Dementia design and equality

An older woman with white hair holds a bouquet of flowers to her face. Her eyes indicate she is smiling.People with dementia are not always seen as having the same human rights as other people with disability. So design for dementia is often viewed as an added extra to existing disability requirements. To help facilitate a better understanding, the World Health Organization published a guide on human rights and dementia. An article from the UK builds on these issues and provides recommendations for policy, practice and research. 

The title of the article is, Accessible design and dementia: A neglected space in the equality debate.

The article can be accessed from Sage Journals, but you’ll need institutional access, and via ResearchGate where you can ask for a free copy of the paper.

Abstract: This paper addresses the issue of accessible design in the context of dementia. It is not difficult to design buildings and outside spaces for people with dementia but you do have to follow clear design principles and values. However, unlike other disabilities, accessible dementia design is still viewed as an added extra and not a vital component of facilitating citizenship. In 2015, the World Health Organisation published guidance on human rights and dementia. People living with dementia are frequently denied their human rights even when regulations are in place to uphold them. This paper will focus on accessible design from a human rights perspective using the PANEL principles. PANEL stands for Participation, Accountability, Non-Discrimination and Equality, Empowerment and Legality. We will then conclude with recommendations for policy, practice and research to ensure that accessible design for people living with dementia does not continue to be a neglected space in the equality debate.

Airport wayfinding: Easy for everyone

A broad view of the inside of an airport building with people coming and going.Airlines are working to improve accessibility, but airports also need to step up. People with disability are making regular complaints, and older people are likely to just give up travelling by air. Not good for the travel industry or tourism. So a well researched guide is welcome in this space. Wayfinding is far more than just good signage – it starts with the whole building design. In airports it’s about the customer experience and promoting independent travel. That’s regardless of age or ability.

Enhancing Airport Wayfinding for Aging Travelers and Persons with Disabilities is a comprehensive guide for wayfinding professionals, signage designers, and interior designers. It is published by the US Transportation Research Board’s Airport Cooperative Research Program. It comes with a checklist that emphasises community consultation as part of their universal design approach to wayfinding. The detailed guide also has a companion PowerPoint presentation that covers the key elements with lots of pictures. The presentation is 15MB and is downloadable from the main webpage and is a good way to get across the key points. There are eight chapters in the guide:

    1. Introduction
    2. Understanding the needs of aging travelers and passengers with disability
    3. Wayfinding strategies via visual, verbal and virtual communication
    4. Airport planning and design consideration
    5. Departing customer journey
    6. Arriving customer journey
    7. Connecting customer journey
    8. Wayfinding technologies for aging travelers and persons with disability

To achieve the overall objective of helping aging travelers and persons with disabilities to travel independently, an airport has to consider more than just helping these customers know where to go.

Copenhagen: the playful city

An aerial view of the power plant showing the landscaping of the green surface of the ski slope on top of the building.Play in urban environments has evolved from free spirits in the streets, to carefully constructed play parks with modular play equipment. The trend is moving back again into adventure play. More broadly, our cities need to be more playful for everyone. This is important for mental as well as physical health. Places that cater for all ages and preferences encourage social interaction as well.

A sunny day in Copenhagen brings out the swimmers at the outdoor baths that are edged with timber boardwalks.An article from Alice Covatta discusses the notion of a playable city. Using a case study of Copenhagen in Denmark she discusses how the concept of play is woven into the fabric of the urban environment. The most famous example, of course, is the ski slope of the green waste power plant in the industrial district. But there is also the outdoor harbour bath at Brygge Park. The key lessons from Copenhagen are a multidisciplinary approach and thinking about play as sustainable design. Reusing wasteland offers plenty of scope for creative design and for playgrounds of the 21st century. And of course, it’s a healthy city approach reaching people of all ages. 

The title of the article is, From infrastructure to playground: the playable soul of Copenhagen. The Journal of Urban Design and Mental Health has more on this topic.

 

Age-Friendly Green Space by Citizen Science

A line of street trees line the roadway.As cities become denser and populations age, quality green space becomes ever more important. In many cities at least a quarter of the population will be over the age of 65 years by 2030. Adelaide in South Australia has one of the oldest populations at 37% over the age of 50. So this is a good place to run a citizen science pilot with older residents. The method involved the use of smart phones to collect data, and the development of audit tools. The participants were encouraged to go about their daily lives so that the data reflected their natural life. While the data were not the main focus of the project, several important design elements emerged. In order of importance they were: seating, street trees, natural bushland, park trees and lakes/river/ocean.

In the summing up the researchers noted that public green spaces in local neighbourhoods may be seen as “green corridors” – a conduit to everyday life rather than destinations in themselves. They conclude that citizen science methods are a good way to implement age-friendly urban design at a detailed level. 

The title of the article is, Using Citizen Science to Explore Neighbourhood Influences on Ageing Well: Pilot Project  

Abstract: Outdoor and indoor environments impact older people’s mobility, independence, quality of life, and ability to “age in place”. Considerable evidence suggests that not only the amount, but also the quality, of public green spaces in the living environment is important. The quality of public green spaces is mostly measured through expert assessments by planners, designers and developers. A disadvantage of this expert-determined approach is that it often does not consider the appraisals or perceptions of residents. Daily experience, often over long periods of time, means older residents have acquired insider knowledge of their neighbourhood, and thus, may be more qualified to assess these spaces, including measuring what makes a valued or quality public green space. The aim of this Australian pilot study on public green spaces for ageing well was to test an innovative citizen science approach to data collection using smart phones. “Senior” citizen scientists trialled the smart phone audit tool over a three-month period, recording and auditing public green spaces in their neighbourhoods. Data collected included geocoded location data, photographs, and qualitative comments along with survey data. While citizen science research is already well established in the natural sciences, it remains underutilised in the social sciences. This paper focuses on the use of citizen science with older participants highlighting the potential for this methodology in the fields of environmental gerontology, urban planning and landscape architecture.

Urban Planning and Coronavirus

Aerial view of a major intersection in the Melbourne CBD.The daily disadvantage of marginalised groups is more clearly revealed as others fall into the ranks of disadvantage during this pandemic.  A discussion paper from Berkeley argues that this current pandemic is an opportunity to consider similar urban health reforms that followed previous epidemics. Promoting inclusive and healthy cities for all is the bottom line in this thoughtful discussion.

The discussion paper takes the perspective of people with functional limitations. For many people worldwide, disability is about health, human rights, and poverty. It’s an urban development issue and time to move from the medical model to the social model of disability. Also discussed are how people with disability are left out of economic responses, such as one-off support payments, and not included in planning to prevent future crises. The authors provide recommendations for how this pandemic can best support people with disability and how this makes cities healthier for all. They warn that pandemics also run the risk of exacerbating further marginalisation through racism and segregation. The abstract below is the essence of the paper.

The title of the paper is, Disability, Urban Health Equity, and the Coronavirus Pandemic: Promoting Cities for All

Abstract: Persons with disabilities (PWDs) living in cities during the COVID-19 pandemic response may be four times more likely to be injured or die than non-disabled persons, not because of their “vulnerable” position but because urban health policy, planning and practice has not considered their needs. In this article, the adverse health impacts on PWDs during the COVID-19 pandemic reveals the “everyday emergencies” in cities for PWDs and that these can be avoided through more inclusive community planning, a whole-of-government commitment to equal access, and implementation of universal design strategies. Importantly, COVID-19 can place PWDs at a higher risk of infection since some may already have compromised immune and respiratory systems and policy responses, such as social distancing, can lead to life-threatening disruptions in care for those that rely on home heath or personal assistants. Living in cities may already present health-damaging challenges for PWDs, such as through lack of access to services and employment, physical barriers on streets and transportation, and smart-city technologies that are not made universally accessible. We suggest that the current pandemic be viewed as an opportunity for significant urban health reforms on the scale of the sanitary and governance reforms that followed ninetieth century urban epidemics. This perspective offers insights for ensuring the twenty-first century response to COVID-19 focuses on promoting more inclusive and healthy cities for all.

Active Living Resources

Banner for Active Living NSW showing a beach scene and people walking on a tree lined promenade.The life of Active Living NSW has come to an end. Consequently, on 2 May, their website will be decommissioned. However, their resources are available on other websites. They are listed below for easy access, or you can download the PDF version of the list. Many resources are recent publications. All resources should be read with universal design and inclusion in mind. We cannot be active without an accessible built environment designed for everyone. 

Healthy Active by Design Website publications

All Heart Foundation built environment resources are available on the Heart Foundation website.

Australian Capital Territory

South Australia

If you would like a hard copy of a South Australian resource for professional practice, please send your details to the Senior Policy Advisor at sa@heartfoundation.org.au  

Green Open Space

When looking to improve streets the best return comes from urban trees and other greenery through their co-benefits for health, cooling, amenity and the environment.

Northern Territory

New South Wales

The scorecard and priority recommendations for Sydney builds upon the first baseline measure of liveability in Australia’s state and territory capitals, presented in Creating Liveable Cities in Australia.

This series of resources was developed for the NSW planning system by the Healthy Planning Expert Working Group between 2018-2019. Heart Foundation provides the secretariat function of this group. 

A baseline study of Healthy Eating and Active Living within NSW Local Government Community Strategic Plans and selected Delivery Programs

Western Australia

The Western Australian report reviews State Government liveability policies in Perth using a scorecard system to indicate where the city is meeting, exceeding, on par, or falling below its policy targets.

Queensland

Age-Friendly university with citizen science

The University of Manitoba is a grand university building.Using citizen science techniques to engage with users takes built environment assessments another step. And a university campus provides a neat environment for a case study. Researchers at the University of Manitoba went about examining the age-friendliness of their campus using specific citizen science techniques. This is all documented in their article, Exploring University Age-Friendliness Using Collaborative Citizen Science. The main aim was to test the method, but the data collected were useful as well. The data revealed physical accessibility, signage, and transportation as being the most important for improving overall age-friendliness. The article was published in The Gerontologist and requires institutional access for a free read.

Citizen science is more than just asking a group of older people to wander around taking pictures and notes. It is a collaboration between citizens and researchers at all stages of the research process. That includes analysis of the data. However, it is not known whether the university implemented any of the recommendations. 

The Age-Friendly University initiative was started by Dublin City University and has turned into a global network. More than 50 universities around the world have joined. You can read more about this global movement in a Forbes article.   

Abstract
Background and Objectives: Since the launch of Dublin City University’s Age-Friendly University (AFU) Initiative in 2012, relatively little empirical research has been published on its feasibility or implementation by institutions of higher learning. This article describes how collaborative citizen science—a research method where professional researchers and community members work together across multiple stages of the research process (e.g., data collection, analysis, and/or knowledge mobilization) to investigate an issue—was used to identify barriers and supports to university age-friendliness at the University of Manitoba (UofM) in Canada.

Research Design and Methods: Ten citizen scientists each completed 1 data collection walk around the UofM campus and used a tablet application to document AFU barriers and supports via photographs and accompanying audio commentaries. The citizen scientists and university researchers then worked together in 2 analysis sessions to identify AFU priority areas and brainstorm recommendations for institutional change. These were then presented to a group of interested university stakeholders.

Results: The citizen scientists collected 157 photos documenting AFU barriers and supports on campus. Accessibility, signage, and transportation were identified as being the most pressing issues for the university to address to improve overall age-friendliness.

Discussion and Implications: We suggest that academic institutions looking to complete assessments of their age-friendliness, particularly those exploring physical barriers and supports, could benefit from incorporating older citizen scientists into the process of collecting, analyzing, and mobilizing findings.

Sustainability, UD and health in urban planning

Front page of the Our Common Future document with the United Nations logo.It’s not difficult to join the dots between universal design, sustainability and health. Universal Design in Sustainable Urban Planning is an article that pulls together these concepts under the umbrella of sustainable development. Three urban projects in Manhattan, Den Haag and Copenhagen are discussed. They show how sustainable urban planning can promote social interaction, health and wellbeing, and cultural expression. The article links the health back to the International Classification of Functioning, Disability and Health (ICF).

The article cites the Burndtland Report which defines sustainability as, “Sustainable development is development that meets the needs of the present without compromising the ability of future generations to meet their own needs.” The aim of the Brundtland Commission is to unite countries to pursue sustainable development together.

The article is available through SpringerLink or you can try for a free read via ResearchGate.

Abstract: There is a fil rouge connecting Universal Design and sustainability which within the Brundtland Report can be recognized in the pillar of social sustainability. The demographic and epidemiological aspects that are affecting western countries, the definitions of health and healthy cities given by the World Health Organization and the international documents dealing with sustainable development oblige building designers and urban planners to reconsider their social role and become “health operators”. The strict link between human beings and the built environment underlined both by Universal Design and International Classification of Functioning is the reasons why our cities and settlements need high quality urban spaces in order to enhance everyday life social dimension. Three urban projects in Manhattan, Den Haag and Copenhagen will be presented to show how sustainable urban planning can promote social interaction and inclusion, cohesion of communities, human health and well-being, cultural expression and dialogue among a wide diversity of people and cultures.

 

Happy homes, friendly neighbourhoods

An older woman walks on a bitumen path in a park. Two older men are sitting on a seat along the pathway.The notion of age-friendly cities is not new, and neither is age-friendly housing design. However, researchers tend to look at one or the other but not both. A study by a group at University of South Australia has sought to join the dots showing the dependency of one upon the other. Creating age-friendly environments begins at home, across the threshold to the street and on to the broader environment. Like any chain, it is as strong as it’s weakest link. While some local authorities are doing their best to be age-friendly in their area, they are not able to influence the design of mass market homes. That is the role of state governments and their control of the National Construction Code.

The report of the study titled, Towards Age-Friendly Built Environment, supports previous research and recommendations. Given that not much is changing, this is another worthy paper. The key point is linking life at home with life in the community and showing how it supports the health and wellbeing of older Australians. This in turn takes the pressure from government funded home modifications and support services – not to mention tax payers.

Abstract: The population of aged people is increasing dramatically throughout the world and this demographic variation is generating different challenges for societies, families and individuals in many different ways. One of the effective approaches for responding towards demographic ageing is to have more evidences on creating age-friendly communities. Despite of having number of researches on ageing, there is limited knowledge on identifying components for developing age-friendly communities and cities. This research therefore, aims at discovering the benefits of properly designed age-friendly communities and interrelationships of key related concepts. To accomplish this aim, relevant research papers have been reviewed and subjected to thematic analysis.This study emphasizes on improving the overall wellbeing of elderly not only by finding out the improvement strategies on the health care facilities but also by finding strong evidences on benefits of designing their housing and immediate outdoor environment. Therefore, this study recommends future research directions on developing built environments responsive to the aspirations and requirements of aged population which can not only assist the adoption and maintenance of an active lifestyle, but it can also be beneficial to the physical and psychological overall well-being of aged population. More studies on planning urban environmental settings targeting aged population can be beneficial to not only aged people but for people from every age group. Thus, these settings will be advantageous for anyone with varying requirements with changing generational needs and lifestyles from a child to a couple to aged people.

Gay neighbourhoods: an urban typology?

Three young men lead a street march with rainbow banners. It's a gay pride event.Last century lesbian, gay, bisexual, transgender (LGBT) individuals felt the need to band together for safety in numbers. Some argue that successive human rights legislation has lessened the need for this to continue. Or has it? The notion that gay neighbourhoods are no longer needed is premature. Other neighbourhoods based on ethnicity or socio-economic factors haven’t completely disappeared, and neither have gay neighbourhoods.

Alex Bitterman discusses the lack of academic documentation and research on gay neighbourhoods. These neighbourhoods will likely continue and be important to future generations of LGBT residents and families. He argues that gay neighbourhoods are neither dying nor flourishing – just existing – in the same way as any other typology. Gay neighbourhoods will also need to adapt to other trends such as gentrification and affordability. The notion that gay neighbourhoods are self-sustaining, or that they are diminishing is erroneous. 

Bitterman concludes his essay; “Through unglamorous scholarly inquiry, the true account of the evolution and trajectories of gay neighbourhoods will be revealed. To better understand the longitudinal progression of gay neighbourhoods, researchers should endeavour to differentiate between well-established gay neighbourhoods and emerging gaybourhoods, carefully studying the trends and demographics that lead to shifting LGBT populations and changes in gay neighbourhoods. This evolution, occurring in plain sight but largely undocumented, is LGBT history in the making and the opportunity to chronicle these unique and important changes is ours to lose.”

The title of the online essay is, Rainbow diaspora: the emerging renaissance of gay neighbourhoods.  You can also download a PDF copy