Developing Age-Friendly Cities: Case Studies From Brussels and Manchester and Implications for Policy and Practice

Developing environments responsive to the aspirations of older people has become a major concern for social and public policy. Policies and programs directed at achieving “age-friendly” communities are considered to require a wide range of interventions, including actions at the level of the social and physical environment. This article compares the age-friendly approaches of two European cities, Brussels and Manchester, with a particular focus on policies and initiatives that promote active aging in an urban context. The article examines, first, the demographic, social, and multicultural contexts of Brussels and Manchester; second, the way in which both cities became members of the World Health Organization Global Network of Age-Friendly Cities and Communities; third, similarities and differences in the age-friendly approaches and actions adopted by both cities; and fourth, opportunities and barriers to the implementation of age-friendly policies. The article concludes by discussing the key elements and resources needed to develop age-friendly cities.     

Environmental and Behavioral Circumstances and Consequences of Falls in a Senior Living Development

This article investigated the role of environmental and behavioral factors surrounding fall incidents in a senior living community. Using a mixed-methods approach, this research included both a retrospective analysis of fall reports and resident interviews. The quantitative analysis showed falls in the bedroom and bathroom were more likely to happen between 12 am and 8 am. Falls in the bathroom were more likely to result in severe injuries compared to falls in other rooms. The qualitative analysis identified three types of fall-related activity (transfer, ambulation, standing) and five behavioral factors surrounding fall incidents (transferring, slipping, misjudged behavior, tripping, health issue).     

Staff Perceptions of Same-Gender Sexual Contacts in Long-Term Care Facilities

An ongoing fear in the gay and lesbian community is that long-term care (LTC) facilities may not be sensitive to their needs. In the present study, 218 LTC staff members responded to one of three vignettes in which resident sexual contact was observed, with only the gender of the characters changing, to create different gender pairings. Results suggested that staff rated male-male and female-female pairings more negatively than heterosexual intimacy. Knowledge about older adult sexuality made little difference in staff ratings. However, staff attitudes were directly related to ratings of negative reaction and level of acceptability of same-gender sexuality.     

Family caregivers’ perceptions of maltreatment of older adults with dementia: findings from the northwest of Spain

Dementia is a neurocognitive disorder that implies a risk factor of maltreatment by family caregivers. In this study, we analyzed both informal caregiver’s perceptions of maltreatment and aspects of the caregiver and caregiving behavior that may be associated with maltreatment. We conducted five focus groups (FGs) in three Spanish cities: Segovia, Soria and León. The themes that were identified were related to two levels of maltreatment: (a) relational and (b) institutional. At the relational level, we observed the justification of maltreatment of Older Adults with Dementia (OAswD) by family caregivers during the occurrence of behavioral symptoms. At the institutional level, we noted that lack of support from the government was considered a type of maltreatment. These themes suggest that policy issues related to healthcare should be considered.     

Attitudes of social work students towards older people

Demographic ageing is a challenge for many countries. Even though Turkey has a relatively younger demographic composition, the proportion of the older people (65+) within the population is rapidly increasing. Within this framework, older people are becoming more important clients for both social work students and social workers in Turkey. This study aims to reveal the attitudes of social work students towards older people and determine the various factors that affect their views on older persons. In the scope of the project, Kogan's Attitude Towards Old People Scale was applied to 419 social work undergraduate students at a university located in Central Anatolia. The findings showed that social work students scored a mean of 130.96 and they generally had positive attitudes towards older people. The correlation between year of study, gender and age was not statistically significant. However, having lived mostly in urban areas was positively correlated with the mean Kogan scores and this finding was found to be statistically significant. Exposure to personal contact with older people at both the personal and professional levels was influential in shaping attitudes about the older people.     

Older Adults’ Expectations about Mortality,Driving Life and Years Left without Driving

ABSTRACT

People are living and driving longer than ever before, with little preparation for transitioning to being non-drivers. We investigated driving expectations among drivers age 65 and older, including sociodemographic and driving context predictors. Cross-sectional data from 349 older drivers were explored to determine variation in how many years they expected to continue driving. General linear models examined predictors of both expectations. In this predominantly Black/African American sample, 76% of older drivers (mean age = 73 ± 5.7 years) expected a non-driving future, forecasting living an average of 5.75 ± 7.29 years after driving cessation. Regression models on years left of driving life and years left to live post-driving cessation predicted nearly half of the variance in older drivers’ expectations with five significant predictors: income, current age, age expected to live to, self-limiting driving to nearby places and difficulty, visualizing being a non-driver. Many older drivers expect to stop driving before end of life.     

Religion in the Lives of Older Women Serving Life in Prison

This exploratory qualitative study examined the roles of religiousness in the lives of 21 older women (mean age = 63) serving life sentences in one southern state. Based on survey and focus group methodology, several themes emerged as important focal points, including early religious experiences prior to incarceration, imprisonment and religious doubt, participation in formal and informal religious activities, and use of religion in coping with stressors such as interpersonal relationships, trauma, and health statuses. Irrespective of their religious upbringing, all participants agreed that religiosity/spirituality played a key role in their ability to cope with their prison experience as well as for maintaining hope and the opportunity for release.     

‘Growing Old’ in Shelters and ‘On the Street’: Experiences of Older Homeless People

Homelessness among older people in Canada is both a growing concern, and an emerging field of study. This article reports thematic results of qualitative interviews with 40 people aged 46 to 75, carried out as part of a mixed-methods study of older people who are homeless in Montreal, Quebec, Canada. Our participants included people with histories of homelessness (n = 14) and persons new to homelessness in later life (n = 26). Interviews focused on experiences at the intersections of aging and homelessness including social relationships, the challenges of living on the streets and in shelters in later life, and the future. This article outlines the 5 main themes that capture the experience of homelessness for our participants: age exacerbates worries; exclusion and isolation; managing significant challenges; shifting needs and realities; and resilience, strength, and hope. Together, these findings underscore the need for specific programs geared to the unique needs of older people who are homeless.     

Gaps in social protection for health care and long‐term care in Europe: Are the elderly faced with financial ruin?

While public expenditure on health care and long‐term care (LTC) has been monitored for many years in European countries, far less attention has been paid to the financial consequences for older people of private out‐of‐pocket (OOP) expenditure necessary to access such care. Employing representative cross‐sectional data on the elderly populations of 11 European countries in 2004 from the Survey of Health, Ageing and Retirement in Europe (SHARE), we find that OOP payments for health care and LTC are very common among the elderly across European countries and such expenditures impact significantly on disposable income: up to 95 per cent of the elderly make OOP payments for health care and 5 per cent for LTC, resulting in income reductions of between 5 and 10 per cent, respectively. Failure to prevent financial ruin, as a consequence of excessive OOP payments, is evident in 0.7 per cent of elderly households utilizing health care and 0.5 per cent of elderly households utilizing LTC. Those particularly concerned are the poor, women and the very old.     

Reaching Isolated Older People

In the second part of a paper reporting a unique single day a week adult day program, the service methodologies developed in the program are described as well as a study of outcomes in four areas: success in reaching the target group, attendance, length of participation, and resolution of psychosocial and health related problems. Outcomes, illustrated by statistical and case material, indicate success in achieving the overall goal of maintenance and enhancement of the participant's life and functioning as a whole. Such a resource is recommended as a vital one for the target population of isolated older people described in the paper.