Creating aging-friendly communities

289 Pages·2016·2.209 MB·English

by  Lehning, Amanda J., Scharlach, Andrew E

Creating Aging-Friendly
Communities

Creating Aging-Friendly
Communities
ANDREW E. SCHARLACH
AMANDA J. LEHNING
1
1
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Library of Congress Cataloging-in-Publication Data
Scharlach, Andrew E., author.
Creating aging-friendly communities / Andrew E. Scharlach,
Amanda J. Lehning.
pages cm
Includes bibliographical references and index.
ISBN 978–0–19–937958–3 (alk. paper)
1. Population aging—United States. 2. Older people—Services for—United States.
3. Older people—United States—Social conditions. 4. Community development—United States.
5. City planning—United States. I. Lehning, Amanda J., author. II. Title.
HQ1064.U5S35 2016
305.260973—dc23
2015024580
1 3 5 7 9 8 6 4 2
Printed in the United States of America
on acid-free paper
CONTENTS
Introduction: Why America’s Communities Must Become
More Aging Friendly vii
PART I AGING AND COMMUNITY
1. Aging in America: Challenges and Opportunities for Communities 3
2. Aging Well 15
3. The Community Context for Aging Well 31
4. Toward Aging-Friendly Communities 47
PART II CHARACTERISTICS OF AGING-FRIENDLY
COMMUNITIES
5. Overcoming Physical Barriers to Aging Well: Mobility
and the Built Environment 65
6. Promoting Social Engagement 87
7. Optimizing Personal Well-Being: Health and Social Supports 107
vi Contents
PART III CREATING AGING-FRIENDLY COMMUNITIES
8. Approaches to Aging-Friendly Community Change 131
9. Community Planning Models 145
10. Cross-Sector Collaborations 163
11. Community Development Initiatives 181
PART IV AGING-FRIENDLY COMMUNITIES—CHALLENGES
AND OPPORTUNITIES
12. The Challenges of Making Communities More Aging Friendly 199
13. Conclusion: Aging-Friendly Communities—Present and Future 213
Appendix: Resources for Creating Aging-Friendly Communities 227
References 231
Index 265
INTRODUCTION
Why America’s Communities Must Become
More Aging Friendly
How do you want to live as you grow older? Will you be integrated into the life-
blood of your community, actively involved in meaningful relationships and
activities, able to go where you want—whether to the grocery store, the doctor,
a place of religious practice, a friend’s house? Or, will you feel like a prisoner in
your own home, isolated from the rest of the community, at the mercy of a world
designed for automobiles that you cannot drive safely? Increasingly, the answers
to these questions very much depend on the community in which you live.
This book is about creating communities that are “aging friendly”—places
where older adults are actively involved, valued, and supported (Alley, Liebig,
Pynoos, Banerjee, & Choi, 2007) in a manner that reflects their unique develop-
mental needs and priorities. We use the term aging friendly rather than age friendly
or elder friendly in recognition of the dynamic, transactional nature of the aging
process as it unfolds in an ever-changing environmental context.
The Future Is Now
Less than 20  years from now, 78  million Americans—fully 20% of the
population—will be over the age of 65. Twenty-three million—6% of the
population—will be over the age of 80. More than a third will be over the age of
50. If you were born before 1995, you will be in the majority. And, if you were born
before 1970, you will be one of those 78 million Americans aged 65 or older (U.S.
Census, 2014).
Already, many of America’s cities and towns have entered that future world.
If you live in Pittsburgh, Buffalo, Miami, Cleveland, Hartford, or Tampa–St.
Petersburg, more than 20% of residents are already over the age of 60. Eighty-nine
vii
viii Introduction
U.S. towns have at least 50% of their residents age 65 or older (City-data.com,
2015). In one third of U.S. counties, at least 40% of residents are aged 50 or older,
and in 87 counties, at least 50% of residents are 50 or older (G. S. Thomas, 2012).
How are America’s cities and towns responding to these changing demo-
graphic realities? Some are building more senior housing, adding paratransit
buses, or even converting elementary schools into senior centers. But, is that
enough? Think about your own community. Could you get around if you were
unable to drive a car? Are there housing options if you needed to downsize, were
unable to keep up with home maintenance, or wanted a more communal living
situation? Are neighbors available for a friendly chat or to help when needed?
How could you spend your time if you were no longer working?
Currently, the physical and social infrastructure of most cities and towns is
best suited to young families and simply does not correspond to the needs and
situations of an aging population. Developing a program focused on just social
services, health care, or even transportation is insufficient to enable older adults
to live full and meaningful lives. What we need are fundamental changes in the
design and social structure of our communities, based on a more nuanced under-
standing of the aging process and the challenges and opportunities afforded by an
aging population.
This Book—What You Can Expect
We have written this book to provide planners, policymakers, scholars, and
community members of all ages with an evidence-based approach for mak-
ing communities better places in which to age. Based on the need to redesign
America's communities to respond to the realities of a rapidly aging populace,
the book proposes an empirically based conceptual model of the characteristics
of an "aging-friendly" community and examines the types of systems that need to
change, the specific changes needed, and promising strategies for achieving those
changes. Throughout this book, we call attention to the importance of consider-
ing the needs and preferences of all segments of the population in current and
future efforts to understand and develop aging-friendly communities, and sug-
gest ways to address gaps in current knowledge and practice.
The book addresses five basic questions:
1. What does it mean for a community to be “aging friendly”? (For example, what
is the conceptual basis for developing aging-friendly communities, and what
are the goals that aging-friendly communities can and should try to achieve?)
2. What specific modifications can increase a community’s aging friendliness?
(For example, what is the evidence base for developing aging-friendly com-
munities, what changes have shown the most promise to enhance individual
and community well-being, and what have not?)
Introduction ix
3. How can change occur? (For example, what can be done to change commu-
nity systems and infrastructures to help them become more aging friendly,
what is being done, and how effective are current efforts?)
4. Do current efforts benefit all older adults and all types of communities? (For
example, have the needs and preferences of older adults from different races,
ethnicities, and cultures been considered, and are recommended changes fea-
sible or even desirable for all types of communities, including advantaged as
well as disadvantaged, urban as well as rural?)
5. Where do we go from here? (For example, what can and should be done at the
local, state, and national levels? What roles can and should older adults play,
and what additional knowledge and information are needed?)
Plan of the Book
Part I examines what it means for a community to be aging friendly in light of
evidence regarding the interrelationships between individual well-being and the
physical and social contexts within which individuals live. Chapter 1 describes the
challenges facing America’s cities and towns as a result of ongoing demographic
and social changes, as well as the opportunities that are emerging therefrom.
Chapter 2 examines the underlying purpose of creating communities that are
more aging friendly, namely, to enable community members to live fully through-
out their lives. Current conceptualizations of “healthy aging” are reviewed, and
a new, integrative model is proposed. Chapter 3 explores ways in which physical
and social environments can affect optimal functioning and well-being among
older persons and community members of all ages. Chapter 4 then summarizes
the characteristics that make a community aging friendly and the implications for
cities and towns wishing to promote the ability of community members to experi-
ence optimal well-being throughout their lives.
Part II examines the specific characteristics of an aging-friendly community—
with particular attention to the areas of mobility, social engagement, and physi-
cal and social well-being. Chapter 5 describes proven approaches for overcoming
mobility barriers through aging-friendly physical environments and transporta-
tion systems. Chapter 6 explores the evidence regarding community approaches
for promoting social engagement in later life. Chapter 7 examines the characteris-
tics of aging-friendly health and social supports for promoting personal well-being
in the face of age-related life changes.
Part III examines what communities can do to implement the aging-friendly
improvements identified in Part II and the effectiveness and limitations of spe-
cific approaches. Chapter 8 introduces a typology of community change mod-
els, based on an analysis of existing community aging initiatives in the United
States. Chapter 9 describes prominent national and international community