Mobility for the old is a challenge - but can be a medicine

 

Supporting mobility for the growing ‘older old’ demographic is already a challenge for local authorities, and the demands are likely to increase as health and social services increasingly regard active lifestyles as preventative medicine. Rhodri Clark reports.

The ‘over 65’ category still appears sometimes at the ends of questionnaires, but not for much longer. So many people are living into their 80s and 90s, and continuing to lead active lifestyles, that the decades after retirement need clearer definition.

The Parliamentary Advisory Council for Transport Safety is one body that has already made that distinction. When it analysed statistics for deaths and serious injuries among UK pedestrians, it saw that these had reduced from 2000-10 by 41% across all age groups – but by only by 33% for those aged 80 and over.

The 2001 census revealed 2.4m people aged 80 or over in the UK. They have different needs from sprightly, freshly retired 60-somethings. Research last year suggested that for the oldest in our society, social isolation posed even greater risks to health than smoking. Getting out and about combats isolation, but Greg Lewis, project manager for community and society at Age UK, says older people can be deterred by such simple things as pavements in poor repair, or a lack of benches where they can rest while walking to local facilities. Closure of public toilets affects older people who suffer the inevitable weakening of bladders with age.

Lack of treatment for pavements during icy weather and reductions in the brightness or coverage of street lighting can also impact heavily on older people, says Mr Lewis. ‘There are lots of reasons why people become socially isolated in later life. There’s evidence that suggests that if people are concerned about accessing local services because of poor repairs to pavements or a lack of public toilets, that will discourage them from leaving the house. That can cause significant health problems later in life.’
Last year Kirklees Council asked residents what were the key things making somewhere a good place to live. ‘Well maintained roads and pavements’ was chosen by 55% of over-65s, compared with 35% and 44% in the younger age groups.

In 2009 Dorset CC’s research for its Ageing Well strategy found that many older people were afraid to go out after dark for many reasons, including lighting, adequacy of pavements and lack of local facilities. ‘The volume of traffic on country roads and through villages … can be daunting for older people, as can the time allowed to cross an automated crossing,’ said the strategy report, which also said road signs with ‘images of bent and feeble older people’ should be challenged as they reinforced the stereotype of the burdensome elderly.

A recent UK study revealed the ‘green man’ phase at pedestrian crossings allowed insufficient time for most men and women aged over 65 to cross the road at natural walking speed. Poor urban design features such as subways and ring roads can lead to people feeling trapped in their locality, says Mr Lewis. ‘It can mean that people on the wrong side of a major road don’t have access to services beyond it.’

He believes local authorities should talk to older people, and not assume that meeting the needs of articulate 65-year-olds means the needs of 80-year-olds are also met. In many areas, Ageing Well schemes provide a feedback channel. Midlothian Council manages an Ageing Well programme which is funded by the NHS, reflecting the savings which will accrue if older people remain physically and socially active for longer.

In January 2010, the Living Streets charity helped one Ageing Well walking group, in Penicuik, to audit key pedestrian routes in the town centre. The pensioners highlighted broken paving slabs, which were subsequently repaired, and confusion at the end of High Street where most traffic turns left but some vehicles go straight ahead or turn right to park.

‘It was difficult for them to cross the road in that area,’ says Vivian Wallace, Ageing Well coordinator at Midlothian Council. ‘The markings on the road had basically disappeared. The council agreed to make the markings a lot clearer. Now it’s clear for drivers to know that they should be signalling if they want o go to park or go straight ahead.’

Manchester City Council, the only UK city in the Age Friendly Cities network, has noticed a number of accident hotspots for older people, says Paul McGarry, the council’s senior strategy manager for older people. Further investigation revealed that the fear of tripping on tactile paving was encouraging some elderly people to detour to less safe walking routes. One solution was to flip the paving over, to eradicate the contoured surface, but this had to be balanced against the needs of partially sighted people.

This echoes the conundrum of shared space, where drivers and pedestrians negotiate safe passage. Age UK hasn’t been able to come up with a policy for or against shared space. It recognises benefits such as the lack of kerbs, but is concerned about the difficulties for the visually impaired.

Pedestrianisation brings the obvious benefit of making commercial areas safer and pleasanter for older people. However, where traffic has been banished from large areas, accessing facilities in the centre can be daunting. Cardiff CC has expanded the city’s pedestrian zone, and since autumn 2010 has provided golf buggies with drivers to take older people from bus stops to places such as the central market which would be too far for them to walk from rail or bus stations, taxi ranks or car parks.

Not all journeys which older people wish or need to make can be accomplished on foot. This is increasingly the case as health and other services have been centralised, and the growth of out-of-town shops has left their centrally located rivals stocking a limited range of household products.

More than a million people aged over 80 now hold driving licences. Not all of them still drive, but many do, raising difficult issues around safety and freedom. Analysis by PACTS shows that deaths and serious injuries to older car occupants reduced by much less than the average from 2000 to 2010. For those aged 80 and over, the reduction was 16%, compared with 54% for all ages.

Greg Lewis says: ‘It’s quite encouraging that there are lots of older people out there driving. We’re likely to see that increase as the generations come through who have driven all their lives. It’s an important way for older people to remain independent.

‘It’s important that older people are given advice about when to stop driving. One of the trigger points for isolation is when people stop driving voluntarily, or when the DVLA say for whatever reason, “We’re taking your licence away.” If they live in rural areas it can have a catastrophic effect on their ability to access services.’

Retired people have benefited from unlimited free bus travel for a decade or more, and investment in low-floor buses. However, usage of free passes is not universal among older people. Research by Lancashire CC in 2010 revealed that 2.4% of pass holders make more than 25% of all free bus journeys, with 8% accounting for 57% of trips.

Paul McGarry, of Manchester CC, says: ‘There are some people who haven’t been on public transport for decades who can’t drive any more. Suddenly they’re asked to negotiate public transport.’ Transport for Greater Manchester provides Travel Training to introduce older people and others to public transport.
Greg Lewis says: ‘Local authorities need to think

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