THE ACTIVE AGEING AT HOME (AA@H)BARCELONA DECLARATION
On the occasion of the Conference “Towards an active ageing at home” held in Barcelona, the 24-25th October 2012, the undersigning entities and persons
1. Preserving and improving the health and well-being of older people is a crucial public health issue of the 21st century. The ageing of societies introduces different organizational challenges and the need to increase support systems; it also brings new opportunities and benefits.
2. Policy for ageing should not be focused exclusively on addressing personal care needs; also has to address the inter-dependencies between the individual and private or collective environments. The home becomes increasingly important as people age due to emotional links, functional loss and the fact that adaptive capacities decrease with aging.
3. The spatial idea of home is fluid, therefore it extends beyond the household, including immediate neighbourhoods, meeting places, corner stores, and other dwellings. Home also plays a key role in enabling social interaction with family, friends and the wider community.
4. Old aged people spend 80 percent of their time at their residence and mainly report that they want to remain the rest of their lives in their homes and communities. Accessibility, temperature comfort, adequate equipment, fittings and security are some of the key objective aspects of decent housing for the elderly that should be included in design within attractive, friendly, activity enhancing and safe surroundings.
5. Different residential alternatives can be provided in order to allow older people to live independently in a suitable environment or to stimulate ageing in place. Ensuring the diversity of residential environments to accommodate the needs of different generations is a preferred alternative in order to avoid the ‘ghettoisation’ of older people into separate, isolated housing communities.
6. The home and neighbourhood are major settings for injury morbidity and mortality. Fallrelated traumatic injury represents a public health time- bomb. There is evidence for the costeffectiveness of preventing falls in all of the local community through the elimination of hazards in the built environment and the design of safe living conditions for all.
7. Intelligent investment in the homes and neighbourhood environment of older people leads to happier, healthier older citizens who are more able to participate and contribute to society. This also reduces costs of medical and social care, and consequently the investment pays both human and economic dividends. Environmental Interventions might include:
- Home modification.
- Older people’s access to small repairs and minor adaptations services.
- Good street design, access to public transport and diverse retail outlets. Such features may also encourage walking and other physical activity that prevent functional status decline.
- Special solutions for groups such as rural residents or older persons living alone.
8. The role of technology is crucial in promoting active ageing for older people living at home. Although some older people may not be keen to adopt new technologies, the combination of better usability, knowledge and marketing can bring successful implementations for innovations such as domotics, telecare, health smart homes or new assistive technologies.
9. Another implication of the demographic change is the emergence of a greying or silver market, currently addressed to people aged 55 or more. Being wealthier, more educated and technology consumer than the former generations, the baby-boom generation is better prepared to utilise innovations and, therefore, demand new products and solutions for autonomous living and well-being.
10.New products oriented to increase autonomy need not be restricted to any market niche; through universal design, the search for functionally less complex products and designs can attract the attention of younger consumers. The active ageing discourse applies not only to older adults, but to all age groups.
I. Active ageing at home is a concept tightly related to the World Health Organization (WHO) active ageing paradigm that fosters ageing-in-place as a strategy for the optimization of opportunities for health, participation and security as people age.
II. Active ageing at home should be understood as the possibility to continue living safe and comfortably in one’s own home and neighbourhood in older age, having access to services, facilities, and healthcare, in order to continue being and feeling part of the community.
III. Active ageing at home should be mainly implemented through policies that enhance quality of life at home and in the wider neighbourhood environments. These factors facilitate activity and participation along the ageing process, and have been proven to be social and economically profitable as compared to other alternatives.
PROPOSE THE FOLLOWING:
a. Ensure the participation of older people, including valuing their views and opinions and active involvement in decision-making. Bear in mind that people aged 65+ are not a homogenous group. Stimulate intergenerational cooperation. Develop collaboration frameworks with the users and their families with other professionals, private companies, third sector and public administrations.
b. Promote strategies, research and evidence or good practice- based programs, addressed to older people and other age groups, for better information and prevention regarding AA@H. Information programs should make available resources that facilitate living independently, and give older people control over making choices about care, carers support and home environment modifications.
c. Integrate different services, such as a one-stop shops to provide information about housing and care options provided by public or third sector agencies, including the following types of advice:
- Options of care in different settings, from staying at home to a care home.
- Residential alternatives, from adapting the home to residence in care homes, including searchable databases of different accommodations available.
- Suitable grants and benefits, including funding and financial advice for long term care and equity release.
- Rights to get the help, care and support when they are needed.
d. Conceive environmental modifications as a continuum of interventions -from home to community- in order to support both the activities and community participation that are necessary for successfully aging in place.
e. Create or promote intervention programs addressed to different professionals, entities and administrations, which share characteristics such as a holistic approach, consideration of general and specific individual needs – including subjective desires and emotional compromises -, cost-effectiveness maximization and sharing of information and experience. These programs might include:
- The provision of suitably designed dwellings. Include accessible design, features that enable different home activities (work, socialization, leisure…), adaptability and energy efficiency .
- Urban planning which addresses demographic change and creates age-inclusive places, allowing for easy access to services and amenities as well as the provision of intergenerational leisure and natural areas.
- Foster prevention and early intervention including identification of poor and inappropriate housing, in order to reduce its impact on health and social care costs through environmental interventions such as repairs, housing advice about safe living conditions, hazards recognition and falls prevention.
- Housing and neighbourhood renovation programs that include barrier abatement in access and building interiors as part of the rehabilitation process, and the inclusion of functional adaptation and rehabilitation technology.
- Create home maintenance programs, necessary for the growing numbers of poorer and older owner occupiers who cannot afford to maintain their own homes.
- Improve neighbourhood security, through awareness-raising and community action. The re-vitalisation of urban environments is an important option for change that should facilitate active ageing.
- Safe mobility. Improve connectivity through mobility planning, public transport integration and reduced fares for elder people. Set walking and cycling preserved routes that communicate with services and facilities stimulating intergenerational use. Consider the special needs of older adults who have difficulty moving around, as they are the most environmentally vulnerable individuals, and be aware of visual and other sensorial impairments in the different amenities.
- Put in place efficiency protocols for processing and delivery of services, to reduce waiting times for older people, especially when involving frail or disabled individuals.
f. Promote multidisciplinary cooperation across health, social care and housing. Reaching trans-sectorial commitments, addressed to implementation, will increase cost-effectiveness. The joining-together of services supported by different government or local agencies would be helpful toward reducing the cost burden for older people living in rural or low density areas.
g. Involve community, neighbourhood and local agents to further programs’ objectives. Through empowered and involved communities the impact and coverage of actions may be improved, including reaching isolated or less engaged older persons.
h. Improve formative programs with transdisciplinary specialization; greater professionalization of all home and community services addressed to older people.
i. Stimulate design for the co-creation of products and services for optimum quality, cost-effectiveness and a reduction in the adoption time. Design and promote with the universal design paradigm in mind.
j. Develop evaluation standards, such as reliable measures of the accessibility, participation or person-environment usable and meaningful fit. The efficiency level of programmes and policies must be compared and contrasted through benefits and savings quantification, as well as direct testimony of service users.
Discussed, amended and approved in Barcelona, 25th October 2012
Original draft by
Institut Universitari d’Estudis Europeus (IUEE)
Universidad Autónoma de Barcelona.
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