Creating Age and Disability Friendly Communities to Support Healthy and Meaningful Ageing

Friedrich Dieckmann and Christiane Rohleder

Growing Importance of an Inclusive Social Planning for Older People with a Lifelong Disability

The growing number of older people and the increasing life expectancy require new solutions worldwide with regard to quality of life, social participation and health in old age (World Health Organization, 2017). These developments also apply to people with lifelong disabilities, especially for people with an intellectual disability. Their life expectancy has increased enormously due to better medical care as well as improvements in socio-economic circumstances and social support structures (Bittles & Glasson, 2004; Chang et ah, 2011; Dieckmann, Giovis, & Offergeld, 2015; Naue et ah, 2013). An increasing number has the opportunity to reach the age ot retirement. The previous chapters have clearly shown that this development requires adaptation of existing support systems to the needs of elderly citizens with lifelong disabilities. Since most physical and cognitive disabilities are age-related, the scientific discourse as well as worldwide initiatives focus mainly on the discussion, development and evaluation ot age- and dementia-friendly communities (e.g. Beard & Petitot, 2010; Buckner et ah, 2018; Lin & Lewis, 2015; Mitchell, 2014; Scharlach, 2017; World Health Organization, 2007). However, it is becoming increasingly clear that in the course of demographic change, addressing the common needs of adults with lifelong disabilities and older people can have many positive effects on the quality ot life of both groups (e.g. Bickenbach et ah, 2012; National Council on Disability, 2004).

According to the ICF model of disability (World Health Organization, 2002), a meaningful and healthy lite in old age is dependent on both personal and environmental factors. Environments, and the way older people interact with them, are major determinants of their activities. The environment provides the resources or barriers that ultimately decide whether older people can engage in activities that matter to them (World Health Organization, 2017, p. 5). In old age higher risks of reduced mobility and decreases in cognitive performance can lead to a stronger focus on the immediate socio-spatial environment, the neighbourhood. In order to maintain an independent and self-determined life as long as possible, there is a need for barrier-free and age-appropriate living environments including opportunities for health supporting social and physical activities as well as appropriate medical support.

Although the financial and social resources for ageing differ and some groups of persons with disabilities age prematurely, people with a lifelong disability as well as those who acquire an impairment in old age have some similar experiences and common interests. First of all, the vast majority of both groups want to age in place, to stay as long as possible in their familiar environments. Furthermore, they are likely to want to continue learning, to build and maintain meaningful social relationships and activities, and to engage in civic and social life as long as possible (Bigby & Wiesel, 2019). But there are also differences in lifestyles, particularly the greater dependence of people with intellectual disabilities on professional help, their smaller social networks and their socio-economic disadvantages. Thus, their concerns are not automatically addressed by the concepts of age- or dementia-friendly cities. There is a need for integrated social planning of the different sectors that support older and disabled persons, for ‘bridging knowledge, policy and practice in ageing and disability’ (Bickenbach et ah, 2012, p. 1) to improve living conditions and social services in the immediate social environment of older people.

This chapter outlines an approach to the design of age friendly communities for older people with a disability, based on a model for an integrated community planning process (Schaper et ah, 2019). The approach combines top-down and bottom-up approaches to ensure the responsibilities of local politics and authorities, the cooperation of various professional stakeholders and the participation of older people with and without disabilities as well as their relatives in the planning process. It was developed in the context of the German welfare-system. To transfer the model would require tailoring planning processes to the respective societal and political contexts.

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