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.

Posted in Housing and community environment | 4 Comments

Ageing in place – design for wellbeing

Judith Davey

6/04/2018

I have written quite a bit about housing in my blogs – using home equity to supplement retirement incomes; calling for a wider range of housing choices and the implications of more older people renting. But I have not delved far into detailed housing design issues.

So I was delighted last year to find three female PhD students in the School of Architecture at Victoria University who were interested in housing for older people. I have been doing my best to help and advise them and have been even more thrilled to see them presenting papers at conferences and publishing their work. With their agreement, I am using some of their findings in my next two blogs (one student has subsequently withdrawn).

One study looks in detail at older people with high care needs living in senior rental housing. This involved detailed documentation of the physical environment, followed by interviews with and observations of the residents and their caregivers. It identified design requirements which could improve quality of life, bearing in mind individual preferences and impairments.

Space for movement

Many older people with mobility problems require walking frames or trolleys to provide support, or hold onto walls and fixtures to keep their balance, when moving around indoors.

Conventional hinged doors, especially with different threshold levels, are difficult for people using these aids to manipulate. Sliding doors, that do not require much strength to open, are better. Doors take up valuable space even though they help to maintain privacy and retain heat. Movement could be eased by removing interior doors between lounges, kitchens, bathrooms and laundries.

Keeping the place tidy

This is important to help people feel that they are in control of their lives. To ensure that they can find things and put them away requires shelves within reach. The kitchens observed in local‐authority housing generally had cupboards/shelves that were impractical for their intended users.

Floor coverings which are easy to keep clean are important for people who are unsteady or whose hands shake.

Visitors

As well as having an environment which is presentable for visitors, older people in the study had a better sense of control when they could see visitors coming. This might require a view of the doorway or driveway from their sitting space, especially for people who found getting up difficult. In this case they could remain seated, call out a greeting and an invitation to ‘come in.’

Privacy

Privacy concerns are particularly important in grouped dwellings where many people pass by. Some residents shut their curtains because ‘people can easily look inside’. Windows need to be positioned to provide residents outside views, but limit views from the outside to the inside.

This is particularly important in cases where there are privacy needs related to incontinence, where toileting needs occur in the lounge as well as in the bedroom through the use of a commode, or other device.

Care

Assistance with showering is the most common personal care requirement and the experience of showering has a high impact on quality of life. Many older people want to do as much as possible themselves during showering to keep their independence and privacy. Many pensioner rentals do not have accessible bathrooms, especially for wheelchair users or those reliant on walker frames. A lack of space, or inflexible design, makes it difficult for caregivers to assist as there is rarely enough space for two people in the bathroom. Keeping wet and dry spaces separate is difficult; wet-area showers can be problematic as water can spread over the floor, increasing the risk of falling. In particular, bathroom design may make this difficult when room for undressing, drying and dressing is inadequate. As one caregiver said:

”She leaves her walker out there [out of the bathroom], because there’s not a lot of space. … And once she’s dry we’ll bring her walker back through with her clothes, and squeeze in where we can and manoeuvre around that. … The clothes that we take off her or that we put back on her, she normally has them all on her walker. … we leave that out there because there just not really enough space, you know, with the water and everything”.

Many respondents wished to be out of sight of their caregivers when they didn’t need assistance. “He never let me in [the bathroom], he’s a bit shy.” Having grab handles, handrails and other fixtures that can be held by the older person with both hands increases their safety and thereby their independence and privacy.

Comfort

Being warm is important when showering and drying. Running the hot water before people entered the shower or turning on a heater well ahead helped warm up an unheated bathroom. A caregiver said:

“I go to one man and he won’t have a shower and what they need is like a wall heater in the bathroom to maybe turn that on, get the room warm first and then they might consider going in the shower.”

I have often said that the greatest challenge for an ageing population in New Zealand is providing housing for older people with high care needs to live at home in the community – to “age in place.” Not to mention provision of the care services to go with the housing. There will be individual differences but the needs of independence and privacy, safety and comfort are basic to the quality of life for older people. Let’s hope that these research findings will resonate with designers and planners for the future.

 


 

  1. Yukiko Kuboshima, Jacqueline McIntosh and Geoff Thomas. (2017). Implications for the design of rental housing for the elderly that improves their quality of life. In M Schnabel (Ed.), 51st International Conference of the Architectural Science Association (pp. 783–792.). Wellington, New Zealand.
  2. Yukiko Kuboshima, Jacqueline McIntosh and Geoff Thomas. Bathroom Design for Assisted Showering that Improves the Quality of Life of the Elderly. (Under review for journal publication)
Posted in Housing and community environment | 7 Comments

Older people as entrepreneurs

Judith Davey
23/03/2018

If we look at synonyms for “entrepreneur” we get words like “tycoon”, “magnate”, “mogul” and “capitalist”. As I said in my last blog, my definition is simply a person who starts up a new enterprise in the private sector, usually, but not always, with the goal of making money. Entrepreneurship comes very close to self-employment. Following the definition in the literature, I am looking at people aged 50 plus.

What are the motives of older entrepreneurs?

Writing in a book published in 2009, Rogoff talks about those who “have to” and those who “want to”. The former are people who find that labour market conditions or discrimination prevent them from getting the job they want as employees. An example would be an immigrant who may have been well qualified in her own country, but who is obliged to take up a low level position.

The “want to” group are moved by wishing to use their skills and abilities in the way they see them; to make a contribution to society and to maximise their work satisfaction. Entrepreneurship is also a way of keeping up a professional presence, knowledge and contacts.

Let’s look at these motivations in more detail.

Following the dream

This may be something which has arisen from their previous career. Or it may be a totally different idea which has come into their minds. An example would be an amateur chef who hopes to open a restaurant.

Managing family and time commitments

If people cannot get the employment conditions, or employment locations, which suit their circumstances, then self-employment, where they are in control of these conditions, may be the answer.

Being your own boss

For many people this arises from dissatisfaction in their previous work. Autonomy brings enjoyment and satisfaction and sometimes the ability to accomplish a political or social purpose – setting up social services, education or health care for a special social or ethnic group.

Downsides of entrepreneurship

Rogoff mentions some less positive aspects of entrepreneurship in later life. One is lack of time to fully develop a new enterprise – less time to recover any losses or to re-build a career if an enterprise does not work out. Older entrepreneurs may find it more difficult to adopt long-term development plans, especially if they still have dependants or if they intend to build up an enterprise and sell it on for profit. There are some ways of getting around these draw-backs, such as partnering with others, purchasing existing businesses or franchises.

Entrepreneurship usually requires capital, but this does not necessarily mean financial capital. Older people have often accumulated rich stores of human, social and cultural capital. In any case, financial requirements may not be large for many service enterprises- gardening, home and pet care.

I have been thinking about how these motives fit with my own experience. I have been an entrepreneur/self- employed (but never a mogul or a tycoon!) at three stages in my life:

  1. When I was in India during my “gap year” (although the term had not been invented then), I started up classes for children coming up to secondary education age who were going back to the UK. Most of them had had their primary education overseas and so were not familiar with pounds, shillings and pence or imperial weights and measures. They needed coaching for the transition or to cope with exams such as the “11 Plus”.
  2. At the time when I had my first child there was little in the way of child-care. So, with another woman in the same situation, I started a contract research business – we were “consultants” in the days before everybody was! We shared the work and the child-care and organised both to suit ourselves.
  3. When I left my full-time job at Victoria University I reverted to taking up research and policy analysis contracts as and when it suited me, avoiding overloading my time and avoiding too much administrative responsibility.

 

Future opportunities for later life entrepreneurs

Rogoff is optimistic about the future for older entrepreneurs. Rapidly developing technology has made business ownership and operation more accessible. A lot of work can be done on-line from one’s own home. A long career in a large company is no longer seen as ideal, or as secure. Small enterprises are more flexible and contribute more to job creation. Watch this space!

 

 

 


Rogoff, Edward (2009) The Issues and Opportunities of Entrepreneurship after Age 50. Chapter 6 in Czaja, S. and Sharit, J (editors) Aging and Work. John Hopkins University Press, Baltimore.

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More older people are becoming self-employed

9/03/2018

We have been hearing a lot about the ageing of the workforce recently. The topic will figure in Age Concern’s conference in April this year.  It is a particular area of research interest for me. In my blogs I have listed the pros and cons of “staying on” in the paid workforce; described the attitudes of employers; and given examples of adjustments that forward-looking employers are making to retain the wisdom and expertise of their older workers. I have also written about unpaid and caring work in later life, upon which many of our organisations and communities rely.

But there is a dimension to this debate which has received less attention.  Among the choices which people have as they contemplate work in later life – part-time, part-week or part-year employment; casual and seasonal work – there is also self-employment. A rather grander way of putting this would be entrepreneurship – setting up a business and working for yourself.

What better way to realise the potential of older workers and to capitalise on their lifelong experience and skills than for them to create enterprises of their own.

What do we know about the older self-employed in New Zealand?

A common definition of “older ” is men and women who started or who are considering starting a new enterprise after the age of 50. To me this sounds rather young, but 50 plus is an internationally recognised threshold. Many countries define older workers as aged 50 plus (not too nice to think about when your children are not too far off this threshold!).

The NZ Census does not have a work status category for entrepreneurs at any age – assuming the above definition of entrepreneurship. But there is some data on self-employment – a related concept.

According to Statistics NZ figures, there were nearly 162,000 people aged 50 plus who declared themselves as self-employed in 2014. This had risen from 139,000 in 2000. The majority of these are men, but the female numbers have been growing rapidly since 2000, so that now almost one in three older self-employed people are women (see table below).

50 plus self employed

Within the 50 plus age group, between 2000 and 2014, the numbers of self-employed men and women aged 50-54 decreased, but there was substantial growth in the 60-64 and 65 plus age groups (see graphs). The same was true for women, adding in the 55-59 age group, although the numbers were lower.

self emplyed graphs

This reminds me of something I read a long time ago. In 1980, Nick Zepke put forward a scenario for New Zealand of a compulsory retirement age of 45, after which people would become self-employed . They would be part of a small scale “household economy”. Perhaps I could use this idea in my own mental picture. The age should be 60. After this people could either teach the skills they had learned through their working lives or, with subsidies (in terms of management training and seed funding), start up new enterprises to contribute to the economy and create jobs. I think it is worth thinking about.

Next time I will follow this up, looking at why self-employment/entrepreneurship might be attractive to older people.

 

 

 

[1] Harpham, M., Wilkins, P. and Zepke, N. (1980) Picture of the Futures. Mallinson Rendel Publishers, Wellington. Harpham and Zepke were then on the staff of the Commission for the Future, which was abolished by the government in the late 1980s.

Posted in Paid and unpaid work (includes volunteering) | 5 Comments

More Older People will be renters – A trend we cannot ignore

Judith Davey

21/02/2018

In December 2015 I critiqued a report entitled Homeless Baby Boomers. Since then housing problems have come to the fore and hardly a day goes by without a headline relating to the “housing crisis”. Often it is first home buyers who are seen to be suffering most. But here I want to look back to other research, which focused on older renters.

The rate of home ownership in New Zealand has been dropping since its peak in 1986, when 73.5% of households were owners, to 67% at the time of the 2006 census and 65% in 2013. And the rate is projected to fall even further in the future, even though homeownership is still somewhat higher among older people.

New Zealand housing policy from earliest times has emphasised the goal of home ownership, imparting it with moral value (ownership was claimed to produce responsible and stable citizenship). As a result, renting has been seen as second class; renters have been stigmatised and renting tenure is insecure.

Older people are especially vulnerable if their housing tenure is insecure and if their housing is cold and damp. Renters cannot easily adapt or modify their housing to deal with declining health and reduced mobility. Many surveys have shown that renting in New Zealand is associated with social and economic deprivation. It is the poorer people in any age group who are more likely to be renters. The implicit assumption has always been that NZ Superannuation will be sufficient to support a basic lifestyle provided that the recipients are home owners and have paid off their mortgages by the time they reach the age of eligibility. So falling home ownership and increased renting among older people should be a cause for concern.

Our report to the Department of Building and Housing in 2008 included the following findings.

• In 2006, there were 288,900 households where the reference person was 65 years old or older. Of these households, one in five was living in rented accommodation.

• 34,920 rented from private landlords (64%); 11,180 households from central government (20%); and 8,120 households from local authorities (15%).

• From 1996 to 2006 the number of older households renting from private landlords increased by nearly 30%. So this is the dominant tenure type for older renters.

• One person households were the predominant type of household among older renters, accounting for nearly two-thirds of such households. The majority of one person households were composed of women.

These figures have probably not changed greatly in the 2013 census and we await the 2018 figures.

Projections

But the projections to 2051, however tenuous, are concerning.

• By 2051 the number of households with a reference person 65 years or older is projected to increase to 820,000, of which 169,000 will be living in rented accommodation (21%).

• Between 2006 and 2051, the number of older renter households in the 65 to 74 age group is projected to more than double. In the 75 to 84 age group it will nearly triple. In the 85 and over age group numbers will grow nearly nine-fold, from 6,670 to 53,885.

• Numbers renting from private landlords will grow from 34,970 in 2006 to 112,260. Those renting from central government will increase by about the same amount, from 10,865 to 40,450. Renting from local authorities is projected to nearly double, to 16,130 households in in 2051.

These figures call for policies to increase the supply of affordable rental housing designed with older households in mind, particularly single (and female) tenants. Can the private sector be relied upon to do this? Concerns are frequently expressed about the quality of housing in this sector, with calls for independent “warrants of fitness.”.

In the past, local authorities received subsidies and low interest housing loans from central government, but both central and local government public rental stocks have been cut and there is considerable concern about the sale of pensioner rental housing and rent increases.

It seems there is a role for innovative private and public rental developments, with central and local government, private sector and ‘third sector’ (i.e. voluntary organisation) landlords working together.

Given growing numbers of very frail and disabled older people, rental housing providers of whatever sort need to recognise the need for home-based services and investment in appropriately designed housing , and also that housing needs interact closely with care needs. This means better integration of social support, health care and housing, and changing expectations, values and standards concerning the quality and appropriateness of housing. Innovative approaches to planning and design and increased engagement of users in the development of housing models and advocacy services are required for all sectors of the housing market. It is vital that the needs of renters are not obscured by the needs of majority home owners.

 

[1] Nana, Ganesh, Stokes, Fiona, Keeling, Sally, Davey, Judith and Glasgow, Kathy (2008) Older Renters 1996-2051: Trends, Projections, Issues and Challenges. NZiRA and BERL.

[1] The reference person is the Statistics New Zealand term for the person who completes the Census dwelling form.

 

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The Business of Ageing

09/02/2018

Judith Davey

The Ministry of Social Development has published three reports entitled “The Business of Ageing: Realising the Economic Potential of Older People in New Zealand” in 2011, 2013 and 2015. Recently a 2017 update has appeared. These reports highlight  the positive side of ageing, or at least the economic contribution which older people can make. This comes in the form of workforce participation, tax-paying, acting as consumers and doing unpaid work.

The series of reports has tracked the growing economic contribution of New Zealanders aged 65 plus. It aims to influence the business sector to adapt to the ageing workforce, accommodation older people in or wishing to re-enter paid work, and to recognise the opportunities offered by a growing older consumer group.

Measurement is not easy in these areas, especially when attempting to make projections into the future and there is considerable uncertainty about the accuracy of the projections in their detail. Modelling uses Treasury’s Long Term Fiscal Model and progressive updates of Demographic and Labour Force Projections by Statistics NZ. In order to make comparisons over time, monetary values have been rebased to 2016 dollars. Technical details are available at the Ministry of Social Development’s Business of Ageing Website.

Results – Older people in the workforce

At present around 52 percent of men between the ages of 65 and 69 participate in the Labour Force and 62 percent of this group are likely to be in paid work, not necessarily full-time, by 2061. The comparable figures for women are 36 percent at present and 48 percent by 2061. By mid-century, nine percent of males over 80 and five percent of women over 80 are also likely to be working. This suggests some catch-up in female participation rates, bringing them closer to those for men.

The overall participation rate for people 65 plus is projected to rise slightly from around 24 percent (current) to around 25 percent by 2051-2061. This is a slowing down of the recent rate of increase, reflecting the movement of the “baby-boom bulge” through the population.

Value of paid and unpaid work

According to this set of projections, wage and salary earnings by older people are likely to rise from around $4.8 billion in 2016 to around $22.8 billion in 2061, a nearly 400% rise in 2016 dollars.

Remuneration from self-employment by older people is similarly likely to rise from around $1.7 billion in 2016 to around $8.1 billion in 2061, also nearly 400% up.

Income Tax paid by older people on remunerated work is projected to rise from around $1.0 billion in 2016 to around $4.6 billion in 2061. This does not take into account, however, tax on sources of income other than earnings, such as interest from bank deposits, other investments and government transfers (including NZ superannuation and GST).

The total value of all tax paid by older people is projected to rise from around $5.5 billion in 2016 to $25.1 billion in 2061,also getting on for 400%.

The value of the unpaid work is harder to assess, but a proxy value of $16.50 an hour was assumed (equal to the “carer’s wage). This showed an equally impressive rise from $11 billion at present to $47.5 billion in 2061. These figures suggest that the value of unpaid work done by older people exceeds the combined value of wages and salaries and income from self-employment, and that this difference will increase. The question arises, of course, of whether increased paid employment will result in a decrease in voluntary and caring work by older people.

Spending

The total value of expenditure by older people [inclusive of GST] is projected to rise from around $20.7 billion per year in 2016 to around $94 billion per year in 2061. This increase exceeds the total projected for tax paid.

On current patterns of expenditure, some 28 percent of this sum is expected to be spent on foodstuffs, alcohol and tobacco, clothing and footwear, and a further 22 percent on housing and housing related items. Health (11%), transport (13%) and recreation and culture (11%) constitute other important market segments.

We have already seen goods and services directed at older people beginning to be developed in the private sector. They include companion drivers (Driving Miss Daisy), personal services (Elder Care Matters) food delivery and assistive technology. Firms offering Super Gold Card discounts provide further examples. There are plenty of other opportunities for the forward-looking entrepreneur.

The same can be said for forward-looking employers, in the face of skills shortages. Rather than seeing an ageing population as a burden or a crisis, it can be the basis for economic enterprise. There is a role for government to ensure that barriers to such development are tackled and overcome.

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