Abstract
BackgroundThere is a need to develop innovative solutions to enhance safe and green physical environments, which optimise health, wellbeing and community participation among older adults. To develop solutions that meet the needs of a diverse ageing population, an interdisciplinary approach is needed. Our aim was to identify the needs of older people in relation to ageing well in the environment by bringing together knowledge from different perspectives using Patient and Public Involvement.MethodsAn international consortium (Retrofit living For ageing well through Understanding and Redesign of Built environments consortium: ReFURB) was established in April 2018, including ten core members, to (i) explore cutting-edge solutions to safe living for ageing populations and (ii) develop innovative approaches to everyday physical environments, which bring about health benefits. We used a co-design, interdisciplinary framework involving older adults, carers, physiotherapists, geriatricians, engineers, human movement experts, geographers and psychologists from the UK and Australia. This engaged people in a 1 day workshop that comprised a series of presentations from international speakers on urban design, social connectedness, hazards and injury prevention, and the physical environment. Small group discussions (facilitated by consortium members) followed presentations to consider the opportunities, challenges and barriers encountered with ageing, which included the use of creative engagement activities (LEGO® Serious Play, mind maps, poster gallery walk), to help participants share personal stories and reflect on the issues raised. Thematic coding was used to synthesise the outputs of the small group work.ResultsFive themes were identified across the workshops: access and transport; involvement of the whole community; restoration rather than redesign; assistive and digital technology; and intergenerational approaches. These dimensions related to the physical, social and nature-based qualities of everyday environments, as they pertain to ageing well.ConclusionsCo-design was a valuable tool that helped understand the perceptions of participants and essential to develop effective interventions and solutions. Participants highlighted several issues affecting people as they age and key environmental considerations to promote wellbeing, activity, and participation. The consortium identified gaps in the existing evidence base and are now planning activities to further develop research ideas in collaboration with our co-design participants.
Highlights
There is a need to develop innovative solutions to enhance safe and green physical environments, which optimise health, wellbeing and community participation among older adults
Co-design was a valuable tool that helped understand the perceptions of participants and essential to develop effective interventions and solutions
The workshop began with presentations about urban design, social connectedness, injury prevention, and the natural environment
Summary
There is a need to develop innovative solutions to enhance safe and green physical environments, which optimise health, wellbeing and community participation among older adults. Over a decade since the World Health Organization’s recommendation for ‘age-friendly cities’ [1], the built environment continues to pose major hazards (e.g. falls due to uneven terrain) to older adults [2], which contribute to reduced community participation. Redesign of the built environment, informed by new knowledge of how older adults engage with their surroundings, is attracting growing attention as a means through which to improve health and wellbeing in old age [6]. New urban design initiatives are emerging to transform public spaces, increase physical activity, participation, and social interaction, and reduce the growing burden of chronic diseases, in older adults. Other groups have reported that the immediate physical environment surrounding an older person’s home, and opportunities to participate in exercise within a social setting, are most important to support physical activity participation [12]
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