Photo: Janne Ulvinen, Image Bank of the Ministry of the Environment
Recommendations of the national development programme for housing for older people 2013-2017
Working papers of the Development programme for housing for older people 1/2018
Senior Specialist Sari Hosionaho and Senior Housing Adviser Raija Hynynen, Ministry of the Envi- ronment, 9 November 2018
CONTENTS
1. Development programme for housing for older people 2013-2017 2. The housing situations of the ageing population now and in the future
3. Preparing for the change in the population's age structure in municipalities and counties 4. A variety of housing options for older people
5. Communality of housing
6. Technologies for the ageing to support living at home
7. Age-friendly and memory-friendly residential areas and living environments 8. Service blocks
1. Development programme for housing for older people 2013-2017
The national Development programme for housing for older people, coordinated by the Ministry of the En- vironment, was implemented between 2013 and 2017. A large number of partners and stakeholders (central government, municipalities, non-governmental organisations, companies) and the partner and coordination groups supporting the programme participated in its implementation. A government resolution on the Hous- ing development programme for older population was issued on 18 April 2013.
The programme was aimed at influencing both the activities of older people themselves and the activities in the housing and construction sector. The target group was older persons aged 65 or over. The target group for measures related to forethought and preparation also included population groups younger than this (per-
sons aged over 55).
The measures in the programme included financial support for repairs of the existing housing stock, creation of new kinds of housing solutions and development of sheltered housing, development of residential areas from the perspective of older people and issues related to services supporting living at home.
Objectives
To improve the housing conditions of older people to enable them to live in their home for as long as possible, considering their state of health
To support older people in their own preparations and forethought regarding housing
To ensure that local authorities pay attention to housing issues concerning the ageing population in the planning of activities and finances
To steer the activities in the housing and construction sector to better meet older people's housing needs
To improve cooperation between the actors and create operating models that support housing for older people.
Mid-term evaluation and focus areas for the period 2016-2017
An external mid-term evaluation of the Development programme for housing for older people was imple- mented half-way through the programme, in 2015. The evaluation produced information on the societal rel- evance of the programme's objectives, the functioning of the programme and its outcomes and impacts, and recommended measures for the rest of the programme period.
According to the conclusions made in the mid-term evaluation, the programme had been successfully planned regarding the challenges identified in the operating environment at the preparation stage. The measures in the programme were suitable in terms of reaching the objectives. The aim was to reach the objectives through measures that would provide different impacts. A critical factor in reaching the set objec- tives was the adequacy of the resources and the question whether it was possible for the participating actors to commit themselves to promoting the objectives.
The most significant outcomes of the programme were related to promoting the retrofitting of lifts, increas- ing the appropriation for repair grants for dwellings as well as relaxing the criteria for them, production and dissemination of information to support forethought and preparation regarding the housing needs of older people, and development of new operating models and tools.
The measures of the Development programme for housing for older people between 2016 and 2017 sup- ported the following outlined policy measures:
Forethought and preparation
Improving the accessibility and renovation of dwellings
Quality of dwellings and diversity of housing solutions
Housing, services and the residential environment as a functional entity.
Between 2016 and 2017, the programme focused extensively on ensuring that attention would be paid to the development needs in the housing for older people in housing policy measures, the plans made by local authorities and the activities of the housing and construction sector. In connection with the programme, an experimental project on the coordination of housing and services was implemented. In addition, the sense of community in housing for older people was improved and age-friendly residential areas were developed.
Information on older people's housing situation was produced and tools were created for municipalities for the anticipation of housing needs and development of housing for older people. The measures also included promotion of technologies and renovation construction to improve the accessibility and safety of apart- ments.
Plan for the future
The Development programme for housing for older people ended at the end of 2017. The programme was the initiator in a process the final objectives of which have been set far into the future. For these objectives to be reached, measures must constantly be taken and information on the outcomes of the programme must be disseminated (e.g. operating practices and tools).
To promote the deployment of the outcomes of the programme and to continue development, the Ministry of the Environment drew up a plan for the future jointly with its partners and experts.
The four main themes of the plan are:
A. Improvement of the housing stock, production of new buildings and development of residential en- vironments
B. Technologies for the ageing to support older people to live at home
C. Activities and cooperation between local authorities in the development of housing and living envi- ronments for older people
D. Forethought and preparation
In a nationwide lift project implemented by the Housing Finance and Development Centre of Finland (ARA), a plan for the future was drawn up for the project itself.
Cooperation on the development of housing for older people will continue with the ministries, non-govern- mental organisations and other actors that participated in the implementation of the programme.
Recommendations from the most important reports drawn up in the Development programme for housing for older people have been compiled in this summary.
Further information: www.ymparisto.fi/ikaantyneidenasuminen (in Finnish)
2. The housing situations of the ageing population now and in the future
In 2030, one quarter of Finland's population, about 1.5 people, will be aged over 65. The Development pro- gramme for housing for older people strongly highlighted and brought to societal debate the need to take the societal change resulting from the ageing of the population into account in all sectors of society and at
different scales. The Finnish Environment Institute (SYKE) produced a report on the housing situations of the ageing population now and in the future, the findings of which provide information on the living areas of older people and the services available in those areas.
The report describes the regional distribution of older age groups with the help of register-based GIS data sets. The project produced information on the overall housing situation of older people and the differences between different areas, municipalities and different types of areas. The report also projected the regional development of older age groups until 2040.
Between 2004 and 2014, the number of residents over the age of 65 has grown by 219,000 people in built- up areas and by 12,500 people in non-built-up areas. While in 2015, 63 per cent of older people lived in cities or their outskirts, their proportion will grow up to 69 per cent by 2040. An increasing proportion of older people live in urban areas. There is an emphasis on well-functioning and accessible residential environments in the planning of urban areas. The need for services and housing solutions that support independent living of older people is also on the increase.
Urban residential environments are the environments that most attract older people. On the other hand, the level of migration among older people is low and they rarely move to an entirely new living environment.
Instead, older people mostly move into a more suitable dwelling in the residential area that is familiar to them.
In the countryside, the ageing population is concentrated in municipal centres, which attract older people from non-built-up areas to live close to the services. More than 40 per cent of the residents of new apartment buildings constructed in rural centres have been over 65 years of age.
When asked about their hopes about housing, older people living in urban areas especially mention centres and subcentres as suitable living areas. Migration over the last few years reveals that they mostly move to where services are within a walking distance and leave the car-oriented zones. However, almost one third of older people in urban areas live in car-oriented zones outside centres.
The ageing of the population in urban areas creates pressure on the development of well-functioning and accessible residential environments for those who want to move from detached houses to live closer to the services. Service solutions are also needed for those who stay in less densely populated areas.
The focus of services and housing for older people is shifting from institutional care and sheltered housing to supporting independent housing. However, this requires that the services needed by older people in the residential areas are easily available. By surveying residential areas with a large proportion of older residents, it is possible to highlight development needs and take into account accessibility and the housing solutions that support older people in community planning.
Development of residential areas to meet the needs of older people supports both their physical and mental wellbeing. It is important to promote the opportunities for older people to their shopping themselves, move around safely in their neighbourhood and maintain social contacts.
Most older people stay in a familiar apartment and living environment, but their hopes regarding housing also reveal a need for the neighbourhood services offered by city centres and municipal centres. The longer lifespan should also be generally taken into account in the planning of residential areas as it means that the proportion of the nuclear family stage in a person's lifetime is becoming shorter and people live a longer proportion of their life in small households.
Link to the publication (description sheet in English): The housing situations of the ageing population now and in the future. 2017. Reports of the Finnish Environment Institute 20/2017. (pdf)
3. Preparing for the change in the population's age structure in munici- palities and counties
The report Action by municipalities to support the older population in living in their own home and to develop the living environment investigated the implementation of the Act on Care Services for the Elderly in terms of four themes:
1. Strategic planning
2. Assessment of the housing and living conditions of older people, taking into account the prevention per- spective
3. The role and activities of councils for older people in issues related to older people's housing and living environment
4. The health and social services reform and its impact on the development of housing for older people Local authorities lack an overall understanding of a good life of older people and an understanding of their housing and living environments. The plans related to the Act on Care Services for the Elderly (Act on Sup- porting the Functional Capacity of the Older Population and on Social and Health Care Services for Older People 980/2012) mainly focus on the planning of the services. The link between housing, services and living environments is emphasised in them. During this decade, municipalities have particularly developed services that support living at home and a speedy discharge from hospital. The report introduces the operating mod- els of municipalities and their cross-administrative cooperation. For example, good results have been achieved through home visits that support older people's wellbeing and independent coping and through the activities of councils for older people.
Link to the publication (description sheet in English): Preparing for the housing needs of the older people in municipalities. Reports of the Ministry of the Environment 4/2017. (pdf)
Councils for older people have an important role
The statutory councils for older people play a central role in the development of older people's housing and living environments. The role of the councils for older people has strengthened along with section 11 of the Act on Care Services for the Elderly as the councils became statutory on 1 January 2014. Councils for older people were common even before this. Under the law, councils for older people should be consulted in all matters concerning older people from planning to impact evaluations (Act on Care Services for the Older People, sections 5, 6). In addition, councils for older people must be given the opportunity to have a say in the planning, preparation and monitoring of activities in those municipal sectors that are important in terms of the older population's wellbeing, health, participation, living environment, housing, mobility or ability to cope with daily activities.
According to The role of the councils for older people and their opportunities to influence the development of housing and living environment for older people report, the councils for older people in municipalities are not, however, able to influence the preparation of older people's issues early enough. Councils for older people are mainly consulted about health and social services, and less often about urban planning, land use planning or housing. The local authority must set up a council for older people to ensure that the older pop- ulation will be able to participate and influence matters.
The findings of the report showed that all municipalities do not have an understanding of how the councils for older people can support decision-making. One in four representatives of the councils considered the council's chances to influence matters to be limited. Councils for older people have contributed to issues that are important in terms of the smooth daily life of older people, including sufficient lighting along the routes, installation of automatic doors in agencies, prevention of pavement slipperiness and public transport services in municipalities.
Link to the publication (in Finnish): The role of the councils for older people and their opportunities to influ- ence the development of housing and living environment for older people. Working papers of the Develop- ment programme for housing for older people 2013–2017 1/2017, Ministry of the Environment. (pdf)
Model for anticipating older people's housing needs and preparing for them
At the local level, municipalities have a key role in anticipating the needs resulting from the ageing of the population. The joint development project of the Ministry of the Environment and local authorities created a foresight model for anticipating older people's housing needs in municipalities. Material from the Finnish Environment Institute, national statistics and a survey submitted to local authorities were used in the exam- ination. As a result, forethought and preparation measures were created at the municipal level. They were formulated at the foresight workshops organised jointly by housing and technical services, health and social services and councils for older people. Consultation of the residents and particularly the councils for older people is important in the preparation. A model for analysing the needs from four perspectives was devel- oped for foresight work. The model is described in more detail on the website on older people's housing (in Finnish): http://www.ymparisto.fi/fi-FI/Asuminen/Ikaantyneiden_asuminen/Kunnat_ikaantynei- den_asumisen_ja_elinymparistojen_kehittamisessa
The forethought and preparation work was based on the perspectives of the above-mentioned model. The findings reveal that the central challenges municipalities face in terms of housing for older people are largely similar. A challenge all of them have in common is the rapid increase in the number of older people especially in the age groups of those aged between 75 and 84 and those aged over 85.
The measures carried out in municipalities relate to the development of residential areas, which also includes the use of the facilities of local authorities and the third sector. Another shared theme in the measures pro- posed by local authorities are activities related to the provision of advice, guidance and information, also on housing. Municipalities are developing the provision of advice and guidance for older people to enable them to anticipate their life and take advantage of repair grants. A third shared practical measure are municipali- ties' practices concerning selling or leasing sites and the changes made in these practices. Accessibility factors in particular should be considered as a central part of municipalities' plot allocation and land use planning policies.
In the development project, anticipation and preparation was carried out especially in cities. The develop- ment work has benefitted the preparation of housing policy strategies in municipalities and in the county.
The model can also be easily applied to residential area -specific examinations.
Municipalities should make better use of their information sources. This development work was largely based on the statistical material ordered from the Finnish Environment Institute. Although municipalities have a lot of knowledge and information, the challenge they face is how to organise joint debates and evaluation based on that information. The findings from the surveys implemented in the project were similar to those from national studies. Municipalities could utilise nationwide surveys and carry out anticipation by comparing their own population projections to the national findings (e.g. Asukasbarometri, "Residents' barometer"). The surveys carried out benefitted municipalities by providing information on older people's housing needs and their expectations. Based on the experiences gained in the project, it is also important that municipalities consult their residents and organise joint discussions.
Link to a press release on the development project (in Finnish): Ministry of the Environment's press release on the outcome of the development project, 12 January 2018
Cooperation between counties and municipalities is required in the provision of housing for older people and special groups – cooperation structures still few
If the planned regional government, health and social services reform is carried out, it will be important for counties and municipalities to cooperate in housing issues concerning older people and people with special needs. The reform will split the tasks related to housing and housing services to different bodies as the pro- vision of health and social services will become the responsibility of the counties. Housing and community planning, which are the responsibility of the municipalities, play a crucial role in supporting living at home and the development of different forms of housing.
The report Cooperation between counties and municipalities in housing and residential services for older people and people with special needs, implemented through the Government's analysis, assessment and research activities, describes the current state of housing, the provision of housing services and the cooper- ation related to them and proposes cooperation models for the future county model. There are few com- pleted cooperation structures between the counties and municipalities as yet, but cooperation between dif- ferent administrative sectors within municipalities is common. These cooperation structures and processes should be redesigned in the regional government, health and social services reform so that the customer can be provided with an apartment and services that meet his or her needs and support living at home.
Link to the publication (description sheet in English): Cooperation between counties and municipalities in housing and residential services for older people and people with special needs. Prime Minister’s Office Re- ports 18/2018 (pdf)
4. A variety of housing options for older people
Older people are a heterogeneous group in terms of their wealth, housing conditions, existing safety nets and functional ability. Therefore, more versatile options that also support a sense of community must be offered to them.
According to the report The demand for housing solutions for the older population and how to meet the demand, the majority of older people want to live in apartment blocks close to services in the future. What they hope from their housing is convenience, accessibility, the company of people of all ages and a commu- nity spirit.
In the future, an increasing number of older people will live on their own. The report emphasises the im- portance of producing housing that enables people of all ages to live together and help each other. Apart- ment buildings and residential blocks designed solely for older people often isolate their residents from the rest of the neighbourhood.
The report also shows that most municipalities have not made sufficient preparations for dealing with the ageing of the population and its consequences in terms of housing. Municipalities even have a partly lacking understanding of the size of the older population and their wealth and income levels, housing needs and distribution within the municipality. Lack of information poses the greatest challenge to planning sufficiently diverse housing production.
Many municipalities solved the housing needs of older people by enhancing the accessibility of the current housing stock. However, accessibility and functionality should be examined from a wider perspective than that of an individual apartment or building. It should cover the entire residential environment and is visible for example as access to services. Support for repair construction should be continued so that the current housing stock would in future be suitable for as many residents as possible. Right-of-occupancy housing for seniors should be built in large localities in which the need for housing is great and the population is large enough. In smaller localities, many risks are involved in right-of-occupancy housing.
There are already a large variety of housing solutions available today. A wide range of rental apartments, right-of-occupancy dwellings and owner-occupied dwellings for older people are available in Finland. Service blocks, generations blocks and housing for older people in rural environments have been built over the past few years. In addition, investments in communal activities have been made by means of construction. The problem is therefore not a lack of options.
Housing-related decisions must be made well in advance. The public sector should take an active role in disseminating information and supporting anticipation. Older people's housing should not be examined as a separate issue but from the viewpoint of a built environment that supports people's functional ability and wellbeing and from the viewpoint of the development of housing. Such necessary decisions can be justified by the fact that they affect the whole population. Supporting people's functional ability and wellbeing are topics that are easier for everyone to identify with. For example, accessibility is not something that only concerns older people: the lack of lifts and having to walk some steps before entering the lift make buildings less accessible also for those who have a pram with them or carry shopping.
Financing and other solutions
One of the central conclusions in the report is that there is a need for central government to support both new construction and repair construction also in the future. Support should be directed to housing solutions for older people with the lowest income. The financial support granted by the Housing Finance and Develop- ment Centre of Finland (ARA) will have a significant role in safeguarding reasonably priced housing also in future. Officials from both ARA and the interviewed ministries have very similar views on measures aimed at developing the housing of older people. In their opinion, central government should support housing for which there is a long-term need. Construction must not be an isolated activity, but municipalities should implement their housing policies and develop housing in the long term. The housing solutions supported by ARA include housing networks, multigenerational building blocks, service blocks and different hybrid building solutions. The representatives of central government particularly stress the importance of municipalities' commitment to construction projects and the need to link the projects to the municipalities' long-term plans.
Banks are the providers of funds that can affect the housing solutions available to older people. This usually means a traditional loan for purchasing a dwelling. The owner of a dwelling may also release the capital tied to the dwelling by taking a reverse mortgage, which means that the owner will pay only interest for the mortgage during his or her lifetime. Reverse mortgages are not very well known in Finland as yet, and they are not widely available. The mutually diverging practices of banks also pose a challenge. Reverse mortgages are available in several European countries and in Australia, Canada and the United States.
One possible funding solution is impact investment, which would be implemented as Social Impact Bonds (SIB). In Social Impact Bonds, private investors would invest in new housing solutions and public actors would repay the investments and interest if the set targets have been achieved through the investments. This re- quires that clear and diverse indicators are created. Impact investment could be used to improve the sense of community in housing, the maintenance of people's functional ability and promotion of wellbeing. Impact investment solutions could also speed up the construction of different service blocks.
Recommendations for development
In future, new versatile housing solutions that emphasise the sense of community should be developed. Dif- ferent service block solutions, generations blocks and solutions involving communal housing across genera- tions are good examples of this. if necessary, they can serve a basis for development. Additionally, function- ing housing concepts from across the world can be utilised and applied to local conditions. They help to create a public debate on the subject and promote the generation of viable solutions. In its policy outline, ARA has already taken into account both community-based and cross-generational housing solutions.
Versatile advice and guidance on housing should be targeted at older people. Healthy pensioners and older people who are still working must be encouraged to consider their housing decisions well in advance. Service points providing advice for residents should be established in municipalities to offer information on housing and housing solutions and advise on repair construction on a one-stop-shop basis. With guidance and advice, older people become more aware of new building production, rental housing, right-of-occupancy housing and the forms of support related to housing. When the turn-over residents is faster, municipalities will also become aware of the repair needs in housing at an earlier stage and the housing stock will stay in a better condition.
Local authorities need to survey the condition of the current housing stock, the number of older people in the residential areas now and in the future, their income levels and wealth, and the form of housing and relate this information to housing production and the planning and development of residential areas.
When the Development programme for housing for older people end (2017), central government should continue to invest in improving the housing conditions of older people, supporting their housing solutions and strengthening anticipation and preparation. The diversity of housing production must be ensured in new construction. In the future, the greatest pressure for government-subsidised construction of new housing for older people will be in city centres and suburbs. The housing should be increasingly centralised in the vicinity of services and along good transport connections. One example is the construction of apartments in connec- tion with or next to shopping centres.
Support for repair construction must be continued so that the existing housing stock can be used by as many residents as possible also in the future. Retrofitting of lifts plays an important role in repair construction. It must be ensured that solutions maintaining and promoting people's functional ability are widely taken into account (e.g. accessibility, safety, flexibility in terms of alterations in apartments and technological solutions).
New housing production should be made more diverse with the help of land use planning. Solutions that support multi-generational housing are a good example. We must ensure that accessibility and functionality are taken into account in land use planning more widely that just from the viewpoint of individual buildings.
For example, this means that parks and services can be accessed by the residents. Taking this into account supports families with children, older people and other groups of residents alike. This way, housing is better linked to decisions concerning land use, transport, services and industries.
Link to the publication (description sheet in English): Demand for housing solutions for the older population and how to meet the demand, 2017. Reports of the Ministry of the Environment 16/2017. (pdf)
5. Communality of housing
A residential area with a strong community spirit is a good place for everyone to live in. The ASUVA re- search project on new housing options and well-being in old age surveyed Finnish and international measures for improving the communality of housing. It looked at measures that support the sense of com- munity and their links with residents' wellbeing and participation in the community. In addition, it was in- vestigated how different models of housing meet residents' need for assistance and services. The project was implemented as part of the Government plan for assessment, analysis and research for 2016 and the Development programme for housing for older people.
According to the findings of the ASUVA project, communal activities promote the wellbeing of older people and their participation in the community. They increase older people's social contacts, make helping each other easier and reduce the feeling of loneliness and insecurity. Successful operating models are resident- oriented and based on cooperation between residents, non-governmental organisations, municipal actors and service providers. Accessible and safe residential environments and versatile shared indoor and out- door facilities promote the sense of community.
The findings support the message that more attention must be paid to the qualities, accessibility and pleas- antness of the built environment, facilities and residential areas as well as the to the availability of services and to green spaces. The creation of good residential environments requires the cooperation of many actors.
Cooperation is needed across sectoral boundaries at the municipal level and
between the public, private and third sectors. As regards the development of residential areas, the partici- pation of residents as well as cooperation between residents of different ages is central for the success and continuity of the activities.
A key finding in the research project was that the perceived wellbeing and quality of life can be improved by increasing social activities and the interaction between the residents in the area. Therefore, supporting social relationships and joint activities need to be made a central part of the development of residential areas. It is important to discuss the direction of housing policy and how housing can be better steered to take into con- sideration the needs and participation of the ageing population. To support local experiments and develop- ment, housing policy and housing solutions need to be outlined and guidelines issued for combining the viewpoints of housing, services, care and social inclusion.
Recommendations for development
The activities must be resident-oriented, which requires that citizens themselves assume an active role, en- gage in the activities and take responsibility for the continuity of the activities. On the other hand, other actors such as the authorities and service providers must see citizens as partners, not as objects of the activ- ities. The experience of participation arises from the sense of being able to influence matters concerning one's living environment and shared activities. Residents must be given the opportunity to engage in the planning, implementation, evaluation and development of the activities. Establishing and making use of re- gional groups in the planning of services and in regional and urban planning is an important way to create sustainable communal activities in the areas. Councils for older people can serve as one forum for regional planning. The different forms of activities may include regularly organised residents' meetings, thematic working groups and workshops arranged by different actors. Groups aimed specifically at seniors are needed but so are also joint groups of people of different ages. We know little about the hopes and experiences of people with memory disorders and methods need to be developed that make it possible to also take into account their points of view when implementing resident-oriented approaches.
Many people are interested in voluntary work and volunteers may be a great benefit when communal activ- ities are set up. Inspiring residents to become volunteers requires giving them the opportunity to influence the content and forms of the activities and ensuring that not too many responsibilities, such as monitoring and reporting, are imposed on them. To support the wellbeing of volunteers, it is important to organise train- ing and opportunities to give feedback and network with others. The creation of regional networks that or- ganise voluntary activities supports community-based activities.
A resident-oriented approach is linked with localness. It is important to base the development of housing and residential areas on the needs and hopes of local actors and to make use of local actors and their expertise and the financial and social resources and facilities. The activities may be launched by citizens, the public sector or third-sector actors. It is important that these actors work in cooperation and are equal. It is also important to always adapt the operating practices to local conditions, needs and resources.
The role of public actors (municipalities and in future also the counties) may be to launch the activities or only to support them. Municipal actors may help to bring continuity to the activities by supporting them with small financial grants or work input. Municipalities play an important role in local community centres and meeting places (the “Lähitori” concept) and in service centre activities as they include communal activities in their service agreements. This shows that social inclusion and joint activities are valued and it helps to estab- lish their position.
It is important that municipalities consider the preconditions for communal activities in the planning of land use, regions and transport. They can reserve plots for communal housing and allocate them to non-profit developers that construct reasonably priced communal housing. Accessibility and functionality as well as the versatility of the facilities need to be considered in construction and transport planning. Central govern- ment's role in local activities is to support the preconditions for the activities by means of legislation and financial support. Collaborative group construction can be facilitated through legislation and start-up grants can be used to support launching of activities.
Cooperation of several actors is important for various reasons. The participation of local actors helps to use the resources more effectively and to survey the need and hopes of different groups. The involvement of local actors helps in reaching different groups of residents and, on the other hand, improves their access to the activities and strengthens the continuity of the activities. Companies, non-governmental organisations, parishes, residents' associations and residents' informal hobby groups can be included in projects and activ- ities.
Assisted living facilities, day-centres and other suitable spaces for the activities should be developed into regional centres that offer activities for different user groups. Meetings of hobby groups (arts, dance and sports organisations) are a good example as their activities can also be offered to the residents. The local authority may subsidise the costs of using the facilities or include access to the facilities for non-profit actors in the service agreement. Companies or entrepreneurs may use the facilities to set up services (full-time or part-time) that are open to all residents in the area. As a result, the use rate of the facilities improves and the entrepreneurs gain a permanent customer base. Municipalities and other actors may use the facilities to organise events, attracting users of different ages and creating activities to the facilities. For example, the restaurant services of assisted living facilities are commonly offered to the other residents in the area.
Cooperation with educational institutions is established activity in assisted living facilities in some localities, but it can be increased by offering work placements in these facilities to students. Accommodation for stu- dents in response to organising communal activities has also been tested in assisted living facilities. Regional cooperation networks can explore and supply information on cooperation opportunities to the actors. The responsibility for the practical operation should be given to an established party, such as a community coor- dinator employed by the municipality.
Strengthening the sense of community in 24-hour care housing (assisted living facilities) and other housing services requires closer engagement of the family and the close community in supporting persons with memory disorders. It requires cooperation between the employees, the next of kin and volunteers at the local level. A resident-oriented approach and cooperation between several actors often require changes in the operating cultures of workplaces.
Housing services targeted at people with memory disorders should utilise local resources and cultural knowledge. Localness supports the wellbeing and continuity of the lifestyle of residents with memory disor- ders. Operating practices that meet the needs of individuals and guarantee continuity and a sense of com- munity are needed in the implementation of services. Communality should be made a condition for obtaining funding and a criterion in competitive tendering and in assessing the quality of the service. Because of its positive impact on wellbeing, communality should be taken into account when the planning and construction of the facilities and service provision are put out to tender or decisions concerning the funding of housing
are made. Communality should also be looked at when services are assessed and it should be considered in development work.
Link to the publication (description sheet in English): Communality of living and well-being in old age, 2017.
Publications of the Government´s analysis, assessment and research activities 47/2017. (pdf)
6. Technologies for the ageing to support living at home
Technologies for the ageing provide new types of opportunities to support living at home. Technologies for the ageing are IT solutions and technical solutions used to maintain or improve the quality of life, wellbeing or health of an older person. Through versatile use of technology, coping in the daily life can be supported in a meaningful way and security can be provided both to older people and to their families.
The Development programme for housing for older people implemented a report on international smart technology solutions and new innovations supporting older people to continue living in their own homes in cooperation with the Ministry of Transport and Communications and Tekes, the Finnish Funding Agency for Technology and Innovation. In the report, the concept smart technologies was mainly used to refer to wellbeing, security and ICT technologies with some kind of data connection. Especially in Japan, a great deal of development work has been made in robotics and it has been subject to a lot of interest, but genuinely useful and extensive robotics applications for homes are yet to be found. In addition to Finland, the report also looked at the situation in Japan, the United States, the Netherlands and Denmark.
The report also provided information and perspectives on how the utilisation of technological solutions can be promoted to support older people living at home. A central challenge in the development of technology to support living at home is how the focus can be changed from the actual technology to its utilisation. The report saw the role of technology as an aid, a functioning link between the older person and the person's needs. The main interests in the report were the human needs of older people: social contacts and safety.
The report describes examples of the most recent smart technology solutions and innovations in the market for supporting older people to live at home. The report provides information to older people and their fami- lies on smart technology solutions that support communality and safe living at home and how these are combined in the so-called smart homes.
Technology also has its downsides: it costs and the implementations often require professional help. Data security and the protection of privacy are often easily at risk when new technologies are introduced. Increas- ing use of technology may also lead to a situation in which older people have even fewer social contacts. It should also be noted that differences of wealth create inequality in terms of how older people can benefit from of technology. Someone may not be able to afford the monthly payment for a broadband modem while even the installation of extensive home automation systems and ordering home services enabled by new technologies is not an obstacle to someone else.
The public sector, the public debate and values play a central role in ageing. Do we see ageing as a cost or is our primary objective to ensure an equal and dignified old age for everyone? This is where different countries take a different approach. The implementation of technology to help older people has been taken furthest by Japan and Denmark.
The dramatic change in the dependency ratio has led to a situation in which it is no longer possible to rely on care provided by one's family and relatives and help is increasingly sought from technology. However, tech- nology has primarily been designed to help people working in the care sector. In Japan, however, the pro- duction of new services and technologies may be speeded up by the country's new insurance system, which gives older people an extensive freedom to choose new services and products that support living at home.
In Denmark, the central government has set as its starting point digitalisation and digital services in many different sectors. This applies to the use of services by private individuals as well as companies. Through legislation, the use of digital services has been speeded up and is required from everyone. A wide use of mobile IDs, the national data security requirements and a robot strategy show that Denmark is taking the utilisation of new technologies seriously.
The Netherlands as well as Finland support older people living at home in many ways and bring services to their homes. In this work, even very traditional internet and mobile technologies can already be of great benefit to service providers, making their work more effective if implemented boldly. In the Netherlands, the experiences of older people as customers are also taken into account and as a result, their opinion has an impact on the development of the services.
Also in the United States, bringing the services to homes is a rising trend in supporting living at home. Differ- ent forms of sheltered housing and residential areas for older people are becoming increasingly popular. The downside is that all older people cannot afford them, but the choice of form of housing depends on the person's wealth and insurance cover. There is no national strategy concerning older people and technology at the level of the federal state. Research and development in the sector are carried out across the country.
The level of technologies in Finland is good by international standards. Compared with any country, we have good and reasonably priced data connections and digitalisation has been given a prominent role in the Gov- ernment's key projects. However, the utilisation of technology cannot progress before the shared standards and interfaces required by smart technologies are complete, uniform and available to everyone.
A central conclusion based on the different areas of the report is that, in all of the countries studied, a sense of community and belonging to a community (e.g. neighbours, neighbourhood, peer support, support net- work and society's safety net) is the need most commonly brought up by older people. Technology companies provide a variety of applications for older people to keep in contact with their families and the providers of services. For example, video calls are an easy way to keep in contact but, because older people still continue to feel lonely, they do not remove older people's need for physical contact with others. In the next five years, different robotics solutions are likely to provide older people with both “someone to talk to” and an oppor- tunity to communicate with a virtual person in their daily life.
Smart household devices, such as smart fridges, may also be introduced for the use of older people in the very near future; however, they will be available to very few people. When smart technologies are purchased for older people or for people of any ages data security must be taken into consideration in the purchase decisions and in the implementation of the technologies. This is where older people need help from their families or professionals. The role of data security becomes emphasised especially in data security and iden- tity management because the provision of services may require monitoring/supervision of older people, which for cost reasons is produced through automation. If data security is poor, there is a risk that infor- mation can be accessed by wrong parties and used for wrong purposes. The risks related to data security should be taken into account in smart technologies and the challenges they pose to business activities should be understood. This provides international market potential for Finnish expertise in the data security sector.
To be able to better respond to older people's needs in the future, we need uniform technical platforms into which different technologies can be integrated. However, technologies alone are not enough; different ser- vices for the needs of older people should be created around them. At the moment, technology companies are not sufficiently acquainted with the needs of older people and the interfaces in the technologies are often unsuitable for older people. The companies should therefore encounter older people in their operating en- vironments although this may consume resources from technological development. If we want to increase the use of technology in the daily life of older people, the technologies can no longer be the primary concern.
Link to the publication (description sheet in English): . Reports of the Ministry of the Environment 7/2017.
(pdf) Smart technology solutions support the elderly to continue living in their own homes
7. Age-friendly and memory-friendly residential areas and living environ- ments
The creation of age-friendly residential environments entails features that are very similar to any resident- oriented planning and design of residential areas, but its emphasis is on the viewpoint of older people. When the point of view is that of older residents, attention is above all paid to the accessibility of the environment, suitable housing solutions, availability of the services and the opportunities for older people to participate.
Attention has been paid to age-friendliness particularly when the aim has been to develop service blocks that also meet the housing and service needs of older people.
According to WHO, the age-friendliness of cities and communities means promoting active ageing by offering older people opportunities for health, security and participation in order to enhance their quality of life. The aim is to make cities and their structures, buildings and services suitable for and accessible also to older people with different needs. The WHO's policy outlines are based on the Global Age-Friendly Cities project (2006-2007), in which 33 cities from across the world participated. The project gathered information from older people, their carers and service providers about factors in the environment that either promoted or were an obstacle to age-friendliness. The result was a guide and a check-list of the features that define the age-friendliness of cities.
The residential environment supports older people's wellbeing and independent life in many ways. Accessi- bility and safety are prerequisites for older people's participation in activities that are meaningful to them and enable them to engage in the activities of their own community. Even if they require very few services, many older people need accessible and functional conditions in terms of housing, taking care of errands and participation. At the end of the 1990s, the UN highlighted the concept of “ageing in place”. This means that an ageing person can continue to live in a place that is familiar to him or her. Familiarity is defined in relation to the older person and may mean a long-term dwelling, lifelong home region or residential area. Familiarity may also not be defined until in later life when the person chooses the place to move or return to and where the person hopes to be able live his or her old age.
The safety of the residential environment means accessibility, trust and openness of attitudes. The safety of the built environment means that residents of different ages can conveniently run errands, go to work and to school, engage in hobbies and spend time in it. A safe environment encourages people to take their place in the shared outdoor spaces. This requires trust in the environment and other people. Solutions that con- tribute to safety are very practical and have to do with lighting or materials considered in the plans for gar- dens, parks and pedestrian zones. In a well-designed environment, the facilities and activities are easy to use and logical, reducing accidents and enabling an independent life also to persons who in a poorly functioning environment would depend on the help of others.
In Design for All (DfA/Universal Design), which takes into account all different groups of residents, does not design special solutions only for some groups, such as children or older people using mobility aids, but the solutions are suitable for all residents. Accessible solutions make life easier for everyone and reduce the need for special solutions and, consequently, also the costs. Designers and builders can in their work make the final result suitable for as many resident groups as possible regardless of their functional ability.
Experts of different fields can in their work assess the safety risks related to housing for older people and promote its safety. Advice and expert guidance are needed in the planning and design of alterations and in the assessment of the costs, even though it is the residents themselves who make the decisions on the repairs and are responsible for the costs. Older people on a low income cannot always afford the costs of planning and implementing the necessary alterations in their homes themselves and the repair projects implemented by housing companies may also result in costs that are too high in terms of their ability to pay. The resident may therefore have to move somewhere cheaper. However, moving is a major effort for older people and as a result, their condition often weakens. The burden caused by moving increases if the person has to move away from the familiar residential area and give up the social networks. The Housing Finance and Develop- ment Centre of Finland (ARA) supports retrofitting of lifts in old buildings and removal of obstacles to mobility in residential buildings by a maximum of 45 per cent of the building costs. ARA awards repair grants for up to 50-70 per cent of the approved repair costs to older people (65 years and older) on a low income or per- sons with disabilities.
The age-friendliness of residential areas is not an achieved state but a continuing development process. What is central to this process is to listen to the older residents and their families and to involve them in the devel- opment of the residential areas. The councils for older people are central also in the implementation of age- friendly solutions as they often participate in the preparation of policy strategies on ageing and issue opinions on land use planning and construction projects. In addition to older people and their families and councils for older people, other actors are also needed in the development of age-friendliness. In the planning and design stage, there is cooperation with the municipality's different administrative branches, especially those responsible for health and social services, land use planning and construction, and with local companies and non-governmental organisations.
Older people can be supported to live at home also through solutions affecting the community, such as land use planning and community planning. Decisions made in land use planning and transport arrangements contribute to older people's opportunities to be mobile and function in their living environment. As the pop- ulation ages, the land use planning and transport planning of residential areas should increasingly be looked at from the point of view of the wellbeing, smooth everyday life and participation of older residents.
In an age-friendly environment, land use planning is used to secure the area's diverse structure, sufficient neighbourhood amenities and their accessibility through traffic and transport connections and to support community activities through space solutions. The connection with nature is a fundamental human need and with ageing, the nature's importance for wellbeing increases. Although getting older makes maintaining the relationship with nature more difficult, good community planning solutions support older residents' access to nature in the neighbourhood.
Municipalities' strategies and methods of developing the community structures and residential areas vary greatly. Large and small municipalities as well as municipal centres and sparsely populated areas face a very different situation. Many rural municipalities have a large number of older people and therefore need to increase the services required by them. Older people in municipalities with a declining population also hope that they could live in their home as long as possible. However, the distances to services may be very long in sparsely populated areas and public transport not frequent.
Memory-friendly and age-friendly housing and living environment
The living environment plays an important role in the wellbeing and functional ability of older people. How- ever, too little attention has so far been paid to it by municipalities in their decision-making and community planning. Older people themselves hope they can live safely in their own home. Living at home is also the central objective of ageing policy. Memory disorders are the primary reason why older people need services at home and sheltered housing. People suffering from memory disorders are currently estimated to number almost 200,000 and more than 7,000 of them are still in working age. As the population ages, the number of people with memory disorders is projected to multiply by 2050.
Memory disorders start to make it difficult for the person to interpret the environment and operate in it at an early stage of the illness. The person's physical functional ability may remain good for a very long time, but functioning at home and mobility outside home become difficult because of the loss of memory and difficulties in learning. Advancing memory disorders do not affect only the person with the illness but also people close to that person as they are concerned about his or her everyday safety.
To enable living at home in spite of illnesses and changes in their functional ability, the needs of older resi- dents should be better taken into account in the planning and development of residential environments. If the living environment supports continued independent life, older people with memory disorders can con- tinue a dignified life at home and this can be arranged cost-effectively in terms of the services.
The Memory-friendly and age-friendly housing and living environment guide looks at how it is possible to develop the memory-friendliness and age-friendliness of the existing housing stock, new buildings and the housing solutions targeted at older people. Residential areas and their services and opportunities for partic- ipation are assessed as well as the buildings and apartments and their surroundings.
The guide introduces the international trends in memory-friendliness and age-friendliness and the relevant concepts and viewpoints, such as Design for All and social inclusion. The changes in the capacity to function that occur in connection with ageing and memory disorders are also taken into account in the development of housing. The guide contains a wealth of examples of useful solutions. The residential area, the residential building, the yard surrounding it and the apartment are examined in more detail through the needs of older people and people with memory disorders. Also, the opportunities to take advantage of technology are taken into account in the ways housing is supported. In the end, a checklist of memory-friendly and age-friendly aspects is presented to support the planning and design of residential environments and it is explained where additional information on the subject can be obtained.
The guide is targeted at all who participate in the planning, design and development of housing, apartments and residential areas and in the promotion of health and wellbeing in municipalities and residential areas. It also provides ideas to older people, people with memory disorders and their families and friends for assessing and planning their housing.
A residential area that is memory-friendly and age-friendly is accessible and easy to perceive. The communi- cation of information related to services and the signposts in the residential area should be clear. A residen- tial environment that has been designed this way benefits everyone and particularly those with a reduced ability to function.
In a memory-friendly and age-friendly residential environment, older people and persons with memory dis- orders are valued and equal residents and feel part of the local community. The residential environment has enough services required by older people (advisory services, health and social services and neighbourhood services) and they are easily accessible. Activities, hobbies and opportunities for meetings people across gen- erations are also available for older people.
Alzheimer's Disease International has been promoting the development of memory-friendly communities globally and the World Health Organisation (WHO) has promoted age-friendly planning. The focus areas in
these approaches are largely similar and the approaches should therefore be combined in the development of residential environments. They are based on resident-oriented planning in which also residents with a reduced functional ability who need support for participating are included.
The objectives of the memory-friendliness and age-friendliness of residential environments:
supporting older people's opportunities for active participation, wellbeing and safety
offering housing solutions to older people and people with memory disorders in addition to ordinary housing
planning of residential environments with various actors such as councils for older people
paying attention to the accessibility of the residential environment and housing and making use of technologies that benefit older people
ensuring that the services required by older people are functional and accessible
taking into account weather conditions and the special features of small, rural areas in planning
ensuring that older people and people with memory disorders can use their capabilities in their living environments, that they are valued as equal residents and that they live together with everyone else.
enabling older people and people with memory disorders to engage in the activities of their own community and to participate in the development of their neighbourhood together with their family.
providing in different ways and in a manner they understand information on services, opportunities to engage in hobbies and participate to older people and people with memory disorders
ensuring that the development of the memory-friendliness and age-friendliness of the residential area is resident-oriented and benefits people of all ages.
Creating memory-friendly residential environments and communities is aimed at enabling a better life for people with memory disorders and their families and at supporting them to live in a normal residential envi- ronment. It is essential to change the attitudes to memory disorders, promote social inclusion of people with memory disorders and increase their safety and wellbeing. The environment that is developed may be a residential area, a municipality or a larger area.
One of the purposes of memory-friendliness is to increase understanding about memory disorders and about what it is like to live with a memory disorder. It is essential to highlight the capabilities and competence of people with memory disorders and enable an independent and active life for them. In addition to the devel- opment of the social environment, the development of the physical environment is one of the central objec- tives in the memory-friendly approach. The aim is to pay attention to the needs of people with memory disorders regarding housing, public spaces and services such as health and social services, public services and neighbourhood services.
Link to the publication (description sheet in English): Memory-friendly and age-friendly housing and living environment. 2018. Publications of the Ministry of the Environment. Environment Guide 2018.
Hervanta age-friendly residential area
Between 2015 and 2017, the Hervanta residential area in Tampere was being developed into an age-friendly area in terms of housing and participation. The number of older people living in Hervanta will see a significant increase in the next few years as many of those who moved to there when the area was built still live there.
The focus of age-friendliness in the development was on solutions concerning the living environment and housing and on improving older people's opportunities for participation. The aim was to pay attention to active ageing and the increasing need for age-friendly services.
Older residents, non-governmental organisations and companies were involved in the development work in addition to the different administrative branches of the City of Tampere. The development was related to the implementation of the Development programme for housing for older people 2013-2017 and the city
strategy of the City of Tampere. The project was funded by the Ministry of the Environment, the City of Tampere, Tampereen Kotilinnasäätiö and Tampereen Vanhuspalveluyhdistys.
The age-friendly city concept provides an opportunity to look at the services, housing options and the built environment of the suburb across sectoral boundaries. When the aim is to support residents' wellbeing and independent activity, an examination of the suburb as a whole enables one to see the potential of coopera- tion of different sectors and Design for All.
At the beginning of the construction of Hervanta, a lot of young people and children with families moved to the suburb. At the time, Design for All or the needs of older residents did not steer the construction or the development of the services. As in Finnish cities in general, the situation is different today. As the number of ageing residents is growing fast, Design for All may create preconditions for active ageing. The solutions made in Design for All are suitable for different groups of residents regardless of their functional ability, which reduces the need for special solutions and repairs later.
The implementation of an age-friendly residential area is a continuing process. This project lasted three years and during that time highlighted the needs of the older population and generated different ways of respond- ing to these needs. The implementation of many of the solutions had already been launched earlier and the project in a manner of speaking reinforced the examination. On the other hand, it included new issues in the development work and intensified cooperation between the actors by utilising WHO's concept of active age- ing. The work to strengthen the age-friendliness of the suburb continues. It has created well-functioning ways of cooperation between different actors. However, the interviewees recognised the risk that major organi- sation reforms and the forthcoming health and social services reform may erode the cooperation practices.
The pilot project in Hervanta has provided resources for the coordination of cooperation between the actors.
In future, the cooperation of the actors in the area will be coordinated in a regional network and their oper- ation will be launched in all service areas.
The “Lähitori” concept (local community centres and meeting places) as a neighbourhood service providing low-threshold advice and guidance is an example of an identified need for age-friendly solutions. Its role is emphasised as one of the targets in the city's strategy is to steer the use of services towards a digital channel.
By 2025, everyone will primarily be using digital services. In the transition stage, service counselling provided by the community centres and meeting places in the Lähitori concept is important for residents who do not yet have the skills or technical resources required for using electronic services. The other example used by the interviewees was related to benches and resting places along walking routes. The discussion on the need for accessible routes to services has successfully demonstrated that accessible walking environments are crucial for older people living at home. Safe routes and resting areas enable them to be mobile outdoors and run their errands independently.
The outcomes of the Hervanta project can also be introduced in development carried out elsewhere. For example, the operating models in the project may be applied and the produced materials exploited. Accessi- ble routes to services can be applied to different environments. Previously, Tampere had only one classifica- tion for pedestrian routes. An accessible route to services is equipped, lit and signposted better than an or- dinary route. It is aimed at providing more residents with the opportunity to run their errands independently and move about safely. A two-tier classification and highlighting the accessible route to services in the city's map service is important so that information on the special quality of the route is available for example to contractors doing repair work along the route.
Improving residents' opportunities to function and participate through co-creation of services strengthens residents' trust that it really is possible for them to influence the activities and services. The launch of the customer panels at Hervanta health centre and at the Keinupuisto Lähitori are examples of opportunities to participate. A regional network consisting of the residents, associations and employees in the area has started its operations as a supplier of information and a forum coordinating the development of the area.
During the project, the Keinupuisto Lähitori has gathered an extensive network of communities and city ac- tors operating in the area to implement events and activities with different groups of residents. The residents and actors in the area regularly convene for co-creation events.
Cooperation networks and monitoring the implementation of age-friendliness
In autumn 2017, the Nordic members of WHO's network of age-friendly cities convened in Stockholm for the first time. The operating principle of the network is mutual exchange of information between the cities and commitment to systematic improvement of the age-friendliness of the city. Large cities in the Nordic countries provide an interesting reference point for Finnish cities as the conditions, service systems and the ageing of the population are very similar. In WHO's network of age-friendly cities, Trondheim in Norway in particular reported its experiences of new systems and quality criteria in winter maintenance and prevention of slipperiness. The cities jointly highlighted the need to find indicators for visualising the results of the de- velopment and the improvements made in age-friendliness to decision-makers and for justifying the need to invest in age-friendliness and the benefits resulting from it.
Objectives and indicators agreed on jointly by the actors are needed for monitoring the residential area when its age-friendliness is strengthened. Indicators that would be suitable for all cities do not exist, but local indi- cators can be defined on the basis of the city's expertise in different sectors. The most effortless way to do it is to use the existing information pools. Customer data related to housing, transport, the built environment and the use of the services is accumulated in municipalities' own information pools.
Information on their residents' wellbeing and its underlying factors is available to municipalities in the Re- gional Health and Well-being Study (ATH) carried out regularly by the National Institute for Health and Wel- fare. Viable key figures may support decision-making and help in steering the cooperation. A number of in- dicators describing the following underlying factors of wellbeing are required for the monitoring of age- friendliness:
accessibility of the walking environment and availability of services
quality of housing for older people
inclusion and participation of older people in their own community
residents' resources for handing everyday situations. They may be internal (e.g. capability, functional ability) or external (e.g. advice, services).
Nordic cooperation may inspire to goal-oriented development of age-friendly cities and residential areas which will provide experiences of strategic indicators and their viability. Making a city age-friendly is a con- tinuous process in which indicators are needed for the prioritisation of the development targets and the demonstration of impacts.
Link to the publication (description sheet in English): Towards more age-friendly Hervanta. Reports of the Ministry of the Environment 5/2018. (pdf)
8. Service blocks
A report carried out by the Research Institute for Health Care Facilities (Sotera) of Aalto University was aimed at developing a service block concept supporting independent living of older people. The report introduces services and housing targeted at older people in Sweden, the Netherlands and Germany and good practices from Finland.
