Ageing in place is an aspiration for all. It has massive financial implications for Governments. The costs of institutional care of the frail threatens to swamp health care budgets. Ageing in place is far more than creating safe houses. A “home” extends outside the boundaries of the house. It extends to the community. To the availability of shops and facilities. To the neighbours and acquaintances met every day. All create that sense of a safe environment in which an old person can age (Newsletter # 152 “A Place Called Home”).

Mobility is key to all aspects of the aspiration. Mobility starts within the home. The availability of appropriate handrails, staircases, furniture are all being addressed. What about the mobility outside the home. Can they walk to the shops? What does happen when a frail person cannot drive? When there are buses, but the nearest stop is too far away? When does crossing the road becomes a hurdle?

A Different Starting Point

Different countries have very different starting points. The urban planning models vary. They have created very different problems for an increasing number of frail citizens. There can be no bigger differences than the approaches of Germany and the United States. At first sight both countries are dominated by the car. Germany is second only to the US in car ownership per head. Germany has the third longest motorway network in the world. It has the highest speed limits on those highways anywhere in the world.

First sights can be deceptive. Germans use their cars very differently. A massive 32% of all German “trips” are on bicycle or foot. 66% of trips under one mile are by car in the US compared to only 25% in Germany. There are big differences in taxation on cars and gasoline. However, one of the main reasons for the differences is the nature of German cities.

In the last fifty years German city planning has deliberately created compact cities. The average population density in cities and towns is three times higher in Germany than the US. Many Germany city centres are pedestrianized. This makes it quicker and more efficient for walkers and cyclists. Car usage is a lot less efficient. “Family Zones” in the cities are to protect children playing. They have speed restrictions of only 7 kilometres or four miles per hour. Up to eighty percent of all city roads are restricted to 30 kilometres or eighteen miles per hour. It is difficult for cars to cross from one side of a city to the other. Policy makers have created dead-end streets and other restrictions. These have forced the cars on to the motorway ring roads.

Mobility

Growth in German cities is oriented along major light railway and tram routes. These are run in separate lanes, because of this they are more effective. Public transport is consistently upgraded. Public transport is well integrated allowing easy changes from tram to train or bus to tram. Today Germany cities average six times as much public transport compared to the US. Public transport usage is five times higher in Germany. That transport will be available for the frail older people no longer able to drive.

The impact on Germany and the US of an expanding frail age group is very different. Increasing reliance on public transport and walking have differential impacts. Germany is in a much better place than the US. This is not a result of short-run action but a concerted policy initiative. This has included the taxation of cars and gasolene. Is it too late for countries with very different start points?

The Japanese planning regulations are conceptually very different. They exclude certain things from the different zones but do not specify what must be built. They do not separate housing from the services needed by their residents. There is a diverse collection of shops, outlets and services within a particular zone. In Amsterdam bicycles are the norm at all ages. There are separte lanes and traffic lights. There are tiny cars. There were introduced as long ago as 1995 and are only four feet wide. They are allowed to drive on those designated cycle tracks and pedestrian lanes. They have separate designated parking spaces. They are only available for individuals with disabilities or mobility restrictions.

Smart Mobility

The US Academies published a joint report this week. The Academies of Science, Engineering and Medicine worked together. The report was about the impact of smart technologies on the mobility of deprived groups in the US. It included the over 65’s as one of those groups. They looked at the emergence of smart services providing bicycles and scooters. They looked at web enabled services such as Uber. They also focused on ride-sharing apps. These offer the potential of reduced costs and convenient door-to-door service.

All these services are only feasible because of technology. They need web enabled smartphones and sophisticated matching algorithms. As the Academies point out there are obvious issues for a frail over 65 in using such services. The first is the ownership of a smartphone and the skills to use. Ownership is increasing, but the over 80 frail user is the least likely to have one ( Newsletter #151 Time to Retire the Digital Divide).

Travelling in someone else’s car with strangers raises safety issues for us all. For an older person those fears may be higher. The report stresses the importance of regulation and communication to overcome these issues. Similar services are run as “on-demand” buses. When operated by regulated companies they do not seem to have the perceived safety issues.

Smart Technologies and Walking

There are other emerging applications of smart technologies. Cities such as Singapore are separating pedestrians and cars retrospectively. Rather than dramatically reducing the speed of cars to enable people to walk safely they redesigned many pedestrian crossings. More now have islands in the middle. Some have the crossing interval increased to allow for frail slower walkers. The “Red Band” scheme in Santiago takes this idea one step further. The band can be read at the crossing. It will trigger a change in the time available to cross when requested. At what point will the crossings become personalized? Will the crossing be able to sense who is waiting to cross?