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Stop bashing the suburbs: Mobility limitations of older residents are less relevant as connectivity options expand
... (Article I,11) The participant had relocated to a more supportive place that enabled her to manage her daily activities with reduced physical mobility. This relates to the idea of 'ageing in the right place', which refers to a place where one can feel comfortable, competent, and in control (Golant, 2015). As the quotation above suggests, the participant clearly found the right place, and a central aspect of it was the proximity to services. ...
... When the participants faced mobility difficulties, their opportunities to reorganise daily life and mobilities were contingent on their socio-material surroundings. Many participants clearly felt that they were ageing in the right place (see Golant, 2015), as the suburb provided valuable resources for overcoming mobility challenges, including good pedestrian and public transport connections, diverse public and private services, and social support networks. Thus, it can be said that the participants' everyday (im)mobilities were place-bound. ...
... The findings highlight the importance of out-of-home mobility for ageing well in place and they provide very concrete knowledge in terms of how to develop age-friendly living environments and services to support older adults who face mobility problems while ageing in their own homes. In recent years, delivering services and goods to older adults' own homes both physically and virtually has been increasingly seen as a cost-effective solution to support ageing in place (Golant, 2019;Valokivi et al., 85 2023). The present findings support the argument that digital services and home delivery should be seen as supplementary or additional to physical mobility, not as a replacement (see Dowds et al., 2018;Kenyon et al., 2003;Parkhurst et al., 2014;Waight & Yin, 2021). ...
Many countries, including Finland, have adopted an ageing-in-place policy goal as a response to population ageing. This policy goal involves prioritising ageing in one’s own home and community and postponing possible relocation to a long-term care facility. For many older adults, the existing home really is the best and preferred place to live, but for some, it can turn into a place of isolation due to mobility problems. As the prevalence of mobility problems and disability increases with older age, one of the key issues that needs to be addressed when pursuing the ageing-in-place policy goal is how to support older adults who have problems with moving around and engaging in activities outside the home.
This doctoral thesis provides an everyday life view of ‘ageing in place’ with mobility difficulties, and thus, it adheres to the tradition of studying social policy from the perspective of people’s daily lives. This thesis focuses especially on local everyday mobilities, including journeys and activities that take place outside the home. It provides a synthesis of three articles and poses the following research question: how do older adults organise and interpret their everyday (im)mobilities when they face mobility difficulties? While article I provides a broader everyday life view of how older adults organise their out-of-home mobility when they face mobility difficulties, the other two articles focus on the cases of a dial-a-ride bus and grocery shopping. More specifically, article II explores how older adults make their everyday dial-a-ride bus journeys to the local mall. Article III studies how the participants organised and reorganised their grocery shopping before and during the COVID-19 outbreak, and how the meanings of everyday (im)mobilities connected to grocery shopping were formed in this abruptly changing situation.
To study older adults’ everyday (im)mobilities, this thesis draws from two sets of qualitative interviews conducted with older adults living in a Finnish suburb. The first dataset includes seven focus group interviews that explored older residents’ (n=28) experiences living in the suburb in 2017. The second dataset involves qualitative repeat interviews conducted with dial-a-ride bus users. In autumn 2019, I conducted go-along and sit-down interviews with 12 bus users to explore how they used the dial-a-ride bus service and what kind of role it played in their daily lives. In spring 2020, I conducted telephone interviews with the same participants1 to explore how their daily lives and mobilities had changed during the COVID-19 pandemic.
This thesis builds on emerging research at the intersection of mobilities research and geographical gerontology. While mobilities research makes it possible to expand ideas of mobility in later life, geographical gerontology provides fruitful theoretical perspectives for interpreting the relationships between ageing individuals and their places of ageing as an active and co-constitutive process. By building on these perspectives, the findings shed light on how the participants’ relationships with the suburb had changed over time and how these changes had created mobility difficulties necessitating many kinds of negotiations and adjustments. The resulting everyday (im)mobilities were both place-bound and place-creating: on the one hand, places shape older adults’ possibilities to be (im)mobile and their interpretations of changing mobility situations. On the other hand, older adults shape places both physically and socially through practices connected to their everyday (im)mobilities. Hence, this thesis contributes to understanding that older adults’ everyday (im)mobilities are central to how ageing individuals and their places of ageing co- constitute each other.
This thesis provides critical insight into the ageing-in-place policy goal and the development of age-friendly communities in terms of how to support older adults who face mobility problems while living in their own homes. The findings highlight the importance of out-of-home mobility for wellbeing and show that even seemingly mundane trips to run daily errands can constitute a meaningful experience and a social event. Thus, daily routine trips can be about much more than just the practical need to “get things done”: they can provide valued opportunities to socialise, enjoy the outdoors, maintain a meaningful daily rhythm, and exercise. In a context where home-delivery and digital services are increasingly seen as cost-effective solutions to support ageing in place, it is important to note that they are not equivalent to physical trips to visit services.
In addition, the findings provide concrete knowledge regarding how to develop age-friendly transport services. Here, three points are key: (i) It is necessary to consider the role of transport services more holistically in later life contexts. Rather than viewing transport services merely as a means of accessing necessary services, it is important to consider their wider potential to foster social participation and wellbeing. (ii) Creating supportive transport services requires scrutinising the entire travel chain in a very detailed manner. (iii) To develop transport solutions, it is crucial to engage older adults with diverse social backgrounds, abilities, and lifestyles to ensure that these solutions cater to the needs of a heterogeneous group of older people living in their own homes and communities.
... Subsidizing or assisting older people's transportation services is the most direct way of improving these services' accessibility. Several policy reviews (Rosenbloom 2009(Rosenbloom , 1988Dickerson et al. 2019;Golant 2019;Li 2023b) show that federal policies relating to older people's transportation needs mainly focus on highway design and vehicle safety, based on the theory that most older people depend on vehicles for daily travel and can travel longer. For those who have limited ability to drive, or have ceased driving, services tend to prioritize on-demand paratransit, but these services are expensive to operate and fall short of supply in some suburban and most rural areas. ...
... All the research cited above has acknowledged the fragmentation of transportation services in the U.S., especially those funded by the Department of Transportation and the Department of Health and Human Services. As for other solutions, while some scholars (Rosenbloom 2009;Li 2023b) point to the need to change built environments and make them more age-friendly, others point to the importance of ICTs in replacing out-of-home travel for older people with travel difficulties (Golant 2019), to new transportation options such as ride-hailing services (Dickerson et al. 2019;Li 2023b), and to interagency collaboration on a more integrated transportation service supply (Wachs 1979; U.S. Government Accountability Office 2004; Li 2023b). ...
Despite increasing attention to theories in transportation equity, few focus on specific social groups, such as older people. Scholars and practitioners need to better understand the implications that residential location, access to transportation, and technology resources have for older people's quality of life. Drawing on literature from urban planning, gerontology, and public health, I develop a framework, accessibility capability, that will support the planning of future transportation systems and neighborhoods to accommodate older people's travel needs. Scholars and practitioners can benefit from this critical synthesis of literature as they consider how to build more age-friendly cities and communities.
... De Graeve (2016) points out in this context that the most significant problems occur in rural areas and remote places. Others, including Alter (2018) and Segedy (2018), speak about the doom of ageing in the suburbs (see for a recent reply: Golant, 2019). When one reaches a certain age, the difference between a friendly place and a hostile one may depend on apparently insignificant details (Dupont, 2014). ...
... Recently, solutions to deliver services and goods directly to people's homes both digitally and physically have been seen as cost-effective ways to support older adults who face mobility difficulties (Golant 2019;Valokivi et al. 2023). The present study highlights that it is important not to assume that home delivery is fully equivalent to making trips to run daily errands. ...
This study contributes to an emerging body of research that combines new mobilities and gerontological perspectives. Most previous studies on older adults’ mobilities have analysed data collected at a single point in time and there is a need for studies that explore the meanings of movement and non-movement over time, especially in relation to unexpected life events. This work explores the meanings of older adults’ abruptly changing everyday (im)mobilities before and during the Covid-19 pandemic. It draws from qualitative interviews conducted with 11 older adults in a Finnish suburb in autumn 2019 and spring 2020, and focuses on grocery shopping, which most of the participants did themselves before the pandemic, but not during it. The findings provide insight into how meanings of everyday (im)mobilities are formed as older individuals (re)negotiate their relationships with their changing places of ageing. The participants’ views of their disrupted everyday mobilities were shaped by active person–place engagements. On one hand, the findings highlight that individuals are not at the mercy of their circumstances; they possess agency that can enable maintaining a sense of self and independence even in restricted mobility situations. On the other hand, the findings reveal relationalities that explain why sudden mobility loss often leads to diminished wellbeing. The relational nature of the meanings of (im)mobility implies that there is no one-size-fits-all approach to supporting older adults who face mobility difficulties while ageing in their homes. It is crucial to recognise the diversity of older adults and to support their individual lifestyles.
... The effects of trip deprivation could be addressed by recent improvements in information and communication technologies (ICTs) as well as app-based transportation technologies [68]. Greater flexibility for workers to work from home could provide relief to those who have difficulty commuting. ...
Social equity is fundamental to achieving sustainability. However, the social dimension of sustainability has received less attention than the environmental and economic dimensions. In the United States, policies mandate equitable distribution of benefits from transportation investments among all people, including the underserved populations consisting of people with disabilities, poor people, minorities, and older adults. These populations were historically considered transportation-disadvantaged because of their inability to travel like others. However, until the release of the 2022 National Household Travel Survey (NHTS) data in November 2023, there were no national data to comprehensively examine the validity of the assumptions about people’s inability to travel. By including a special-topic question on equity for the first time that enquires about people taking fewer-than-planned trips in a 30-day period for certain reasons, the 2022 NHTS makes it possible to take a deeper look at the trip-deprived Americans. This research uses logit models and confirmatory factor analysis with a national sample of more than 11,000 NHTS respondents to examine the personal, household, and geographic area characteristics of the trip deprived. The models controlled for variations in travel need. The results show that people with disabilities, unemployed people, people with low income, Black people, and people without cars are at a higher risk of being trip-deprived. Similar evidence was not found for older adults. Geographic area characteristics are not as important as the personal and household characteristics, but they also provide important insights for transportation planning purposes.
... Reflecting the need to address not only enduring (e.g., relocation) but also novel issues of place and aging, Golant's model has been utilized recently to explore smart technology adoption behaviors of old consumers (Golant, 2017), challenges of aging in suburban communities (Golant, 2019), and the role of place with respect to distance to death perceptions of older adults (Golant, 2020;see Chapter 18). Other novel issues of place and aging such as the role that information and communication technology might play are scarcely conceptualized and empirically addressed with respect to later life. ...
Past studies show that trip deprivation or unmet mobility adversely affects older adults’ objective and subjective well-being. Researchers are optimistic that new trip-enhancing technologies (e.g., ridehailing and autonomous vehicles) and trip-substituting information and communication technologies (ICTs) could potentially reduce those impacts. Against that backdrop, this paper compares ICT access and use among trip-deprived (TD) and non-trip-deprived (NTD) older adults of New Jersey by analyzing survey data from 2357 respondents. The data were analyzed by logit models, propensity score matching (PSM), and χ2 tests. Logit models showed that certain characteristics of the TD are similar to the characteristics of the ICT non-users (e.g., people with low income and disability). The PSM analysis, which generated a matched dataset of an equal number of TD and NTD older adults, showed that the TD have lower access to computers with internet but equal access to smartphones. The results showed that the only ICT that is used more by the TD than the NTD is ridehailing. The TD were not found to use trip-substituting ICTs like online shopping, online banking, videoconferencing, etc., more than the NTD. Emphasizing that transportation improvements remain important in light of the results, χ2 tests were undertaken to compare the improvements recommended by the two groups. The paper recommends the separation of the TD and the NTD for planning purposes, collection of trip deprivation data by transportation planning agencies, and the consideration of ICT use by the Coordinating Council on Access and Mobility at the federal level.
Most older people experiencing chronic health problems, physical disabilities, and memory losses are still able to age in place in their own homes. However, they often need help from others to enjoy healthy, active, and independent lives. They turn mostly to family members, mainly women and usually their daughters, daughters-in-law or wives. But caring for frail elders has become more demanding and complex, and these family members often feel physically and emotionally overwhelmed and burnt out. They concede that they cannot do it alone. Others find it more difficult to hold full-or even part-time jobs. Hiring home (direct) care workers to assist their loved ones can be an effective solution to ease their caregiving responsibilities. However, these personal care aides, home health aides, and nursing assistants are already in short supply. Moreover, going forward the aging of the baby boomer population will result in an even greater demand for their services even as these jobs are often unattractive to American-born workers and turnover is high. This country’s immigration policies will make it even more difficult for women caring for older persons to hire these workers. Over 25 percent of home care workers are low-skilled immigrants or foreign-born. However, the Trump administration’s policies reduce the number of immigrants entering the U.S. and specifically choke off the various pathways that enable low-skilled persons to be hirable in the home care sector. Female caregivers seeking relief from their caregiving responsibilities will lose out unless we remove these immigration barriers.
Urban ageing is an emerging domain that deals with the population of older people living in cities. The ageing of society is a positive yet challenging phenomenon, as population ageing and urbanisation are the culmination of successful human development. One could argue whether the city environment is an ideal place for people to grow old and live at an old age compared to rural areas. This viewpoint article explores and describes the challenges that are encountered when making cities age-friendly in Europe. Such challenges include the creation of inclusive neighbourhoods and the implementation of technology for ageing-in-place. Examples from projects in two age-friendly cities in The Netherlands (The Hague) and Poland (Cracow) are shown to illustrate the potential of making cities more tuned to the needs of older people and identify important challenges for the next couple of years. Overall, the global ageing of urban populations calls for more age-friendly approaches to be implemented in our cities. It is a challenge to prepare for these developments in such a way that both current and future generations of older people can benefit from age-friendly strategies.
At any age, the pursuit of a good life is easier in a physical environment that promotes health, supports activities important to self‐fulfillment, and facilitates connections to the larger community. In old age, the home and neighborhood environments are particularly important: they are the locations where older people spend most their time, and they can have a great impact on independence, social connection, feelings of self‐worth, and physical and emotional well‐being.
Within the urban planning field, home and neighborhood characteristics are important dimensions of debates about the measurement of human progress and quality of life, particularly as an alternative to purely economic measures. They are also key issues in public health, particularly as they relate to physical, social, and mental well‐being. Here, we focus on how to improve the fit of environments for people as they age.
This article describes the forces behind the resurgence of home-based primary care (HBPC) in the United States and then details different HBPC models. Factors leading to the resurgence include an aging society, improved technology, an increased emphasis on home and community services, higher fee-for-service payments, and health care reform that rewards value over volume. The cost savings come principally from reduced institutional care in hospitals and skilled nursing facilities. HBPC targets the most complex and costliest patients in society. An interdisciplinary team best serves this high-need population. This remarkable care model provides immense provider satisfaction. HBPC models differ based on their mission, target population, geography, and revenue structure. Different missions include improved care, reduced costs, reduced readmissions, and teaching. Various payment structures include fee-for-service and value-based contracts such as Medicare Shared Savings Programs, Medicare capitation programs, or at-risk contracts. Future directions include home-based services such as hospital at home and the expansion of the home-based workforce. HBPC is an area that will continue to expand. In conclusion, HBPC has been shown to improve the quality of life of home-limited patients and their caregivers while reducing health care costs.
The dawning of the twenty-first century in the United States has seen a structural shift in how the country creates its built environment (defined as infrastructure and real estate). The suburbs have played the major role for a century, but that role is fundamentally changing. Understanding the implications of this structural shift requires the introduction of a few basic concepts.
Older adults with complex care needs want to live as independently as they can for as long as they can, and limit stress on family caregivers. Telehealth strategies offer the potential to improve access to care and the quality of care, while reducing strain on family caregivers. For health care systems, home telehealth may help address the challenge of rising costs. Though limited today, home telehealth is likely to be implemented more widely as policy makers reduce regulatory barriers and providers focus on improving telehealth strategies to meet the needs of families.
By 2030, the number of adults 65 and older in the United States will surpass 72 million, almost doubling the number in 2010. This population continues to rely on automobiles to satisfy transportation needs; however, with the onset of aging, physical, cognitive, and motor abilities decline and affect those people’s ability to drive and their level of mobility and independence. Lack of mobility and accessibility affect the quality of life and the ability to age in place and could lead to social isolation and a reduction in activity level. The shift to transit is often difficult because of a lack of familiarity and accessibility. Dynamic ridesharing is surging as a viable transportation alternative. This study investigated a unique integration of a dynamic ridesharing system into a local government transportation portfolio to satisfy the mobility needs of older adults by subsidizing the cost of trips on the basis of income level. Over a 9-month period, 40 older adults enrolled in the program. Older women constituted 83% of the people enrolled and were less likely to discontinue use. The majority of trips over the first 6 months were for social purposes, followed by shopping and medical purposes. Fear of driver variability did not seem to affect the level of use. The use of dynamic ridesharing seems to be a feasible low-cost transportation alternative to meet the transportation challenges of older adults and may have policy implications for the future of public transportation systems. Enhanced levels of outreach and training could lead to higher enrollment.
Objectives:
This study aimed to determine whether use of certain types of online communication technology is associated with subsequent depressive symptoms.
Design:
Nationally representative, population-based prospective cohort.
Setting:
Data were obtained from the 2012 and 2014 waves of the Health and Retirement Study (HRS).
Participants:
1,424 community-residing older adults (mean age, 64.8) in the United States.
Measurements:
We examined associations between use of four communication technologies (email, social networks, video chat, and instant messaging) in 2012 and depressive symptoms (eight-item Center for Epidemiologic Studies Depression scale) at two-year follow-up.
Results:
564 participants (39.6%) did not use any communication technologies, 314 (22.1%) used email only, and 255 (17.9%) used video chat (e.g., Skype). Compared to non-users (13.1%, 95% CI: 9.5-16.7%) or those who used only email (14.3%, 95% CI: 10.1-18.5%), users of video chat had approximately half the probability of depressive symptoms (6.9%, 95% CI: 3.5-10.3%, Wald Chi2 test, Chi2(1)=13.82, p < 0.001; 7.6%, 95% CI: 3.6-11.6, Wald Chi2 test, Chi2(1)=13.56, p < 0.001). Use of email, social media, and instant messaging were not associated with a lower risk of depression.
Conclusions:
Older adults who use video chat such as Skype, but not other common communication technologies, have a lower risk of developing depression.
Older women currently have travel patterns substantially different from those of older men even when they are licensed to drive. These differences have different safety and mobility implications for older women in the future—if they persist—but equally important consequences if they do not. This paper shows that women drivers at all ages drive less often and for fewer miles than men of comparable ages; as a result, in the next three decades most women will enter their retirement years with substantially less driving experience than their licensing status might indicate. The differences in travel patterns and driving experiences between women and men are likely to persist, and policy makers must address both their safety and mobility consequences. There is a significant need to conduct the kind of safety and mobility research that will inform intelligent policy development and planning strategies for what has been called the feminization of aging.
Cohousing is a resident-led neighborhood development model that clusters private dwelling units around collectively owned and managed spaces, with potential to address long-term social and environmental challenges in American metropolitan regions. To date, however, the cohousing model has been slow to diffuse beyond a demographically narrow following. This limited following may signal to policymakers that cohousing is an unappealing housing model, and therefore an impractical policy objective. Drawing from a survey of 1,000 American residents, the results of a multivariate regression model suggest that (a) many of the characteristics of the current resident population of cohousing in the United States have no statistical association with the individuals who indicate interest in cohousing nationwide; (b) other characteristics serve as better predictors of interest in cohousing; and therefore (c) the slow diffusion of cohousing is likely the consequence of inaccessibility rather than low appeal. Overcoming these challenges demands shifts in policy.