmet need so about thirty percent of older adults with disabilities report an unmet need

For assistance long-term care is also very expensive spending from all public and private sources was an estimated two hundred seven billion dollars in 2007 and then informal family care for giving from friends husbands and wives children was valued at another three hundred fifty seven billion dollars per year in

۲۰۰۸ navarrete national average rates for a room at a nursing home is almost two hundred dollars a day this is about seventy thousand dollars a year of the average cost of assisted living facilities is a little over three thousand dollars a month over thirty six thousand dollars per year and then the

Rate for in-home services varies from between around eighteen dollars an hour to up to forty six dollars per hour depending on the amount of care required long term care also has an institutional bias so Medicaid accounts for almost fifty percent of long-term care spending in the US and even with increases in

Home and community-based services in recent years about seventy percent of Medicaid long-term care dollars so some nursing homes in addition in this past January the Medicare Payment Advisory Commission recommended adding a copay for the home health care benefit because it as a way to discourage use of this

Benefit so this will lead to even more older adults meeting to enter a nursing home because they can access community-based care and then finally long-term care in the United States is of a questionable quality so for example according to the institute of medicine about one in six nursing homes have

Problems in quality of care and this can result in things like pain pressure shore sores of malnutrition and urinary incontinence in residence there’s also a little oversight over assisted living facilities or home and community-based services and then while there will always be a need for some form of institutional long-term care things like

Nursing homes and assisted living facilities of the majority of people prefer to remain in their own home or community for as long as possible a recent survey ninety-three percent of adults that they wanted to age in place as long as they could moving on to evidence of benefit in an effort to

Reduce reduce excess disability potentially prevent or delay the need for institutional care and facilitate Aging in Place despite age-related functional decline there is a growing interest in fostering comprehensive changes in physical and social environments of our towns and cities in this country before giving some specific examples of what is happening right now

I just want to provide an overview of the evidence that changing the physical and social environment can help achieve your goals so we can think about this in terms of what is called the ecological model of aging and what this basically proposes is that elements of elder

Well-being such as health or Aging in Place are based on what’s called the confidence of the older individual and the environmental press of their situation so confidence is defined as a characteristic of the individual with is biological functioning motor skills or cognitive functioning and an environmental press is made up of the

Characteristics of the physical and social environment the place and man’s on the individual so as an individual experiences declines and health and functioning that often accompany old age environmental press may exceed confidence potentially resulting in negative outcomes such as depression or limited mobility or even institutionalization so creating more aging frantic communities involves

Modifying the environmental prep to better match the confidence of older and a growing research literature suggestive specific changes to the physical and social environment can improve the health and well-being of older adults and health and aging face in terms of the physical environment I’m going to focus on modifications within three

Areas community design housing and transportation mobility the first person communities design empirical studies report a consistent association between aspects of community design such as mixed-use neighborhoods higher density development liveblog continuity traffic calming and improved street lighting with increased physical activity for individuals of all ages while there are

A few studies of the relationship between community design and health and well-being and older adults studies indicate that mixed use and walkable neighborhoods are associated with an increase in physical activities a decrease in disabilities and fewer symptoms of depression and this could reflect older adults ability to remain

Connected to the community and they can access foods and services within walking distance of their home in terms of housing research is fairly limited an area of housing and elder well-being for example it’s not yet possible to determine if cities that adopt an accessory dwelling unit ordinance for increasing supply of affordable housing

For seniors see a reduction in institutionalization or social isolation in our elderly population however home modifications and environmental adaptations this is causing with wider doorways slopes entry pass for grab bars in the shower are associated with a lower risk of experiencing pulse problem lowers across decline in functional

Independence and a reduction in health care expenses and then finally in the area of transportation and mobility research indicates that older adults to give of driving experience negative effects for example non-drivers make fifteen percent fewer trips for medical appointments and fifty-five percent fewer trips social or community activities compared

To older adults who are still driving a recent study indicates the negative impact of driving cessation on elder well-being can be avoided and transportation needs are met through other modes of travel with the public transportation or senior band services however about thirty three percent of older adults do not have public transit

In their communities and those who do frequently deal with inadequate public transportation that offers frequent service the destinations targeted at commuters this is office parks rather than elderly forces medical complexes and senior centers exclude bus systems are often viewed as unsafe unresponsive and accessible and inconvenient older

Adults and a recent study reported that an inability to use six through public transit is related to shrinking social network side suggesting potential benefits for improving the accessibility of public transit and also providing alternative transportation services the social environment including social support social services community involvement and civic engagement also

Plays a vital role and elders ability to age in place previous research suggests that social support enhances physical and mental health among older adults whereas loneliness with social isolation and stressful social relationships contribute to a higher risk of disability or recovery from illness and even mortality in terms of opportunities

For community engagement formal volunteering membership and organizations political participation and social activities are associated with longer survival rates and lower risk for dementia in addition volunteerism is associated with increased levels of self-rated health and self-efficacy and decreases in functional dependency and depression and then studies indicate that both out of

Home services such as adult day care rehabilitation services and senior centers as well as in-home services such as meal deliveries programs companionship programs or household chore services can positively impact well-being among elders for example adult day health centers are associated with fewer feelings of loneliness anxiety and depression and also in-home

Services are associated with improved physical functioning reduce depressive symptoms and greater life satisfaction so moving on to some of the research results I wanted to share with you today so first of all my dissertation so it’s on San Francisco Bay Area government’s looking at the adoption of 22 different

Policies and programs in the areas of community design housing transportation health and supportive services and opportunities for community engagement so I collected information through surveys and then some interviews with city planners and community development directors how many aging services directors county transportation planners and then some higher-level public transportation employees and what I

Found is that the most common policies and programs include those at target alternative forms of transportation and by that I mean things like walking and public transit so including incentives for mixed-use neighborhood infrastructure changes to improve the walkability of neighborhoods discounted public transportation fares and changes to improve the accessibility of public

Transportation as you can see here also all counties offer traditional aging services and censored directories of programs and all cities offer an accessory dwelling unit or second unit ordinance in my sample though it should be noted that California state law limits the ability of cities too restrictive development of a be used so

That’s not the case across the country and then among the least popular policies and programs while almost sixty percent of cities has made infrastructure changes that could help older drivers remains they feel they stay on the road this could be things like larger road signs or added with

Panty remains only a small minority offer driver education programs driver assessment programs or have a slower moving vehicle ordinance like allowing people to operate golf carts on roadways and this supports other research but local state and federal governments have not been giving too much attention to keeping elders behind the wheel they

Focus more on the public transportation alternative transportation side in general but older adults want to keep driving for as long as possible so there’s a bit of a conflict here less than thirty nine percent of cities offer developers incentives to incorporate accessibility features including wired doorways and chooses without chef and

Grab bars into new housing since the majority of new homes that includes visibility provisions have been built in areas where is legally mandated it appears that local laws and incentives could lead to the development of more accessible housing in addition it is more cost-effective to incorporate accessibility features in the new

Housing then to retrofit existing home many older adults reside in older homes that may require extensive renovations but may not live in communities with adequate housing options if they have any physical limitations that require excessive accessibility features I’m moving on to more of what is happening on the nonprofit and private side

Working with andi are like at UC berkeley through a web-based search we identified 293 initiatives across the country that are working to create more aging family communities and 124 completed an online survey for us so base only is 124 we created five different types of community aging initiatives and I’ll describe these in

More detail in the following slides but just very basically a community-wide planning efforts to get pop down governance approach and they include community-wide needs assessments and strategic planning consumer driven support networks using more bottom up governance approach and they include consumer-driven associations to provide peer support and activities to increase neighborhood

Social capital the distinguishing characteristic of the third and fourth types is their collaborative approach as as opposed to their governance structure the cross tech sector system change initiatives collaborate among various stakeholders typically across existing service delivery sexors meanwhile resident States support services include collaborations between service providers and geographically defined housing

Settings and then finally single sector services primarily involved new expanded or improved access for a specific type of service for example transportation but they’re generally not working for its overall system pain when I’ll go through each of these in a little more detail so community-wide planning initiatives so good primarily on

Planning and data collection funding for these initiatives comes mostly from local governments so nonprofit organizations and grants also provide substantial financial support respondents indicate that older adults are highly involved in these initiatives but primarily in terms of providing input so for example participating in a community needs assessment at the

Advantage initiative of the visiting nurse service of New York offers one example of this category the communities across the country participating in the advantage initiative received assistance and guidance from gathering information directly from elder residents which is then used to inform planning and community education efforts initiatives within the consumer driven support

Networks category offer peer support networks and services and rarely engaged in activities such as data collection or planning or advocacy their funding comes primarily from C’s such as annual membership dues gifts such as contributions from members or others and in-kind donation most of these initiatives consider themselves to be villages which are

Organizations based on secant Hill Jared’s a membership-based association created by a group of seniors living in Boston but in return for annual dues village members receive a variety of services and support including access to course services such as weekly grocery shopping trips referrals and discounts to vetted outside services such as home

Repair or even a beauty salon and opportunities to develop sources of social support and engagement elders are highly involved in that many of these organizations activities including developing the initiative providing oversight and governance and offering support and services to other members so a lot of these are grassroots

Organizations that was started by older adults themselves and to date about 45 other organizations modeling themselves on the Beacon Hill Village have emerged across the United States cross-sector systems change initiatives use inter-organizational collaboration as a method to achieve their goals which typically include community education and enhancing existing programs services

And infrastructure for older adults a large number of initiatives in this services grant funding from the robert wood johnson foundation community partnerships for older adults c PF OA is a competitive grant program that calls for the formation of partnerships among community stakeholders for example policymakers older adults social service

Providers and local governments food plan and implement strategies note the independence and dignity of older adults older it’ll play a major role in providing input and developing the initiative initiatives within the residence space Support Services category we’re primarily naturally occurring retirement communities or norcs norcs are residential settings or

Neighborhoods that were not designed for older adults they’re not like requirement communities but in which one in fifty percent of residents are 50 or older so they have aids in place at Smith and needs of these older residents a community agency will create what’s called a North supportive

Services program or North SSP provide or refer residents to such services as transportation nutrition programs and opportunities for socialization the majority of initiatives in this category and provide services or linkages to program participants as well as some of the involvement of elders in their initiatives their focus on service

Division can be seen in the large percentage of initiatives that listed older adults as highly involved in receiving services and support have public funds are the primary source of funding listed by these initiatives many of them participated in the US administration on Aging demonstration grant projects that defended in 2010 and

Then finally single sector services include initiatives that may survive services to mode elder involvement or improve community awareness of older adults initiatives in this category differ from those other categories in terms of their focus on a specific sector such as transportation for housing or arts and culture many of

These initiatives that participated in the aging and placed initiative of partners for livable communities and the National Association of area Agencies on Aging as this Aging in Place initiative provided some start the conversation grants to organizations and partnerships across four countries to develop policies and services to address a

Specific sector in each community the majority of single effective service since initiatives with grants for nonprofit organizations as their primary source of funding and similar to residents phase support services single sector services involves adults primarily as recipients of services and support so thank you so much for

Listening you can contact me if you want any more information about these projects what I presented today is a very sickening the surface of the two research projects and now I’m going to turn it over jana okay thank you amanda excellent overview and framework for helping us understand aging and older adults needs

And how planners and local governments can help to facilitate connecting these older individuals to various services and supports to help them age in place in terms of my presentation today what I thought I’d do is provide very brief background of some of our p’s activities on livable communities add a little bit

To what amanda covered in terms of some of the challenges we face with an aging society and then dive more deeply into some innovations that we see out in communities just to give some examples of some of the things that amanda touched upon and some additional

Examples as well so with that let me get started the AARP really has a social contract with the 50-plus population which basically states that we want to support those older Americans to have independent voice in control in ways that are beneficial and affordable to them and for society as a whole and as

Part of the social impact agenda we have a program at AARP called livable communities and it is kind of a stepchild to our other well known work and healthcare access as well as social security issues finance issues etc but there are a number of us at AARP who are

Working to promote livable communities out there at the federal level as well as at the state and local levels AARP defines a livable community as one that is safe and secure provides affordable and appropriate housing supportive community features and services mobility options and all of these things work together to facilitate personal

Independence and engagement of residents in civic and social life so I think our definition of livable communities very much aligns with the five key elements that Amanda talked about in terms of an age-friendly community in terms of some of our legislative priorities we’ve been working in the area of Complete Streets

Policy promotion older driver safety specialized transportation in affordable and accessible housing much of our work while we do have federal lobbying efforts much of our work happens more at the local level on livable communities through our state offices this is a photograph of an example from New York

Where our volunteers as well as others in the community went out and did our sidewalks and streets surveys to really draw attention to the need for improved infrastructure within the state in our communities so some of the challenges we confront one thing that’s very important to recognize is that most older adults

Want to remain in their homes and communities for as long as possible it’s somewhat of a myth that older folks are going to move to the Sun Belt and retire in Florida Arizona etc there are certainly on you know hundreds of people who do that but the great majority of

People more around eighty five percent and on up remain in their homes and communities throughout their older years and you can see that ninety percent of those 65 to 74 wish to age in their communities even higher percentages for those 75 and older so it’s very important that we as planners look to

See how we can promote Aging in Place many people know that our disability rates have been declining for the past couple of decades however what’s less well recognized is that because of the growing numbers of older persons in this country as well as decreasing rates of institutionalization the numbers of

Older adults who are living in community with disabilities is on the rise so again the types of services and supports that are going to be necessary to meet their needs are going to be different today and as we move forward much more tailored to meeting the needs of those with more mobility constraints

Etc another challenge is that the majority of us homes are not accessible only about three percent of Americans lived in a house with any kind of accessibility feature even though almost thirty percent of our families have at least one member with a disability of any age sixty-five percent of american

Homes are single-family residence and these are outside the scope of any federal accessibility laws now the recession has hit older adults very hard if you’re 55 and older among the two million who have been unemployed as of you know january on average you would have been out of work for ten weeks

Longer than younger workers and there are nearly six times as many older adults with unmet housing needs as there are currently served by rent assisted housing and from a study that we did back in 2008 we find that nearly thirty percent of all delinquencies and foreclosures in the current housing

Crisis were of americans 50 and older who were having their homes foreclosed upon so it’s not just an issue that’s impacted younger adults in terms of housing cost burden that is paying more than thirty percent of your income toward housing costs you can see that among those 50 and older and the lowest

And second quartile nearly universal that these individuals are paying more in housing costs than they really should be paying the exception to this would be those individuals who are lucky enough to own their homes free and clear sprawl really exacerbates many of the challenges of in place particularly when it comes to

Mobility and getting services to individuals we know that about one in five adults 65 and older do not drive and on average if you’re lucky enough to live until you’re 70 you’ll outlive your driving years anywhere from seven to ten years so looking to have some transportation options in the community

Is extremely important now another thing that’s very important to note is that older persons are our most vulnerable road users they’re about thirteen percent of the total population but they’re involved in about fifteen percent of motor vehicle fatalities being the individuals actually killed in these these crashes and nineteen percent

Of vestrion fatalities and this is really because as we age our bodies become more frail and the the impact of a crash is much more severe and often folks cannot survive the crash older adults also tell us that their roads are inhospitable forty percent say they do not have adequate sidewalks in their

Neighborhoods and nearly half say they cannot cross their main road safely so this really underscores our rationale for putting a lot of energy toward Complete Streets and recently in the last couple of years we published this document and complete streets for an aging America and as part of this report

We did an online survey with the Institute of Transportation engineers and had more than a thousand planners and engineers respond to this survey and found that two-thirds of those individuals reported they had not yet considered the needs of older users in their multimodal planning we also worked with the National Complete Streets

Coalition to evaluate the 80 Complete Streets policies that had been adopted by the end of 2008 and found that less than a third of those policies explicitly address the needs of older road users even though they’re the most vulnerable users another challenge when we look at providing of transit services to older

Adults is the very high cost of providing ad a paratransit service and just because you’re older and frail does not mean you qualify for ad a paratransit service and we’re seen that many communities because of these rising costs are scaling back their eligibility for services and really tightening that

Eligibility up so that only those with qualifying disabilities would receive this type of specialized service and you can see the reasons why on average in the United States a one-way trip on ad a paratransit costs about thirty dollars and even though less than one percent of the total system ridership it accounts

For about eight and a half percent of the total operating costs so we all need to be looking for other means to provide public transportation to people who need a more robust form of service other than ad a paratransit service another challenge within the specialized transportation arena is that we have a

Numerous federal and state agencies local agencies that provide funding for transportation services they all bring their own requirements for eligibility for reporting administrative hurdles etc and what often happens out there in the community is that an older adult or person with disability is unable to really figure out where to go for that

Transportation service so now let me turn over to talking a bit about some of the innovations that are happening in our kennedys and starting with a transit-oriented development now of course this is not a new concept for planners and what I wanted to feature here is just how some of the evidence for

The ways that transit oriented development specifically benefits older adults and I take this from my own research with the Northern Virginia Transportation Commission where we did a study back into the 2005-2006 time frame to understand the transportation needs of older adults throughout Northern Virginia and as part of this study we

Did a series of focus groups with residents from different types of communities throughout Northern Virginia and I recall one gentleman who talked about being diagnosed with macular degeneration and how he felt his life was over because he had to give up driving but then he moved to arlington

And do one of the transferring to development neighborhoods in the Senior Living facilities and he was able to walk to you know within a three to five block walk of the metro rail system the numerous bus routes an indoor shopping mall grocery store public park library high school with the swimming pool banks

Churches etc and really found that his quality of life was quite good even after he gave up driving now for the transportation planners who may be listening in we also did a telephone survey this was a randomized scientific survey with I believe more than 1,500 responses and divided all of those

Responses that we received from those 75 and older and throughout Northern Virginia by community type and found that those who were living in these walkable mixed-use Tod or historic downtown neighborhoods were much more likely to have gone out the previous day they were on average taking twenty

Percent more trips per week and this could indicate that these type of communities are good at helping folks avoid some of the social isolation that too often comes with aging terms of some of the other measures we looked at the sheriff trips and found that those folks living in these urban

Walkable mixed use areas were about four percent of their total trips were on fixed route public transportation and well that sounds fairly low it actually is much higher than the national average even for urban areas and really shows that the the trend of declining at transit ridership along the older

Population in the United States that we’ve seen for the last couple of decades was not being seen in these type of communities in Northern Virginia but perhaps more significantly we found that twenty two percent of all of their trips were on foot they’re really taking advantage of the proximity to these

Various services in the community their share of trips were less by driving themselves or less about fifty percent compared to two-thirds of all trips by those individuals living in suburban and exurban areas and we generally associate transit oriented development with urban areas but the same type of principles

Can be applied to rural areas as well with successful transit oriented development and one state that has done a really great job and planning for transit oriented development in rural areas is the state of Washington and this is an example from Walla Walla and this transit center which is in the

Heart of the downtown area links six different transit services a couple of local town and county public transportation services a tribal transit system greyhound and the state’s inner city one of the state’s intercity bus routes during the weekdays the park-and-ride lot is you know for commuters but on the weekends it opens

Up to a farmer’s market it really provides a nice central gathering space for the community to you know pick up fresh fruits and vegetables etc and all of this is part larger system of inner city bus network where the state has gone in in using federal 53 11f funding has helped to put

Back in place some of the bus service that was taken out by Greyhound beginning in the nineteen eighty and that we’ve seen all over the country and they’ve done this too in along with looking at planning for transferring to development in some of these intermodal hubs so and have done an excellent job

Of connecting local public transportation transit services with ferry services airports rail stations etc and there’s one story I remember the state transit planner talking about how when they opened up one of their new inner city lines the first people in line were an elderly couple who said we

Just can’t wait to get on the bus because now we get to go visit our grandchildren and we don’t have to wait for them to come visit us AARP has done some work and transit oriented development we certainly have policy that supports this type of mixed use

Planning and put out this document a couple of years ago on preserving affordability and access and livable communities and did this in conjunction with reconnect in America and the national housing trust but in terms of the policy recommendations coming out of the report one is the need to preserve

The existing and create new affordable housing in these advantageous locations about more than half of all federally assisted housing units have at least one resident age 50 and older and we can see from the Northern Virginia example that transit oriented areas are very beneficial to older adults but we need

Especially those of more limited income but we need to make sure that we’re preserving at these subsidized units in these locations it’s a section 8 program section 202 program that builds a affordable housing for or older adults and a couple of the other programs as well we want to make

Sure we integrate transportation and land use policy with housing policy and direct investments in transportation to improve station areas the accessibility make sure that our streets and sidewalks network provides safe access to those station areas that older adults can take advantage of now in addition to federal affordable housing policy and programs

At the local level Amanda touched upon this the accessory dwelling unit ordinances California relieved being a leader in this regard Santa Cruz offering a national model and accessory dwelling units for those who may not be familiar with the Chairman basically it’s a separate residence that’s associated with a single-family zoning

District it could be attached to the main house within the main house or a detached unit it’s considered affordable housing in that it allows someone to rent a unit it’s for additional income helps an older couple or an older individual to have some additional income in order to remain in their home

Or that an older couple could rent a small unit from someone in the community or live in a unit that’s in say their children’s home as well so Santa Cruz won a 2005 a PA award they’ve developed 75 hundred square foot prototypes and homeowners who choose one of these

Prototypes they get through an expedited review process those homeowners that price rents at affordable rates qualify for financial assistance and some fee waivers etc in my own community of Arlington Virginia back in 2008 Arlington passed an accessory dwelling unit ordinance Arlington now Allah allows accessory dwelling units by right

Within the home and by use permit for detached unit and this was actually extremely controversial within the community lots of editorials over a many month period going back and forth about the pros and cons of accessory dwelling units with you know many in the community feelings there single-family home zoning

Districts under threat one of the issues was parking and the way Arlington dealt with that is to say that 65 if the parking on the block where the 80 units proposed is parked at sixty-five percent or more than the homeowner would need to provide one space off off of off street

Parking in order to accommodate the additional residence accessibility within the home is a very important issue and needs to be addressed and additional publication that we released back in 2008 is this one on visit ability and visit ability is basic access to the home so that if someone in

A wheelchair could visit you in your home with in a comfortable sort of way comfort and safety and it includes 10 step entrance located either front back or side of the house a 32 inch clearing clear opening at doorways accessible circulation throughout and at least a

Half bath on the main floor so it’s not considered to be a permanent solution for prolonged disability but at least allow someone to visit your home or allows you if you develop a disability to at least temporarily not have to move or spend an sorbitan amount of money to

Retrofit your home just to stay there and really visibility can be done through the site planning process and design process with any type of unit whether it be your live work a townhouse units more of the cottage townhouse style or a bourbon single-family home type of units the greatest number of visibility

Properties that have been built have come from mandatory ordinances we’re developers builders are required to put in visit ability features and the most well-known are from pima county arizona san antonio texas bolingbrook illinois now i’d like to transition over to some of the transportation solutions innovations Complete Streets again I

Mentioned that AARP has done a fair amount of work in this area we see Complete Streets is absolutely essential for providing access in a safe and convenient way for people who travel not only by car but by foot bicycle in transit really regardless of age and ability I want to run through these

Slides very quickly but I think it is important just to describe what Complete Streets policies try to accomplish and basically it’s to make sure that the entire right-of-way is plan designed operated maintained to provide safe access for all users what we’re trying to do with the passage of Complete

Streets policies is move away from everyday transportation planning and design practices move away from the project by project fight for additional accommodations to really institutionalizing the planning process that is accommodating to all users trying to go after a network of roads where some roads in the community will

Slow vehicle speeds and give priority to pedestrians and bicyclists other roads in the community maybe give more priority to larger vehicles such as buses and trucks but still provide the basic accommodations for pedestrian safety bicycle safety we’re not looking for a new pot of funding but looking to shift how we

Spend our transportation dollars today because we know that going back and retrofitting streets actually cost more money than just doing it right the first time an incomplete Streets policy also helps to provide support to those transportation planners elected officials other community leaders for doing things a bit differently so

Complete Streets policies they’re not a mandate for an immediate Metro fit it’s as you would be doing work on your roads anyway to take a new approach to their planning and design it’s not a silver bullet Complete Streets does not deal with land use which we know has a lot of

Impact on transportation and it’s not a design prescription there’s no single Complete Streets cross section it really depends on the land use and transportation environment in the community at this point there are over 200 communities that have adopted Complete Streets policies across the country you can see in 2009 there was

Something like 48 policies adopted in just last year 78 policies adopted so the movement is really taking off now I mentioned that we published planning Complete Streets for an aging America and just as an example of what you might find in this publication we’ve tried to provide some examples of how you balance

The different needs of road users so for instance the Federal Highway Administration recommends a 25-foot curb radius for older drivers who have a tendency to turn too sharp and hit the curb or turn too wide into a neighboring lane of traffic but the larger your curb radius the faster other drivers tend to

Take the corner but you can maintain that same effective curve radius by adding parallel parking and bike lanes so you really can accommodate additional users of the system at the same time that you accommodate the older driver so moving on to public transportation and Human Services transportation safety Lu mandated development of locally

Developed coordinated public transit and Human Services transportation plans in order for communities to gain access to their section 5310 which is the elderly and disabled funding stream for public transportation FTA program the job access reverse commute program and the new freedom program these are plans that typically aren’t plans for coordination

But a plan using a coordinated process but ultimately the goal is for more coordinated services in the community unity the trains a cooperative research program documented some of the benefits valued at around seven hundred million dollars per year for coordinated human services transportation and drains of services and it makes economic sense to

Not send two vehicles to the same neighborhood at the same time to transport clients from two different agencies but instead really try to have a centralized type of system so that to the extent that the needs of those individuals can be met jointly that you just send one vehicle in serve them both

At the same time there’s other benefits offered from coordination improved service quality larger service areas more accurate reporting of costs and outputs so that it makes it easier to write grant proposals and really show what the value of your transportation services are and one of my favorite examples of coordinated transportation

Is from the portland oregon area ride connection which is a not-for-profit organization but which works closely with trimet the region’s transit provider and planning organization and right connection has this vision to create independence and community connections through the gift of mobility and they do this by offering door-to-door trips on their vans for

Persons with disabilities and older adults or through volunteer driver programs they have a centralized dispatching system so that individuals call in and they can work with them and determine which type of service they that would best meet their needs they work with something like around 30 different government agencies human

Service agencies and nonprofit organizations that also provide transportation and and help them provide that transportation again for people who have fairly severe disabilities who need to use more of the paratransit vehicle versus a volunteer driver program they’re able to to match the individual to the need very well and they also have

Some other innovative ways to coordinate services and support the community as a whole for instance when right connections vans are not in use they will loan them out to other nonprofit organizations in the community who say a church who will use the van on Sunday to pick up parishioners and take them to

Mass and they’ve also have a program where they will sell their vehicles at fairly low cost to other nonprofit and government agencies to get you know the full use out of the vehicle before it’s it’s finally retired one term that is very common in the human services transportation specialized

Transportation arena that has the potential to overlap with the planning community is what’s terms mobility management and mobility management is really a catch-all term it can take many different forms but under the section 5310 new freedom and dark programs fta’s eligibility rules allow mobility management to be treated as a capital expense which

Allows a funding match of eighty percent as opposed to the typical fifty percent fund a match for operations and there are many communities states out there that are using this this funding to create mobility management programs higher mobility managers so they again they take many forms one of these its

Policy where they may a mobility manager may be a point person in helping to develop the coordinated Human Services public transportation plan develop local partnerships not only you know help to bridge the public sector with the private sector nonprofit sector address some of the institutional issues this

Could be land use issues that could help to support public transportation maybe more of the operational service broker model where there’s a centralized dispatch referral scheduling system they may directly provide rides or it could take more the form of the customer travel agent more of the social worker

Type of format working with directly with caseworkers with clients to do travel training and teaching them how to do use public transportation developing individualized trip plans so that really concludes my presentation for any of the publications I mentioned through the Public Policy Institute you can access

Those through our website AARP org /p P I for the Public Policy Institute /live com for livable communities and one other resource that lead to developed in conjunction with the Center for housing policy is this toolkit for older adults housing needs and that is available from housing policy org and this is really

For anyone working housing this is an excellent resource to to access additional resource it’s not only on housing issues for older adults but affordable housing issues at large so with that I will turn it back over to Ramona who will help facilitate our question period thank you very much

Gianna and thank you amanda we have some interesting questions that came in first of all Jonah summer wants you to clarify your comment and data concerning the elderly outliving their driving ability person couldn’t understand your slide or your comment okay I apologize for that

What I mean by that is that at the end of the typical person’s life span if one lives to the age of 70 you will give up your driving and not drive for the last seven to ten years of your life so hopefully that is a little clearer okay

Someone talks about how agent in place has become a new buzzword which we can agree on one reason is because it is theoretically cheaper um how will we ever regulate such a decentralized system of care like nursing facilities or are these institutions grossly over regulated china or monday you doing well

This is amanda i mean i can in terms of the second half of the question I don’t think nursing homes are overly regulated having worked in the nursing home for a while as a social worker they have annual state visits and they go through the medical records that I wouldn’t say

That they’re overly self regulated can you your piece of beginning of the question Ramona yeah the question is really we do know that it’s cheaper to do Aging in Place but how how can you regulate all these nursing facilities that keep coming up and and because there’s so many different

Shoes that you have to regulate and even now there’s issues in regards to health happiness into those sort of things so how do you put your arms around regulating if Aging in Place is goal and you need nursing homes okay well yes I me I think we will always need nursing

Homes for a select part of the elderly population you know people who don’t have family members to help out people who have severe functional or cognitive limitations as far as Aging in Place initiatives go I’m not entirely sure that Aging in Place initiatives are cheaper alternative you can know for

Example providing care to somebody in their home might be cheaper on daily basis you know compared to you know save paying twenty twenty-five dollars an hour compared to two hundred dollars a day when you’re a 24-hour facility I think Aging in Place depends on significant resources being invested in

Things like what Jana and I were talking about in terms of changing the infrastructure changing the housing options improving the range of home and community-based services available to people i don’t know if that answers the question but is addressing the fact that i think it’s it’s not just a not just a

Buzzword like aging in place and we’ll put it all on the family shoulders which tends to be happening in the long-term care system anyway but it requires a significant amount of resources invested in creating communities where older adults can continue to live for as long as possible jana do you want to add

Anything to that in regards to the coordination that you saw on some of those community examples yeah i just i’d like to add that based on my colleagues research here at the Public Policy Institute it is what we have found is the cost of providing support services to help

People aged in their own homes in communities is like a third the cost of what Medicaid for instance would pay to put someone in a nursing home so I I do think that there are a lot of opportunities to provide these types of supports but we have to look at you know

The different funding streams and make sure that the that we are able to put some of this money to toward providing home and community-based services and and you know unfortunately when the recession hits we see quite a number of places that cut back on things like transportation services for older adults

Instead of looking at the long-term bigger picture that ultimately it may be cheaper to keep people in their homes and provide that that transportation service but those budgets are coming from different pots of money and and so it doesn’t always get looked at in that

Way but I also wanted to add for the the question on the regulation of nursing home facilities I’m certainly not an expert in that in any regard particularly in terms of what goes on inside the nursing home but at the land use planning level I think planners do

Play a very important role and there’s a new model or new models out there for instance something called the green homes that is provides the type of services that would be provided in a nursing home but it does that in a manner that’s much more integrated into

The community and that it feels much more like a home to the individual living there but they folks trying to build the green home models have run into some of the the land use barriers building code barriers to actually putting these things in place so it’s

Being aware of those types of things and in some ways to reduce the barrier to having a more innovative type of institutional care become available in the community you mentioned the whole thing about the elderly drivers in an aging in place should we be providing more support for this kind of assistance

Or rather how can we provide more support for elderly drivers well I think there’s there’s a couple of different approaches on one is through the actual Road design and in a longer Complete Streets presentation I would talk about how we design Complete Streets for older drivers it’s things like investing in

Larger fonts on signs on retro-reflective sign materials pavement marking making sure the edge lines of our highways are are wide and retro reflective to help people with aging eyesight navigate that system using paint to paint the arrows on the center of the lane for turn movements etc and

So there’s a number of things within the engineering realm that can be done the Federal Highway Administration is currently undergoing an update to their highway design guidelines for older drivers and pedestrians and that document the earlier version of that is in part critiqued in our planning Complete Streets for an aging America

And we offer some recommendations for that update and it’s to be seen how those recommendations are addressed but um you know that’s certainly one way then with respect on some you know some of the other aspects of driving I think we we do need to be careful of how we

Talk about this for the most part older drivers are very safe drivers there’s evidence from a recent study from ia iihs the insurance institution that shows that crash rates have declined more rapidly for oldest drivers then they have four younger drivers over the past number of

Years and you know when it is time to give up the car keys we need those transportation options in the community so that it doesn’t become the the life-and-death decision that it’s too often does become for many older persons some while we’re talking about the mobility question Simmons said that one

Of your slides talks about the slow moving vehicle organs what is it slow moving vehicle ordinance yeah you don’t come open for that okay well why don’t we talk about examples of mixed income independent living senior housing communities and small and mid-sized cities are there any examples that fits

That and for example when you talk about santa cruz in Virginia is enforcement been an issue for an 80 you in Santa Cruz in Virginia and possibly because of the easy the transition the ability to use that for other accommodations for other than they’re just the elderly if

And if are there any incentives and disincentives to building an 80 you in these types of communities so Ramona I’m going to jump in and offer clarification we had a number of astute audience members that knew exactly what the slow moving vehicle talking about the golf carts so there was some discussion of

Golf carts on the streets and potential ordinances associated with those perfect that was the presentation is a man ah wonderful Amanda great that’s perfect okay so let’s get back to the question Jonna did you have any comment about that and we go to a tu and enforcement

Issues and possibly using that same ad unit for accommodations for other than the elderly which is always a challenge in these types of situations well to my knowledge both Santa Cruz and arlington do allow those a tu unit it’s to be used for you know to house younger persons as

Well so there’s not a limitation by aged mind to my knowledge I haven’t heard about enforcement issues I know that that was a big issue as part of the debate when arlington county was considering and a tu ordinance I sense the board adopted that policy in 2008

That issue just it’s it seems to have gone away you are not inside the government agencies so I don’t know if they’re getting still a lot of comments but it’s not in the press any longer and possibly in part that that ordinance to address some of the community’s concerns

Put a limit of 28 units per year that would be approved as part of the ordinance but I I can’t speak specifically to enforcement I do know that in the literature for Arlington County they’ve said that they’re going to really because they’ve passed this policy now they’re going to if they

Catch someone having an illegal unit they’re going to really use a much harder stick than they otherwise may have in order to encourage people to go through the the process to get an approval from the county board and county governments you know I let me ask this question and oh are there any

Examples of communities republic resistance to mix use rezoning within largely low density residential areas have been won over because of the argument to provide aging in place has aging-in-place been used as an argument against NIMBYism I’m trying to think of any examples um you can’t think of a

Specific examples but I think that it probably could be a strong argument we’ve seen that with in the Complete Streets movement to adopt policies they are peas boy at the table talking about the needs of older persons has a tendency to change that debate from one of just accommodating the bicycling community

And young people who want to use more active transportation to a much larger community dialogue on some of the larger issues and how our road infrastructure impacts all of us so I would only imagine that by bringing that forward it would help to make some strong arguments for mixed-use development as well I

Think this last question will probably bring both Amanda and Jonna in a closing discussion the question is with the recession state and local funds are decreasing what do each of you think are the cost effective strategies to enable Aging in Place based on this environment

This is Amanda if we could just go back to the previous question very quickly okay part of my for the for the Mindy resistance part of my dissertation I did interview a select group of city planners that agreed to talk to me for about an hour on the telephone and

Several of them mentioned that there was a significant amount of public resistance to things like mixed-use neighborhoods for large senior housing centers or things like that and that the concern was usually around parking I me especially in the Bay Area like if you’re talking about a city in campuses

So we’re parking Dennis p.m. so i did just want to mention that that did come up in my interviews and that really the public resistance is only around things like mixed use as far as the people i supposed to so you know in general the public supports you know providing

Additional supports for older adults but but when you talk about you know increasing the density in their own neighborhood there is some as a fence for that Thank You Amanda so shall we look at that the last question the idea about what each of you would recommend or suggest is costly

Vector strategies based on the fiscal crisis that states and local governments are going to currently and as well as having the baby boomers age in place sure I guess I can try to answer that question I think there are a number of solutions that are really low cost to no

Cost to the the public sector for instance within two complete streets in accommodating older pedestrians it doesn’t cost a lot of money to go out and change the signal timing all to provide folks more time to get across the intersection in the crosswalk it is something that’s now required by the MU

Tcd the manual on uniform traffic control devices but it certainly wouldn’t hurt to put that in place ahead of schedule which i think the requirement is for 2014 I think other policies policy adoption regulatory adoption that involves the private sector in implementation such as the Adu ordinance or visit ability ordinance it

Of course it costs some money to do the research to do in the public process into to get support for that and and to do the planning around that but the the actual implementation down the road doesn’t necessarily cost money in terms of transportation services I think within specialized transportation

There’s probably a need in most communities to reach out to the private sector and try to find some partnerships like ride connection has done in Portland Oregon or trying to think of other communities where they’ve gotten you know sponsorships for from the private sector to make donations to volunteer driver programs these don’t

Have to be government based by any means but look more to the the charitable giving a components in and raise awareness of the need for a you know an aging community and some of their transportation needs etc thanks Jan Amanda yeah a couple things again that came out of the interviews that I

Did for my dissertation first of all at least in the bay area particularly in some more suburban community there was this general perception that there are economic benefits but you know a lot of these policies and programs if it’s entertain is that we’re talking about are not only going to improve the

Well-being of older adults that can improve well-being of all residents for the city as a whole so for example several cities had made adjustments or investments in their downtown areas providing incentives from this mixed-use developments you know trying to make more walkable areas because they saw that as a way to revitalize their

Downtown district and bring in more stores more services more job opportunities for their residents another thing i do want to mention too is that when i talked about these community aging initiatives a lot of the grants that came from foundations such as the Robert Wood Johnson community partnerships for older adults those were

Given directly to local governments who develop partnerships to make infrastructure changes so for example in California the city of Fremont receive a significant amount of money from the Robert Wood Johnson Foundation to improve the services that they provide directly to older adults and coordinate them and also to focus specifically on

Culturally competent services over adults so understanding and learning more about these foundations programs and also use nonprofit organizations across the country I think there’s a lot of partnership opportunities or opportunities to receive additional funding to create more aging friendly communities Thank You Amanda Thank You Jonah I really want to thank you for

Participating today and for sharing your knowledge Jennifer yes thank you all very much for joining us I really learned a lot today for our attendees on your way out you will be filling asked to fill out an evaluation form we ask that you do that for us for our speakers

I will be following up with you and letting you know what the evaluations say so you can expect to receive an email from me thank you all very much for joining us today I hope that you will see you in future webcast thank you okay Ramona Amanda and Jana thanks so

Much for joining us today I’m going to go ahead and close out and i will just chat with you via email

ID: IP1pvFL3JZQ
Time: 1344359829
Date: 2012-08-07 21:47:09
Duration: 01:25:18

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