2020 Report

5. Ageing in Cities

HelpAge’s global report, “Ageing and the city: making urban spaces work for older people” looks at conditions under which older adults live in cities that are transforming rapidly. It highlights systematic social, economic and spatial marginalization and exclusion of older adults in cities, and how this is impacting their lives.

For many that live in an urban environment, safety of the family is largely associated with controlled spaces and secondary support structures like reliable services and safe neighborhoods. With higher mobility among the working population for economic opportunities, more elders today are likely living alone or feeling lonely. Some of them are limited by their vision, mobility, physical conditions and thus fearful of moving too far from their place of residence. According to the WHO, over 20 million older adults live alone, and this is expected to rise in the next decade.

The real estate industry has captured this need and today offers safe gated communities with a suite of accessible services for elders. Senior housing and assisted living communities are on the rise however, these affect only a few due to the nature of these projects (expensive and isolated). It is also widely observed that most elders prefer to age at home as there is familiarity and a routine associated with everyday activities, and access to trusted services in the immediate neighborhood. Older adults are dependent on their support systems which include family members, peers and friends, neighbors and informal service providers that fulfill their basic needs (local grocer, newspaper agent, barber, pharmacy, security guard, driver, etc.). Moving out of this support system is a difficult decision for many, and even when their physical conditions require a higher level of committed care and support.

While disability is a much broader concern for the general population, it manifests differently in older adults due to the natural ageing process. While longer lifespans and ageing are generally associated with healthy populations, it also results in chronic and degenerative conditions among the old. Where physical deterioration results in older adults becoming disabled, it limits their activities, impacts their routine, and reduces their chances of recovery. In such situations, they need specialized care, geriatric support and support groups.

Early results from a pilot phase of the Longitudinal Aging Study in India showed that 13% of “older Indians sampled have some type of disability that affects at least one activity of daily living“. Another study found that 51.5% of elderly people over 60 years of age had fallen (ending up on the floor or ground unintentionally), and 21.3% sustained fractures and 79.6% sustained other injuries. It also notes that the fall is not a diagnosis but can be a manifestation of “multiple underlying disease like visual impairment (cataract, corneal opacity), postural hypotension, degenerative joint disease, giddiness, and depression, the effects of certain medications on homeostasis, and/or environmental hazards or obstacles that interfere with safe mobility.” It is thus not a stretch to say that older adults in particularly unfriendly cities and with loss of traditional support systems, are likely to feel more vulnerable, anxious and fearful. Many of the changing dynamics in cities and the perception of urban spaces as ‘unsafe’ for older adults presents an opportunity for businesses to provide at-home services and support systems. This could go a long way in enhancing their quality of life, and making the ageing process one that is dignified, active, productive and joyful. This has particularly taken more roots given the current pandemic, and restricted mobility among the 65+ population group.