Title:چارچوبی برای ارزیابی سالمندی در فناوری‌های مکان

۲۰۱۱-۰۲-۲۵ ارائه دهندگان: Amber Joplin این وب‌کست فقط برای مشاهده در دسترس است، برای اعتبارات AICP CM قابل استفاده نیست. بر اساس نظرسنجی اخیر AARP، “هشتاد و نه درصد از آمریکایی ها می خواهند تا حد امکان در خانه های فعلی خود بمانند… [and] چشم انداز رفتن به خانه سالمندان یک ترس همیشگی است.” با این حال، محیط ساخته شده فعلی از تعداد فزاینده افراد شکننده چه در خانه و چه در جامعه پشتیبانی نمی کند. برنامه ریزان و سیاست گذاران باید زیرساخت ها را توسعه دهند. حمایت از سالمندی در محل در قالب یک استراتژی برنامه ریزی جامع و فراگیر. این جلسه به طور خلاصه تحقیقات مربوط به سالمندی را بررسی می کند و ماتریسی از سیستم های فردی، فرهنگی، بهداشتی، اقتصادی، قانونی، زیرساختی و محیطی را ارائه می دهد که در آن فناوری های پیری در مکان را در نظر می گیرند.

قسمتي از متن فيلم: Hello my name is cody price and i just want to welcome everyone it is now one o’clock so we’ll begin our presentation shortly today on february 25th we’ll have a framework for assessing aging and place technologies given by amber joplin for help during today’s webcast please

Feel free to type your questions in the chat box found in the webinar toolbar to the right of your screen or call 1-800-263-6317 for content questions please feel free to type those in the questions box and we’ll be able to answer those at the end of the presentation during the question answer session

Here is a list of our participating chapters divisions and universities for our upcoming webcasts you’ll see that on tuesday we’ll have our march 1st webcast on child care and then we’ll have our next one on march 10th with renewing our love affair with cities i just want to make note on the march

۱۱th webcast this was recently added it’s on urban retail so if you want to sign up for this go ahead and do so and here is another as you can see more webcast that we will have coming up and to find a complete listing for a 2011 webcast series

And to register for these events please go to www.utah.apa.org webcast and then select your webcast of choice to log your cm credits for attending today’s session you’ll need to go to www.planning.org cm select activities by day and then underneath february 25th you’ll see a framework for assessing aging in the place technologies

This is up so you’ll be able to log it right after today’s session and i’ll be reminding you of these steps at the end if you happen to forget or miss at the beginning and then afterwards you’ll be able to find a pdf and a video recording of today’s webinar at www.utah.apa.org

Pastwebcast.htm and this should be up by monday and again i’ll be going over this at the end at this time i’ll now like to hand it over to amber joplin who will be presenting our presentation for today and then so amber joplin is a doctoral candidate at washington state university

Interdisciplinary design institute she receives received her ba and american studies in 1983 and a master of arts and design housing and apparel in 86 from the university of minnesota joplin currently works in the wsu gis and simulation lab on pedestrian accessibility and public transportation modeling her dissertation research

Involves developing and testing with gis a model for sustainable aging that includes individual social material support and natural systems and now i’d like to hand it over to you thanks thanks corey thank you all for coming today again my name is amber and my research interest is in how the environment enables and

Disables individuals throughout their lifespan today i’m sharing with you a framework that i hope will be of value to your work of creating convenient equitable healthful efficient and attractive places or environments for present and for future generations okay corey oh got it to work i’ve broken the topic down into three sections

And so we can almost treat these like three separate presenters and if you have specific questions please send them to corey and he can alert me if there are many questions about the same subject that i need to address but the first section is just going to be a

Background on aging how to interact with our legacy infrastructure and a little bit about technology the second section is a general overview of my research on aging and on environments and the scope and complexity and then several significant concepts that i think are terribly important for us to consider in our work

Finally the third section introduces a matrix that may be of use to you it includes individual cultural health economic legal infrastructure and environmental systems within which to consider aging and place technologies so this first section is just going to i’m going to do some definitions and maybe give you some

Numbers and some trends and some projections and it’ll take a while because we have to rummage through aging and legacy infrastructure and technology but i’ll try to move quickly the u.s census bureau projects that the number of people ages 65 and over will increase from 40 million in

۲۰۱۰ to 72 million in 2030 and the 85 plus population is going to double by 2025. if you want to have a different way of looking at that number they tell us that every day this year 7 000 baby boomers in the united states are turning 65.

I haven’t heard the projections for 2012 but some version of this is going to continue for the next 17 years this graphic illustrates the change in population structure the darker inner column represents population projections by age in developed countries at the top in 1990 the thick part of the

Column is in the center by 2030 the lower image the wider area has moved up and the column appears a bit top heavy in the united states the percentage of the population over 65 will go from 12 percent in 2010 to 20 in 2030. of course every community is different

And some rural communities particularly in the midwest are already at or above that average but for um great information on all of these facts and figures i’m going to suggest that you view the webinar planning for an aging population which had a lot of great information on demographics and the role of planners

And ideas on housing models and as long as i’m plugging the webcasts check out the developing aging friendly communities and the active design guideline webcasts both of them had some great slides on health impacts and opportunities so those are our demographics because there’s a lot of good ones out there specifically to aging

Aging is a normal developmental human process and it has losses and gains in physical intellectual spiritual and social arenas not just losses but losses and gains u.s census data show that the continuation of good health free of problems with personal and instrumental activities of daily living ranges for women

From the ages of 37 to 76 and for men from the ages of 45 to 80 with many individuals experiencing good health into their 80s and 90s the kinds of loss oh i’m sorry i guess i told you that the kind of losses that they can experience mobility um intellectual functioning lung capacity

All of the sensory acuities that we value and and yes and then um the last three blood flow muscle mass and physiological efficiency those are just um their physiological aging and so somebody may be you know one of those wonderful people who still can climb mount everest

But they are going to have some elements of this because those are just our normal physiological changes over time and what’s happening is that individuals all of us and those that we love are aging in homes neighborhoods and communities that were designed for active mobile sighted adults as health and mobility begins to

Deteriorate elders are no longer able to operate successfully in the shared community environment whether it is because that is a damaged or or really old environment or whether it’s an environment that was not designed for people who couldn’t drive here’s a place that’s relatively new um looks like it’s a really nice place

To go to but if you’re not in a car there’s some sort of a question as to how you would actually get there you certainly couldn’t get there in a wheelchair and i don’t know if you would want to try to go in a walker and here in washington state when it’s winter

I don’t even see a path for a walker like me to take even though i’m still mobile and still active so the problem is is that most existing built environments don’t serve the needs of our rapidly growing number of aging people and it ends up being unsustainable for

Individuals for society and for the natural environment the longevity program at stanford lists all of these things that inaccessible housing social isolation dependence on cars lack of safe sidewalks and all of these are linked with increased rates of diabetes of course if you have a car then you’re helping raising carpet emissions

If you move to a retirement community you can help with age segregation i’m back to our car we can have higher prices and gas these are all things that are part of our our legacy infrastructure i’m calling it it’s the way things are and and that’s a really important thing

To understand and to respect because it’s the way things are and and it’s going to shape in many ways what we do next or what we have to do next and it’s also what we expect because it is kind of our norm for us so this is where we’re going to jump to

Technology just a little bit because we’re going to rely on technology to help us make some differences and perhaps to save us from all of these problems so how does that kind of work for us who’s using technology what are they doing what’s available where is it being

Implemented well you know technology is like design every time you figure out how to do something or make a plan you’re designing and every time you use a tool or come up with a better way of doing it you’re using technology so it’s it’s getting a little bit hard to define

But we’re going to talk about recent technologies and more kind of high-tech and the kinds of technologies that are rapidly changing and that we don’t actually know how they are going to impact us not that i’m not saying that either positively or negatively i’m just saying that

Something that is so new to us is something that we don’t have a track record for so we’re going to have to see what happens and we’re going along for the ride so who’s online um the pew um internet and american life report shows us um this is a fairly

Recent report i think they released it in 2009 by age shows who’s on the who’s using the internet and what was really interesting to me is that in the oldest age groups the 76 plus and the 70 to 75 that are represented on this chart there’s a phenomenal growth between 2005

And 2008 and the number of people who are using the internet and that’s really encouraging another thing that i would like you to note is that um in 10 years the the people who are in that um 65 to 69 and 55 to 59 and so forth

You can just slide them on up so right now and this is the baby boomers they’re using the internet at about 62 71 78 and so these are the people who are going to be the seniors or the elders um in the next 10 and 20 years and they are

Quite connected already and it looks like even 76 classes can still learn how to use the internet so i think that’s very encouraging future technologies for boomers so now you have to talk to futurists and here’s a futurist who is telling us that boomers will wear sensor equipped

Exercise clothing to keep track of their physical condition boomers will buy low-cost gene scans and we’re going to track our own health data they tell us we’re going to say goodbye to tiny screens i can’t wait we’re going to have mobile phones with built-in projectors

We can push a button and we can see it on the wall i love that and some boomers are even going to have their medical records implanted as tiny chips so that’ll kind of be like i don’t know if the same companies that are doing it

For our pets are going to move into the old or not so the technology users private technology users let’s call them individuals and families are using um new technologies basically for communication for entertainment for connection with social networking and not just social networking but political networking education and education can be formal but

For many senior users it has to do with personal health education going online and finding out what’s wrong with you or what’s wrong with your spouse they’re using it to get to get assistance to get goods and services for health recently i’ve heard that that game that’s spelled w-i-i

Is being used by seniors for um balance which really is important to to avoid falls and for monitoring for self-monitoring providers are using really high tech they’re actually finding great savings and great service improvements by using technologically assisted medication optimization equipment they’re using remote patient monitoring just like our baby monitor in the

Bedroom they can monitor um what’s going on in in another room or at a remote distance post acute care transitions maybe you don’t have to go to the nursing home maybe you can go home as long as somebody’s keeping track of you assistive technologies

And you know a lot of that a lot of the medical assistive technologies have just been really made great improvements in the last one two and three years remote training and supervision for staff disease management tracking for instance i’ve recently heard that google can tell where flu or colds are coming because

People are looking up the symptoms online and so then google can track that and the cdc taps into that to find out where the flu is going so i heard that from a speaker yesterday and that’s probably true um i know esri tracks social unrest in the middle east if you

Haven’t checked that website lately that’s really interesting providers are also using technology for cognitive fitness and assessment and for social networking and social networking is really important for caregivers because that can be a very lonely job of you always have to be with somebody who needs a lot of care and attention

So they tell us in the future that our homes are going to be really amazing um they’re going to be like going to amazon.com they’re going to tell us they’re going to give us ideas for things we want to do and things we want to buy the televisions will figure out

Our favorite programs and they’ll remind us it’s going to start they’re going to keep track of older residents to you know make sure they’re not doing anything unusual so here you have couches that constantly monitor blood pressure and here um the idea that the carpet isn’t just gonna say

If you’ve fallen it’s gonna say you’re not walking right and so that’ll be kind of exciting and of course we’re gonna have the robots they promised us and they’ll put the dishes away and and so on and so forth and i think it’s wonderful that they are training robots

To apologize when they make mistakes because i know that i would want my robot to apologize when my robot makes a mistake so that’s all very far away but look at this this has been on the news um for the past few months and this is a prototype of uh

Ultimate granny flat that you can pop down in your backyard for your loved one to come and stay with you and this has a kitchen a bedroom a bathroom and the toilet measures your weight or your loved one’s weight their temperature and their urine content in the morning how convenient is that

Inside it’s really quite attractive um your loved one will have a virtual companion a video system monitoring the floor um it monitors the floor so that you have privacy there’s pressurized ventilation there’s lighting and there’s even a lift in a track in the ceiling so that when somebody has to come in and

Help you get stubbed it can’t look very well then then there’s no heavy lifting involved so it’s really quite exciting um they’re going to be available they the company hopes to have the first one out this year and they plan to grant them for two thousand dollars a month or sell them

For 75 000 and that is a lot cheaper than sending somebody to a nursing home and so that’s something um you know very technologically advanced that we’re looking for in care facilities is now being made available for people who can afford it to bring it into their own backyard

Something else coming down the road um are cars semi or fully autonomous vehicles with cameras radar and computers that take the wheel apparently high-end cars already have some of these features and um maybe they’re going to be available like cabs without cabbies you get in the car

Punch into a computer where you want to go and sit back while the car drives you there of course we don’t really drive because collision avoidance systems are standard equipment and futurist eric klein thinks it’s going to be too dangerous for us to drive because the computers are going to

Be keeping track of all of our cars so this is going to be really great for the people who can afford it and it’s also going to be really great for those of us who can’t afford it because there’s going to be spin-offs from this public transit is going to

Be able to implement technologies that we can’t imagine the whole idea of the shared car or maybe some sort of car banking or ride banking programs can be available but things that we haven’t thought of because right now it would be really hard for us to do and really hard for us

To supervise and really hard for us to manage um it could be something like the cell phone where um you know people who didn’t need a cell phone a few years ago ninety percent of people have a cell phone now ninety percent of adults um have a cell phone now so um

And some of them have iphones and i started with a track phone because it’s still a cell phone and it still gives me some of the essential benefits of the phone even though it’s not you know the high-end model it’s a it really does um make technology available at multiple

Price points and so i think that although all of us aren’t going to be able to have these cards by 2020 i think they’re going to be some real exciting possibilities well that’s not supposed to come up okay so where would we expect to see technology um sustainability literature tells us that

There are seven human systems i’m not going to argue with anyone on it but i’m going to start with those there’s housing transportation business industry agriculture and so on and so forth and if you start searching on the internet you actually find out that you can search for smart housing smart cars

Smart manufacturing yes there’s smart agriculture we know there are smart phones there’s smart care though they probably use other words there’s certainly web enhanced education and there is smart government we’re doing a lot of smart things in government but implementing technology in our work to help make better

Decisions in planning is a way that we can have even smarter administrative processes and we can look for ubiquitous applications um technology is going to affect housing it is it is affecting transportation it is affecting business and industry and all of those other areas and we may as well

Just plan on it because it’s happening and it’s going to happen and it’s going to accelerate and i bring all of that up because elders are just people who’ve been around a while and they live in all the same places that we do and they uh some of them work

In the same places that we do and some of them go to school in the same places that we do or they have and so they are affected by all of those systems that were on the last slide elders are are they’re impacted by the place they are by the space they occupy

If they’re relocated they’re impacted by meaning they’re significant activities they’re impacted by community connections like programs by policies positive and negative crime health care access to services they’re affected by stigma by poverty by safety hazards pollution and they’re affected by access to nature and to spirituality into transcendence and

We’re going to find technology involved in each of these areas in fact i recently heard on npr that there is an app for um preparing to go to confession so there’s a case where technology is enabling people to prepare themselves for spiritual activity um and i’m sure there are many others

When we when we think about things that we find on the internet that that was it was really interesting example when it’s hard to say what does spirituality have to do with my work as a planner well spirituality occurs in a place and as a planner i deal with places and so

I have to think about places where people go to have spiritual experience or where people go to have transcendent experiences or where people go to have quiet personal or creative experiences okay this brings me to the end of section one and so i’ve asked corey if there’s a lot

Of questions on the same subject to let me know and we’ll stop and answer those otherwise i’m gonna go on to section two the only question um we had is is the virtual companion available now and if so like where it is available um i’m sure it’s available now because

They have virtual companions in in japan and i would just do an internet search for virtual companion and personal robot because you know that depending on how um specific a virtual companion you need if you some people just have you know it’s the equivalent of a dog or a cat only

You don’t have to feed it or clean up after it um and i know in some of the there have been some news shows on nbc and abc on homes that where children want to keep track of mom or dad and they live across the country and so

They’re letting mom or dad stay in their own home but they’re putting in monitoring systems a lot of these monitoring systems obviously they link to a service center much like the service center you would have from your call for help button that a lot of our seniors wear around their neck you know

They push a button and somebody knows to call them on the phone well so that’s a call center and so they will have a monitoring center usually at a care facility or a health facility that monitors the individual who’s subscribed to their service and so some of those programs also have those

Virtual companions and um you can find you can even find little videos on youtube about people’s experiences with them and a lot of times families expect that the senior isn’t going to like them that they’re going to feel like big brother is watching but it turns out that we actually get

Quite used to ubiquitous cameras and you know if nothing bad happens to us we sort of forget about them and a lot of the um seniors that have been featured in the programs have just been really positive about it so um you know it’s it’s um kind of like everything else it

Has really good parts and i’m sure it has drawbacks and costs but if it’s a compromise you know between living at home and going to a much more restrictive environment i know that a lot of people are willing to make that compromise so thanks for that question okay

Gather my thoughts for a minute so the scope of my okay so i’m a graduate student i’m in a doctoral program and i’ve been doing a lot of research for three years which is way too long but i’ve been doing a lot of research on how the environment enables and disables us

Through our lifespan and most of my research is on aging although currently i’m working on obesity and adolescence but um the kind of the concepts are really similar and so that’s what’s making like i want to share this with you because this has been very helpful for me

But the scope of the literature when you try to study something as broad as aging when you try to study something as broad as the environment just becomes overwhelming the fields that i read in and i continued to read and are from the health and design gerontology environmental sciences and in order to

Manage the the amount of information that was out there i chose to focus on the theoretical models which are applicable to aging in the built environment there are actually very few models on aging and i don’t know that there is actually one model on aging in the built environment but there

Are many models that either talk about aging or they talk about the environment or they talk about the built environment so what i tried to do is i tried to collect all of those models and i want to share with you six of them that i think are really important and

They’re very important and we rarely get to become familiar with them in our field the first one comes from environmental gerontology which is based on the concept that there’s a relationship between persons and their environment and that this relationship can be described explained and modified in order to improve quality of life for

Aging individuals and this is the foundational model the ecological model of aging and everybody says it’s commonly referred to as the competence crest model but actually it’s commonly referred to as the environment press model this model focuses on capacity excuse me on competence so here on this axis an individual can have

Low or high competence there’s a range of competencies and on this axis we have the environmental press there can be a small amount of environmental press and environmental press is pressure from the environment or there could be strong environmental press and so some examples of environmental press might be um

When it’s too cold or when it’s too hot or when there’s a lot of hostility in the environment or when there’s a lot of pressure to perform in the environment or when there are many cracks in the sidewalk so all of these kinds of things are things that

Are challenges so i guess we could talk about environmental press as being challenges and competence as being our ability to handle the challenges and the idea behind this model is that there’s a kind of when we have high competence we can handle quite high levels of environmental pressure

So this is the case of the people who can climb mount everest they have high competence and they can handle climbing a mountain without much air and with a whole lot of snow and wind now the theory here is as our competence reduces then we cannot handle as wide a zone

Of press and so we have a zone of maximum comfort and then we have a zone of when it’s our maximum comfort is kind of our easy chair and then our zone of maximum performance is when they get us out of the easy chair maybe they put us

On that exercise ball because that’s like making us stronger and we’re getting a good core um but we’re still quite comfortable we’re good there um if if it gets if the press gets too strong it starts being a marginal situation like i’m so hot i’m not pleasant anymore

Or i’m so cold i can’t hold my keys to open the door if it gets too cold then i get into this negative affect and maladaptive behavior and that would be i might say bad words i have a really bad mood or i might give up and the same thing happens if there

Isn’t enough environmental press so if you take me and you put me in a nursing home prematurely and i don’t have to cook my food or do my laundry or pick up my clothes or scrub my back or wash behind my ears pretty soon it’s entirely possible that

I may not have a good mood or good behavior i might start getting really crabby or really whiny or depressed or something like that so this is this is the model that is kind of the foundational model from the gerontology field especially the environmental gerontology field

And it’s a brilliant model of course but it’s also highly criticized because if you take it um you know as the only explanation for how people uh relate to their environment you’re really looking at organisms and not people and and people aren’t organisms you know we

We have stories we can you know watch wonderful stories on uh that movies or you know on public television about people who’ve been in really strong environmental press and they’ve been fine they’ve been heroic and so um and then you know we find people who are

Whiny you know no matter what so there’s there’s a lot more to a person than the fact that they and we are organisms but we’re more than organisms we’re selves and so we also have this whole part of the individual that has a whole lot to do with how we behave and

Our mood and maybe it has to do with who we are and you know what our values and our and our value as human beings so i’m getting out of the planning disciplines but we have to fit it in here somehow because i guess i’m not really because the truth

Is is that the the reason that we have planning and design disciplines is is to create good environments for people and so we’re not creating the kind of environment that they did in the movie matrix where you take all the people and you plug them in and you feed them the correct nutrients

And you play movies for them because we believe that people you know have a lot more than just that organism people have they have spirits and they have creativity and all of these things are valuable and need to be fostered okay so this is the person environment the foundation for thinking about

People in the environment the second model is a model that includes everything because the question is is okay so what’s the environment and turns out that everything is the environment because there’s the natural environment which is you know nature and the sun and the planet and water and wind and ice and snow

And then there’s the um the environment that we have built and that’s the built environment and our streets and our houses and communication um yeah water sewage utilities all of it also um the people that that um create those things and manage those things and provide those services so all of those are

Important elements of our environment and as are the things that we create with our built capital and our human capital and so we create things like health and wealth we create leisure and mobility we create knowledge we create communication and we create consumer goods and why do we do that

We do that so that people will be happy and live in harmony and have identities and fulfillment on and on so this particular model comes from the sustainability literature and denial of meadows uses it in order to find indicators of sustainability because if it’s not serving people then it’s not sustainable for people

And this is a model from economics and so everything is either an end or a means and so the ends are at the top the ultimate end is human well-being that’s the ultimate end for humans um the intermediate end for humans are are those those things that we like to

Have those things that make us happy or make us safe the intermediate means that we use are the labor and the tools and the ultimate means is like what we have from the earth and from the sun and so this model has room for everything and you can see in the center

It has room for the disciplines it’s got science and technology it’s got politics and economics and it’s got theology and aesthetics so this is a great model because it helps think about am i thinking am i considering everything so if you look at this model it says okay have you

Considered everything and this model really dries what this model doesn’t really get it it starts the conversation by by pointing out that everything comes from the earth and everything that we do um is is intended to be for human well-being and i’m not saying that that we don’t care about animal well-being

I’m just saying that most of us would like to be one of the species that survives even though most of us would also like the other species to survive as well and we would like to throw all right so i’m not trying to be too human-centric here but we honestly are

Working for human well-being and we should be a little bit more explicit about it because sometimes i think we forget sometimes i think we think we’re working for efficiency but we’re actually working for well-being and efficiency is one of the steps that we use to get to well-being

Okay the third model is really trying to get at the kinds of values that underlie our basis for doing something um h.r moody um has been working in education for elderly people for many many many years and i believe he may have recently retired as the head of education for

Aarp and before that i think he was head of education for the adult education program in the country so he really he really has a lot of great information on how people are educated and he came up with these modal patterns for the treatment of the age that he noticed was happening in

Education and he started at the bottom and he said that a lot of times we don’t provide education for seniors because why would we educate somebody they’re not useful anymore so we don’t educate them but then if you go up to stage two somebody might think about this and say wait that’s not

Right hope people should have some services let’s give them a craft class they’ll enjoy that and so that would be a stage two kind of educational experience and then somebody else might say you know those are retired professors they probably don’t want a craft class they probably want to teach the craft class

Why don’t you ask them and let them tell you what they should be doing and the most amazing thing happens when you do that where people have great ideas and they take responsibility and suddenly the program blossoms and a lot of people are enjoying it and people are coming and

They’re having a lot of benefit from it and moody would call that stage three of participation and then he suggests that there are very few samples of education for seniors that have to do with self-actualization i think in my work i’ve probably found them in religious communities where

There’s actually places and support for seniors to actually develop their um their self and not just a skill or not just keep busy or not just shut up and just sit there quietly okay you’ve had your day and look what you’ve done with it so how does this apply to

The design of the built environment well i don’t think of using this for the design of the built environment actually one of the people who presented on wednesday lynn hunemann talks about this in in one of his books really great books but he suggests that this is also going on

In the built environment that we actually do have patterns of rejection in our built environment and these patterns of rejection are characterized by keeping people separate by mandatory retirement which often leads to poverty and there’s neglect there could be family abandonment and the basic attitude is either repressing or avoiding seniors

And he considers that the type of value that this represents it’s just an economic value it’s it’s not that we think old people are bad it’s just that they’re done with their working lives and so why would we invest money into making something work for them with us they can go to

Places where there are places for people like that and that according to moody would be called rejection and that would be evidence in the environment the second level or stage two would be a social services level and somebody stops and says wait we shouldn’t do that to those people

We should help those people they don’t deserve that let’s give them some welfare let’s make sure they have access to medical care in fact let’s send a professional over to see them and make sure that we have identified all of their important needs and then affordably

At some sort of minimal level we will provide them with professional care because we are caring people and we know what we’re doing i don’t mean to be cynical but that is where our country is coming from and we’re slowly moving into the stage three of participation where we’re starting to realize that

And and this is driven you know by organizations such as aarp where seniors are not going quietly into the dark night seniors are saying wait i have a lot to participate i have a lot to offer i actually had a full life i know some things i

Have some skills i have some energy i want to participate and i want to be involved in my life so what does this look like the social services housing stage 2 is going to look more like nursing homes and it’s going to look more like separated off communities and they don’t

You know a separated off community can be a very nice place but it is separated off and and when it’s a very nice place it’s usually only available for those who have enough money to pay for it back to the participation stage we get a whole different kind of

Of a built environment because here we have our aging in place we can stay in our community we can stay in our home we can be social integrated we can be normal we have equality we have freedom we have the right to happiness we have the right to

Live in our home as long as we can and and that’s great it’s a really big improvement and you know the health impacts of that are enormous people are much healthier when they have control over their health care and they’re much happier when they have control over

Their lives and then they can stay in their places of meaning however both in our built environment and in our housing environment i don’t know of places that represent a self-actualized environment possibly the closest thing that i’ve seen in the literature is the nun study by snowden where he talks about

As as the people in the religious community as they retire and as some of them begin to evidence severe um physical and and in many cases severe mental limitations it turns out in these communities that by keeping all of the residents living together and eating together that the people that have the more

Difficulty remembering how to eat or remembering that they need to eat they can look around themselves and they can see somebody else who’s doing what they need to do and they can model their behavior and so they find that there’s a much higher quality of life for individuals even with very very

Profound limitations when they’re living in an environment where they’re completely integrated into the environment what this would look like if we had this in our built environment is it would look like a community that is built that supports all of the residents so that as more as you get more and more disabled

As a loved one ages and becomes more fragile there is within the built environment the elements that they need to continue to live and pursue their own inner dreams and wishes and and for many people that may be exactly aging in place but it may also mean that beyond the door

When they walk out of their apartment or when they roll their wheelchair out of their apartment there’s a zero step entry there’s a sidewalk there’s a sidewalk to the to the main sidewalk there are ramps there’s public transportation and there are other elements in place that allow a person to

Continue to pursue their life the way they want to the way they’ve been doing it all their life even as they become very old and very frail so we don’t actually have a model of that but it’s something to think about and it’s certainly a challenge for us to consider

Get pretty excited about that pattern my belonging dropped its g on this slide okay so this uh model takes us back to um the person environment fit model that was criticized for considering people to be only organisms so this is based on that same idea yeah i don’t know i guess i could

I get i don’t think i need to flip back but the model is the this thing on the top and it’s got the same idea that you go through time you start at middle adulthood and then you become a young old and then you become an old old and and so on and

So forth so you’re going along here and you’re getting older and so instead of um frailty here what you have is an intensity of socio-physical places over time and this is a really hard chart to understand but it’s really important so i hope you have patience to listen to it

So these are the expected intra individual trajectories for belonging and for agency so agency is what those people call function so all of those people all of us as we age and we pursue um an environment where we can function so you will find people moving

Out of their big home into a smaller home because the big home was too hard to take care of they’re moving for agency and then they need to replace doorknobs and have door levers because those work better so agency is all about how well i function in the environment and that is

One thing that changes over time for middle adults it’s very important and as people age and become very old it becomes less important now it probably becomes less important because at a certain point it kind of doesn’t matter where you live because you’ve lost a lot of agency so once you

Lose a whole lot of function agency stops being as important but something else becomes very important and that’s something that maybe wasn’t that important in middle adulthood but over time as you go from middle adulthood young old to old old suddenly belonging becomes really important

So now we can stop looking at this and just look here because this i think explains it a little better so up and down here we’ve got the stage of aging we’ve got middle adulthood the early age and the old age and then you’ve got how important agency is how important belonging is

And how people fit so it turns out in middle adulthood functioning is really important and belonging isn’t that important when you’re just getting to that young old part of your life they’re kind of equally important you kind of want to function and you kind of need those feelings and belongings in place

But for the oldest old this one is the is much less important because the the need for belonging becomes really important over time in the very old and so the person environment fit dynamics are that middle adulthood what you’re looking for in your environment is a lot of stimulation and activation

And safety and familiarity isn’t important and continuity and meaning isn’t particularly important and then as you get older then you want some stimulation and activation but you start wanting safety and familiarity then you start wanting continuity and meaning for the very old the stimulation and activation just isn’t that important but safety and

Familiarity is hugely important and continuity and meaning is usually important and those are really important things to consider for um socio-physical places over time so these are the places where we live or the place the community the home where we live the um when we’re younger it’s much more important to function

Well or to be stimulated and activated and have interesting things but as we age it becomes much more important to be someplace where we feel at home where we feel we belong our place this is another model i think this one’s pretty easy to understand and this one talks about um

We have the same thing here where we have agency and belonging and this is how do we get to agency and how do we get to belonging and so um wall i think this is wall and lang say that experience our experience our time the places that we’ve been the places of

Our life give us a sense of belonging and through belonging primarily we build our identity we also have a certain autonomy but the primary relationship is belonging gives us our identity whereas agency or function has to do with our behavior so when we can do the things we want to do

And we have agency then we have autonomy which is a great thing we love our autonomy and agency also gives us part of our identity like i’m the kind of person who always does this for myself and so that having agency is is a really important

Part of i’m for me i walk everywhere so part of my identity is i’m the person who walks everywhere and that’s that’s related to my agency and it could happen that i will not be able to walk someday and i may lose some of my autonomy and i hope that i won’t lose

Too much identity in the process either i hope to have developed enough of my transcendent spirituality so that i can still be myself when i no longer have as much agency as i do now but together the combination of identity and autonomy are what lead to

Well-being and so when we are looking to create environments to create communities um to help people age in place we’re really supporting both their belonging which helps support their identity and we need to add in to that built environment what wasn’t put in in the first place and

That is those functional things that support agency and lead to autonomy okay courtney how am i doing for time you um are doing fine uh you can you still have about 10-15 minutes if you want to okay well i have a lot more to say so i’ll just keep going um

I’ve got one more um model that i want to share with you and i don’t know if you’re familiar with this this is um actually quite uh quite been around for a while um this is the disablement disablement process model and it underlies the world health organization approach to ability and disability and

It’s really quite exciting for us because usually when we hear about somebody when we describe disability we think about a person having a disability and this act this model actually explains that people actually don’t have disabilities what people have is they have pathologies or impairments and so

In english down here an active pathology would be arthritis so if an individual has arthritis and so they have an impairment their hand isn’t working right you know they can’t they can’t close it the way they used to and so they have a functional limitation and so they can’t they can’t grab the

Doorknob and so they can’t open the door so you would call somebody who can’t open the door you would say they have a disability but if you put a handle on the door instead of a round knob then it turns out they can open the door so then they don’t have a disability

Anymore so the world health organization their approach to ability and disability in the environment is that that the environment shares the responsibility when there’s a disability because you know the environment may not be responsible for the pathology or for the impairment or for the functional limitation but in that but in that the

Correct environment the disability is really it’s not there if you give the person with arthritis leverage or not they no longer have difficulty opening the door so it’s gone and that’s a really exciting thing for us to think about particularly when we think about applying technology because of course a

Lever is a piece of technology and a leather doorknob is applying the technology to solving the problem so um if you have corey if people have questions about any of these models i’d like to take a minute no questions have come in at this time so okay um so

Taking away from those models i think our four four significant concepts one is is that when we’re working with people we’re working with ourselves and they’re more than organisms i think the second significant concept is that individuals both their capacities and their values are going to change over time and so that shouldn’t

Be surprising to us that somebody who was perfectly willing to give up their home when they were 45 to go you know take an exciting new job some place might suddenly become very stubborn about moving out of their room 40 years later because even while they may have become more

Fragile they also have had a change in their values i think the third significant concept is that disablement occurs in the environment and so if we can be creative enough to make environments more adaptive and adaptable then then there’s going to be a whole lot less disablement

And i think we see that just with curb cuts you can see all sorts of people out in all sorts of kind of weather that you would never think would be out cruising the streets in in wheelchairs and carts but they can because now they have the technology to

Do that and so now they can go to the store or they can go get their haircut or go visit a friend and that’s really important um the fourth thing is to really consider that we express rejection in the environment when we when our environment doesn’t accommodate

Particular needs and that’s a hard thing to to really realize but if you have loved ones who’ve been in wheelchairs or we’ve had other kinds of functional limitations they can you can understand that kind of level of rejection that our environment creates for them and that certainly isn’t part of well-being so

In my research what i did was i collected all of these charts this is um i’m going to go through this quickly because i don’t expect you to to read through all the fine print but this is where i was comparing the hierarchy of purpose that had everything

In it with some other charts and then i took the values model and i looked for similarities and this was um every time i added another model i actually have 17 models in my literature review so this got to be so big it wasn’t useful

This is a chart of what we talked about today we we used we talked about the hierarchy of purpose we talked about the modal patterns the values and we talked about the person environment models and i put this up here just just to point out the benefit

Of doing this kind of charting if you’re doing some research you’re trying to think through are we covering everything why are we using a framework and this is a this is kind of a very cumbersome overdone framework but it what it shows me is is that the person environment models

Talk about well-being but they don’t even really think about it as having a category the only categories that they have are behavior and mood and then they have um you know the press of the environment and they don’t really even talk about natural capital and sustainability

Issues so you’re going to find some of these person environment models don’t deal with sustainability and they don’t deal any meaningful ways with spirituality or transcendence or some of the other things and and they don’t necessarily have to because really they’re almost medical models because they’re really dealing in

This area of health and services and but if we don’t look beyond these models then we can miss out on some really important things and and the person environment models would actually benefit from adding some sustainability issues to start thinking about what they’re making um things out of what they’re

Recommending if that’s you know something else we can sustain in the long term so anyway what i want to present to you is that um synthesizing all of these things what we really find that we have to consider when we try to deal with the whole person is that there are systems that

Have to do with the individual and those the those would include spirituality identity in the and the body the body’s health and the body’s activities the body’s needs social systems the personal social system family and friends cultural system educational system economic and political and the material support system which

Includes all of the goods and labor and technology in our built environment as well as the natural system the resources land pollution climate and season and so what this leads to uh well this will have some examples for you um so examples of individual systems are and i i’m coming up with transcendence

And i don’t know if that’s hard for you to deal with but apparently a lot of aging people especially the very old people um really struggle with um the the approaching the end of their life and feeling like was it worth it or did i

Become who i needed to be and so that this word transcendence is really about that sense of overall life satisfaction that yes my my life had meaning yes you know everything i went through was worth it and you know either i have something to look forward to

Where i can feel good about what i’ve left behind so that’s what that word is referring to but that’s something that if we want to have environments that provide well-being for aging people we have to really consider because that’s a real that’s the developmental phase that elders are still they’re still

Developing their individuality their wisdom and and kind of their deeper inner selves of course the social systems we know those are all important and of course we know that the material support systems are important people need the goods they need shelter and technology and the natural systems that

You know not only provide the raw materials for this but are very important in well-being and in our health and preserving and maintaining health and also each of these constructs has themes that go along with it and so the theme when we think about it for when we’re considering individual systems as well

Being choice meaning preference perception for social systems it has to do with belonging and being able to access the social system and being protected from negative aspects of the social system participation equality is very important and of course we need access and protection with the material support systems we

Need assistance this is where we need goods and services especially people who need to have goods and services possibly delivered to their home or they need assistance with accessing goods and services and these things must be done efficiently and they need to be sustained and then the natural systems the

Preservation of natural systems as well as access to nature and protection of nature and protection from nature and the you know all of our concerns about sustainability if you want to take this in a shorthand if you want to look at it from you just want to carry four words around

Um and stick them in your pocket those four words are well-being equality access and adequacy so when you’re looking at a new technology you’re saying okay how does this support well-being and if you want to look at it more deeply in order to support well-being it has to

Have choice and meaning it has to be some sort of preference on the part of the user they have to perceive that it has value to them if you want to have equality then there has to be belonging opportunities for learning opportunities for two-way communication enough you

Know enough food so they’re not hungry they’re not cold if you’re looking at a technology um for material support systems it needs to promote access and it has to assist in access and of course it has to be efficient because when we work with material support system we’re talking about goods

And labor and those are things that we can’t uh be casual about we have to be very serious you know in our efficiency in how we use people’s time and how we use goods and services and then the adequacy of of the natural system being willing to provide being

Willing to put resources into into people throughout their lifespan to access protection and provide sustainability so i’ve i’ve given you some examples of places and spaces that are needed for um for the expression of these four constructs so and this kind of hard language but if we want to support a person’s

Individuality these are kinds of places where some people would choose to go some people would go to a meditation space or a trail or a bathtub or a place where they can do the things they want to do and one of the things that’s really important for individual

Identity is when they have multiple choices so if we’re doing planning for technology and we’re not giving people choices we may not be supporting well-being like if there’s only one store or one doctor or one provider there that may not support individual well-being so places and spaces needed for social

They might be near family or friends or pet friendly or someplace to volunteer or a third place a cafe a bar a library a gallery education and and all of those kinds of things that help us economically be involved the phone the computer the community betterment group and so forth

I think it’s pretty clear i think we don’t have a problem understand of well-being and aging that they need to be able to get to the store they need groceries they need medicines they need service providers um sometimes maybe we forget that they need lawn services that they do or they’ll

Have to move out of their house and go into a smaller place and they won’t be happy about it um all of these things are very important to provide access and efficient opportunities to access material support services and of course nature parks trails trees green space as well as protection from seasonal

Elements those are all important um things that as we think about the places and spaces that are needed we think about the technologies that support that and you know that it’s kind of overwhelming to think about all the different things but perhaps if you think about is this

Going to mean individual well well-being is this going to um give social equality or social participation is this going to give access and protection and is this giving again really access and protection and probably good concepts to use here so um cody i think that i pretty much have to click

And see if there are any questions right here otherwise i would go into how i’m using gis to do this so yes we’ve had a couple questions come in um and then for those of you still an attendant um just make sure if you want

To ask a question feel free to send that in and we’ll be able to answer that during our question and answer session and so our first question is from sarah what do you think are the key changes that should be made to the built environment to accommodate these new technologies

Well right now the technologies are very computer intensive and so right now it seems very important to make sure that people have access to things like the internet having said that it’s hard for you know communities have tried to to implement programs and and there’s you know a lot of political

And social things um so i would say that i would put nothing in the way of helping people access technology um those would be the kind of things where um you know requiring that or recommending or giving points for um links to to the internet i think would be really helpful

So that’s just communications technology another aging in place uh issue two two really important issues that we haven’t addressed well are helping with home modifications in sweden for example they don’t they now have every home that’s built has to have at least one bathroom and one room that could become

A bedroom on the main floor and so what that does is that allows people to stay in their home a lot longer because we actually never do plan on having an accident and we actually don’t plan on you know becoming frail we actually plan and work hard to be strong and to be

Independent so having policies in place that really drive more main floor bathrooms more main floor spaces that can be bedrooms will help people down the road the concept of visibility visitability if you’re not familiar with it that’s something i think that would go a long way because visitability

Isn’t making every place ada accessible and it’s not even universal design but what it does is it lets grandma come to your house because there’s a there’s a way there’s a door that she can enter with no staff and there’s at least a half bathroom on the first floor and if we have

Homes that are designed for visitability homes businesses churches i mean a lot of these places already fall under ada but there are a lot of places that don’t if we work toward in the future making making every place that we built from now on visitable

We will have gone a long way to helping people age in place so what’s the technology for that well you know this year’s technology is going to be different from next year’s technology but i the technology you know the technology is to be less restrictive on some of these

Creative solutions and what can we do to be proactive and encouraging people to build things that are going to work for a longer time and those are i think probably the best things that we can do okay um a couple of the people asked about if you could address the gis thing

Because they do believe that that’s important so if you could give it maybe like a five minutes or something on that that would be great okay well um in my doctoral program they’re making me prove my theories they’re not letting me just say i think this is the truth

And going with it so um i’m doing a combination of surveys and gis to to test um to try to understand what is actually um you know with with people talking to real people um what actually promotes well-being or what is the interaction between aging people and well-being and so um

Just a real brief presentation on geographic information systems for those of you who don’t work with it gis is it just collects it’s just a way of storing data it’s a database that’s linked to uh to a spot on the map and so the data can be

You know pictures of the satellite data or aerial photographs and then you know tabular information could be the value of the house um yeah you know when you work with this too much good i wrote something um so for instance in this case um i would be linking the population densities the

Percent of people who are over age 65 if they’ve reported a disability and then i can track the availability of public transportation i can measure the distance to medical care i can look for the aging program and see how far they’d have to travel to get to the aging program you can

Identify locations of stores parks churches senior centers and you know any place that you know all of the places that we go all are mapped all of the things we do we do them somewhere and so all of those things can actually be linked to a location and through gis i can

Layer those and look at them and then you know if you find something interesting you present that visually you can say look this is the way you can walk and you can’t walk that way because there’s no sidewalk or something like that a lot of the research we do um

For the city of spokane we um evaluated all of the bus stops in the city and there were i think there was about 5 000 bus stops in the greater metropolitan area and 75 of them had a meaningful um route that a disabled person could follow otherwise the other ones the all

Of the buses are handicapped accessible and all of the bus stops are not because they might go on grass or gravel or there might be a landing pad for the individual getting off the bus but if there’s no sidewalk to use after that then that’s not

Really going to get a person in a wheelchair very far i was i included this if i would have had time i would have talked about how planners can use gis this is you know a map for children but it’s kind of i like it because it’s nice and easy because you

Can take a map like this and you can start planning with it because if you have somebody you know somebody gave me this idea that what if somebody really likes to fish and they want to relocate to some place where they can fish really well or

Something and so you could take a bunch of maps and you could say okay so if you want to fish you probably want to go someplace where there’s water so you have to find rivers and streams and then you probably if you’re aging you probably also want to be by places where there

Are medical care so then you have to go to where there’s some population density or some total population and then you can start layering in order to pick out so if you if you if you layer these uh one on top of the other you can you

Can ask you know the gis system to kind of point out places that have all of these elements because i want to be near a big enough city but i want to be you know by a river or stream or i don’t want to be by a city i want to be

You know i want to be back to the ladder i want to go into the federal lands and you can determine your the elevation that you want to operate at but you can also do this um oh here we go i even had that written

So if you want uh you know you also after you figure out all of the physical things that you want from the environment then start thinking about so what else am i going to need well i’m going to need medical care i’m going to need housing what else am i going to

Need do i need a job or do i need services and so helping people to find places to relocate is one way to do it but another way to do another way to use gis is for a community i guess i don’t have it i turned off most of those slides

But basically a community can look at their city and they can evaluate where do we have services where don’t we have services where does the bus go where doesn’t it go of course they already do that but let’s look at that in comparison with where the sidewalks go are the sidewalks going

Where the buses go what about the schools what about the senior centers are there sidewalks around the senior centers other sidewalks around the schools and if they’re the winter are we making sure that um certain routes are shoveled or are we just going to bow for cars and

Not worry about people who have to walk so there’s a lot of things that we can do with gis with taking the mapping layers and looking for the places where people need to go and looking for the fixed routes that they have to take and then making choices or prioritizing

The work that we do to facilitate as much as we can you know optimal use of resources okay one of our questions is what’s okay um how do you um like how do we help our aging parents uh feel comfortable in like the new place so this is going back to where you

Were talking about the smaller building being put in the placement backyard and so how do you deal with like the emotions involved um with like the pride of not wanting to ask for help do you deal with any of that at all or well kinda i mean you know that is kind of

Beyond beyond the the discipline but it’s in the literature because the the big thing is is as much as we can to help people um choose as much as they can as you know as many things as they can and there’s a lot of things that you know and now i’m talking

From personal experience helping my mom downsize a few times and then helping her go to a nursing home and you know sometimes the senior can be quite brave and they can say oh yes i’m ready to do this but then so then you’re like oh finally you know and you start

Moving ahead and you find out no they’re not ready to do it or when they get there they’re very unhappy that they did and i think um probably you know the best thing that we can do is to understand that we’re you know possibly we’re violating their

Values you know if they’re if they’ve moved to values of belonging or values of meaning and we’re trying to talk them into values of functionality then we’re not really communicating with them so it’s really helpful i think you know and everybody will tell you this you

Know let them take as many of their very important personal things with them and you know be very patient and be very patient with yourself too all right our next question is from ken um to what extent is their progress toward providing senior housing and their existing neighborhoods as a way to

Preserve their social connections well in the literature that’s um considered to be really favorable and i think i didn’t give you a lot of information on relocation excuse me but most seniors who i think only five percent of people over 65 who relocate relocate out of state and most people choose to stay

In their community and i um working with some people with parkinson’s they absolutely reject leaving their town because that’s where their friends are and maybe their family or maybe the place where they work so um having senior housing you know in in the communities where people are living is a great idea

Another great idea that we didn’t talk about is supporting the development of naturally occurring retirement communities and if you’re still here and if you haven’t looked these up norc naturally occurring retirement communities and those are communities where people moved into the community a long time ago raised their family

Kids grew up and left this school and there’s just a whole lot of people living there that are still living there and that’s home and when there’s a certain volume or a certain percentage of people um over the age of 55 i believe um in some communities they’ve been designated

As naturally occurring retirement communities and they have services that can be brought in kind of treat it like you like a planned retirement community and have you know shared services with coordinators and so forth without making everybody relocate and that’s a kind of a neat model too as

Well as building housing in communities so our next question is from scott they would like to know if you have seen the ecological model and or major themes used as a frame framework or guide for age focused planning efforts like in land use slash community inventory efforts comprehensive planning

Objectives sub-area plans etc either separately or in combination with one another those construct those construction concept concepts could easily guide the visioning process for making our communities more universal in their design yeah that’s a great question you know i don’t think anybody’s doing it it’s

You know it’s it’s in some of the work that we’re trying to do in our department but you really need to look at the wednesday some webinar because there’s a graduate student who presented in the first 20 minutes and her research project was actually done in the berkeley area

And i you know i don’t remember the numbers but she uh surveyed all the planning um entities all the governmental entities and found out that something like 80 of them have not incorporated any aging needs into their plans and so that’s seems really counter-intuitive since planners are the forward-looking ones and they’re looking

Ahead to see what needs to be done um and here i think planners are very good at seeing what’s coming down the road so it’s just kind of surprising that that component of aging hasn’t been integrated but you’re right you know using an ecological model would certainly

Be a wise thing i think it would be a great place to to go to it okay and then our last question um do you recommend any good universal design website or resources um let’s see and i you know i didn’t put together a whole lot of resources there’s a few here

There’s the the checklist for aging in place design the complete streets for aging america is really good um the leading edge center for aging services and center for technology and aging those those look those are looking more at kind of health care needs you know kind of that high tech stuff

Um i can’t think of it but i think if you keep searching there’s a valerie brown works in boston and she does some really great work on planning for aging um and universal design so you know if you actually look um yeah i’m sorry i should have thought of

That if you contact me why don’t i put it this way if you contact me i’ll give you some of my links because i’m on some great mailing lists so here it is amber.joplin email.wsu.edu because there are some great organizations and groups out there okay um well i will take the screen

Again thank you so much amber thank you and then so for those of you still in attendance um i just wanted to go through and um the process of vlogging your cm credits for attending today’s session um you just need to go to uh www.planning.org today’s date february 25th and then select a

Framework for accessing aging in the place technologies and then as i said before we are recording today’s session and so you’ll be able to find a pdf and a video recording at the utah.apa.org flashpasswebcast.htm and this should be up by monday so with that i would just

Like to again thank you amber for today’s session and everyone have a good day thanks

ID: 60Pj3bAaQXo
Time: 1344355971
Date: 2012-08-07 20:42:51
Duration: 01:29:14

منبع