Building the Age-Friendly City

In October the National Development Council projected that in 2018 Taiwan will formally enter the ranks of “aged societies.” By then 14% of the population will be at least 65 years of age. In 2025 Taiwan will be a “super-aged” society, with at least 20 out of 100 people aged 65 or older.

Providing for the happiness and physical health and safety of the elderly, and removing barriers to their social participation, helps them to live fuller lives.

Everyone will get old if they live long enough, but not everyone can spend their senior years happily. Apart from good health, there is also the psychological need to be respected. Only with respect can seniors be happy.

That’s easier said than done. With regard to many aspects of life—food, clothing, housing, transportation, leisure—seniors find themselves constantly caught between doing what they want and abiding by the rules. Their lives are full of compromises and concessions to Father Time. Driving is but one example.

Since July of last year, most drivers in Taiwan have been granted driving licenses for life, so there is no system in place to ascertain whether seniors are competent drivers.

You may point out that just because someone is old, it doesn’t mean that they aren’t able-bodied. Furthermore, just because someone has a license doesn’t mean they will actually be driving. Still, all nations hope that the elderly will assess their mental and physical health to determine whether they are competent to drive and will sensibly refrain from driving if it puts themselves or others at risk.

Active and joyful participation in social activities is a boon for the elderly population.

Take Britain. Last September the Royal Automobile Club (RAC) released data showing that British drivers over 70 years of age had surpassed 4 million, comprising 11.1% of the nation’s 36 million licensed drivers.

The RAC explained that they defined “older drivers” as those who are at least 70 because British law requires that drivers reapply for new licenses ­every three years once they are in their seventies. When they change licenses, they don’t have to take a formal road test. Instead, they are required to submit self-evaluations about whether they are physically and mentally suited to driving.

Yet there are no universal standards with regard to older drivers. According to the ROC’s Ministry of Transportation and Communications, of Taiwan’s 12.7 million drivers, those over 60 comprise 15% or 1.9 million.

­Huang Kuo-chin, director of the Taiwan Association of Gerontology and Geriatrics and director of family medicine at National Taiwan University Hospital, explains that although medical and public health statistics classify everyone over 65 as elderly, assessments of how well individual seniors function are more appropriate for determining whether they should be behind a steering wheel.

Taipei is leveraging its strength in design by commissioning professional designers to develop smart bus stops. These will allow for the elderly and others with limited mobility to register their presence, thus alerting drivers to prepare for their boarding.

Simply put, most people begin a steady physical decline after their thirties or forties: Their eyes age and get cataracts, their muscles atrophy, and they may end up suffering from osteoporosis. There is considerable variation from person to person, but generally speaking, the older a person becomes, the worse their physical condition.

With regard to driving safely, Huang says that ideally the conditions for licensure should involve measures of drivers’ general kinesiological fitness, as well as of the functioning of their sensory organs and central nervous systems. Generally speaking, the elderly experience declining vision, hearing and physical coordination, and slower reflexes. And if they suffer from chronic diseases, the medication they take may further interfere with their ability to drive safely.

In recent years, seniors have become an increasingly high risk group on the roads. According to the National Police Agency, since 2002 the number of traffic fatalities involving those 65 and older has surpassed the number of roadway deaths for those aged 15–24 (although the much larger group of drivers aged 25–64 still experiences more fatalities). Last year, those 65 and older accounted for 555 traffic fatalities or 28.7% of the total.

These aged-based figures encompass drivers, passengers, pedestrians and so forth—everyone killed in road accidents. There are no statistics specifically for elderly drivers, but whether or not seniors are behind the wheel, they have a greater chance than younger people of dying if they are involved in an accident.

Some may say that life begins at 70 and that one’s golden years are the best time of life, but in reality elderly drivers have deteriorating vision and reflexes and are a high-risk group for traffic accidents.

According to Li Huihong, assistant chief of the motor vehicles division at the Directorate General of Highways (DGH), nations such as Britain and Japan, where drivers must exchange licenses, require those over 70 to consider every three years whether or not they are still capable drivers. In Taiwan, which requires no such exchange, the best that can now be done is to encourage seniors who are ill-suited to driving to turn in their licenses of their own free will.

Starting last year, the DGH worked with police and local government to put on 540 local promotions aimed at getting the elderly to turn in licenses. More than 6600 of them did so in 2013. So far this year the response has been even greater, with 6300 turned in by August.

Yet ­Huang emphasizes that you’ve got to first put into place a generally senior-friendly environment before you can start talking about depriving seniors of their licenses. That’s the only suitable and undisruptive approach to take with an elderly society. Ageing successfully, apart from avoiding illness and maintaining fitness, also requires that seniors participate in social activities and demonstrate the value of being alive.

In other words, if the elderly are to live happily, then they shouldn’t be isolated. If you don’t want seniors to drive, then you must first help them find alternative means of transportation.

­Huang cites elder-friendly communities in the United States as an example: In order to convince seniors not to drive, they adopt various measures, including providing high-frequency community shuttle buses, encouraging car-pooling programs, and creating special lanes for electric mobility scooters. What’s more, the street lights are a little bit brighter at night, the streets better paved, the signs a little clearer, and the red-green cycles at intersections a bit slower—all of which help convince the elderly that the environment is pedestrian-friendly.

Smart service bells can help restaurants and other businesses better serve the elderly and others with limited mobility.

With modernization, the growing concentration of populations in cities is ever more apparent. According to World Health Organization estimates, by 2030 three out of five people worldwide will be living in cities. Cities will of course be looking for ways to satisfy the needs of their inhabitants, so the ageing of society will shape how society provides such necessities as housing, medical care and transportation.

According to WHO estimates, those over the age of 60 comprised 11% of the world’s population in 2006 and will rise to 22% by 2050. Facing the ageing of urban populations throughout the world, the WHO has already started planning. In 2007 it published Global Age-Friendly Cities: A Guide, which calls for cities that aim to be elder friendly to go to work on eight fronts: outdoor spaces and buildings, transportation, housing, social participation, respect and social inclusion, civic participation and employment, communications and information, and community support and health services.

Taiwan is taking up the WHO’s call. In 2010, the Health Promotion Administration of the Ministry of Health and Welfare launched a pilot program on all eight fronts in Chiayi City. In 2012 it was expanded to all 22 of Taiwan’s counties, cities and special municipalities. With a participation rate of 100%, Taiwan became the nation with the highest proportion of localities pushing age-friendly policies.

Each city and county has creatively developed an ­individualized age-friendly plan of its own based on local characteristics. For instance, Yi­lan County has been promoting grandchild–grandparent joint education programs, whereas Hsin­chu has developed a cloud-based personal health management system. Tai­pei, meanwhile, which has been declared “World Design Capital” for 2016, has brought conceptions of universal design and social design to civic administration, leveraging that emphasis to create a happy and accessible city for the elderly.

Taipei has become a place where designers fulfill their social obligations.

For instance, creating a friendly and safe mass transit environment is one of the best ways to convince old people to give up their cars. With this aim in mind, the city has established smart bus stops, which were formally launched just recently.

New Design Dimension’s Eric Chen, who directed the effort, says that smart bus stops can satisfy the needs of two groups: riders with mobility issues (the elderly, pregnant women, young children, and the disabled) and bus drivers who want to provide as attentive a service as possible.

Apart from showing when buses will arrive, smart bus stops can also register the status of those waiting for a bus.

For instance, the elderly can use their senior transit cards at bus stops to convey what bus they want to take, and that information will be transmitted to the dashboard of buses to remind drivers to prepare for their boarding. In response, drivers can slow down when approaching the stop or remind riders to give up their seats to senior citizens.

Many elderly people in the city are just as dependent on buses as they are on mass rapid transit systems. Chen’s father, who is in his 90s, has to take three different buses for his regular hospital visits. Chen says that smart bus stops can make bus travel friendlier, but artificial intelligence is no substitute for real human interaction. Consequently, he hasn’t allowed bus-stop functions to get too complicated, but instead has created a friendly interactive environment between drivers and riders.

Meanwhile, “smart service bells” are aimed at creating a friendly bridge of communication between restaurant staff and elderly customers. Other target customers for the technology include those with impaired vision or hearing, people with physical disabilities, pregnant women, and other solo customers with mobility issues.

Designer Wu Zhi­xiang cites the example of an elderly person: When restaurants are understaffed at peak hours, solo elderly diners, no matter how much they wave their hands, may find it very difficult to get noticed and be served.

Furthermore, although some restaurant tables have bells, servers may have difficulty responding to the bells immediately even if they do hear them. Elderly who don’t understand the situation may feel anxious. Some seniors are shyer and unwilling to call out to servers, or fear the disapproving eyes of those who will come when they ring the bells, so they just decide not to press the bell and wait unserved. Going out to eat becomes a kind of torture.

Wu explains that smart service bells allow for two-way communication: When a customer rings the bell, it will start flashing. When the wait staff receive the signal, they can remotely turn off the flashing light (to signal that they will arrive shortly) or turn the flashing light to green (meaning: please wait; the server is busy but will be there shortly).

Wu reports that these smart service bells underwent trials recently at Mövenpick Café and Restaurant chain and Kiki restaurant group locations. The restaurants anticipate that the smart service bells will improve the quality of their service and better satisfy elderly people and other customers with special needs.

Three years from now, when Taiwan officially enters the ranks of aged nations, the silver-haired set will become one of society’s most important pillars. If we want to help the elderly live happy, fulfilling lives, we must create an age-friendly environment. Understanding the needs of elderly people will increasingly become essential for all of us as individuals as well as for society as a whole.