Older Māori and aged residential care in Aotearoa | Ngā kaumātua me te mahi tauwhiro i Aotearoa

Judith A. Davey                                                                                                         

We are all well aware that populations are ageing, but this trend is increasing at a faster rate for Māori than for the rest of the NZ population. The proportion of Māori aged 65 plus is expected to almost double in the near future, increasing from 50,000 in 2019 to 90,000 in 2029. As people age, Māori are more likely to require support, including aged residential care (ARC). Māori are currently under-represented in this form of care, with only 3% aged 65+ in ARC. The rate of admission to ARC for Māori is only half that for non- Māori, but, with the expected increase in the older Māori population, the demand for ARC is expected to grow significantly.

Changes in life expectancy contribute to this. Over the last two decades Māori life expectancy at birth has grown from 66.6 years for men and 71.3 years for women to 73.4 years for men and 77.1 years for women. This compares to figures of 81 years and 84 years for pakeha men and women. Combined with reduced fertility this means that the 85 plus age group, the group most likely to need ARC, is growing rapidly for both groups.

Lack of data based on ethnicity makes it difficult to compare differences or inequities in the quality of ARC care, but international studies show important areas which need attention:  ensuring services are accessible, improving social support networks, building community capacity; a wellness-based approach; and preservation of cultural values. Here are some of the major themes from a recent New Zealand report.[1]

Acceptability

Lack of Kaupapa Māori services may make older Māori reluctant to enter ARC – Māori may need to see, hear, and feel the presence of Māori cultural values and practices in an ARC environment. This calls for greater Māori leadership in the development and delivery of ARC. Largely negative expectations of ARC are widespread in the community in general. Fears of being admitted to ARC for older Māori include being forgotten by their whānau and being lonely, not being cared for properly and having nothing Māori to make them feel welcome.

Staffing

ARC workforce training, relevant to residents’ needs, including cultural needs, is central to ensuring their wellbeing. There is no data on the ethnicity of ARC staff, but 40% of caregivers and 39% of registered nurses are currently on migrant temporary or permanent visas and the majority come from the Philippines and India. Training documents may omit issues relating to Māori and health equity. This may be especially relevant for palliative and dementia care. Cultural safety training may be mentioned in training policies and procedures in ARC, however the implementation and measurement of its impact is not often evident. There is the potential for Māori-led training organisations to support ARC workforce development.

Co-design

We know that older Māori are more likely than non-Māori to be cared for by ‘informal’ caregivers, often whānau, at home. This knowledge provides opportunities for whānau members to contribute to training and treatment programmes in the ARC sector. Co-design and partnership with Māori in development and administration will be essential to meet the needs and expectations of older Māori.

Data

As already mentioned, there is limited information available regarding ethnic variation in quality of care and health outcomes in ARC.

Funding

New Zealand Aged Residential Care is mainly funded through contracts between providers and DHBs. There is increasing privatisation within the sector, linked to increased size of facilities to produce economies of scale. There are concerns that funding has not increased corresponding to growing dependency among residents.

Means-testing means that nearly all ARC residents make a contribution towards the costs of their care and the proportion making the maximum contribution is increasing. If this cannot be met by regular income, homes may have to be sold. Where homes are on Māori land or occupied by extended families this may produce difficulties for whānau. Collective ownership and guardianship of land and property for Māori needs to be considered in the context of ARC.

Access and choice

If a kaumātua is assessed as requiring ARC, questions then arise about cost, choice of provider, location, accessibility for whānau and quality of care, especially about cultural support. This may be difficult for whānau especially in rural areas. The report calls for work to ensure Māori are well informed of ARC options, including the potential benefits and the financial implications of both at home care and residing in ARC. Māori also need to have the ability to influence and lead the development and delivery of new models of care.

Māori-led models of aged care – examples from the report

Hoani Waititi, a pan-tribal marae includes housing for kaumatua adjoining the marae. and there are similar models across the country. These allow kaumātua to participate in the day-to-day activities of the marae and to be acknowledged for their knowledge.

Project Toru arranges weekly visits by school students, who can speak te reo, to talk and interact with Māori ARC residents. This is not only an intergenerational programme of learning and of cultural support, but also provides potential employment opportunities as young people learn the basics of caregiving. Participation in this programme qualifies for NCEA credits.

The Māori Health Authority – Te Mana Hauora Māori

The Māori Health Authority, according to a statement by the Department

of the Prime Minister and Cabinet in 2021, “will support the Ministry of Health

in shaping system policy and strategy to ensure performance for Māori, and will work in

partnership with Health NZ to commission care across New Zealand, ensuring that the needs

and expectations of Māori communities (are met)”. This presents an opportunity for Māori-led development and delivery of services that will deliver equitable health outcomes in ARC.


[1] Joanna Hikaka and Ngaire Kerse (December 2021) Older Māori and aged residential care in Aotearoa | Ngā kaumātua me te mahi tauwhiro i Aotearoa.

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New Strategy for the elimination of family and sexual violence – Te Aorerekura

Judith Davey 20/12/2021

 “Strategy” can be defined as the “art of directing large military movements”, but it has become the name for government reports on major policy areas in need of renewal. Although it is not exactly a military challenge, the prevention of family and sexual violence (FVSV) is certainly a major social issue that requires action in many sectors of society.

The strategy, with the Maori title Te Aorerekura – the enduring spirit of affection[1], was launched at the Te Papa marae on 7th December. I was a member of the “independent advisors” group, intended to speak up for older people, drawing on my over 20 years of research on the wellbeing of older people and its policy implications, as well as my own great age!

I soon found that my terminology differed from that of the other advisors. We tend to talk about ’elder abuse” rather than violence against older people. Elder abuse tends to involve mainly financial and psychological abuse rather than physical violence. And the latter is what people tend to think of when FV/SV are mentioned. Financial and psychological abuse, and also coercive control, do not figure highly in Te Aorerekura, although I would maintain that the harm they cause is as destructive as violence. Although family members figure significantly as perpetrators, policies to prevent elder abuse need to involve sectors such as financial and care services, scammers and fraudsters.

Elder abuse is mentioned very rarely in the report. The report’s glossary defines elder abuse and neglect as “physical, sexual, or psychological/ emotional abuse and violence towards an older person, financial abuse, and/or not meeting the older person’s basic physical, emotional and medical needs”. In a statement of the prevalence is the assertion that “one in ten older people will experience some kind of elder abuse”, but no evidence or references are suggested.

The dream and vision (Moemoea) of Te Aorerekura is that “all people in Aotearoa/New Zealand are thriving; their wellbeing is enhanced and sustained because they are safe and supported to live their lives free from family violence and sexual violence” a great and commendable aim. It is a realistic document, detailing the shocking extent of violence in our society and recognising that it will take a generation of sustained investment and focus to strengthen protective factors and enable the social changes required – hence the 25-year scope of the report.

“Older people” as a demographic group are mentioned 23 times in the report, as one of the communities which need special preventive action, support, specialist healing, and restorative services. These communities are specified as women, and men, impacted by violence, people who use or have used violence, tangata whenua, Pacific peoples, children and young people, LGBTQIA+ (“rainbow” communities), older people, disabled people and ethnic communities. Older people are given a little more attention in two places. Firstly, in the section where the needs and aspirations of these communities are considered separately and presented in the first person (page 20).

The violence we experience is often not visible because of our poor health or disability, or being dependent on others for our care or our social isolation. Sometimes society doesn’t respect us. We need people to acknowledge and understand the specific violence that happens to us. We need services we can navigate, with all healthcare workers and other frontline services able to notice signs of our abuse or neglect, and able to respond safely. Promoting our wellbeing includes addressing ageism, involvement in family and community, access to transport, and fostering intergenerational relationships. We want to build understanding of legal protections including Enduring Power of Attorney, advanced directives, and capacity assessments, so they’re not misused.

Secondly, when specifying the third of six “shifts” which are needed to achieve the aims of the strategy – Towards skilled, culturally competent and sustainable workforces – a question is posed – “How will this change impact older people?”

Older people can experience violence that is not visible because of social isolation, lack of understanding about elder abuse, and a lack of care/respect of older people that means their concerns are minimised or ignored. Elder abuse happens across all genders, religions, ethnicities and income groups. It may happen at home, in residential care, or in hospitals. Abuse is usually at the hands of a family member or a person of trust. The impact on the older person can be significant. Government actions to increase training about family violence and sexual violence will mean healthcare workers and other frontline services are able to notice signs of abuse or neglect of older people and respond safely. Publicly available resources that increase awareness and education of the specific violence that happens to older people (for example, financial and psychological abuse) will help make elder abuse more visible and help to prevent it.

Both these sections are well stated and identify salient issues related to elder abuse. But there is no mention of older people in the other shifts required –

  • Towards strength-based wellbeing – changing social conditions, structures and norms that perpetuate harm
  • Towards mobilising communities
  • Towards investment in primary prevention –a recent announcement of funding included older people’s communities
  • Towards safe, accessible and integrated responses.
  • Towards increased capacity for healing.

All these could be applied in the elder abuse area. But this needs more attention than is given in Te Aorerekura. Perhaps we should be calling for a strategy for the prevention of elder abuse.


[1] According to Māori lore, Aorere is a cluster of stars that navigates humankind to gain knowledge and comprehension. Aorere transmits healing energy through the whatumanawa (supreme subconscious) to restore balance and harmony to all aspects of a person’s toiora (enduring).

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Stay Connected to Family this Festive Season

With Aotearoa/New Zealand’s annual holiday season almost upon us and Covid-19 restrictions in place, this year many of our seniors will be facing a Christmas of loneliness rather than family gatherings.  Those who aren’t yet digitally connected have additional challenges being unable to even see family faces via video calls as an alternative to meeting in person.  The internet affects social relationships in many ways, but as a backup when visiting is impossible it can be really positive, helping reduce social isolation and loneliness.

The current attention to digital inclusion and equity in Aotearoa/New Zealand is good news for marginalised groups – including seniors – who have been identified as most at risk of being disadvantaged in everyday life by their exclusion from the digital world around them.

Maintaining social connections and access to services are two keys to living contented, independent lives as we grow older. Both of these increasingly need an online presence.  As younger generations discard landline phones and communicate more by text and photo exchanges, their off-line seniors are left out of the loop of day-to-day family news.  As service providers – including government agencies – move to online access and reduce in-person and telephone contact, these seniors are either excluded or forced to rely on others, losing their independence.

In 2020 and 2021, Covid-19 has highlighted these inequities with lockdowns, travel restrictions and limits on family visits and gatherings. Our seniors both in residential care and living independently who were reliant on face-to-face visits have been particularly isolated and at risk of loneliness. Their options for face-to-face access to services from banking to health and community involvement through churches, social groups, and libraries have been curtailed as it has for younger generations, but without the backup of an online option.

The gap between digital skills needed for life in Aotearoa and the reality for our senior generation is now being addressed, with robust research on the skills divide and programs such as Better Digital Futures already in place.

As a provider of touch-screen tablets designed specifically for seniors, New Zealand company Kitcal recognises the elements of digital inclusion – motivation, access, skills and trust – identified in The Digital Inclusion Blueprint that is informing current government initiatives to bring seniors online. 

Our mission encompasses all these elements with an emphasis on access. We’ve broken this down further, identifying three linked components that all need to be provided:

  • Affordable, reliable internet access
  • Appropriate hardware
  • Appropriate software

Kitcal’s vision is to bring generations together through a digital connection. We recognise that not all seniors want or are able to use existing technology, so we designed a pre-configured purpose-built tablet with simple features so that they can be safely and securely connected without the usual challenges and barriers. We’ve met the brief for the three components of access, and we’re working with providers, including Age Concern, on the other key elements.

The outcome of this combined mahi will be the inclusion of these seniors in digital technology, reconnecting them with their families and support structures, reducing their social isolation and boosting their confidence to live independently.

You can read more about Kitcal, our mission to reduce loneliness through digital inclusion and our tablet for seniors on our website at our Kitcal website.

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Older people and the digital world – What is New Zealand doing?

Judith Davey 19/11/2021

In Aotearoa/New Zealand very little had been written on older people and their digital inclusion until recently. The Department of Internal Affairs published The Digital Inclusion Blueprint, Te Mahere mō te Whakaurunga Matihiko and Evaluating digital inclusion initiatives: Examples of good practices, in 2019 with hardly any reference to older people. However, among the initiatives on older people’s issues, the Wellbeing Budget (2019) included funding of $600,000 to provide computer training and skills. This acknowledged the extent of digital exclusion experienced by many older people and the increasing need to improve their ability to participate in communication and services offered by the internet, especially in the context of the COVID 19 pandemic.

The Office for Seniors subsequently gave a contract to the Digital Inclusion Alliance Aotearoa (DIAA) to develop a digital literacy programme for seniors. This led to Better Digital Futures for Seniors, based on their Stepping Up programme, which appeared in June 2020. Research by Victoria University of Wellington described the different levels of engagement among older people from those who are highly skilled and engaged to those who see no reason to become digitally involved.  Four pathways were developed within the Better Digital Futures programme, each containing four 2-hour modules, to target groups of older people at different stages of their digital journeys:

  1. Introductory – reasons to go online, such as communicating with family, becoming less dependent on others, discovering suitable digital devices, and pursuing hobbies.
  2. Digital Essentials – computer and online essentials as well as options for connecting to the internet.
  3. Digital Engagement – for seniors who want to expand their online skills, focus on online shopping and banking as well as managing photos and solving common problems.
  4. Digital Safety – addresses concerns about protecting privacy and keeping safe online.

Older people, aged 65 plus, are able to choose one of these pathways and be referred to groups throughout the country, in local libraries, community centres, retirement homes, marae, and other convenient locations. Participants complete a pre-and post-training survey to help measure their digital skills and confidence.

Emphasising the importance of digital literacy for older people, Laurence Zwimpfer, writing in Digital Inclusion in June 2019 suggested that it should figure among the Key Action Area in the new strategy for older New Zealanders, Better Later Life He Oranga Kaumātua 2019-2034.  Digital education and digital inclusion do figure in number 4 of the five Key Action Areas  – Enhancing opportunities for social connection and participation. Zwimpfer suggests that Digital Inclusion should be recognised as a Key Action Area in its own right, given that it can contribute to all areas identified in the Strategy.  For example, as physical banking facilities are withdrawn, seniors are one of the most disadvantaged groups.  They are also amongst the most vulnerable when it comes to financial scams.  Seniors living in rural and remote areas are also facing new challenges in accessing health and social services and online technologies and services are starting to plug this gap.

Digital inclusion also figures in the Better Later Life/He Oranga KaumātuaAction Plan 2021 to 2024, published very recently. It is one of its three main priorities, alongside employment and housing. The aim is expressed as “Enabling older people to embrace technology and ensuring everyone can access essential services”. The proposed action includes ongoing activity by the Department of Internal Affairs, The Office for Seniors, and the Ministry of Social Development. Although the ultimate aim of digital inclusion is “an end state where everyone has equitable opportunities to take part in society using digital technologies,” there is recognition of people who do not use digital technology – “As people age, they safely use technology to improve their lives. People not online can still access the services they need.”

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Older people and the digital world – with COVID 19

Judith Davey 

I found a quote which really struck me in an article in the Canadian version of the on-line journal “The Conversation” –

When it comes to older adults, having the liberty to choose their involvement with technology can provide independence and autonomy. When the decision is theirs to make, their quality of life tends to increase, especially regarding social isolation.

There has been a lot of discussion recently of seniors’ digital literacy and their access to digital information and services through the internet. Yet they are less likely to have the means to participate than younger people. A 2019 government report – Digital inclusion and wellbeing in New Zealand[1] – estimated access to the internet by age (and other characteristics), using several sources of data. This showed that around a quarter of retired people and over a third of people aged 75 plus had no access. Internet access clearly diminishes by age, even though oncoming cohorts will have more experience. The youngest age groups could have 99% access.
The Citizens’ Advice Bureau followed up in February 2020 with their report – Face to face with digital exclusion- which looked especially at the impacts of digital public services on inclusion and wellbeing.
In Britain, the Centre for Ageing Better (which, incidentally, shares an acronym with the Citizens’ Advice Bureau), published Covid 19 and the digital divide: Supporting digital inclusion and skills during the pandemic and beyond, bringing the discussion right up to date in July 2021. I am looking at their conclusions in this blog post.

Findings

The findings of the research, which involved a wide range or organisations, can be applied to New Zealand, especially that –

• Even before the COVID-19 pandemic, people without access to the internet were already at a significant disadvantage, but the pandemic has made this worse because many people, for the first time, have had to rely on the internet and digital devices to access support, get things done and to participate more fully in society[2]. Typical quotes were about not having a device and having to book doctor’s appointments and shopping slots or not having access to library computers to check emails. Organisations responding in the research were helping people to do new things online, including online shopping and banking; getting devices and affordable data packages and helping to set them up.


• Digital inclusion is not just about being online, it’s also about building skills and confidence. The research identified that a significant barrier to digital communication for individuals was related to self-perception and lack of motivation.

• Organisations had to adapt to continue to support users throughout the pandemic especially given strong recommendation by government to stay at home. Many moved services online or to telephone connection and there are examples of how they achieved good practice and supported people despite the challenges. Examples included upskilling volunteers, who might also be older people.

• Many older people were not aware of how they could get help if they needed it, even when support was available.

• Local organisations reported an overwhelming demand for digital support during the pandemic, especially those in places with higher deprivation. Some had been effective at reaching out to communities and people, but some reported that it has been challenging to balance the demand for a wide range of digital support with the resources available.

• Beyond COVID 19 considerations, there is evidence that remote support can be more convenient to people and more efficient for the providers. On-line services could overcome the difficulties of travel and costs, as well as enabling sessions at more convenient times. There could be reduced venue costs and less time spent travelling in-between sites, allowing organisations to reach greater numbers of people. Users with mobility problems could find that the offer of a remote session was a positive development, for example for many types of medical consultation.

• “Non-digital channels still need to be supported. Over half of the British respondents said they still didn’t want to use the internet because “I don’t feel the need to” or “it’s not for me”. Some organisations were able to continue in-person services after making their venues more COVID-19 secure; others started telephone hotline services. There are examples in the report.

Recommendations

The UK CAB recommended that government agencies at central and local levels should recognise and support the important digital support offered by community organisations and offer increased funding. There should be collaboration on digital inclusion projects to identify who is excluded and lead to more targeted work between the authorities and organisations.

There is also an ongoing need for devices to be made available, especially for older people. Device recycling organisations could be helpful.

Non-digital options from both the public and private sector, such as telephone or mail , need to continue for those people who cannot or choose not to be online. “ The future model should be a hybrid one with remote as well as face-to-face sessions in delivering digital skills support.”

The next blog I will look at what is being done in New Zealand to combat digital exclusion and its effects on older people.


[1] https://www.digital.govt.nz/dmsdocument/161~digital-inclusion-and-wellbeing-in-new-zealand/html [2] The UK CAB research involved people in the 50-70 age group, plus public and community-sector organisations.

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Is NZ Super enough to fund a comfortable retirement?

It is no secret that New Zealand has an aging population. As medical care improves, we’re living longer – on average, 80% of Kiwi men aged 65 can expect to live until they’re 90, and women until they’re 94.

A longer life means a longer retirement, and a longer retirement means more spending. But with everyday costs becoming more expensive, many are finding New Zealand Superannuation and their retirement nest eggs are not enough.

New Zealand Super is not enough to pay for retirement

Considering the rising cost of housing and food, increases in council rates, and the low-interest rate environment for savings accounts, it can be incredibly challenging for retirees who no longer have salaried income to live a comfortable retirement on NZ Super alone. Research from the Financial Services Council shows that as at June 2020, a retiree living alone receives $873.88 fortnightly (after tax), while a couple receives $1,344.44 total.

According to the New Zealand Retirement Expenditure Guidelines, a couple wanting to live a ‘no frills’ lifestyle in a major city would need $1,670.68 per fortnight – and a couple wanting the freedom to live more comfortably with some luxuries would need $2,846.78 per fortnight.

As you can see, funding a dream retirement lifestyle is no longer possible on NZ Super alone.

Unlock an unexpected source of wealth

When it comes to managing these financial concerns, the good news is many Kiwi retirees are lucky enough to be homeowners – and house prices have increased immensely, meaning there may be some good capital gains to be had. However, many people would prefer to stay in the family home rather than sell up – and this is where equity release options, such as a reverse mortgage, can be helpful.

A reverse mortgage allows people over 60 to access some of the equity in their home, giving them the freedom to relieve financial pressure and fund a more comfortable retirement. Importantly, with a reverse mortgage you continue to own and live in your home and community for as long as you choose.

Unlike a regular mortgage, you’re not required to make repayments, as the total loan amount (including accumulated interest) is repayable when you move permanently from your home.

By unlocking some of the equity in your home without needing to make regular repayments, you could access the funds you need to cover day-to-day expenses, consolidate debt, complete home improvements, or even just go on a once in a lifetime trip you didn’t think you could afford.

Heartland has helped over 19,000 Kiwis fund a more comfortable retirement. To find out more about how a Heartland Reverse Mortgage could help you take the stress out of increased living costs, get in touch with their customer care team on 0800 488 740 or reverseinfo@heartland.co.nz to discuss your options.

Applications are subject to loan approval criteria. Heartland Bank Limited’s responsible lending criteria, terms, conditions, fees and charges apply.

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Senior living: a place to call home

Guest Blog by Private Care NZ

Getting older, it’s often said, is a privilege to be cherished. It’s different for everyone: some of us are keen to carry on working, some will retire, and some have whanau or family members whom we live with or care for. It’s often more than not one of these.

We also have our hobbies and community commitments, as well as health considerations. All these factors come into play when planning where we will live.

A choice that fits

In Aotearoa New Zealand today, and especially around our main centres, there is no shortage of choice in specialised retirement living. From the ‘village’ style communities, where single residents or couples choose from private, self-contained homes, through to partial-care or serviced apartments, and on to a more purpose-built, full-care environment.

These do suit many people, but of course, not everyone. Moving to a new neighbourhood can be a challenge, emotionally and physically – especially with the potential for lots of new people to deal with, and a change in access to our usual friends and support network. Moving can also be a rather large cost financially once we factor in real estate agent fee, moving costs, and the price of the new place we move into. 

Other considerations, like safety and independence, need to be weighed according to our own needs and capabilities. As these can change over time, it helps for both us and our loved ones to keep an open mind – as with most things in life!

Independent living

The benefits of staying in our own home, or downsizing to a similar one independently, are many. Not having to relocate helps provide a reassuring continuity to daily life, and allows us to keep our preferred routines and privacy.

If we don’t own our home, or if downsizing is less of an option, sharing with friends as housemates can be a sociable and more cost-effective way of maintaining our independence.

Getting the right support

Those of us living with certain health conditions can be eligible for government-funded care. However, private carers are also available – allowing you to specify exactly the kind of help you need. It might be making meals, certain household tasks or personal care and grooming – anything that will support you to keep living comfortably and safely.

Making the most of technology

Throughout our lifetimes, we have seen extraordinary leaps forward in the tools we use to communicate. Video calls were once a concept for futuristic fantasy movies, and now they’re part of many people’s daily life.

As with any tool, smartphones and computers are easy to use with a bit of practice. Most care providers will have a tool for you to request and change carer visits, which connects straight into their system and is free for you to use around the clock.

There are also personal medical alarms, like Freedom Medical Alarms, which provide peace of mind knowing that help will find you fast in an emergency.

Where to from here?

If you’ve got these matters on your mind, a good first step can be talking to your GP – potentially alongside a whānau member or support person. They can advise you on your current health needs, how these might change in future and what support options are available to suit.

If you’re keen to know more about personalised care that lets you stay in the comfort of your own home, get in touch with Private Care NZ by calling 0800 55 55 88 or visit www.privatecarenz.com.

For more information about how medical alarms can keep you safe at home, call 0800 380 280 or visit www.freedomalarms.co.nz.

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Active Travel – barriers and enablers – Part 2

Judith Davey

The second part of the Centre for Ageing Better (CAB) 2021 report covers the role of the environment in encouraging or discouraging active travel (walking and cycling) among older people.

Supportive infrastructure for walking and bicycling

There should be continuous and easy-to-follow routes for travel for the duration of a journey, whether on foot or by bicycle. Any danger, posed by motorised traffic and other risks and obstructions should be minimised. Supportive infrastructure also requires good streetlighting.

Connected street networks

Environments that are connected and create shorter and more direct routes to key local destinations encourage walking or cycling, compared to driving. These would feature a high density of intersections, crossings at junctions that are safe and easy to use, minimal dead-ends (cul-de-sacs) and traffic calming measures, such as low speed limits. In several; New Zealand cities 30 KPH speed limits have been introduced in central areas, but need to be enforced. In Wellington there are attempt to improve “lane-ways” – traffic-free alleys between the main streets, which can be attractive and safe for pedestrians.

High population density and mixed land uses

Areas with high population density and mixed land use – where shops, housing, workplaces and other amenities are close together – meaning journey distances are short and can encompass a range of activities in one trip.  Places where people can meet their everyday needs within a short walk or cycle, have become known as 20-minute neighbourhoods or 15-minute cities – concepts which are being adopted in urban planning in this country. Aiming for this type of development will boost not only levels of physical activity but also local economies, while at the same time tackling climate change (by reducing vehicle emissions). Wellington City is promoting higher densities in the central area through increased zooming for apartments.

Implications for policy and practice

Many local authorities and local transport authorities have not given specific consideration to older people and those approaching later life when designing active travel schemes. To increase active travel options policymakers and planners should:

Invest in walking and cycling infrastructure

This includes improving and maintaining pedestrian pavements; keeping an eye on deteriorating surfaces and making them smooth; fixing potholes; providing good pedestrian and cyclist bridges and crossings; and implementing traffic-calming measures such as reduced speed limits. This ideally means walking and cycling paths that are physically separated from motorised traffic of which there are already some examples in New Zealand. Good street lighting is also important.

Invest in street networks to provide connectivity

Design and re-design street networks that start from the doorstep and are connected to key local destinations, maximising accessibility and allowing pedestrians and cyclists shorter, more direct trips.

Emphasise safety

Fear of traffic, whether real or perceived, is a key barrier among people as they grow older, so emphasis should be made to improve infrastructure and crossing facilities to increase accessibility, convenience and safety. They should also provide easy and safe connection to public transport for longer journeys. Neighbourhood street networks should dovetail with ‘whole town/city’ networks.

Invest in aesthetic improvements

Seating, planters, community parks and green spaces add to a greater visual sense of pleasure and comfort.

Aim for longer term plans to increase population and housing density

Increased density, alongside mixed land uses supporting diverse local amenities, services and facilities – will help to ensure that distances to be travelled are short and therefore more amenable to walking and cycling.

Recognise the role of public transport

The availability and accessibility of public transport can increase walking (and, to a lesser extent, cycling). Street networks should be designed with direct access to numerous bus stops (with shelter) and a convenient and extensive network of bus routes. The buses themselves must be accessible and safe for everyone.

Conclusion

Findings from the CAB reviews lead to the view that combining environmental interventions with behaviour change approaches is likely to have a greater impact on uptake of active travel than environmental interventions alone. Actions to encourage active travel must take account of, and be based on an understanding of, attitudes, beliefs, and motivations as well as improving the built environment.

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Active Travel – barriers and enablers

Judith Davey 24/8/2021

In early August the Centre for Ageing Better  (CAB), in the UK, published Active travel and mid-life: Understanding the barriers and enablers to active travel, The CAB (https://www.ageing-better.org.uk/) is a charity which produces relevant and well-researched material on current issues related to ageing. It commissioned research on the barriers and enablers to participation in active travel for the 50-70 age group. The report draws on a wide range of relevant recent literature. This blog post looks at the results on barriers and enablers. The second blog post looks at findings on the role of the built environment in encouraging or discouraging active travel.  

Active Travel and its benefits

The promotion of “active travel” – defined as walking and cycling – is based on the belief that:

“being physically active helps to prevent and delay the onset and progression

of many age-related diseases and conditions that cause disability in later life. For individuals who have already developed a health condition, physical activity can help them manage their condition and maintain their functional ability, their independence and their quality of life as they grow older.”

Yet the UK data show that the proportion of people who are physically inactive (meaning they are doing less than 30 minutes of physical activity per week) generally increases with age, beginning to drop around the age of 50. About a quarter of adults aged 55-74 are currently inactive, and nearly half of all adults aged 75 and over. Active travel – walking or cycling for everyday journeys -is a key approach to increasing levels of physical activity.

What are the motives for active travel?

There appear to be two distinct sets of factors that influence participation in

active travel – 1. psychological, social and cultural factors, and 2. the impact of the built environment. Motivators for active travel, as found in the relevant literature, are –

Health benefits – this was the most important motivator, often expressed in general terms, such as ‘getting exercise’ or ‘helping the weight’, rather than specifically in relation existing health conditions or reducing the risk of developing health conditions. Mental health benefits (relaxation and stress reduction) are almost as likely to be identified as physical health benefits.

Enjoyment of the outdoors – expressed as enjoying fresh air, being in green spaces, feeling free, being open to social contact and feeling part of the community, were all noted in the literature. The report comments that ”protecting the environment”, “saving the planet” or “reducing carbon” was more likely to be mentioned by people aged 65 plus. It would be very interesting to know if these patterns would also apply in New Zealand.

Feeling free, independent and in control – this related especially to independence from cars.  Walking and cycling were seen as quicker and more predictable than car travel. This, of course might depend on location, whether in a city or a rural area, and also on the time of day.

Preparing for an active retirement – many people make a deliberate choice to become more active on retirement, perhaps because they find they have more time. Retirement, or the contemplation of it, can thus prompt changes in active travel habits.

What are the barriers to active travel?

Personal safety or feeling unsafe – older people may feel safer in a car than waking or cycling. And in some areas there are obstacles and hazards in the walking infrastructure. There has been considerable discussion in New Zealand about the hazards to pedestrians posed by other footpath users, such as scooters and, skateboarders. Not to mention advertising material, shop displays and outdoor café furniture.

Declining health or disability – people with health problems or a disability are less likely to see walking or cycling as viable alternatives to short car journeys. They may also be discouraged by lack of accessibility.

Prevailing car culture the car is commonly viewed as the ‘normal’ mode of transport. For many people, using the car has become habitual and a part of a normal lifestyle, even for short journeys. In rural areas, the car is often seen as essential for transport especially in the absence of public transport. 

A lack of motivation or desire to prioritise active travel – perceptions of not having the time, that it is “too far to walk”, and bad weather. This will be encouraged by perceptions of congestion and danger, already listed.

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Music: for Good or Ill

Dr Doug Wilson – 20/08/2021

There are few people who don’t have happy or sad memories based around music. It appears to be a fundamental, almost primeval emotion. Primitive tribes, unsullied by exposure to the choruses of great music from other civilisations, each have their own music and dances, based on rhythms, drums and singing. We interpret the sounds of whales as songs, even if they might be communication vehicles. Old people remember hit songs of their youth far better than hot music of today. Patients with dementia frequently are roused by musical memories, and temporarily break from their locked in shells.

The power of music. At its best it uncovers deep, honest emotions, even many years after an event often recalled in curdling clarity. In June 1968 Bobby Kennedy was assassinated. After the death of his brother Jack it seemed the world desperately needed a new leader of hope, and maybe that was Bobby. I’d recently met some American Rhodes scholars based at Oxford University. Bobby had just visited them and they were converts. Two day later we had tickets to a concert by the great African American soprano Leontyne Price in the 10,000 seat Albert Hall in London. She was booked to sing with one the great London orchestras. An opening announcement said she was a close friend of Senator Bobby Kennedy, and wished to honour his memory by singing, unaccompanied, 3 spirituals. She asked that there be no applause. As the huge audience sat on their hands and sniffed tearfully this great opera singer filled the historic hall with her peerless voice. She sang from the very bottom of her soul, tears streaming down her face, the orchestra still and silent behind her, heads bowed, many crying. Ten thousand captured by the intertwined magic, drama and tragedy of the event ached to stand and clap. But silence was a far more powerful conclusion. The power of music.

For those of us able to recall the 1960s, there were the phenomena of Elvis Presley and the Beatles. Rock music burst from the steady jolly beat of 1950s pop music, into the wonderful 1960s wild world of rock, and the extraordinary creativity of 4 guys from Liverpool. The impact was global for these overlapping influences. TV, radio and film built them into musical, almost religious cults. From then and since the popular music world has found its stars and super stars. Longevity is reserved for the very few, like Elton John, Michael Jackson, Stevie Wonder, Rolling Stones, Prince, and Bruce Springsteen. Others on records, movies, TV clips and you tube have outlived their lead singer, like AIDS victim Freddie Mercury of Queen, and their visit to Wembley stadium. Some of these older musicians are now star turns as they reprise their great days of decades before. I have friends, 60 years and plus friends, who are Rolling Stone groupies, and try and attend as many international concerts as they can, and love it. Those were their days.

The power of music to bless. It converts most everybody to happy and warm emotions, when the stars align. For the older community these memories don’t disappear; they may fade but play their favourites and the memory banks light up, and smiles and glowing harmony abound. Play for the poor sufferers with dementia and see how they respond. Amazing are the stories of individuals suddenly emerging from the dementia fog, to reprise a tiny view of themselves decades before. Glen Campbell was one of those; he could play and sing, but not recognise close friends, causality from his Alzheimer’s. Play for those who struggle with vision and support their hearing, their major alternative sense.

Various countries’ national anthems can stir the blood, even of their opponents at large sporting events. The French La Marseillaise, and Wales Land of my Fathers sung by 70,000 locals is are classic calls for patriotism, tears and country.

At my high school it was tradition for the entire school to sing the Messiah, the great oratorio of Handel, with the Hallelujah chorus as the star. Five hundred boys, as loud as each was able, a few wonderful voices, many shrill sopranos, the crackling of pubescent voices, the newly minted basses and tenors, the blazing roar of the organ at full blast, and we glowed and loved this thrilling event, boys enthralled and captured with 18 Century religious music. That must have brought in the faithful in the mid-1750s. It certainly still does today around the world.

Once, in the 1990s my wife and I attended a great restaurant in Paris. The maître d, learning we were from New Zealand declared he was a rugby aficionado. Zey recently had ze All blacks to dine. They sang these Mori songs, fabulous. Can u sing? My wife Adele, with her great voice, sang unaccompanied the Maori Po Kare. The restaurant was silent, the boss directing them to hush. Then they customers stood up hollering, cheering with joyful French élan. We were friends of the city. The maître d, with tears in his eyes kissed my wife and thanked her and presented a fine cognac. Who ever suggested the Parisians were not friendly.

The power of music over the generations builds communities of certain ages where they gather and share their emotions, learnt with the common love of music which had burgeoned in their time, their musical highlights, genres and performers. Behind that are the great music of the classical and operatic traditions. Even today an aria like Nessun Dorma from Puccini’s Tosca, and Beethoven symphony 9, the great choral symphony, can attract thousand even hundreds of thousands together to share, love and enjoy.

But the power of music is not always reserved for the good and the joyous. The Nazis in Germany were masters of the huge assemblies, big bands and Wagnerian tributes to supremacy of the Fatherland. William Sargant, a 1960s English psychiatrist, author of a book on brain washing: Struggle for the Mind, proposed that many robust religious groups, laudable music events, but also evil assemblies were brought together by various contrived musical performances and rhythms. He showed films of such disparate groups as Mayfair drug parties, fundamental Christian church services with wailing and speaking in tongues, voodoo rites in Haiti, Nazi rallies and rock bands. Rhythms were a major common factor, but all could engender similar states of ecstasy and escape and, if needed, unsavoury objectives. Ah the power of music.

Music is for everyone, just about. Treasure its power to entertain, to lift spirits when they are low, to move, and to give visible face to deep emotions, and as haunting accompaniment for permanent farewells, where the shared music and emotions tie close friends and loves together for ever.

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