Older People and Drugs – legal and illegal 1. Illicit drug use and its consequences

Judith Davey
13/07/2018

It is well known that how we live our lives has a profound effect on how well we age and our wellbeing in later life. It is not just a case of what we do when we reach our sixties. I often wonder what young people are doing to their hearing when the sound at rock concerts can be palpably felt on the body; when exceedingly loud music is pumped directly into the ears through headphones. Let’s hope that advances in hearing aid technology keep up – both in efficacy and affordability. But that may be sour grapes on the part of an ageing kill-joy and, anyhow, it is not what I want to talk about in this and the following blog. I want to start with illicit drug use.

For those who can remember that far back in drug use history – in the 60s the fashion was LSD, in the 70s (and ongoing) cannabis, in the 80s and 90s Ecstasy, then “party pills” and now methamphetamine/P. This is not an exhaustive list, but it illustrates that we have had significant levels of illegal substance use for many decades.

Some sources suggest that at one stage New Zealand had the highest per capita rate of heroin use in the world and we may now top the world for marijuana use. A 2015 Global Drug Study found that, in the previous 12 months, more Kiwi respondents had smoked pot (32.5 percent) than tobacco (30.1 percent).

So the length of time that this smorgasbord of drugs has been around means that users are now reaching their fifties and beyond. A report from the Royal College of Psychiatrists (RCP) in the UK in March of this year concluded that the proportion of older people with substance misuse is rising more rapidly than can be explained by the rise in the proportion of older people in the UK[1]. And the “baby boomer” population, who are all now aged over 50 is at the highest risk of rising substance misuse in the older population. These are the people who may have participated in and enjoyed the successive fashions for illicit drugs, which I mentioned at the beginning, so they could be exhibiting cumulative effects in the same way that earlier tobacco smoking can have long-lasting consequences. The RCP further conclude that the misuse of illicit drugs such as cannabis and amphetamines and prescription painkillers is a growing public health problem. And substance misuse in older people is associated with reduced life expectancy and accelerated ageing, which is further compounded by socio-economic deprivation and chronic mental and physical health problems.

The older heroin addict

The RCP reports that drug treatment services in the UK have increasing numbers of patients who are being maintained on opioid substitution treatment (to counter heroin addiction) into their 50s and beyond. It was once believed that illicit drug users ‘matured’ out of their drug use, but there is evidence that older heroin users do not reduce their use as they age.  Older people with a history of heroin dependence have poorer physical health and social functioning than their non-dependent peers and show high levels of depression, PTSD, anxiety, arthritis and hypertension, not to mention liver disease, through hepatitis C infection.

This may be an extreme result, but many years of illicit drug use may leave older people with poor physical health, reduced mobility and limited social support. Death rates in older people with substance misuse are higher than in the general older population.

This situation results in increased demands on a variety of services such as older people’s mental health, primary and social care, acute hospital services and help from the voluntary sector, not to mention criminal justice for continuing users. Often staff in these settings have little specialist knowledge of how to deal with the older people involved. Older people, with ongoing problems related to drug use have distinctive and varied  needs, requiring diverse responses from services. Hearing their voices and encouraging close links between health and social care services, as well as family and carers, will be needed.

It may also be difficult to place ageing drug users in mainstream residential care. Some countries (e.g. Denmark, Germany, Netherlands) have developed specialised nursing homes and accommodation services for this group, but there are concerns that this process may introduce stigmatisation and increase social exclusion.

But then there are the legal drugs – alcohol, prescription and over-the-counter remedies. How much of a problem are they in our ageing society? Next time……

 


[1] Royal College of Psychiatrists  (2018) Our Invisible Addicts, 2nd edition.

College Report CR211, London. The report also involved   the Royal College of

General Practitioners and the British Geriatrics Society. It follows on an earlier report published in 2011.

 

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It matters what we call older people

Judith Davey

29/06/2018

I once asked my students for examples of epithets used for older people. I got the usual: oldies, grey-hairs, wrinklies, geriatrics. And a new one, apparently from the USA – “geezers”. None were complimentary, but none as bad as one I heard from a government official once – “pre-dead”.

There has been ambivalence about ageing for millennia. On the positive side, throughout time leaders have been greeted with “Long Live  X!” The Old Testament is full of statements in which long life is seen as a reward from God.

The fear of the Lord prolongs days: but the years of the wicked shall be shortened (Proverbs 10:27).

A grey head is a crown of glory; It is found in the way of righteousness (Proverbs 16:31).

But Shakespeare, in the “Seven Ages of Man” speech[1], is not complimentary about old age. The sixth age is “the lean and slippered pantaloons…. his big manly voice turning again toward childish treble”. And the last scene of all “Is second childishness and mere oblivion. Sans teeth, sans eyes, sans taste, sans everything.”

I like the Grimms’ story quoted by Simone de Beauvoir in The Coming of Age (1970, p. 135).

God set 30 years as the lifetime for man and animals. The ass, dog and monkey wanted this reduced to, respectively, 18, 12 and 10 years. Man asked for longer – so he was given 30 years as a Man; 18 as an ass, carrying burdens and feeding others; 12 as a dog, growling; and 10 as a monkey, without wits, making children laugh (adding up to 70).[2]

Nowadays, there is still ambivalence. “Old” can be a term of endearment – “good old so and so” we often say.  But “dirty old man” is not complimentary and “elderly” is demeaning, assuming frailty and inactivity.

Paul Spoonley, interviewed on RNZs “Nine to Noon” programme on 19th June agreed. He talked about much longer lives and the increasing prospect of living to 100 years and beyond. On this basis the sixties decade is “middle aged” – 75 is the new 65. Are we applying “elderly” to an age group spanning 35 years or more, and two generations?  The Kapiti Observer of June 14th, under the heading: “Should we ban the E word?” quotes Spoonley and gives examples of people in their sixties being described as “elderly”.

So “elderly” is roundly condemned– perhaps only to be used, if at all, for the very frail and dependent. So I was surprised to hear that a model law for ” The Protection Of The Elderly “ drafted by the John Hopkins University School of Advanced International Studies International Human Rights Clinic, dated  2012, was up for discussion at an event is to be held in Wellington in August. This is called, “Positive Ageing Strategy and a Constitution for older New Zealanders; Informing the discussion,” clearly linked to the consultations, led by the Office for Seniors, to update the 2001 Positive Ageing Strategy.

I read this draft law and, while it can be applauded for its aim to promote respect and appreciation for the participation of older adults in the community; to protect their rights and interests and provide them with the support necessary to sustain the quality of life and dignity; older people are consistently referred to as “the elderly” and frequently their autonomy and ability to choose does not appear paramount. “The family” is given the main responsibility for care and support, with the state coming in only when this is not possible. Further examples –

18.3. The State shall have the duty to take measures to carry out cultural, sports and recreational activities of a public nature that are suited to the elderly in order to enrich their cultural life.  

Who decides what is “suited”? Where does it say that older people should make their own choices?

18.8.1. Implementing a policy to encourage employers and the public, in general, to understand the importance of employing the elderly, to stabilize employment, and to find ways of meeting problems arising from the impact of age on employment.

Yes, but ideally on terms set by the older people themselves, giving them a strong say in working conditions. We shall see how this discussion progresses.

One of the first blogs I wrote for Age Concern asked –What’s special about human rights for older people? The United Nations has conventions protecting the rights of population groups – women, children, refugees, prisoners, people with disabilities. But nothing specifically covers the rights of older people. Does this matter? Doesn’t the Universal Declaration of Human Rights say that “all human being are born free and equal in dignity and rights”?

I believe that any document, UN-sponsored or otherwise, must be based on the preferences of older people in relation to their lifestyle, residence, assets and relationships. Not that they are treated as passive and incompetent and certainly not clumped together as “the elderly”. As I concluded before, respect for older people’s rights benefits everyone. Because, if violation of these rights leads to exclusion, poverty and discrimination, then society is robbing itself of the potential that older people represent and of their contributions based on their experience and wisdom.

 

 

 

 


[1] “As you like it”.

[2] All these examples refer to men or “man”. Sometimes virtuous women were also rewarded with long life.

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A new idea to fund your retirement

Dr Judith Davey

15/06/2018

Many of the (many) discussions about retirement income and about the financial aspects of retirement, talk about the “three pillars” model (originally put out by the World Bank in the 1990s), recognising that income in retirement could come from several sources. In the New Zealand context, the first pillar will be NZ Superannuation, which everyone receives at the same age, subject to residence requirement and with the same amount of money, depending on their living circumstances – living alone, living with others.

The second pillar is an occupation-based pension, based on contributions throughout working life. Workers’ contributions may be supplemented by employers’ contributions and the money invested. In NZ this is Kiwi Saver (KS), which is a relatively new scheme. It is not compulsory and it will take a while before people receive significant lump sums when they reach age 65 and their schemes mature.

The third pillar is either a private pension, arranged by individuals themselves, or income from savings – interest, dividends, possibly rents. The third pillar therefore depends on the ability of the individual to save and to invest.

As the proportion of the population over pension age (please do not say retirement age, as I will hit the roof. THERE IS NO RETIREMENT AGE IN NEW ZEALAND) increases, governments around the world are becoming more and more concerned about the cost of providing retirement incomes to older people. This has led to increases in the age of eligibility and other means of cutting back. It has also led to great “financialization” . What this means is that government policies are shifting more of the responsibility for retirement income planning to individuals. In this case, more and more, retirement income will be funded from financial market returns, subject to market fluctuations.

Our first pillar – NZS – does not fall into this category, although it may be subject to political fluctuations. Even here, the New Zealand Superannuation Fund (the so-called “Cullen fund”), which is intended to help pay for NZS as the demand grows, is invested in the international financial system and its returns cannot be guaranteed. Kiwi Saver – our second pillar- is certainly financialized. Contributions from regular wages or salaries go into investment funds run by private companies. The size of the lump sum delivered on maturity depends on the state of the financial markets over the period of investment and also on the skills of the fund managers to deliver good returns. Individual Kiwi Savers are subject to these uncertainties. They also have to be sure they have chosen the right KS scheme in the first place. Two people could have put the same amount into their KS pots but will get different pay-outs depending on the performance of their separate schemes.

To turn to the third pillar – self-funding. Could individuals do better by managing their own savings and investments to produce an adequate retirement income? Do people have adequate information and expertise to make appropriate and informed investment decisions. Not to mention enough self-discipline to save enough. This pillar does not get any subsidy from government, like KS. There is no tax relief on contributions to private schemes, which was the case in earlier times. Earnings from investments are subject to taxation. But, in this approach, people are freer to choose how they use their own resources to plan for an adequate retirement income.

There may be a fourth pillar to make our retirement income edifice more stable. I spoke about decumulation in my blogs last September. This means running down savings and investments to increase current income. Some people can trade-down to smaller/less expensive dwellings (perhaps moving into retirement villages), or take on commercial equity release schemes, mainly in the form of reverse mortgages.

Many people die with money in the bank, perhaps for a “rainy day” which never came; perhaps to provide inheritances; perhaps through inertia. But perhaps our savings could be used for a new form of retirement planning and a new source of income in later life to supplement the less reliable sources I discussed above.

In March this year I blogged about older people and entrepreneurship. Could this be a new source of retirement income? Could people develop businesses from their fifties onwards specifically to derive income from them when they retire from employment? There would be several advantages – it would allow more control over personal resources. It would provide stimulation and a way of applying accumulations of wisdom and know-how and a lifetime of building networks and contacts. It would avoid age discrimination by potential employers. The business could operate from home, allowing work to be more easily combined with caring responsibilities for relatives and grandchildren. Work at home would reduce costs. Modern technology can provide sophisticated communications and even production – 3D printers. It would be a new concept of home-work balance.

Risky, are you saying? But no more risky than seeking to create income through the volatile and uncertain financial markets, which have been called “the gaming tables of a global casino.”

What are the possibilities? Internet shopping, personal service delivery, writing and editing, small scale printing, catering, cakes for special events, bed and breakfast. The possibilities are endless. Older entrepreneurs rule!


[1] Thomas Wainwright and Ewald Kibler (2013) Beyond Financialization: older entrepreneurship and retirement planning. Journal of Economic Geography, vol.14 pp 849-864

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How business can respond to an ageing population (and perhaps save the world!)

Judith Davey
1/06/2018

bike

As I observe NZ society in its adaptation to population ageing, I take a special interest in business enterprises which have sprung up in response to this world-changing  trend. The private sector has done a lot better than many areas of government in recognising the implications.

  • Driving Miss Daisy started up in Havelock North in 2008, building on an idea from Canada. It now needs no introduction and has franchises operating in most main centres.
  • Since 2000 Elder Family Matters has provided a range of services for older people in their own homes, ranging from companionship to palliative care – “Our purpose is to enable healthy and happy elders and their families living as they wish to live.” They operate in the Greater Wellington region and Palmerston North.

These are two examples and I am sure that others are emerging. However, while trawling through the literature for my research on older entrepreneurs (see blog of March this year), I found a wonderful example from Indiana, USA , which combines entrepreneurship and product development to suit older people[1].

Pedego is a company, founded in 2008, which makes bicycles and is USA’s leading brand of electric bike. Most of its distribution is through independently owned branded stores usually launched by people in their 50s and older. They encountered the bikes as consumers and came to corporate Pedego’s rescue in the early days, when it was struggling for lack of distribution.

The 50-plus age group also makes up Pedego’s primary market, many returning to two wheels for the first time in decades. The entrepreneurs built their bikes to accommodate older bodies.  The spirit was willing, the flesh, perhaps, not so much. Electric bikes acted as “psychic training wheels”. “A lot of customers had bad hips, ankles, hearts, whatever,” says Pedego’s CFO. “If their hip starts to hurt, they can just use the throttle. So they are willing to venture out and do things because they know they have the ability to get home.”

They realised that the then-existing electric bikes didn’t cater to that audience. Most came in black and positioned riders to lean forward. Older customers wanted colours and to sit upright. They also wanted models they could mount easily. So they hired a computer-aided-design professional.

At first, bike stores shunned the product. “”They think electric bikes are cheating.” For a while, the founders sold bikes to their friends, who in turn sold them to their friends through parties—not the usual business model. But then a customer asked if he could open his own branded Pedego store and now they receive about 400 inquiries a year. The average customers are a 58-year-old man and 57-year-old woman; some customers are as old as 95. Often they were introduced to electric bikes while hiring them on holiday. One enterprising store owner, with previous marketing experience, rigged up a simulator to train people on the bikes and an indoor track for test rides in poor weather. Others organise regular group bike rides.

The secret appears to be that older customers trust someone who looks like them more than they’ll trust the Lycra-clad enthusiasts who haunt traditional bike shops. When they see the store owners still going strong – out there riding and enjoying life – they get “a sense of hope”. Says a 61-year-old owner, “I can say to a customer, ‘Look, I had my knee replaced.’ And the guy says, ‘Oh, I had my hip replaced. We talk about aches and pains, hills and headwinds.”

At a recent dealers meeting, two new products were introduced – an adult tricycle (I would certainly be in for one of those) and a vehicle for people with disabilities. So the innovation continues along with the health, social and environmental benefits, which I am sure my blog-readers will have noticed from this example.

 

[1] Leigh Buchanan, Editor-at-large, Inc. magazine – Boomers Are Ditching Retirement for Entrepreneurship: And They’re Killing It. March 9, 2017.

 

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More about the cause of “wrap rage” Why don’t manufacturers make more accessible packaging?

Judith Davey
18/05/2018

This is a good question. There are many reasons why making packaging usable by a wide range of people must be good for manufacturers. On her blog, Becky Taylor says – “Designing packaging that allows for universal usage therefore makes good sense from a strategic standpoint, but even without this economic incentive I believe that brands also have a responsibility to ensure that their products are accessible to all” .

Developing accessible packaging is an investment for manufacturers, as satisfied customers can result in increased profits and a well-respected brand identity. A product that is known for being easy to use and accessible for people with impairments is likely to be favoured by consumers who have difficulties with packaging. With an ageing population, this group is sure to increase . “It’s great for customer satisfaction and ultimately, improving sales. The market for easy-open products is huge”. So what is stopping them?

Are there any signs of a response?

Some commentators suggest that the packaging industry is very set in its ways and not ready for change. There is often an assumption that making packaging easier to open is going be very difficult or automatically very expensive. Manufacturers may be committed to a certain pack format which they believe is needed for consumer recognition. Another barrier may be regulatory requirements, for reasons of security (as with medication). Rules about labelling, or which compel suppliers to put a lot of information in a small space may make things difficult for people with less than perfect eyesight.

It seems that small to medium organisations may be better attuned to the need for more accessible packaging. They may have a greater scope to fundamentally redesign a product. With a multinational, the process of making a fundamental design change to a brand, especially one used nationally or globally, can be quite significant. But if you’re a small manufacturing company and somebody says, “here’s an opportunity, here’s how to redesign the product, you can just say ‘yeah’, let’s do it”. This can produce a competitive edge – “you can pick up contracts and replace existing suppliers in a market just by putting the consumer at the centre of the design process.”

Easy open packaging is a point of difference and gets away from price-only competition. Where a lot of companies are competing on more than price, winning contracts may be the rewarded for innovation.

An example I found on the internet is Ecobliss India. Its ‘easy opening’ blister packs have a special focus on “aged” customers . They aim to minimise the use of tough adhesives, use thin and easy-to-tear materials, simple instructions and opening features. They illustrate a new design for a toothbrush with an easy-to-open blister package. The design is simple; a blister presenting the product is encased in a printed cardboard card. After folding back the cardboard card, the customer can simply slide the product out of the blister. “Finally, no more cuts and puncture wounds due to jagged edges”.

“Imagine, the plight of an elderly person unable to access a special toothbrush from a blister pack and who may end up throwing away the product without using it”. Chakravarthi, managing director of Ecobliss .

Packaging Pic

What could help?

Getting feedback from consumers is crucial. Manufacturers could benefit greatly from the insights of older consumers, especially those with impairments.

Arthritis NZ’s initiative (the survey mentioned in my previous blog) is a good example of informing manufacturers. Arthritis NZ is now working with the Packaging Council and packaging companies to address accessibility for people with arthritis. Arthritis Australia has set up an Initial Scientific Review (IRS) which rates products according to their accessibility.

Perhaps what is also needed is some direct action by consumers. Boycotts of troublesome products could be considered. Not quite about accessibility, the example of older people who left all their packaging at the supermarket is worth a look.

1 http://www.mmr-research.com/blog

2 https://www.healthcarepackaging.com/article/applications/healthcare/accessibility-medical-packaging-learning-people-impairments

https://foodmag.com.au/packaging-accessibility-an-ageing-issue/

4 http://www.blisternews.com/wp-content/uploads/2014/03/easy-open.jpg

 

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Inaccessible packaging can threaten composure and life itself

Judith Davey

7/05/18

Reading through “Joint Support”, the Arthritis New Zealand newsletter, recently (March 2018), I came upon an article about a packaging survey initiated by the organisation. Although this was aimed at people of all ages who have arthritis, it got me thinking about how the challenges of packaging access will apply to many older people, with or without the condition – and I am well aware how these challenges have already confronted me!

Packaging access problems

Medical products

Requirements for safety of medical products can compromise ease of access to them.  Packaging must protect products from contamination, tampering and damage without making them too difficult to open. The physical action of opening the packaging usually requires some manual strength and dexterity. If users have impaired cognitive, visual, or physical abilities as a result of illness, disability, or old age, the task of opening packaging can be a major inconvenience, even when their independence or even their lives depend on the medication. Being unable to open packaging may make people less likely to adhere to their medication regimen and so to manage their medical conditions.

Everyday grocery items

About a third of respondents to the Arthritis NZ survey said they struggled with the pull-tab seals on plastic milk bottles, either because the tab wasn’t big enough or because they had lost grip and strength in their hands. This was top of the list of hard-to-open packaging, here and in other surveys.

blog 1blog 2

Next came child-proof lids – “push and turn” – which require strength for the push-down action and problematic when a twisting action is needed at the same time.

A third set of culprits, which I am sure most of you will have come across, are products encased in hard shrink-wrap plastic, such as tooth brushes, batteries and small tools. Users have to pull apart both sides of the casing, often held together with a strong adhesive and often without a notch indicating where to tear. How often someone end up throwing away the product without using it?

Inaccessible packaging can cause malnutrition

For older people with reduced dexterity even something seemingly trivial, like not being able to open food packaging, can be a major obstacle to eating well. This is often an issue in hospitals, particularly when there is no-one to help patients open single serve and portion-controlled food items.  A Canadian study of 132 cognitively healthy nursing home residents found that 37% were at risk of malnutrition—and food packaging was identified as one of the primary contributing factors.

Access-related injuries

Another consequence of Inaccessible packaging is increased numbers of injuries caused when people resort to the use of tools such as scissors, sharp knives, razor blades, or even hammers in order to break through packaging. An investigation carried out by “Which” magazine in the UK suggested that, over a two-year period, 25 million people hurt themselves while trying to open packaging.  Not to mention wrist strain from trying to loosen jam jar and broken teeth!

Comments from the Arthritis survey

“I find my nutcracker very effective on salad dressing bottles.”

“A teaspoon can be used to open jam jars.”

“I need to use pliers on tins with pull tabs.”

 

Wrap rage

‘Wrap Rage’ is defined by Wikipedia as “the common name for heightened levels of anger or frustration resulting from the inability to open packaging”. How common is this? Not to mention public embarrassment and lack of independence by having to rely on other people (to open things – perhaps the last bastion of male “superiority”)[1].

Next time I will look at the problem from the manufacturers’ point of view.

 


[1] http://www.proportionfoods.com.au/significance-accessible-food-packaging/

 

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Another housing option – Divide and Share

Judith Davey

20/04/2018

Making better use of existing housing could be another way to the solution of our “housing crisis”. For a long time there have been suggestions, especially by public sector landlords, that older people should move out of ”family” accommodation to smaller units more suitable to their needs, thereby freeing up larger units. At the moment, four out of every five people aged 65 plus live in small households, either alone or with a spouse/partner only.

Interest in communal dwellings seems to be growing and could be appropriate for older people as they can provide assistance and companionship. In Europe “co-housing” often serves multi-generational communities, but Abbeyfield houses are a New Zealand example of senior co-housing.

But what if larger houses were subdivided into smaller units? This is the question posed by another PhD student in the School of Architecture at Victoria University of Wellington, who I am pleased to advise and assist as I can. The research goes beyond design into the implications for energy and resource use . But here I am looking at just some of the options for subdivision and how “sharing” is viewed by older people.

Examples of division and sharing

Typical New Zealand housing types were redesigned to Lifemark standards and proposals developed for each type with various degrees of sharing. These were presented to people aged 55‐85 using an online questionnaire. Respondents were asked how much they liked the design options; whether they met their housing requirements; and what they thought about sharing space.

I am looking at just two examples here (using the scheme names from the questionnaire for convenience):

1. An early 20th century villa with a central corridor. This could be divided into two separate units with a shared entrance (Scheme B) or into two “bed-sitters” with shared living areas (Scheme E).

scheme B

scheme E
2.  A 1940-60s single storey State House. This also could be divided into two separate units with a shared entrance (Scheme C) or into two “bed-sitters” with shared living areas (Scheme F).

scheme C.jpg

 

scheme F.jpg
The survey found that while almost 80% of the respondents were interested in either of the Scheme B units in the Villa example, only 52% found either of units in the State House example (Scheme C) acceptable. People preferred the larger units and more private space. Around 75% of respondents singled out private decks as important features. The original house did not have a deck; this was the only addition in the division. Two-thirds of respondents liked an open-plan kitchen and dining area, suggesting that this arrangement might suit smaller domestic environments.
A considerable number of respondents did not favour one-bedroom units, considering the need for an extra room for visiting guests, family members and live-in carers. In some plans for subdivision extra bedrooms could be shared. Schemes E and F could accommodate two older people, one person and a long-term live-in carer, or one older person and a lodger, which could be a way of giving additional income for the house owner.

Sharing Space

The survey showed that there was not much enthusiasm for sharing spaces and features inside the dwellings, especially living/dining rooms and kitchens. But almost 60% of the respondents were interested in sharing a laundry, perhaps because such facilities are often shared in multi-unit housing and because self-service laundromats can be an option.

In terms of the age groups which the respondents might be willing to share with, the 41-64 group received the highest votes, and the next choice was 21‐40.

Findings

The research carried out to date shows that it is possible to convert typical New Zealand houses to allow ageing in place in smaller units that are easier to heat and meet Lifemark Home standards. But this might not satisfy the target client group. There was little enthusiasm for very small living units and sharing space (apart from outside space). This suggests that engaging potential users in the design process at an early stage would be a good idea.

“Converting houses into smaller units …… seems like a good idea but is not worth doing unless people want to live in them.“


 

  1. Fatemeh Yavari and Brenda Vale (2017) Sharing Space and Older New Zealanders: Preferences for the Conversion of Existing Houses. In M. A. Schnabel (ed.) Back to the Future: The Next 50 Years, (51st International Conference of the Architectural Science Architectural Science Association (ANZAScA), pp. 305–314.Yavari, F., & Vale, B. (2017). User and expert perspectives on designs for converting existing New Zealand houses to make them suitable for ageing in place, in The International Academic Forum (eds.), East Meets West: Innovation and Discovery: Proceedings of The Asian Conference on Aging & Gerontology 2017, The International Academic Forum (IAFOR), pp.1-15.

Papers available at:
http://papers.iafor.org/wp-content/uploads/papers/agen2017/AGEN2017_35621.pdf
http://anzasca.net/paper/sharing-space-and-older-new-zealanders-preferences-for-the-conversion-of-existing-houses/

2. These diagrams are included here with the permission of the authors, but are subject to copyright.

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