Use of community support and health services in an age-friendly city: the lived experiences of the oldest-old

ABSTRACT

Increases in population ageing and urbanization have led to the development of age-friendly cities. While much has been done to integrate the needs of younger, healthier older adults, little research has examined the needs of the oldest-old. This phenomenological study explored the lived experience of 10 community-dwelling individuals, aged 80 years and older, using community support and health services. Three central themes emerged: individual circumstances, personal compensatory mechanisms and community design and structure. Numerous implications for age-friendly development were highlighted: (1) functional ability rather than chronological age should be considered in age-friendly planning, (2) informal social community supports are very important for those in advanced age; age-friendly city planners must consider individuals in advanced age who are on the edge of losing their independence, and whose loss of independence may be hastened or delayed based on informal social supports available, (3) community design that recognizes and integrates structures to support the needs of frailer older adults may provide a protective buffer to enable these individuals to remain in their homes longer, and (4) socially isolated frail older adults are difficult to reach; innovative strategies are required to ensure their unique needs are discovered and incorporated in community planning.

KEYWORDS:

• Age-friendly cities
• community support
• health services
• oldest-old
• hermeneutic phenomenology

This article is related to:

Research for city practice

Acknowledgements

We would like to thank the Westmount community for their support and participation in this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Flora M. Vieira Zamora

Flora M. Vieira Zamora was a Master of Science graduate student in the Health and Rehabilitation Sciences Graduate Program in the Faculty of Health Sciences at the University of Western Ontario. Her program of research focused on enhancing health and community services for older individuals living in the community. She is currently completing her PhD at the Institute of Health Policy, Management and Evaluation at the University of Toronto.

Marita Kloseck

Marita Kloseck is Director of the Sam Katz Community Health and Aging Research Unit, a Scientist with the Lawson Health Research Institute and Associate Professor in the Faculty of Health Sciences at the University of Western Ontario. Dr. Kloseck has 38 years clinical, research and community development experience. She is known for her novel work engaging communities, consumers and frail older individuals as active research partners to improve health, chronic disease outcomes and independent living in communities of seniors.

Deborah A. Fitzsimmons

Deborah A. Fitzsimmons is Professor of Healthcare Innovation and Technology in the School of Nursing and Allied Health at Liverpool John Moores University in the UK. Her research focuses on innovative care delivery models, with a particular focus on how information and communication technology can leverage specialist resources and facilitate expanded care capacity and timely care delivery.

Aleksandra Zecevic

Aleksandra Zecevic is Associate Professor in the School of Health Studies in the Faculty of Health Sciences and an Associate Scientist with the Lawson Health Research Institute at the University of Western Ontario. Her program of research focuses on a systems approach to falls and injury prevention in the elderly, safety culture in healthcare, biomechanics (gait, balance, mobility) and age friendly-cities.

Patrick Fleming

Patrick Fleming, MSW, RSW, has been practicing social work for 37 years, 3 years in child welfare and 34 years in geriatric mental health. He has been a strong advocate for older adults, a champion concerning elder abuse in the community and a major support for London becoming an Age-Friendly designated city by the World Health Organization. Patrick currently chairs the local Elder Abuse London Middlesex Network and the Social Support and Health Services Working Group with the Age-Friendly London Network.