Tag Archives: age-friendly cities

A fall broke her leg but not her spirit

December 9, 2013

Susan Ryan, the federal Age Discrimination Commissioner, was feeling happy after her meeting with Sydney’s gay and lesbian community. She’d been discussing the efforts underway – which later proved successful – to make it unlawful for church-based aged care facilities to discriminate against gays. You could say she had a spring in her step as she walked to the corner of Pitt and Bridge Streets in the heart of the city. But when the lights at the crosswalk changed and she stepped off the kerb, she fell into the gutter. “The next thing I’m in the most excruciating agony with blood everywhere,” she told me.

More than five months later, she still doesn’t know what happened. She was wearing flat shoes. Perhaps she slipped on something. But when she looked at her legs, she felt shock – her left foot was facing the wrong way. This is how the nation’s chief advocate for the elderly became one of the 84,000 or so older Australians who end up in hospital each year as a result of a fall. “I’m 71 and I’d never broken a bone before,” she said. “And this was a compound fracture, two bones in the ankle broken – one had gone through the skin – and the tendons torn.”

It doesn’t necessarily take personal experience to sensitize you to the travails of others. But sometimes it can be a short-cut to deeper understanding. For Ms Ryan her experience has proven an eye-opener about the potentially calamitous consequences of a simple fall, and about the urgent need for age-friendly cities, communities, houses and apartment buildings.

“Falls in the elderly” is a topic entirely deficient in sex appeal. It lacks the newsworthiness of, say, bringing to heel remnant churches intent on banishing gays from their nursing homes. But it’s a deadly issue. Data from the Australian Bureau of Statistics shows that 1530 people aged 75 and over died as a result of falls in 2011. That’s higher than the national road toll – vehicles claimed 1290 people of all ages that year.

Since her appointment in 2011, Ms Ryan, a former minister in the Hawke government, has been a tireless advocate for older Australians. She’s worked to improve policy, laws and public awareness about “active ageing.” Engagement and independence have been her themes. And suddenly she was an invalid; ten days in hospital, three steel pins in her ankle; a fibre glass cast up to her knee for eight weeks; a wheel chair for three months, and finally a walking stick. Without her partner, Rory, she couldn’t have stayed in her flat. Even with him as a strong and willing helper, it was hard to get inside the apartment building.“There was one step that was too high to get the wheelchair up,” she said. The buzzer in her flat to allow people into the building was out of reach from the wheelchair. The step onto the balcony was too steep. She couldn’t have a shower, and needed community nurses in. She wasn’t able to cook – and cooking wasn’t Rory’s thing.

Physical recovery took its time as it does with complex breaks. But the psychological aftermath was also a factor. “I’d lie in bed thinking ‘Will I be able to walk again?’” she said. “I feared I wouldn’t get the use of my ankle back. I’m no athlete but I’ve been pretty active. I fly around Australia. I go overseas.” Perhaps the worst fear was whether the fall signalled the start of a decline. “Was this the beginning of going downhill? I had intimations of dependency,” Ms Ryan said. “I didn’t want to be someone who couldn’t make herself a cup of tea.”

Working from home helped her recovery. As she was able to get out more, she found herself being “super-cautious” and lacking confidence: “I walked down the street constantly looking at the road, the footpath, the kerbs, looking for a trap.” She started to notice things: the lack of rails on stairs; public buildings, such as the State library, where the lifts shut down at night; broken footpaths, uneven gutters, bumpy asphalt patches on the pavement; obstacles to trip over. “Being in the city is a constant hazard,” she concluded.

Though her jurisdiction is federal she’s now keen to promote greater awareness among local councils of the UN’s age-friendly cities movement. It aims to make communities safe and accessible places for older people but it’s been slow to catch on here. She’s meeting with the City of Sydney and Randwick councils, and she’s taken the matter up with the Commissioner for Senior Victorians, and will do so with the NSW ministerial advisory committee on ageing. Human error and human frailty can play their part in falls. And for many, it’s the home, not the street, that’s full of hazards. Even so, Ms Ryan says, “Those entrusted with the planning and maintenance of our cities and suburbs should be much more conscious of public safety.”

As I write this, my left foot is in a “moon” boot. I, too, broke my ankle a month ago. I was walking fast and tripped on a subsided, broken piece of pavement. My break was simple compared to Ms Ryan’s. But it’s been a tough time none-the-less. This is a huge hidden health problem incurring ballooning health costs yet our national response to falls prevention has been patchy. Medical experts tell me more can be done. I’ve no doubt Susan Ryan will be a passionate advocate. Once it happens to you, you don’t forget.

Has it happened to you or someone you know? Any ideas? Please Comment.

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A city to grow old in

May 20, 2013

I’m trying not to be a NIMBY about the tower block to be built in my street. After all, it will house “independent living units” for older people. The developer is a church and claims it must sell the units to finance construction of an adjacent nursing home. I hate that the eight-storey building will loom like a neighbourhood bully over the area’s 1920s houses and three-storey walk-ups.

But I’m fighting the Not-In-My-Back-Yard syndrome because I know my neighbourhood would be perfect to grow old in. For a start it’s still a neighbourhood with a heart (rather than a shopping mall) which is rare enough. It boasts a cluster of lively and modest-priced eateries with outdoor tables. It has a couple of corner shops where you can buy milk late. There’s a newsagency, a liquor store and, the crowning glory, a cinema. It’s close to a hospital and a university, and the buses run frequently to the city and the railway station. Unless the tower ruins the ambience and causes traffic chaos which it might, I want to stay here as I get older with all these amenities and all this life a short walk away. And I guess I should share it.

The oldest baby boomers are turning 67 this year and whether the new-age retirees will do what so many of our parents did – take the seascape or treescape option – remains to be seen. I know I don’t want to move to a small coastal town or a village in the hinterland or mountains. Some of us have seen our parents, once they hit their 80s, forced to beat a retreat back to the cities for good hospitals and family care. Or we’ve seen parents stranded in far-flung suburbs, struggling as they aged. The transport is hopeless, social isolation becomes a problem, and the fast-paced city is a place they avoid.

It’s a challenge to make a city “age-friendly.” But around the world many cities, faced with the prospect of burgeoning numbers of older people, are exploring ways to become kinder and gentler places. In 2007 the World Health Organisation kicked off an age-friendly cities movement, and it might surprise you that New York City is one of the stars in the firmament. When I lived there in the 1970s it was the best place to be 22, a tough place to be 62, and surely a dreadful place to be 82. Crime, graffiti, and street homelessness plagued the city; it was exciting but aggressive. The first time I ordered a sandwich in a crowded deli, people in the queue heckled me for procrastinating over the choice of bread. (As a Perth girl I knew only white or brown then). But now New York City is becoming so darn age-friendly, it’s a haven for retirees.

For a start, it’s given pedestrians more time to cross at hundreds of intersections by re-timing the signals. It’s turned boring old senior citizen centres into art spaces. Instead of older people playing bingo, they get lessons from artists who in turn use the workspace for free. Declining crime rates mean older people are less afraid to go out; 3000 bus shelters have been fitted with seats and 1000 benches placed around the city, and more public toilets, too; and fewer elderly pedestrians are being killed thanks to a concerted safety campaign.

In Australia, the age-friendly cities movement is slowly gathering steam. Canberra and five other city councils – though not the major capitals – have joined the World Health Organisation’s network. They’re using the WHO research tools to find out what’s preventing older residents from participating fully in their communities and what can be done about it. One of the councils is Melville which covers the Perth suburb I grew up in. In the 1950s and 1960s, it was your typical post-war housing development where armies of children ran amuck while young mothers played tennis. Now it’s an area with a higher-than-average population of over-60s.

There’s a long wish-list arising from Melville’s forums with its residents aged 60-plus: from better bus services to more respectful retailers. It’s not surprising the council has picked up cheaper do-able items – running IT classes, and groups on home safety. But the big issues like public transport and seniors housing are beyond its powers. Even a measure adopted by Toronto – increasing the font size of street signs – is not on the radar. Still Melville is a beacon among Australian city councils. In July, John Beard, director of the WHO’s Department of Ageing and Life Course, will visit Sydney to tell us more about age-friendly cities at a conference held by the Centre  for Excellence in Population and Ageing Research (CEPAR).

What would it take to make your city, suburb, or town age-friendly? From bus drivers that wait for the elderly to sit down before taking off, to restaurateurs that turn the music down, to community transport that takes people to the theatre not just the doctor, I could add endless items to the wish-list. Even in my neighbourhood, there’s room for improvement: piles of perilous pavement lie in wait for the newcomers.

What are your thoughts?

Coming of Age is updated every Monday. But look out for a special report Thursday afternoon.