Population ageing is a global phenomenon and the policy response is to focus on aged care and congregate living. The majority of older adults live in ordinary neighbourhoods, in ordinary homes. This policy blind spot means that anything to do with ageing is seen as a health or care responsibility and not an urban planning one. We need places and spaces for all ages and that means planning policy has to catch up with demographics.
It’s likely that ageist stereotypes underpins the policy blind spot. The World Health Organization’s Age-Friendly Communities Framework covers all aspects of life. Assumptions based on ageist stereotypes might also be why education is not on the WHO’s list.
Image: Eight Domains of Age-Friendly Cities by WHO.
An article in Rethinking the Future briefly covers the issue of population ageing from a global perspective. High income countries are reaching the peak of their population ageing where up to 30 percent of the population is over 60 years old.
Making cities age-friendly is everybody’s business. It is the business of policy, planning, housing, transport, social services, corporations, small business, etc. The article introduces three guides for age-inclusive cities and public spaces.
The Alternative Age-friendly Handbook for the Socially Engaged Urban Practitioner discusses actions such as mapping, auditing, fixing and collaborating.
Age-Inclusive Public Space is a book that documents interaction with 19 practitioners – architects, geographers, psychologists, and social scientists. Each has a view of designing, using and transforming public space to be more inclusive.
Shaping Ageing Cities focuses on 10 European cities facing ageing populations. This report looks at the built environment, housing, mobility and digital environments.
The article concludes by saying cities will have to adapt to changing needs with inclusivity – age-inclusive design practices. There is a short reference list at the end.
The Autumn 2023 Access Insight magazine has an article by John Van der Have on designing for autism. He introduces a design guide by Magda Mostafa and her work on design for the autistic community.
Van der Have begins his article with an older medical description of autism (ASD) and some statistics. As many people know, sensory overload is common for people within the neurodivergent community. Too many sights, sounds, smells and tactile experiences can cause stress and anxiety. That’s why the choice of building materials and systems need additional consideration.
Minimising noise and unwanted sounds through good acoustic design is a vital criterion. But how much acoustic insulation is enough, and how much is too much? Questions such as these have implications for construction costs.
Biophilic principles are beneficial for everyone, but for the autistic community, these elements can enhance their sense of wellbeing. Natural lighting, natural ventilation and views of nature are especially helpful.
Van der Have discusses educational settings and a time-out room where children can still learn in a supportive environment. A calming space at home, as well as a room fitted out to suit a child’s preferences is also a good idea.
As we begin to understand autism and neurodiversity, it’s possible there will be moves to regulate suitable designs. However, regulation should not be needed if designers take action themselves to be more inclusive. Van der Have’s article is on page 18 of Access Insight. It is titled, Design for People on the Autism Spectrum and introduces the work of Magda Mostafa.
Autism friendly design guide
Magda Mostafa, an architect and researcher, developed a design framework for incorporating the needs of the neurodivergent community. The framework is based on 7 design concepts:
Acustics
Spatial Sequencing
Escape
Compartmentalisation
Transition
Sensory Zoning
Safety
In Cities People Love, Mostafa talks about her experiences as an architect working as an autism design consultant. She says designers have to rethink the tools they need. A human-centred approach to design, such as focus groups, assumes everyone is able to speak and participate. She wants to see the principles from the Autism Friendly University Design Guideapplied more widely.
The Autism Friendly University Design Guide was developed in collaboration with the Dublin City University and is applicable in other settings. The first half of the 116 page detailed guide covers the research, and the second has the guiding principles. Mostafa’s work is worth following for anyone interested in designing for neurodivergence.
This edition of Access Insight also has an article on water safety for autistic children on page 4.
While the principles of universal design aim to enable people to stay in their own home for as long as they wish, the principles are also applicable to aged care settings. Four principles underpin the Australian Government’s National Aged Care Design Principles and Guidelines. These principles are:
Enable the person
Cultivate a home
Access the outdoors
Connect with community
The four principles are, of course, applicable to any dwelling or place of accommodation. This is an example of universal design where specific features are essential for some and good for everyone. Consequently, the document is useful for anyone designing any type of home.
The guideline provides detail on each principle. For example, the first principle covers acoustics, air quality, lighting, tonal contrast, supportive seating and comfortable temperatures. Before and after illustrations as shown below provide additional information. At the end of each sub-section is a checklist.
The authors have chosen to use six personas to bridge the gap between abstract concepts and lived experience of residents and staff. Three personas for each group is possibly too few and runs the risk of limiting a designer’s vision of the breadth of diversity. For example, cultural diversity is considered, but other characteristics such as marital status and sexual orientation are not.
The outcomes for the resident personas are explained alongside each checklist. They provide some of the “why” certain features are required by individuals.
Overall, this is a useful guide for aged care in any context – indeed for all people. After all, home is the centre point of our lives. Below is a page from the guidelines showing before and after illustrations.
Design impacts both social and economic value to a community, but how do you measure and track it? The RIBA Social Value Toolkit has the answer. The Toolkit makes it easy to evaluate and demonstrate the impact of design on people and communities. A research project by the University of Reading provided the evidence for the Toolkit.
“If we cannot define what we mean by value, we cannot be sure to produce it, nor to share it fairly, nor to sustain economic growth.” (Mazzucato, 2018)
“Social value is created when buildings, places, and infrastructure support environmental, economic and social wellbeing to improve people’s quality of life.” (UK Green Building Council)
The underpinning concepts for the Toolkit are based in the wellbeing literature. Social value of architecture is in fostering positive emotions, connecting people, and in supporting participation. The Toolkit has two parts. A library of post occupancy evaluation questions, and a monetisation tool that links to other post occupancy evaluation processes.
Eilish Barry says that if we don’t define and measure the social impact of design, it will be pushed further down the priority list as costs rise. Generating social value is useful for potential future residents as well as designers and developers. Barry poses five recommendations for industry in her Fifth Estate article:
Knowledege sharing is vital
We need a common language
Social value should be part of the design process
Methodologies need to be flexible
Opportunity for collaboration (Eilish Barry pictured)
The Social Value Toolkit
The library of questions means you don’t have to reinvent the wheel. They cover positive emotions, connecting, freedom and flexibility, and participation. Each of these has a monetary value attached.
The dimensions of social value in the built environment context.
The approach to monetising social outcomes is based on Social Return on Investment. There are several different ways to measure this.
Value for money: Willingness to pay extra for something you value.
Time is money: The value of savingtime.
Subjective Wellbeing valuation: Putting a value on wellbeing – most appropriate to understanding the impact of design on end users.
The Toolkit references the UK Social Value Bank, an open access source that contains a series of values based on subjective wellbeing valuation. There is also an Australian Social Value Bank with resources.
The Toolkit is briefly explained on the Royal Institute of British Architects website where you can download the 2MB document. Or you can access the document here.
We know that people want to stay home as they age. This does not change for people with dementia. Staying safe at home also means staying safe in the neighbourhood, not just at home. That means we need a dementia-friendly outdoors.
Ash Osborne writes in the Access Insight magazine about dementia and outdoor environments. Although dementia is NOT a normal part of ageing, one in ten people over the age of 65 experience dementia. It is the single greatest cause of disability for this group.
Osborne takes us through the key design elements that support people with dementia as well as other groups. Depth perception often changes and that means strong changes in contrast can be perceived as steps or a hole. This can lead to falls.
Wiggly lines in paving and sun-cast shadows from a pergola are similar situations. A black mat at a doorway looks like a hole in the ground and pooled lighting can be confusing. So the images show what NOT to do.
Distortions of perception are not just experienced by some people with dementia. So, once again, think universal design.
In Improving the lives of people with dementia through urban design, Barbara Pani presents four brief case studies: a gated community, a dementia-friendly city, intergenerational housing, and health services at a neighbourhood level in a social housing estate.
The article provides technical information and in the conclusion raises several points. Retrofitting existing buildings could be better than a massive redevelopment.
Consideration of people with dementia could also be good for the wellbeing of people with mental health issues, and the importance of developing social spaces at the neighbourhood level.
Many people with dementia are able to live independently for several years before they need constant care and support. Studies are showing that the design of the built environment is influential in supporting people with dementia to maintain their sense of well-being and independence.
Out and about with dementia
Getting out and about is good for everyone’s physical and mental health. However, the fear of getting lost or confused when outside the home prevents many people with dementia from leaving home. Consequently, they tend to limit their time away from the house. But with good planning and community help, people with dementia can maintain the benefits of walking and taking a holiday.
“I am a person.
Sometimes people like to go for walks, even people with dementia. Sometimes people get lost, even people without dementia”
Taken from Kate Swaffer’s poem, ‘Wandering along the beach’. (2014)
Dementia Australia has two booklets, Walking safely with dementia, and Travelling and holidays with dementia. These booklets are designed for people with dementia and their families. However, the information is good for communities who want to make their places and spaces dementia friendly.
Walking
The walking guide features strategies people can take to make sure they stay safe and know what to do if they become lost. They can be as simple as carrying identification and establishing familiar routines and places. The section on safety involves avoiding crowds and disorienting entry and exits. Double entry and exits in shopping centres can cause confusion for people without dementia. Directional signage on the way out of the toilet is useful for everyone.
Dementia Australia has a Dementia-Friendly Communities program where people can learn more about dementia and how they can help. There’s a list of things you can do if you meet someone who may be lost.
“My mother has dementia, but her life continues to be enriched with fulfilment. We went on a cruise last year that provided us with uninterrupted time, gave me some time to relax and just be there for my mum while our needs were taken care of. It was difficult at times, but so rewarding to have shared this time together”
Travelling and holidays
Similarly to the walking guide, careful planning is key to success. The holiday booklet covers travel by sea, air, car and public transport. There’s a checklist of things to consider and how you can plan to optimise your level of capability. When it comes to accommodation, it’s useful to notify hotel staff. Some hotel accessible rooms might be more comfortable.
There is nothing in this booklet for transportation agencies for people with dementia. However, it gives travel and accommodation providers insights into the lives of people with dementia and their families.
Talking about inclusive built environments is easy, but how do you do it well? With different stakeholders involved in the design and delivery of a project, how do you get them to join up their thinking to approach projects with the same inclusive mindset? An inclusive building design guide focused on the processes is the way to do it.
The Royal Institute of British Architects (RIBA) created an Inclusion Charter in 2020. One of their commitments was to embed inclusive design in all projects. But architects cannot work in isolation – all stakeholders need to take on an inclusive mindset. As an extension to their Charter, they created the Inclusive Design Overlayto the RIBA Plan of Work. It seeks to bring all stakeholders on board for every part of the project.
“The role our built environment has on each and every person’s life cannot be overestimated. This Inclusive Design Overlay provides a consensus across built environment professions for how we accelerate inclusion and value diversity.” Robbie Turner, Director of Inclusion and Diversity, RIBA.
Twenty-five different built environment professions provided insights and best practice content for the overlay. The inclusive design tasks apply to the client, project management team, design team, construction team and asset management team.
There are three core parts: the Client Team, the Design Team and the Construction Team. In addition, they recommend having an inclusive design consultant, or champion, with specialist inclusive design expertise. As Australian access consultants know, the earlier they are consulted the better. So it is good to see RIBA encouraging involvement from the outset of the project. The overlay also encourages the project team to look beyond building regulations.
Good design must be fundamentally inclusive just as it should be sustainable and resilient. Inclusive design should be elevated to the same level as sustainability.
The overlay details the roles of each team and stages of work. It begins with setting the project brief and budget through concept design, construction and handover to asset managers. There are separate sections for each of the key teams and what they should do and understand at each stage.
Enablers
The document includes a section on inclusive design enablers. These are actions that support the development of an inclusive design strategy, and implementation of inclusive design across the delivery of a project. Each sub-section has clear information on the diversity of the population and different levels of capability, and how to approach them in design and construction processes.
This design guide aims to improve infrastructure for people wanting to walk, cycle, scoot, and ride mobility devices. That means anyone and everyone who is not a driver of a motor vehicle. This is part of the ACT Government’s policy is to support active travel.
In the Canberra context, unless designated, all paths are shared by people walking, wheeling, cycling and using mobility aids.
Few people fully understand road rules, which is why design treatments must indicate that pedestrians have priority.
People using mobility devices and older people are given the label of “vulnerable” pedestrians. This is default language in transport jargon, but serves, unfortunately, to reinforce stereotypes. In reality, all pedestrians are vulnerable compared to motor vehicles.
When all pedestrians are incorporated into designs, we should just talk about “pedestrians walking and wheeling”. And with a Safe Systems Approach there should be no delineation between who is safer than whom.
Movement and Place framework
The Movement and Place framework together with a Safe Systems approach puts people into the centre of the frame. The lens has always been on vehicle traffic flows and the convenience and economics of reducing traffic delays. If we are to have active travel really happening, we have to re-think this priority.
The Design Guide is comprehensive and serves as a “how-to” tool for transport planners. It covers:
The Royal Institute of British Architects has updated their Access Audit Handbook in conjunction with the Centre for Accessible Environments. Access auditing is an evolving concept and means different things to different people. Some take it as being compliant with a standard while others consider aspects beyond compliance.
Fortunately, the Ergonomics in Design for All Newsletter explains the content of the document. In doing so, the newsletter provides an synopsis of some of the key concepts in the handbook.
Similarly to Australian Standards, British Standards only apply to people with disability and do not cover any other groups in terms of access and inclusion. This is despite other groups who fall under anti-discrimination law. The handbook addresses some of these gaps. For example:
Faith spaces, prayer facilities, features relating to women’s safety and their well-being, including pregnancy and menopause, baby feeding and changing, and non-gendered sanitary and changing facilities.
There is guidance on neurodiversity and reducing sensory overload, anxiety and stress, such as quiet rooms. Designers are asked to plan logical wayfinding with straight lines, and create curves rather than corners.
Technology is evolving on building accessibility, space and wayfinding, and auditors need to keep up with these developments. Lift destination control systems are a case in point where people no longer press a button for their floor. The central control system can be very confusing where there is a bank of lifts.
Case studies
The handbook recommends engaging with building users for insights into the level of accessibility and to keep them engaged throughout the project. There are six case studies: a theatre, a zoo, a parish church, a university science lab, and an outdoor space. The case study of an inaccessible heritage town hall shows how to create an accessible community building.
The handbook has 32 checklists for the external environment, internal building space, management and communication.
The Centre for Accessible Environments in London has been providing access advice for many years, many of them heritage buildings. As a not-for-profit, their aim is for more mainstream buildings to be accessible and inclusive. They got the chance with the office space for the Royal College of Occupational Therapists (RCOT). The Centre for Accessible Environments (CAE) website has an overview of the work they did on this building.
The image shows the accessible shower room prior to the refit. The design is based on a public standard and looks very clinical.
Image from the CAE website.
The building accommodates around 90 staff across four floors with meeting rooms on the ground floor. This floor had level access, powered doors, and an accessible shower room that looked like a hospital room. Not what CAE would consider gold standard.
The image shows the same wheelchair accessible shower room but with improved colour aesthetics. While this might meet British Standards, Australian access consultants might take issue with some aspects. The placement of the mirror, for example.
Image from the CAE website.
The outcome of CAE’s involvement is that the fit-out of the shower room looked less clinical despite the considerable amount of specialised equipment and features. The overall success was the focus on detail such as the amount of pile in a rug.
Quiet spaces and soundproofing and height adjustable desks are also part of the fitout. CAE’s access consultant also acknowledge that flexibility of space is essential. “Until people use a building following a redesign, you don’t know if it’s going to meet the needs of everyone.
The World Health Organization has updated their resources on age-friendly cities and communities and added a toolkit. In 2007 the Age Friendly Cities and Communities (AFCC) program was rolled out. A Global Network of Age-Friendly Cities followed in 2010. The strength of the program was an early form of co-design with older people in local communities. That is, it promoted a bottom-up process with top-down policy support.
The guide has suggestions for meaningful engagement of older people in creating age-friendly environments. It includes detailed examples of existing national AFCC programmes, and practical steps for creating or strengthening such a programme. The vision is for all countries to establish a national AFCC programme by the end of the UN Decade of Healthy Ageing (2021–2030).
The toolkit is a separate set of resources to the guide.
The glossary lists all the words and labels used for older people and is a useful resource in itself. As with many official guides there are a lot of words and explanations about the history and ideas. The eight domains of action are the same as the 2007 version of the guide. The Framework for implementing national programmes is in section 3.
There are more than 1400 members of the Global Network, and looks like it will continue to grow. The network acts locally to encourage full participation by older people in community life and active ageing. The program is an important step in meeting the goal of the UN Decade of Healthy Ageing. Setting the scene for improved participation by older people benefits everyone. What’s good for older people is good for all people.
The Age Friendly Cities and Communities program puts older people at the centre and covers all aspects of life. It’s where policy meets people. The vision is that older people can transform themselves by transforming the environments in which they live, work and play.
