Category Archives: Dementia & the Environment

Building a better world: can architecture shape behaviour?

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US architect Frank Lloyd Wright, who designed Fallingwater, believed that appropriate architecture would save the US from corruption.
Via Tsuji

Jan Golembiewski, University of Sydney

In 1966, a British planner called Maurice Broady came up with a new term for the architectural lexicon: architectural determinism.

This was to describe the practice of groundlessly asserting that design solutions would change behaviour in a predictable and positive way.

It was a new phrase but the belief system behind it – that buildings shape behaviour – had allowed the heroes of architecture to make all kinds of outlandish claims.

A hopeful history

Leon Battista Alberti, an Italian Renaissance-era architect, claimed in the 1400s that balanced classical forms would compel aggressive invaders to put down their arms and become civilians.

Frank Lloyd Wright, the US architect who designed one of the most famous buildings in America, Fallingwater, similarly believed appropriate architecture would save the US from corruption and turn people back to wholesome endeavours.

British author and thinker Ebenezer Howard believed companies would be more efficient if their employees lived in village-like garden communities.

Swiss-born French architect Le Corbusier made claims about how his Villa Savoye building in France would heal the sick – and when it did just the opposite, he only avoided court because of the commencement of the second world war.

It took a long list of failures over the millennia before postmodern theorists took to critiquing architectural fantasy with malevolent vengeance. The high-point of this trend was the delight shared over the demolition of the famously dangerous and dysfunctional Pruitt-Igoe urban housing complex in St Louis in the US.

It was designed by architects George Hellmuth, Minoru Yamasaki and Joseph Leinweber to provide “community gathering spaces and safe, enclosed play yards.” By the 1960s, however, it was seen as a hotspot for crime and poverty and demolished in the 1970s.

The demolition of Pruitt-Igoe in 1972 fuelled resistance to deterministic thinking.
Wikimedia

The loss of faith in architecture’s power has been regrettable. Architects’ well-meant fantasies once routinely provided clients with hope and sometimes even with results.

Without this promise, the profession was left inept before the better structural knowledge of engineers, the cumulative restrictions imposed by generations of planners, the calculations of project-managers and the expediency of a draughtsman’s CAD (computer-aided design) skills in turning a client’s every whim into reality.

Without fiction, architecture has become a soulless thing. But was determinism dismissed too soon? Is there a role for imagined futures without rationalist restrictions?

Restoring the faith

Just think of some of the ways architecture can manipulate your own experience. In his book, Happy City: Transforming Our Lives Through Urban Design, US author Charles Montgomery points out that some environments predictably affect our moods.

The fact is that environments do affect us, regardless of whether by design or by accident. In 2008, researchers in the UK found that a ten-minute walk down a South London main street increased psychotic symptoms significantly.

In my own research, I find that the healthier a person is, the more a good environment will affect them positively and the less a bad one will affect them negatively. Mentally ill patients show about 65 times more negative reactivity to bad environments than controls and all these reactions translate directly into symptoms.

The same patients have about half the positive responsiveness. That’s fewer smiles, less laughter and a reported drop in feeling the “fun of life”.

But that’s not all. The potential for architecture is richer still. The ease with which architecture can embrace sublime aesthetics makes it great for generating awe.

Psychiatrists have found that awe reduces the prevalence and severity of mood disorders. Could sublime architecture even potentially save lives?

The psychological effects of architecture are difficult to prove, but difficulty doesn’t dilute the value of a building that hits the right notes and creates a sense of awe. Each building type has different functions, and for each there’s an imperative to use the building to help create an optimal mood, desire or sense of coherence, security or meaning.

Awe reduces mood disorders: Gaudi’s Sacrada Familia church in Spain.
Wikimedia

Fortunately, there’s a resurgence of belief that buildings can change behaviour, led by a few architectural journals: World Health Design, Environment Behavior and HERD.

Most of these focus on health care design, because that’s where behavioural changes have life and death consequences.

But nobody dares make any promises. As such, research rarely opens the black box of environmental psychology, leaving findings unexplained and prone to failure.

To give architecture back its mojo, a new interest in how architecture changes us must be fostered. Clients have to learn to trust architects again and research funding bodies have to re-gear to encourage research into how buildings affect our mood, health and behaviours.

Finally, architecture schools have to teach students how they might predict psychological, emotional, healing and functional effects.

The ConversationAll innovation, ultimately, is led by the imagination – even if that means taking risks and sometimes getting it wrong.

Jan Golembiewski, Researcher in Environmental Determinants of Mental Health, University of Sydney

This article was originally published on The Conversation. Read the original article.

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How the brain selectively remembers new places

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Neuroscientists identify a circuit that helps the brain record memories of new locations.

MIT News release – Source: How the brain selectively remembers new places

When you enter a room, your brain is bombarded with sensory information. If the room is a place you know well, most of this information is already stored in long-term memory. However, if the room is unfamiliar to you, your brain creates a new memory of it almost immediately.

MIT neuroscientists have now discovered how this occurs. A small region of the brainstem, known as the locus coeruleus, is activated in response to novel sensory stimuli, and this activity triggers the release of a flood of dopamine into a certain region of the hippocampus to store a memory of the new location.

“We have the remarkable ability to memorize some specific features of an experience in an entirely new environment, and such ability is crucial for our adaptation to the constantly changing world,” says Susumu Tonegawa, the Picower Professor of Biology and Neuroscience and director of the RIKEN-MIT Center for Neural Circuit Genetics at the Picower Institute for Learning and Memory.

“This study opens an exciting avenue of research into the circuit mechanism by which behaviorally relevant stimuli are specifically encoded into long-term memory, ensuring that important stimuli are stored preferentially over incidental ones,” adds Tonegawa, the senior author of the study.

Akiko Wagatsuma, a former MIT research scientist, is the lead author of the study, which appears in the Proceedings of the National Academy of Sciences the week of Dec. 25.

New places

In a study published about 15 years ago, Tonegawa’s lab found that a part of the hippocampus called the CA3 is responsible for forming memories of novel environments. They hypothesized that the CA3 receives a signal from another part of the brain when a novel place is encountered, stimulating memory formation.

They believed this signal to be carried by chemicals known as neuromodulators, which influence neuronal activity. The CA3 receives neuromodulators from both the locus coeruleus (LC) and a region called the ventral tegmental area (VTA), which is a key part of the brain’s reward circuitry. The researchers decided to focus on the LC because it has been shown to project to the CA3 extensively and to respond to novelty, among many other functions.

The LC responds to an array of sensory input, including visual information as well as sound and odor, then sends information on to other brain areas, including the CA3. To uncover the role of LC-CA3 communication, the researchers genetically engineered mice so that they could block the neuronal activity between those regions by shining light on neurons that form the connection.

To test the mice’s ability to form new memories, the researchers placed the mice in a large open space that they had never seen before. The next day, they placed them in the same space again. Mice whose LC-CA3 connections were not disrupted spent much less time exploring the space on the second day, because the environment was already familiar to them. However, when the researchers interfered with the LC-CA3 connection during the first exposure to the space, the mice explored the area on the second day just as much as they had on the first. This suggests that they were unable to form a memory of the new environment.

The LC appears to exert this effect by releasing the neuromodulator dopamine into the CA3 region, which was surprising because the LC is known to be a major source of norepinephrine to the hippocampus. The researchers believe that this influx of dopamine helps to boost CA3’s ability to strengthen synapses and form a memory of the new location.

They found that this mechanism was not required for other types of memory, such as memories of fearful events, but appears to be specific to memory of new environments. The connections between the LC and CA3 are necessary for long-term spatial memories to form in CA3.

“The selectivity of successful memory formation has long been a puzzle,” says Richard Morris, a professor of neuroscience at the University of Edinburgh, who was not involved in the research. “This study goes a long way toward identifying the brain mechanisms of this process. Activity in the pathway between the locus coeruleus and CA3 occurs most strongly during novelty, and it seems that activity fixes the representations of everyday experience, helping to register and retain what’s been happening and where we’ve been.”

Choosing to remember

This mechanism likely evolved as a way to help animals survive, allowing them to remember new environments without wasting brainpower on recording places that are already familiar, the researchers say.

“When we are exposed to sensory information, we unconsciously choose what to memorize. For an animal’s survival, certain things are necessary to be remembered, and other things, familiar things, probably can be forgotten,” Wagatsuma says.

Still unknown is how the LC recognizes that an environment is new. The researchers hypothesize that some part of the brain is able to compare new environments with stored memories or with expectations of the environment, but more studies are needed to explore how this might happen.

“That’s the next big question,” Tonegawa says. “Hopefully new technology will help to resolve that.”

The research was funded by the RIKEN Brain Science Institute, the Howard Hughes Medical Institute, and the JPB Foundation.

Architecture And Design Help the Brain to Recover

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How does the hospital environment affect our rehabilitation? New research from the University of Gothenburg, Sweden, into how the space around us affects the brain reveals that well-planned architecture, design and sensory stimulation increase patients’ ability to recover both physically and mentally. Digital textiles and multisensory spaces can make rehabilitation more effective and reduce the amount of time spent in care.

In an interdisciplinary research project, Kristina Sahlqvist has used research into the recovery of the brain to examine how hospitals can create better environments for rehabilitation.

“We want to help patients to get involved in their rehabilitation, a side effect of which can be an improvement in self-confidence,” says Sahlqvist, interior architect and researcher at the University of Gothenburg’s School of Design and Crafts (HDK).

The project drew on all the expertise used on a ward, with input from neurologists, rehabilitation doctors, nurses, psychologists, occupational therapists and physiotherapists. The result is a conceptual solution for an optimal rehabilitation ward.

“Our concept gives the ward a spatial heart, for example, where patients and their families can prepare food and eat together, which allows for a more normal way of spending time together in a hospital environment,” says Sahlqvist.

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In tandem with her research work, she has teamed up with a designer and researcher at the Swedish School of Textiles in Borås on an artistic development project where they redesigned furniture, developed easy-grip cups and cutlery and used smart textiles, in other words textiles with technology embedded in them. The concept includes a table and chairs, a rug and a muff with integral heating, a cardigan with speakers and a soft bracelet that is also a remote control.

In order to measure and test the research theories Sahlgrenska University Hospital will be developing an intensive care room featuring multimodal stimulation, where all the senses are affected. The work involves an architect, doctors, hospital staff, musicians, a designer, an acoustician and a cognition specialist. In a bid to see what kind of results the environment can produce in practice, the researchers will take account of the entire social situation of patients, family and staff.

There are other interesting tricks in the field of neuroarchitecture, where it is possible, for example, to use spatial expressions to improve learning. Although these are currently used predominantly in schools, they could also have potential for the elderly.

“It’s worth wondering why there are so many educational models for preschool children but so few for the elderly. Many old people need a far more stimulating environment than they have at the moment,” says Sahlqvist.

Date: November 3, 2011
Source: University of Gothenburg
Release from University of Gothenburg

建筑和设计帮助大脑恢复

发布日期:2011年11月2日。
哥德堡大学发布 

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医院环境如何影响我们的康复? 瑞典哥德堡大学的最新研究发现,我们周围的空间如何影响大脑,显示出精心策划的建筑,设计和感官刺激可以提高患者身心恢复的能力。 数字纺织品和多感官空间可以使康复更有效,并减少花费在护理上的时间。

在一个跨学科研究项目中,Kristina Sahlqvist利用大脑恢复研究来研究医院如何创造更好的康复环境。

哥德堡大学设计与工艺学院(HDK)室内设计师兼研究员Sahlqvist说:“我们希望帮助患者参与康复治疗,其副作用可以提高自信心。

该项目利用了病房的所有专业知识,由神经科医生,康复医生,护士,心理学家,职业治疗师和物理治疗师提供投入。 结果是最佳康复病房的概念性解决方案。

Sahlqvist说:“我们的理念给病房提供了一个空间的心脏,例如,病人和他们的家人可以一起准备食物和一起吃饭,这样可以在医院环境中更加正常地花时间在一起。

在她的研究工作的同时,她与布罗斯的瑞典纺织学院的一位设计师和研究员合作开展了一个艺术发展项目,重新设计了家具,开发了易握杯子和餐具,并使用了智能纺织品,换句话说纺织品其中嵌入了技术。 这个概念包括一张桌子和椅子,一个地毯和一个带有整体加热装置的手套,一个带扬声器的开襟衫和一个也是遥控器的软手镯。

为了衡量和测试研究理论,萨尔格林斯卡大学医院将开发一个以多模式刺激为特征的重症监护室,所有感官都受到影响。 这项工作涉及建筑师,医生,医院工作人员,音乐家,设计师,声学家和认知专家。 为了研究环境在实践中能产生怎样的结果,研究人员将考虑患者,家属和工作人员的整个社会状况。

在神经体系结构领域还有其他一些有趣的技巧,例如使用空间表达来改善学习。 虽然这些目前主要用于学校,但也可能对老年人有潜力。

Sahlqvist表示:“值得一提的是,为什么学龄前儿童的教育模式如此之多,而老年人的教育模式却很少。许多老年人需要的环境比现在更为刺激。

Alarming amounts of noise demand ways to silence noisy hospital environments

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Spending a night in the hospital is not only stressful, but also loud. The constant beeps, whirrs and alarms ascend to a cacophony that produces anything but a relaxing, restful environment. Researchers will summarize the limited number of studies available on hospital noise and discuss the different approaches health care facilities are taking to bring restful repose to patients across the country during the 174th ASA Meeting, Dec. 4-8, 2017, in New Orleans, La.

Source: Alarming amounts of noise demand ways to silence noisy hospital environments

Hospital noise is a growing concern for patients, family and staff, but many facilities are looking for new approaches to reduce the din and bring peace back to their environment.

Public Release: ACOUSTICAL SOCIETY OF AMERICA

WASHINGTON, D.C. December 6, 2017– Spending a night in the hospital is not only stressful, but also loud. The constant beeps, whirrs and alarms ascend to a cacophony that produces anything but a relaxing, restful environment. Ilene Busch-Vishniac, of BeoGrin Consulting in Baltimore, Maryland, will summarize the limited number of studies available on hospital noise and discuss the different approaches health care facilities are taking to bring restful repose to patients across the country.

According to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, noise is the top complaint of patients, staff and visitors. “Nearly everyone has a stay in a hospital at some point,” Busch-Vishniac said. “Noise is a universal problem in hospitals around the world.”

Busch-Vishniac will explore these concepts during the 174th Meeting of the Acoustical Society of America, being held Dec. 4-8, 2017, in New Orleans, Louisiana. Noises emanate from a variety of sources at the bedside. Airflow and the noisy machines controlling it are kept on high to prevent pathogens from lingering near patients, and overhead pages alert staff of needs or announcements. Equipment alarms are the most egregious source, and although they are designed to alert staff of changes in the patient’s medical condition, many also sound when medication needs to be changed or when battery conditions are low.

“Alarms in hospitals are being horribly abused,” Busch-Vishniac said. “Most of the time, they don’t in fact indicate urgent situations.”

Previous studies showed that alarms at a patient’s bedside sound an average 133 times per day. With so many alarms, staff often face alarm fatigue as well.

“Most alarms are being responded to eventually, but not all in a timely fashion,” said Busch-Vishniac. “Staff also may not respond quickly because they recognize that the sound is not critical and the situation will right itself.”

Besides the obvious barrier to rest, high noise levels have been associated with changes in the patient’s heart rate, respiration and blood pressure. These changes increase stress levels and may impair healing. The noise can also impair communication between patients and staff.

With noise levels on the rise, the Centers for Medicare and Medicaid Services (CMS) initiated the HCAHPS survey in 2008 to assess consumer perception of health care providers and systems. Today, more than 5,500 hospitals contribute to the report, which consists of patients’ responses on seven composite measures, including questions focused on room cleanliness and quietness.

The survey has teeth. Hospital value-based purchasing links up to 30 percent of CMS payments to hospitals across the country to the results of the survey.

“Faced with a loss of money, many hospitals are looking for ways to address noise levels in a way that patients can see as an improvement,” said Busch-Vishniac.

Hospitals have been developing and implementing noise control programs that can be broken into two categories: engineering and administrative interventions.

Engineering interventions aim to find ways to quiet the room. The solutions can be as simple as closing the door to a patient’s room or as complex as installing acoustical absorption materials along the walls and ceiling to dampen the noise level. Administrative interventions focus on changing behaviors. Many hospitals have instituted quiet hours when doors are closed and voices are kept low.

One of the big changes during the past 10 years has shifted alarms from solely sounding at the patient’s bedside to also alerting a central monitor at the nursing station. This approach improves the ability of staff to identify and respond to alarms set at a reduced volume.

According to Busch-Vishniac, it may be possible in the future to remove alarms from the bedside. A quiet hospital may not be a pipedream for much longer.

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Presentation 3pIDa: “Hospital noise: how bad is it?” by Ilene Busch-Vishniac is at 1:45-2:05 p.m. CST, Wednesday, Dec. 6, 2017, in Salon E in the New Orleans Marriott. https://asa2017fall.abstractcentral.com/s/u/M8hKSrQu66E

Green for wellbeing – science tells us how to design urban spaces that heal us

 

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Generic plotting of ‘green space’ on an urban plan does not target mental wellbeing unless it is designed to engage us with the sights, sounds and smells of nature.
Zoe Myers, Author provided

Zoe Myers, University of Western Australia

One in five Australians will suffer from a mental health issue this year and living in a city makes it far more likely. Research shows that city dwellers have a 20% higher chance of suffering anxiety and an almost 40% greater likelihood of developing depression.

Promisingly, however, research has also found that people in urban areas who live closest to the greatest “green space” are significantly less likely to suffer poor mental health.

Urban designers thus have a significant role to play in lowering these rates of mental illness, and the data on how nature affects our brains are central to changing the ways we design. As depression is the world’s biggest cause of disability, we cannot afford to ignore the impact of public environments on mental health.

Multiple stressors associated with city living have been shown to increase activity in the parts of the brain corresponding to the “flight or fight” response.


Further reading: Vanishing Australian backyards leave us vulnerable to the stresses of city life


How does exposure to nature reduce these stresses? There are two enduring theories on how nature affects the brain. Both are based on nature having a restorative effect on cognitive and emotional function.

Hyde Park, Perth, allows for an immersive ‘escape’ from the urban world.
Zoe Myers, Author provided

It is not emptiness or quiet, however, that has the effect. Nature in its messy, wild, loud, diverse, animal-inhabited glory has the most impact on restoring a stressed mind to a calm and alert state. This provides a more complete sense of “escape” from the urban world, however brief.

This idea is not new, nor is it surprising. Many people seek out nature to restore wellbeing, and multiple disciplines have sought to measure these restorative effects.

The result is more than 40 years of research quantifying specific neurological, cognitive, emotional and physiological effects of “nature” elements. These effects include increased calm and rumination, decreased agitation and aggression, and increased cognitive functioning – such as concentration, memory and creative thought.


Further reading: Biophilic urbanism: how rooftop gardening soothes souls


A neglected resource for urban design

This wealth of data has been largely overlooked in driving good urban design.

Much of this can be attributed to the data being siloed into scientific disciplines separate from design. All use different languages and are often hidden behind academic journal paywalls.

Also significant is the complexity of mental health issues. This makes it difficult to draw conclusions on environmental effects. To use this data required first a meta-analysis of these methodologies and outcomes, and my own interpretation of how the data applied specifically to urban design.

There are some notable conclusions.

This pedestrian and bike path in Perth is unlikely to maximise the benefits of green space.
Zoe Myers, Author provided
  1. Different natural elements can induce different benefits. This means generic design plotting of “green space” on an urban plan, however aesthetically pleasing, does not specifically target mental wellbeing.
  2. Time plays a significant role. There is no point having great green spaces if these do not provide good reason or opportunity to linger long enough to experience the restorative benefits.
  3. How you engage with your environment matters. Results differ depending on whether the user is observing, listening, or exercising in the space. Taking these variables into account can produce a vast combination of design scenarios.

For example, despite the many studies on the restorative effects of forests, these are not the most accessible option for most city-dwellers. Urban parks are an alternative, but creative, natural interventions in urban spaces that encourage incidental interaction with green space can also produce much benefit.

Much has been written about how walking or exercising in green spaces seems to amplify the effects on the brain of viewing nature. Indeed, as little as five minutes of “green exercise” can produce these benefits.


Further reading: Higher-density cities need greening to stay healthy and liveable


What’s wrong with existing green spaces?

Many urban parks and green spaces – particularly in residential areas – are unimaginative, repetitive and lack basic elements to evoke these references to nature. Nor do they encourage walking or enjoying the natural elements for any length of time.

A typical reserve in Perth, Australia.
Zoe Myers, Author provided
A residential footpath and verge in Perth, Australia.
Zoe Myers, Author provided

For example, paths without shade or protection do not encourage walks long enough to achieve benefits. A lack of landscape diversity does little to activate fascination or interest, and fails to offer incentive to visit them, especially given the ways in which parks can be separated from their surroundings.

In an attempt to create spaces to serve function, such as ensuring enough turf for a game of football, much biodiversity has been removed, thus also removing the sights, sounds and smells needed for an immersive, multi-sensory experience. This applies equally to many suburban footpaths and residential streets.

A suburban residential street in Perth, Australia.
Zoe Myers, Author provided

When urban design gets it right

Septuagesimo Uno Pocket Park, Manhattan.
‘Jim Henderson, Atlas Obscura’

Compare this to urban areas that employ creative uses of incidental nature to capture attention and offer genuine interaction.

Successful parks and urban green spaces encourage us to linger, to rest, to walk for longer. That, in turn, provides the time to maximise restorative mental benefits.

Urban design’s role in shaping our cities is becoming less about the design of physical spaces and more about extracting principles that can be applied to urban spaces in ways specifically tailored to context, site, region and climate.

This means urban design can have a real impact on mental wellbeing, but we need to look outside our discipline for data to make it effective.

A Tokyo road reserve.
from Tokyo DIY Gardening

The ConversationFurther reading: Greening cities makes for safer neighbourhoods

Zoe Myers, Research Associate, Australian Urban Design Research Centre, University of Western Australia

This article was originally published on The Conversation. Read the original article.

Japan offers us many lessons in embracing longevity

Japan offers us many lessons in embracing longevity

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With a quarter of the population aged over 65, Japan has had to be innovative in catering for their wants and needs.
Martyn Jones, Author provided

Marco Amati, RMIT University; Marilena Kavoura, RMIT University; Martyn Jones, RMIT University, and Robin Goodman, RMIT University

Japan is famous for the longevity of its citizens. A quarter of its population is older than 65. That is a proportion that Australia is likely to reach only by 2056. Japan’s experience makes it an interesting example to learn from in the area of aged care.

In 2000, following a decade of stagnant growth, mounting public debt and skyrocketing hospitalisation, Japan introduced the Long-Term Care Insurance Scheme (LTCIS). This universal and compulsory scheme provides support to assess and deliver care through institutional or community-based services for all people over 65. It provides sufficient funds to allow everyone to age in place – even those in public housing and with late-onset dementia.

The scheme represents one of the boldest social democratic experiments in aged care policy in the last 30 years. Yet with bold experiments come surprises.

To the chagrin of the scheme’s designers the LTCIS has been too successful. Cheaper to implement than the policy it replaced, it is still oversubscribed and contributing to Japan’s public debt (230% of GDP).

Happy Active Town in Kobe is a public housing estate where more than 50% of residents are older than 65.
Photo: Martyn Jones

The universal acceptance of the scheme contributes to a paradox: while Japan has the largest ageing population in the world, it is difficult to make a business of providing aged care, as the collapse of Watami, the food chain-cum-nursing home provider, demonstrates. So what can this experience teach Australia’s aged care sector?

Care happens within the community

The first set of lessons concerns community-based integrated care. Here, the LTCIS, following 2012 reforms, mobilises support through community general support centres.

Australia is seeking to improve integration of multi-level care. The support centre in “Happy Active Town”, Kobe, provides an example. This public housing estate houses many refugees from the 1995 Great Hanshin Awaji earthquake. Its proportion of residents over 65 is more than 50%.

The LTCIS, with the local government, provides a care hub for volunteers, social workers and health professionals to provide services and respite care free to all residents on and off the estate. Community hubs such as these are designed to support a range of needs from intense support to community and family engagement in care across the life course.

Happy Active Town in Kobe houses many aged survivors of the devastating 1995 earthquake.

Harnessing technological innovation

The second lesson comes from watching and observing the Japanese experience of integrating technology in care provision. Dense, multistorey buildings of small units are typical in Japan. New, so-called “Platinum” housing integrates universal design and new technologies to ensure safe independent living for the elderly.

Retrofitting large areas of public housing to this standard is complex and expensive. A limited number of exemplary regeneration projects where the local municipality, private providers and the LTCIS work together guide the way. One example is Toyoshikidai, a public estate built for young families in the 1950s in Kashiwa to the north of Tokyo.

Alongside these urban changes a generational change is afoot. As the digitally literate generation reaches old age, smart home devices and new security and communication technology assume increasing importance. The business opportunities alone could amount to US$1 trillion by 2035.

The Japanese government supports this shift with its “Silver ICT” agenda. This includes a raft of e-strategies to bridge the digital divide between “active and inactive” elderly populations.

Yet in the nation where the development of robotic assistive technologies enjoys vast sums of research and development support, there is little sign of this in daily life. In Japan, applying technology in aged care is fraught with ethical, personal and logistical challenges. The solution, for now, centres on the involvement of humans.

The ConversationThe Japanese experience of ageing is unique and varied, but presents a foretaste of the future for many post-industrial societies. The “Happy Active Town” of Kobe, 20 years after a major natural disaster, is one example of a place where public policy, housing and technology converge to create solutions for an ageing society. Its mechanisms to support the passion and commitment of the people working and living there can teach Australia how to age with dignity.

Marco Amati, Associate Professor of International Planning, Centre for Urban Research, RMIT University; Marilena Kavoura, Manager Industry Linkage, RMIT University; Martyn Jones, Associate Professor of Social Work, RMIT University, and Robin Goodman, Professor of Urban Planning, Deputy Dean, Sustainability and Urban Planning, RMIT University

This article was originally published on The Conversation. Read the original article.

Ageing in Place? Yes, we can!

Article: Why it’s good to be old in Wakabadai estate, where nearly half the residents are elderly

Read about a community that has come together to age together at the Wakabadai public housing estate.

Recently Channelnewsasia did a piece on the Wakabadai housing estate in Yokohama, Japan. It’s a really interesting estate and the means in which the estate has been configured bears many similarities to the high rise housing estates found in the big cities where we all live a wall away from our neighbours. However, despite living in the same building for 30 to 40 years a lot of us may just be acquaintances, saying the passing “hi” and “hellos” as we greet each other at the elevator or when we pass each other along the corridors.

A few years ago, I visited a couple who lived alone in a little apartment with two bedrooms, their children had moved out and the husband was caring for his wife with dementia. She is very quiet and apathetic. His greatest worry was that he may suffer a stroke or a heart attack and is unable to get help in time and both of them may pass away in their apartment despite being surrounded by hundreds or thousands of people living in the building. He cited a neighbour living a few floors below them, who had passed away without anyone noticing until a number of days later. He talked about the need for services for families like them, and many services assume that because they have children, there would be someone watching out for them. However, with the busy lives that his children lead, looking after their families and juggling work, they could only call in on the weekends and rightly so with the changing landscape of the economy.

His son offered to have them stay with him but leaving their much familiar neighbourhood might be too much for his wife. Even now she would get agitated if they left the vicinity. For them this is home, this is where they had built their lives, house their memories, thrived in their love, and they wouldn’t want to live anywhere else.

Why is it that when we grow old, we have to move away? We have to sell our home, move into a retirement village and start all over again. I want to live in a place that will evolve and age as I age, that grows old as I do.

Back to Yokohama, the Wakabadai public housing estate is just that, with slightly less than half of the residents 65 years and older, the people living in the estate are ageing in place together. To date, there is a total of 14,658 residents living in the estate in 6,304 units. To ensure that they needs are met, they have come together with organisations and council to organise a range of services.

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Map of Wakabadai

Social Engagement for Older Adults:

The Wakabadai Non-Profit Organisation enables social activities such as health, music, cultural and sporting events to be held in the vicinity. Himawari provides a space for volunteers to interact with older adults over a cuppa. Residents are also keenly aware of “kodokushi”, which refers to people who are living alone and have passed away and their deaths have gone unnoticed by the community. In Wakabadai, residents band together and keep a keen eye out for the sudden build up of mail or newspaper in the mailboxes of older residents and the mail continues to be left unattended with no notice that the resident might be away.

A paid service is also available at the Himawari Community Centre where they can have a staff to ring their phones to ensure they are alright. They can also have a spare key stored at Himawari for approximately 500 yen.

In addition, celebrations during festive periods are arranged by the organisation to encourage engagement among the residents. Sports events are also organised regularly to encourage and promote a healthy lifestyle among residents.

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Wakadabai Estate

Creating an Intergenerational Community:

To encourage engagement from children and younger adults, a facilty for mothers group known as Wakaba Family Plaza Soramame can be found in Wakadabai. A safe space for mother’s of infants and toddlers to interact, support and exchange vital parenting information with each other and older adults. Older adults with early childhood qualifications can find work as advisors, helping to support young mothers, sharing with them their years of wisdom. Coming into Wakaba Family Plaza Soramame, you may find three generations interacting and hanging out together.

Meaning Occupation:

The Wakabadai Non-Profit Organisation also helps to find jobs for older adults.

Older adults can also showcase their culinary skills at Haru Dining, a restaurant staffed by older women living in the area serving up old school, heartwarming home cooked meals.

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Assistance with Activities of Daily Living:

Residents can also tap on a home help service at the cost of 490 JPY per hour which covers everything from house chores to transport to get their food or groceries delivered. Transport is highly efficient with buses running every 3 mins to the major train station, currently, residents are campaigning for a train station to be built close to their vicinity.

Other accessible facilities in the area include a post office, supermarkets, salons, restaurants, shops, gyms and parks.

Healthcare:

When it comes to healthcare, the Community Centre run by the Yokohama City Council also provides exercise classes for older adults, a care facility for older adults during the day, and medical staff such as nurses are available to provide older adults health and medical advice.

In addition, Asagao, a district nursing service consisting of nursing and medical staff from an acute hospital in the area man an emergency hotline that is accessible for residents in the estate at all times of the day or night. On top of the hotline, staff also provide and provide home care to the residents in the community.

When it comes to high care needs, residential aged care facilities are also located in the estate for residents who are too frail to reside in their own home.

With all the facilities to encourage a positive ageing in place, it is no wonder that the rates of older adults requiring nursing care much lower than the average rates found in other estates in Yokohama. In Wakabadai, the rates of nursing care currently stand at 12 percent whereas, on average 17.5 percent of older adults in each estate is found to require nursing care at home.

Wakadabai has shown that ageing in place is possible and it is achievable in the big cities with high-density living. With key elements in place, council and community support, we all can grow old gracefully in the luxury of our homes.