aarp international THE

JOURNAL2014

Reimagining the Aging Experience

HEALTH COMMUNITY MONEY PERSONAL TIME Living Well With Dementia AARP Age-Friendly Network Age-Friendly Employers Time Worth Sharing A Global Epidemic Age-Friendly Efforts Addressing Aging in Korea Fine Print The G8 Commitment Global Best Practices Singapore Silver Workforce Talent Exchange Designs on Dementia Michelin Mature Workers Campaign to End Loneliness t

THEJOURNAL featured contributors / 2014 PRINT EDITION

June Andrews Paul Ladd Eun-Kyung Park Director, Dementia Services Head, Team on the Post 2015 CEO, Senior Partners Development Centre Development Agenda, Bureau for Development Policy, UNDP Eun-Kyung Park is the head of Senior June Andrews is director of the Partners, a senior-specialized platform Dementia Services Development Paul Ladd joined UNDP in 2006 and operating company established in 2007 Centre at the University of Stirling. She currently heads the organization’s that leads the senior industry in Korea. advises health departments and service Team on the Post-2015 Development providers around the world, and is a Agenda. Previously, he had led UNDP’s trustee of the Life Changes Trust, an policy team on inclusive globalization— independent charity disbursing grants covering issues of trade, development Louise Plouffe totaling £50 million across Scotland. finance, and migration—as well as the Senior Policy Analyst, International group that prepared UNDP’s contribution Longevity Centre (ILC) to the September 2010 Review Summit on the Millennium Development Goals. Louise Plouffe is a senior policy analyst Anna-Liisa with 24 years of experience in aging Hämäläinen policy research for the government of Canada, the World Health Organization, Editor in Chief, Oma Aika Magazine Sarah Lenz Lock and currently with the ILC in Brazil. With Alexandre Kalache, she led Anna-Liisa Hämäläinen has worked in Senior VP, Policy, Strategy and the preparation of the World Health magazines since 1978 and in Aller Media International Affairs (PSI), AARP Organization´s Age Friendly Cities: A Finland since 1996. From 1997-2012, Sarah Lenz Lock helps position AARP as Global Guide. she was Editor in Chief of Koti ja keittiö a thought leader addressing the major magazine (Home and Kitchen), and since issues facing older Americans. Working that has been Editor in Chief of Oma on behalf of PSI, Sarah integrates and Aika (Own Time). coordinates policy within AARP to help Eduardo Schutte assure policy consistency and maintain Senior VP, Global Sales Services & AARP’s social mission. Distribution, Hilton Worldwide Zhang Jianguo Eduardo Schutte has built a successful Director, State Administration of and ascending professional career in Foreign Experts Affairs, China George McNamara the Hospitality Industry. At Hilton Worldwide, he manages all functions Zhang Jianguo is the Vice Minister for Head of Policy and Public Affairs, and business processes that support and Human Resources and Social Security and Alzheimer's Society UK enable the Global Sales organization. Administrator of the State Administration George McNamara currently supports the of Foreign Experts Affairs. He also serves implementation of the Prime Minister's as the Vice Chairman and Secretary Challenge on Dementia, in particular General for the China Association for the creation of dementia-friendly Asghar Zaidi International Exchange of Personnel. communities. George has held senior Professor of International Social policy positions at the British Red Cross, Policy, University of Southampton Action for Children, the UK parliament Neelie Kroes and civil service. Asghar Zaidi is Professor of International Social Policy, University Vice President, Digital Agenda, of Southampton; Senior Advisor at European Commission European Centre Vienna; Visiting Senior PJ O'Rourke Fellow at CASE (London School of Neelie Kroes worked for years in Dutch Economics); and Research Affiliate at the politics, including as minister responsible Humorist and Political Reporter German Institute for Economic Research for postal and telephone sectors. In P. J. O’Rourke is the author of The Baby (DIW Berlin). His recent research 2004 she became the EU's Competition Boom: How It Got That Way (And It Wasn’t interests span active aging, well-being Commissioner, and, in 2010, Vice My Fault) (And I’ll Never Do It Again). of older people and issues linked with President of the Commission responsible financial and social sustainability for the Digital Agenda. of European public welfare systems. t

26 feature A MILLION V O I C E S Paul Ladd More than 1.5 million people all over the world have engaged in 100 national dialogues, 11 thematic meetings, and an online Head, Team on the Post 2015 Development Agenda, portal that includes a survey on global priorities called MY Bureau for Development Policy, UNDP, New York World. The global conversation has responded to a thirst for engagement by all people to shape their future, and provided a host of good ideas on how governments, businesses, and civil society can help to make that future a reality.

34 health LIVING WELL WITH DEMENTIA George McNamara Cities, towns and villages across the UK are leading the way Head of Policy and Public Affairs on a new path to becoming dementia-friendly communities. Alzheimer's Society UK Alzheimer’s Society, working with others, have set out on an ambitious agenda to make living well with dementia a reality, one community at a time.

92 personal time TIME WORTH SHARING Eduardo Schutte Every boomer’s travel experience is unique; some are Senior Vice President, Hilton Worldwide road warriors while others are once-a-year vacationers. But regardless of frequency or travel style, many polls rank travel as boomers’ No. 1 leisure activity, for a variety of reasons. in this issue

53 60 78

HEALTH 53 68 Longevity Dividend Best Practices 34 Lessons from Okinawa Age-Friendly Examples from Living Well by bradley willcox and Around the World With Dementia craig willcox Dementia-Friendly Communities 74 Offer Services and Support 58 Global Innovations by george mcnamara The Jiminy Wicket Project: Global Innovations Connecting Through Croquet Weifang University and Texas A&M 38 University-Corpus Christi: A Global Epidemic Sharing Best Practices Through Addressing the Growing Reality International Exchange of Dementia Around the World MONEY by alzheimer’s disease international (adi) 76 COMMUNITY Recognizing 40 Age-Friendly Employers The G8 Commitment 60 Announcing the 2014 AARP Best Dementia Treatment by 2025 AARP’s Age-Friendly Employers International Award by sarah lenz lock Network AARP’s Network of Age-Friendly 78 44 Communities Helps Cities to Addressing Aging in Korea Prepare for Aging Residents Designs on Dementia Senior Partners, Korea A Dementia Center Improves Lives by eun-kyung park by june andrews 64 Supporting 82 48 Age-Friendly Efforts Treasuring the Silver The WHO Global Network of Age- Campaign to Workforce Friendly Cities and Communities NEA, Singapore End Loneliness Influences Age-Friendly Initiatives Helping Older People to Create and by gloria chin by louise plouffe and Maintain Personal Connections ina voelcker by kate jopling and anna goodman

2 92 DEPARTMENTS & FEATURES THEJOURNAL editor-in-chief 4 Josh Collett From the Editor managing editor 7 Holly Schulz Maintaining a contributing editors Erica Dhar Global Perspective Bradley Schurman by a. barry rand Natalie Turner Susan Zapata

10 contributing writers The 10 Unsolved Mysteries Nicholas Barracca Brandon Cheslock in Aging Policy Jonathan Peterson 87 by debra whitman Boe Workman Respecting Mature Workers design Michelin North America 12 LevineDC.com by david stafford How the Boomers Ruined the journal online (Saved) Everything journal.aarpinternational.org by pj o'rourke 90 aarp international online Global Innovations 15 aarpinternational.org Koureisha Ltd: A Digital Agenda facebook Redefining Flexible facebook.com/aarpintl Retirement Opportunities by neelie kroes twitter 18 @aarpintl Surveying the Aging contact PERSONAL TIME Landscape AARP Office of International Affairs by asghar zaidi 601 E Street, NW 92 Washington, DC 20049 Time Worth Sharing 26 United States The Growing Popularity of t +1 202 434 2402 Multigenerational Travel A Million Voices f +1 202 434 2717 by eduardo schutte by paul ladd e [email protected]

96 32 AARP on the Scene Fine Print AARP International: The Journal is a Oma Aika Appeals to Finland’s publication of AARP. The views expressed herein do not necessarily represent policies 50-Plus Population 102 of AARP and should not be construed as endorsements. The mention of a product by anna-liisa hämäläinen Life Reimagined or service herein is solely for information to our readers and may not be used for any commercial purpose. AARP, which was established in 1958, is a nonprofit, 100 106 nonpartisan organization with tens of millions of members ages 50 and older. Talent Exchange Twitter Shoutouts State offices are located in all 50 states, the Cooperation Promotes District of Columbia, Puerto Rico, and the Virgin Islands. Sino-US Relationship 108 January 2014 by zhang jianguo ©2014, AARP Spotlight: Toby Porter Reprinting with permission only.

THEJOURNAL | 3 from the editor

Aging demands a response and compels us to reimagine our institutions and imagine the possibilities for living our best lives.

Josh Collett VICE PRESIDENT FOR INTERNATIONAL AFFAIRS, AARP

Those of us working in the field of global and engage globally to generate collec- aging are familiar with the numbers. tive action. AARP’s international work is Current demographic trends and pro- focused on highlighting best global poli- jections are unprecedented. The United cies, models and innovations, and this edi- Nations reports that the number of tion of The Journal features leading global persons over the age of 60 will more voices that offer perspective and experi- than double by 2050, exceeding 2 billion ence on trends and opportunities. From people and surpassing the number of noted authors, to top-level government children (15 and under) for the first time officials and representatives from busi- in history. But this change is upon us now ness and academia, The Journal highlights and population aging is happening in local efforts and broader initiatives that all regions of the world. Aging demands are embracing demographic change. For a response and compels us to reimagine example, our Spotlight section provides our institutions and imagine the possi- an opportunity to get to know Toby Porter, bilities for living our best lives. the new CEO of HelpAge International, As a social change organization, AARP an organization focused on helping the is dedicated to enhancing the quality of world’s most vulnerable older citizens. life for all as we age. To meet this objec- To best approach the megatrend tive, we work with all sectors of society of aging requires a reexamination of

4 process and tactics, and AARP is to feature humorist P.J. O’Rourke no exception to reinvention. In his to describe how the boomers, who column, AARP CEO A. Barry Rand invented contemporary adoles- Supporting the describes how AARP has adapted cence, are now redefining adult- interests and tapping over recent years to better help peo- hood and retirement. O’Rourke the potential of people ple age with dignity and purpose notes that the boomers’ unique 50 and older enhances and live their best life. Recognizing vision of the future has had a “pro- the individual the ever-changing world in which found and permanent effect on experience and lets us we live, AARP has launched Life American life.” imagine a new Age. Reimagined to help people thrive in Of course aging is a global the “Age of Possibilities.” Supporting phenomenon. As Neelie Kroes, the interests and tapping the poten- Vice President of the European tial of people 50 and older enhances Commission reports, “Aging knows the individual experience and lets no borders.” The European Union us imagine a new Age. has been focused on its aging pop- In our Big Picture section, ulation, advancing initiatives that Member States, the AAI provides Debra Whitman, AARP’s Executive promote healthier and more active quantitative data for 22 measures Vice President for Policy, Strategy lives. The EU is working to meet across four domains to identify and International Affairs, identifies changing needs by driving innova- opportunities for improvement ten mysteries in aging policy that tions that work locally and can be and chart progress over time. AARP need to be addressed. This year, we scaled up internationally. worked with Professor Zaidi to should all focus on finding solutions But how are we doing? How include the United States in the AAI, to the challenges of global aging so well are countries facilitating and he reports on these findings and that we all can better prepare for active aging and orienting policies how countries compare and can later life. More than ever, 2014 pres- to embrace and enable health and improve. ents a unique opportunity to embed security for older people? In this While countries need to focus on aging in the planning and develop- edition, Asghar Zaidi, Professor of how best to enable active aging, there ment of our institutions. All of us International Social Policy at the is an opportunity in 2014 to bring need to be cognizant of the real pos- University of Southampton, lets global attention to the rapid aging of sibilities offered by longevity. us know through the Active Aging the world’s population. As Paul Ladd Driving the longevity revolu- Index (AAI). The AAI is an analytical of the United Nations’ Development tion in the United States, with an tool that tracks progress and helps Programme reports, work is under- impact on all aspects of society, are governments enact policies that way to establish global goals that the baby boomers. This cohort, 76 empower older people to realize will frame sustainable development million strong, is defining longev- their potential and age with secu- policies over future years. A global ity and redefining norms, standards rity and independence. Developed dialogue is occurring now and voices and expectations. We are pleased by the European Union for the EU 27 are needed to embed the protection

THEJOURNAL | 5 from the editor

expectancy and from the UK on how are increasingly focused on “how to people can maintain personal con- spend old age more actively.” nections in later life. The Personal Time section cov- The concept of dementia- ers examples of how people are imag- friendly communities can build ining new possibilities for life after AARP advocates for on and enhance broader efforts. 50 that explore new opportunities social change at the The AARP Network of Age-Friendly and utilize skills for self-discovery personal, community, Communities is affiliated with the and purpose-driven exchange. For national and World Health Organization’s pro- many 50+ adults, travel is a top pri- international level. gram to prepare for the megatrends ority, and we feature a report from of population aging and urbaniza- Hilton Worldwide on how multi- tion. As of January, 2014, there are 20 generational vacations afford time members in the AARP Network, and with family visits close to home we feature best practices from these and also in new locations. We also communities and from around the report on an opportunity to com- world. Louise Plouffe, one of the bine travel with life experience. and promotion of older people in originators of WHO Network, and AARP has signed an agreement with these new priorities. Ladd describes Ina Voelcker, trace the history of this the Chinese government that facili- this effort and the opportunities to movement from concept to achieve- tates talent exchange for Americans add your input. AARP is engaged in ment and describe how it offers a in China that enhances individual this process and working to ensure national, regional and global means experiences while offering skills and that appropriate attention is given to of exchange. knowledge for mutual benefit. Also issues that impact the quality of life Perhaps no issue resonates in this edition, AARP is pleased to of older people and account for rap- across borders and across sectors spotlight a new magazine in Finland, idly aging societies. more than extending working lives. where nearly half the country is 50+, One issue that is getting global In 2014, AARP International will, that reports on new possibilities for attention and that demonstrates the once again, manage the AARP Best this demographic. need for coordinated planning is Employers International (BEI) pro- AARP represents over 37 million dementia. In this edition, we feature gram. AARP will recognize innova- people that are aged 50 and over. We a series of articles that identify the tive practices in age management want to ensure secured lives for all challenge of this global epidemic, in September and hold regional and enable our members to live their demonstrate the potential for better events to highlight our award win- best lives. AARP advocates for social care at a lower cost, and highlight ners and their policies into 2015. change at the personal, community, the need for broad engagement. We are pleased to feature award national and international level and AARP was pleased to participate in winners NEA (international win- works with governments, the private the December 2013 G8 Summit in ner from Singapore) and Michelin sector and civil society in ways that London that prioritized dementia North America (US winner) to see benefit individuals and their com- with promise for improved research, how they are including and manag- munities. We produce this Journal treatment and care. While interna- ing diverse talent in the workplace. to elevate the issue of aging and tional collaboration is needed, local Eun-Kyung Park, the CEO of Senior place it on the international agenda. initiatives offer learnings, such as Partners in Korea, one of our part- The world’s population is aging and the effort to establish Dementia- ners for the BEI program, reports we, individually and globally, have Friendly Communities in the United on how population aging creates an opportunity to imagine new pos- Kingdom and a holistic approach opportunities for government and sibilities that enhance the individ- to improving services and care at business to create policies and ual experience and benefit society a center in Scotland. Additionally, markets to the benefit of all. She as a whole. • the health section also includes les- also notes that older Koreans are sons from Japan for increasing life reimagining their later years and

6 from the ceo

MAINTAINING A GLOBAL PERSPECTIVE A. Barry Rand | CEO, AARP

different ways and at an increas- We developed an enterprise ingly faster pace. If AARP was going to remain relevant and successful in strategy to establish the future, it would have to change. So, we developed an enterprise strat- AARP as an organization egy to establish AARP as an organi- zation that fights for and equips each that fights for and equips individual to live their best life. We have made significant prog- each individual to ress over these past four-plus years in advancing our social mission, helping people to live their best lives live their best life. and revamping our organization to function in this new, ever-changing world. We have become a recognized I came to AARP a little more than leader in social media. We have refo- four years ago to help guide this cused AARP Foundation on the key organization into the future. I was issues of hunger, housing, isolation, drawn by its powerful mission to and income, making it one of the enhance the quality of life for all as most respected foundations in the we age. What I found when I arrived country. We’ve brought Experience was a very successful organization Corps into the AARP family. We con- dedicated to making life better for tinue to make new products and ser- people 50 and older and their fam- vices available to AARP members. ilies. But I also recognized that the We have revitalized the AARP brand. world was changing in new and We’ve launched Life Reimagined to

THEJOURNAL | 7 from the ceo

help people thrive in this new life stage we call the Age of Possibilities. Our shared goal, our And we continue to fight for the issues that matter to our members, common purpose, is to people 50 and older and their fami- lies — health, financial security and create a world where all living their best lives. As we strive to achieve our people can age with enterprise goals and make life bet- ter for all, we do so from a global independence, dignity perspective. We collaborate with those other countries that also face and purpose—a global the challenges and opportunities of aging societies. We learn from their experiences and teach them what society for all ages. we have learned from ours. Our shared goal, our common purpose, is to create a world where all people can age with independence, dignity help young elementary school stu- shift that is so great, it is creating and purpose — a global society for dents learn to read. a new life stage in our life cycle—a all ages. As part of our international period that comes after middle age Central to AARP’s vision is the collaboration, we have advo- and before old age. At AARP, we call belief that older people have much cated the benefits of volunteer- it the “Age of Possibilities.” It’s a to contribute to creating a world ism throughout the world. AARP time that more and more men and where everyone can age with inde- President Rob Romasco, recently women are using for continued pendence, dignity and purpose. This traveled to Beijing, China to sign an growth, development, exploration goes back to our founder, Dr. Ethel agreement with the Chinese State and self-discovery. Percy Andrus, whose philosophy of Administration for Foreign Experts This is a monumental shift in productive aging viewed older peo- and the International Executive how we live our lives—and it has ple as the solution, not the problem. Service Corps (IESC) that will make lasting influence and impact. We Dr. Andrus believed that engaging it possible for senior American exec- are witnessing the emergence of a older people in making the world utives to volunteer for executive new set of expectations and actions, a better place through volunteer assignments in China. The program skills and purposes that will dra- activity, would not only give them will be administered by the IESC. matically alter the landscape of life purpose and a way of continuing This effort aligns with AARP’s Life after 50 in America—a new “Age of to contribute, it would bring their Reimagined initiative, which helps Possibilities.” valuable lifetimes of leadership and people discover the real possibilities Tens of millions of people 50+ experience to address social issues. in their own lives and use their skills, are leading longer, healthier, more Volunteers continue to play knowledge and experience to live a productive lives. They reach tra- a vital role in AARP. We have an meaningful and fulfilling life. ditional retirement age and real- all-volunteer board of directors. At AARP, we are deeply ize they’re not ready to retire. They Many of our programs — such as immersed in helping people 50 and want to do more—to continue to AARP Tax Aide, AARP Driver Safety, older reimagine their lives. We are contribute to society—they’re not AARP Foundation’s Drive to End leading the national conversation done, yet. They want to explore the Hunger and others — rely heavily to reimagine what aging is all about. possibilities that lie ahead, and on volunteers to operate. And AARP Something important, deep and they’re reimagining their careers, Experience Corps relies on volun- permanent is changing in American their relationships and their lives to teers to serve as tutors in schools to life. We’re facing a demographic do just that.

8 At AARP, we’ve learned that and many countries. AARP will rec- reimagining life is a key concept ognize leading organizations in 2014 for today’s generation of aging and plans to hold international pro- Americans—especially those who grams to highlight model policies seek something other than the in age management across different retirement experience that grew sectors. from the aging revolution that gave We have also launched the us “the golden years.” “AARP Network of Age-Friendly While millions of older people Communities,” in affiliation with pursue their life reimagined, far too the World Health Organization. many still seek a life secured. Many This program educates, encourages, still must contend with inadequate promotes, and recognizes improve- health care, poor nutrition, inade- ments that make cities, towns, and quate housing, uncertain finances, counties more age-friendly for their and crushing loneliness. That’s why residents. As we enter 2014, the we continue to fight every day to pro- AARP Network includes 20 US com- tect Social Security and Medicare, to munities. We are working to grow lower the rising cost of health care, and integrate this effort domesti- to make communities more livable cally and to connect internationally for people of all ages, to improve with this global movement. long-term care and to make sure As we confront both the oppor- future generations have the oppor- tunities and challenges of an aging tunity to achieve health and finan- society, we recognize that people cial security, to live their best lives and governments throughout the and to pursue their dreams. And our world are dealing with the same work internationally contributes issues, each in their own ways. At a great deal to inform our work on AARP, we continue to recognize that these issues. we can learn a great deal from the We also support older workers experiences of other countries, and through our “AARP Best Employers the hope that they can learn from us International (BEI) Program.” BEI as well. A. Barry Rand promotes opportunities for people With 10,000 people a day turn- CEO, AARP to extend their working lives. This ing 65 for the next 17 years in the benefits individuals, corporations United States, issues related to aging and society as a whole. AARP BEI are going to become even more spotlights innovative workplace urgent than they are today. Global policies and practices that support demographics show that this is an workers of all ages through events, international trend. Therefore, AARP discussions and an award. will continue to collaborate with The AARP Best Employers others at international conferences, International Award honors non- events and policy discussions to US-based organizations that value highlight and promote best practices. the skills and talents of experienced And we will continue to promote workers while meeting their needs community building among inter- and providing a path for future work- national and UN organizations, ers. Previous winners have included governments and civil society orga- organizations large and small repre- nizations serving people 50 and older senting a variety of industry sectors around the world. •

THEJOURNAL | 9 the big picture T HE 10 UNS OLV E D MYSTERIES IN AGING POLICY Debra B. Whitman | EXECUTIVE VICE PRESIDENT FOR POLICY, STRATEGY, AND INTERNATIONAL AFFAIRS, AARP

10 The aging of populations around the them as a caregiver, a granddaughter, world poses a serious challenge for an employee and an employer. No policymakers in many countries. I matter what continent you live call these challenges the Unsolved on, you also may be running into Mysteries in Aging Policy. some of these same issues in your professional and personal lives. 1.How can we encourage more peo- We all are affected by this ple to save more for retirement? demographic change. Adults are increasingly caring for their older 2. How do we make sure people’s parents and children. The growing nest eggs will last for the rest of prevalence of chronic illness is a their lives? challenge for families, communities and health care systems. The cost of 3. How do we encourage people to supporting large older populations work longer, while taking care of is placing financial stress on those who cannot? retirement systems in the United States and overseas. 4. How will we pay for long-term ser- These problems are interrelated, vices and supports, including in like pieces of a puzzle. And they do the home and community? not have easy answers. Now, to be clear, I am upbeat 5. How will we get the workforce about the future. I view the changing that’s needed to support a vastly demographics not as a tidal wave to larger aging population? be feared but as an opportunity to embrace. An older population offers 6. How can we help consumers play a benefits of maturity, stability and bigger role in managing their own knowledge. It can spur innovation health and wellness? in goods and services as varied as banking, tourism and retirement Debra Whitman 7. How can society best deal with living. It can help us look at the way Debra Whitman is AARP’s growing numbers of people with we build and design communities in Executive Vice President for Policy, diminished mental capacity? a whole new way — for everyone’s Strategy and International Affairs. She is an authority on aging issues benefit. with extensive experience in 8. How do we better protect older But to have the best possible national policymaking, domestic adults from fraud and abuse? future, we need to be realistic about and international research, and the the challenges, and take them on, political process.

9. How can society do a better job of while we still have time. She oversees AARP’s Public supporting people in making deci- Different cultures and societies Policy Institute, Office of Policy sions about care at the end of life? are tackling them in different Integration, Office of International ways, and we can learn from each Affairs and Office of Academic 10. How do we get politicians to take other’s experience. We can benefit Affairs. She works closely with the Board of Directors and National a long and broad view of the needs by applying lessons learned and Policy Council on a broad agenda of an aging society? insights from all over the world. to develop AARP policy priorities We welcome your perspective. and make life better for older These are issues I’ve struggled We want to know about relevant Americans. An economist, she is a with for two decades — first at the initiatives, pilot projects and strategic thinker whose career has been dedicated to solving problems Social Security Administration, strategies. Help solve the Unsolved affecting economic and health then working for the US Congress Mysteries of Aging Policy by security, and other issues related to on Capitol Hill, and now as head of emailing [email protected] or population aging. Policy at AARP. I’ve also dealt with send a tweet to @DebAARP • THEJOURNAL | 11 special essay

HOW THE BOOMERS RUINED (SAVED) EVERYTHING PJ O’Rourke | HUMORIST, POLITICAL REPORTER AUTHOR, THE BABY BOOM: HOW IT GOT THAT WAY (AND IT WASN’T MY FAULT) (AND I’LL NEVER DO IT AGAIN)

the benefits of the postwar period’s And now, the boomers extraordinary economic growth. We were dizzy with our aspira- run the world. The tions. We’d be rock stars. We’d be spir- itual avatars. We’d be social activists. youngest members of We’d be billionaires. No, better yet, we’d be all those things at the same the generation that time. (Steve Jobs came close.) Every time opportunity knocked, we let it in, even when it should have decided to be young been locked out for decency’s sake. And behold the boomers’ remarkable forever are turning 50. experiments with prosperity—the dot-com bubble, the housing bubble, Yes, we’re spoiled rotten. the enormous financial bubble that’s We’re self-absorbed. And it still got the nation trying to get fidu- seems like we’ll never shut up. But ciary gum out of its hair. the boomers made a better world for And now, the boomers run the everyone else. You’re welcome. world. The youngest members of the We’re the largest, richest, best-ed- generation that decided to be young ucated generation of Americans, the forever are turning 50. That’s the age favored children of a strong, confi- of maximum privilege and power. dent and prosperous country. Or, We’re giving everybody orders. And as other generations call us, spoiled we’re taking everybody’s money. brats. Born between 1946 and 1964, The oldest boomers are enrolled in the 76 million boomers reaped all Medicare, collecting Social Security

12 and receiving tax-free Roth IRA dis- sex-drugs-and-rock-and-roll wheel, Some days I’m a Part D prescription bursements. Plus, American life we had a good time while it lasted. drug beneficiary, and some days it’s expectancy has increased by almost This is how we brought down April 15. 12 years since the baby boom was the Berlin Wall. Reagan, Thatcher We’re also the generation that born, so it doesn’t just seem like and Gorbachev get the kudos, but we laughed off the kind of casual big- we’ll never go away. From President were the ones who tagged the wall otry once widely acceptable in Obama, Rand Paul and Jeff Bezos at with all that awesome graffiti. When American life. To see how far we’ve one end of our age cohort to Hillary people our age on the wrong side of come, compare All in the Family Clinton, Rush Limbaugh and Cher at the Berlin Wall saw how much fun with Modern Family, two popular the other, we cannot be escaped or people our age on the right side of TV shows about intergenerational avoided (or shushed up). the Berlin Wall were having, it was relations in a changing world. The But running the world means all over with the Communist bloc. 1970s sitcom was considered ground- taking responsibility for it. The Today the Soviet Union is just a col- breaking because it got laughs from boomers have been good at tak- lection of counties with too many K’s middle-aged Greatest Generation ing things: Mom’s car without per- and Z’s in their names, and China is patriarch Archie Bunker’s unrecon- mission, drugs, umbrage at the the kind of dictatorship whose idea structed racism and sexism. The establishment, draft deferments, of world conquest is domination of current show is considered ground- advantage of the sexual revolution, the global smartphone manufactur- breaking because it gets laughs from and credit for civil rights and wom- ing sector. We’re the generation that middle-aged boomer patriarch Jay en’s liberation movements that laughed off totalitarianism. Pritchett’s bemused confusion about rightly belongs to prior generations. Little wonder that we’ve cre- gay marriage, blended families and The one thing that can be left in ated a political system best known … Actually, Modern Family is not plain sight without us putting our for producing comedy. A Rasmussen considered groundbreaking. It’s just sticky mitts on it is responsibility. poll from a few years ago found that considered funny. Ask our therapists. Or the parents 32 percent of Americans under 40 Boomers didn’t exactly create a we haven’t visited at the extend- think that satirical TV programs race-blind society, but the kids we’ve ed-care facility. like Jon Stewart’s The Daily Show raised might. When my daughter was The world is being run by irre- are replacing traditional news out- nine, she came home from school sponsible spoiled brats. And yet the lets. Who can blame them, consider- asking about adoption. She didn’t world started to get better as soon ing the news that Senator Blutarsky quite understand what it meant. as the boomers took over. That was and his colleagues make. And yet, My wife and I explained and said, in the late 1970s, when we were although partisan polarization may “You’ve got friends who are adopted.” old enough for our deepest beliefs, have Washington deadlocked, there “I do?” said my daughter. our most cherished values and our are worse things than a deadlocked “Suzie Duncan,” we said. “Suzie unique vision of the future to have Washington—such as a unified was born in Ethiopia. The Duncans a profound and permanent effect on Washington marching boldly for- adopted her when she was a baby.” American life. To be precise, we took ward to disaster in Vietnam when The Duncans are pink, freckled, over on July 28, 1978, the day Animal the Gulf of Tonkin Resolution was short people of Scots-Irish extraction. House was released. passed in 1964 (with a vote of 416-0 Suzie is tall and thin with a luminous Things have been more fun in the House, 88-2 in the Senate). anthracite complexion. since we elected Senator Blutarsky. Anyway, we’re not “polarized.” My daughter said, “I thought Sometimes too much fun. The We’re just bickering on the Capitol Suzie looked different than her mom boomers can be scolded for promis- Hill playground. We love to argue. and dad.” cuous sex, profligate use of illegal Half the boomers want more social But boomers haven’t made life intoxicants, and other behavior that services, to be paid for by other peo- perfect, the way we promised we didn’t turn out to be healthy. But ple. And half the boomers are those would back in the 1960s. We prom- somebody had to do the research. other people. At our age, we can’t ised we wouldn’t fight any wars. We Somebody had to be the guinea always remember which half we’re were fibbing—we’ve had seven or pig. And, running around in the in. For me, it depends on the day. eight since Vietnam. But we did make

THEJOURNAL | 13 special essay

Boomers didn't exactly create a race-blind society, but the kids we've raised might.

them smaller. The United States has haven’t put many bean sprouts in the suffered more than 5,800 combat pita pocket. deaths in the three decades of the But a lot more things now come post-Vietnam era. The number is standard with our standard of liv- painful, but it’s also less—by almost ing, thanks to all the great stuff a thousand—than the number of we’ve invented. In 1978, few peo- US servicemen who died in just five ple had a personal computer, and if weeks during the Battle of Iwo Jima. they did, it took up half the house. It would be nice to think the There was no GPS in your car. The boomers did something to make Greatest Generation was lost all the the world less warlike. More likely, time (this may be how LBJ wound our voracious consumerism has just up in Vietnam). You had to go to the made the world richer. Gross world library to look things up, and then product—the total of all the goods you couldn’t because the Dewey and services produced on earth— Decimal System made it impossi- increased fivefold between 1975 and ble to figure out whether Dewey ran 2012, to almost $72 trillion. There’s for president against FDR, defeated a theory that rich people don’t like the Spanish navy in the Battle of to fight huge wars—itchy uniforms Manila Bay or invented the Dewey and ugly shoes. China’s economy is Decimal System. We may not have nearly 40 times larger than it was in managed America’s money well, but PJ O'ROURKE 1978. Let’s hope the theory’s true. the boomers’ demand for more and Our own standard of living hasn’t better gizmos has filled the nation Humorist and political reporter P. J. O’Rourke is the author of The climbed at that heady rate, the way with amazing playthings, from tiny Baby Boom: How It Got That Way the Greatest Generation’s did. But we talking computers to gigantic flat- (And It Wasn’t My Fault) (And I’ll didn’t get to start with nothing. In a screen TVs with 2,000 channels to Never Do It Again). world destroyed by the Depression watch on them. We’re the generation and war, every Levittown bungalow that will die with the most toys. looked like the Ritz-Carlton, and a $20 Until that day finally comes, pay raise was a winning lottery ticket. we’ll still be riding our bicycles, jam- American family income, adjusted ming in garage bands, and wearing for inflation, grew by about $25,000 jeans and T-shirts. We’re famously between the late 1940s and the mid- careful about the way we raise our dle 1970s. Since then it’s grown by kids, because somebody has to grow only about half that amount after up. It won’t be us. adjusting for inflation and has in And what about those kids? Will fact declined overall since 1999. For Generation X and the millennials do a so-called sandwich generation— a better job running the world than pressed between the demands of the boomers have? Let’s hope so. But kids who aren’t yet independent and first they’ll have to move out of our parents who are getting less so—we basements. •

14 the big picture

A DIGITAL AGENDA Innovating through Information Communications Technology

Neelie Kroes | VICE PRESIDENT, EUROPEAN COMMISSION

many people see aging as a challenge, A major part of the answer contributing to a rising cost in national accounts and demanding arduous lies in digital technology responses. One can also see it as a fantastic opportunity, to enable people or, more officially, ICT- to contribute to our society after they turn 65. The European “silver economy” enhanced products and already amounts to €3 trillion—and is growing fast. Whichever way you look services for aging well. at it, one thing is clear: the change is huge, and we must respond. In my role as European Commissioner for the Digital For me, the United States has always been Agenda, I have been trying to make the land of unlimited possibilities. It is people see the unlimited possibilities of also the land where my grandchildren are demographic aging and convince them growing up. Thanks to Skype (European to change their politics, policies, and Union-invented!), I can be part of their philosophy. In 2060, the world will be lives whenever I like. Of course, I say this entirely different demographically, and because I am a proud grandmother, but that calls for more than a few tweaks to also because it can help us get the essence pension rules. of aging in sharp focus. Aging is about maintaining quality Innovation is for Everyone of life, health, independence, and an We need innovation, but in a broad active life without social exclusion. The sense—including technological, social, big challenge is to organize our economy and economic innovation. But how do we and society in such a way that we can stimulate and support it? That’s a tricky make this a reality for a large part of the question. A major part of the answer lies population in an aging society. That is no in digital technology or, more officially, easy task. ICT-enhanced products and services for You could look at our aging society aging well. I am convinced they can help as a triumph. Advancing medical science us achieve a better quality of life, more and enlightened public policy have sustainable health and care systems, and delivered something wonderful to our economic growth and new jobs — a triple citizens: longer, healthier lives. Still, too win. But many people think technology

THEJOURNAL | 15 the big picture

should not overtake care. Care and is more responsive. And then there is innovation actions to demonstrate cure are people’s work, they say, or the European fragmentation along how certain solutions yield a return that older people and new technol- national borders, which we work on investment in terms of quality ogy do not go together very well. ICT so hard to overcome. That is proba- of life, care efficiency gains, and innovation is by default associated bly why we are slow in applying the economic growth. We look forward with young people: teenagers texting potential of innovation, especially to continued cooperation with US constantly, cool websites targeted at in areas like health and care, which companies and institutions under twentysomethings, and start-up mil- is dominated by national regula- H2020, more notably on open lionaires barely out of high school. tion and government intervention. platforms and interoperability But that’s blatantly wrong. If well-de- Yet, our diversity can help us design standards as a basis for an open, big- signed and responding to real user solutions that are not one size fits all, data approach to care innovation. needs, innovative technology is for but applicable and transferable to everyone, and it can support our shift different settings: flexible and open Assistive Technologies for to an age-friendly society. solutions for a global market. AARP Independent Living Health and care can be used as an shows us something that Europe does Under H2020, we will also fund example. Our care institutions were not have: a unified advocacy organi- the Member State–driven Ambient built in a different age: intended to zation for the whole population, with Assisted Living Joint Programme deal with acute conditions and short- the buying power to help shape the (AAL JP). With this program, we want term problems, and based on doctor growing silver market. But Europe to help translate interesting ideas visits, hospital stays, and medication also has a lot to offer American from research into realistic prod- prescriptions. An aging population companies. The active government ucts and services with a clear mar- faces different challenges: chronic, policies on aging, research, and ket potential. After a successful first degenerative, and multiple long- innovation are certainly at play here; version, we plan to launch a second term conditions are becoming more the Intel Technology Research for round for the next 7 years. In each and more frequent. That calls for a Independent Living Centre in Ireland AAL project, at least three Member different kind of solution, i.e. one is a fine example. States, one Small or Medium-sized that does not rob people of dignity Many initiatives of the Enterprise (SME), an academic insti- and independence, but puts them in European Commission support tution, and a user organization work the center of care provision. It calls innovation for aging well. They take together. Part of its success is the for an approach that does not focus into account the specific European participation of innovative SMEs on treatment, but on prevention dimensions mentioned above, yet that come up with ground break- and early detection, and supporting always aim for solutions with ing ICT-based solutions—for exam- active and healthy lifestyles. ICT international potential. First, there ple, to keep older people socially provides many practical ideas for this are the major multiannual research interactive, enhance their mobility, approach, from simple mobile apps and innovation programs: the or help them manage their daily that empower people to take control current Seventh Framework activities at home. To improve and and monitor their health, to entire Programme (FP7) and the new support knowledge-based policy environments for assisted living Horizon 2020 (H2020), running making, we run a “More Years, Better without being dependent on others. from 2014 until 2020. Promoting Lives” Joint Programming Initiative. longer and healthier lives is one of Finally, innovation for healthy liv- Cherish the Differences the societal challenges of our €70 ing and active aging is one of the Aging knows no borders. The billion H2020 program. There we priority themes of the Knowledge European Union, the United States, will continue to fund fundamental and Innovation Communities of the and many other countries share this research on the effect of aging on European Institute for Technology. challenge. In Europe, national gov- body, mind, and community; as This is already a lot, but it is not ernments are still largely responsi- well as the technologies, services, enough. Innovation is only valuable ble for delivering care to those who and applications that can tackle if it makes a concrete difference to need it. They can be effective agents these challenges and support active people’s lives. Only then will people of change, but sometimes the market aging. We will also fund large-scale see the benefits.

16 It’s time to remove the barriers, including regulation and institutional arrangements that block the deployment of good practices that are already available.

Kindle the Sparks to Build a Fire of chronic patients has increased. Two years ago, we decided an extra There are even regions where new step had to be taken to ensure that jobs have been created. In other what works at a local level is shared words, the sparks are there, but we and scaled up internationally. To need to build a fire. That’s why the achieve that, we needed to create EIP-AHA participants gather evi- a more favorable environment for dence, share and learn from each innovations with a proven track other, exchange good practice, ener- record and to define which policies gize those who get the message, we need to adopt to make this hap- and educate those who don’t. These pen—be it health and social policies, many initiatives are already helping or employment and economic poli- to improve the lives of millions of cies. It’s time to remove the barriers, Europeans in a practical sense. including regulation and institu- Creating an age-friendly tional arrangements that block the European Union is also about Neelie Kroes deployment of good practices that building smarter and more age- are already available. That is the phi- friendly cities where it is easier to get Neelie Kroes was born in 1941 in Rotterdam. From 1971 to 1989 losophy of our European Innovation around, with houses and buildings she worked in Dutch politics, Partnership on Active and Healthy that are more responsive to people’s including as minister responsible Aging (EIP- AHA.) More than 3,000 needs. That is the topic of yet another for postal and telephone sectors. parties (companies, patients, carers European innovation partnership Subsequently, she worked on and health professionals representa- in the making. And, of course, we various company boards. In 1991 she became chairperson tive organizations, academics) have need ubiquitous, fast broadband to of Nyenrode University. In 2004 committed to join forces on six con- make all of this possible. That is why she became the EU's Competition crete actions: medication adherence, I recently presented the proposal for Commissioner, and, in 2010, Vice fall prevention, frailty and malnutri- a single market for telecoms. President of the Commission tion, integrated care, independent Aging isn’t a problem; on the responsible for the Digital Agenda. living, and age-friendly environ- contrary, it can be a source of ments. Trials have shown that tele- innovation and growth. It’s not just health can improve survival and an expanding cost to be cut, but a recovery as well as cut inconvenient, growing market opportunity to be costly hospital visits. In some places served. We all should benefit from with telemonitoring services, medi- it. Let’s join forces to turn this global cal costs have gone down considera- challenge into a source of inspiration bly, while in others the quality of life and growth for all. •

THEJOURNAL | 17 the big picture

SURVEYING THE AGING LANDSCAPE Asghar Zaidi* | CENTRE FOR RESEARCH ON AGEING/ESRC CENTRE FOR POPULATION CHANGE, SCHOOL OF SOCIAL SCIENCES, UNIVERSITY OF SOUTHAMPTON, UNITED KINGDOM

The Active Aging Index reported here is calculated for each of the 27 European Union (EU) countries as well Data helps to depict as for the United States, with a focus on the current the contribution of older generation of older people and by using the latest available survey data. It covers diverse aspects of the people and provide key active aging experience, and points to older people’s lessons from EU contribution with respect not only to employment, but also to their unpaid familial, social, and cultural Member States and the contributions, and to independent, healthy, and secure United States. living. It also captures how countries differ with respect to capacity and enabling environments for active and healthy aging, and offers the all-important breakdown by gender. Its key findings are that the United States, Sweden, Denmark, Ireland, the United Kingdom, and the Netherlands come at the top of the ranking, whereas the majority of eastern European countries and Greece *With contributions from Cinthia Josette Arévalo in producing are at the bottom. Women fare worse than men in most results from the United States, and from Katrin Gasior, Maria M. countries, identifying a need for a renewed social policy Hofmarcher, Orsolya Lelkes, Bernd Marin, Ricardo Rodrigues, emphasis on reducing gender disparity in regard to Andrea Schmidt, Pieter Vanhuysse and Eszter Zolyomi for results active aging. from European Union countries.

18 ACTIVE AGING INDEX

FIGURE 1: THE DOMAINS AND INDICATORS OF THE AAI

Capacity Independent, and Enabling Participation Employment Healthy and Environments in Society Secure Living for Active Aging

INDICATORS NEEDED TO CONSTRUCT ACTIVE AGING INDEX

Employment Rate Voluntary Activities Physical Exercise Remaining Life Age 55-59 Expectancy at age 55

Employment Rate Care to Children/ Access to Health and Share of Healthy Life Age 60-64 Grandchildren Dental Care Expectancy at age 55

Employment Rate Care to Older Adults Independent Mental Well-being Age 65-69 Living

Employment Rate Political Financial Security Use of ICT Age 70-74 Participation (Three Indicators)*

Physical Safety Social Connectedness

Life-long Learning Educational Attainment

Actual Experience of Active Aging Capability to Actively Age

*Financial security aspets are captured by three different indicators: (1) relative median income of 65+ relative to those below age 65; (2) no poverty risk for older persons; and (3) no severe material deprivation rate.

THEJOURNAL | 19 the big picture

Access to high-quality data allows us to draw a full picture of active aging outcomes for the current generation of older people across different domains of their lives.

We live in a society that would be unrecognizable to a that stimulate and sustain the activity, health, indepen- visitor traveling forward from the early twentieth cen- dence, and security of older people. The strategies that tury. The visitor would notice many great technological have come to the fore over the past decade, and that are wonders, but he would surely notice something unprec- linked with improving the well-being of older people, are edented about humans: increasing numbers are living referred to collectively as “active aging.”1 longer than ever before, are healthier, and can look pos- Active aging strategies draw on the insight that suc- itively to the prospect of an active life long into old age. cessful measures enable older people to increasingly This is the outcome of extraordinary developments in participate in the labor market, social and family activ- technology, medicine, and public hygiene, but equally ities, and live independent, secure, and healthy lives. important are adjustments to lifestyles (such as adopt- The rationale is that setting in place the conditions to ing a healthy diet and undertaking regular exercise empower older people to live active lives with degrees of throughout the life course) and the provisions of pub- independence and security is the catalyst for sustainable lic policies and welfare state institutions. For citizens aging societies. The multifaceted design of a compre- of European and North American countries, a full and hensive active aging policy discourse allows the setting active life in old age is no longer an idea, but it is already of policy goals to maintain, and even raise, the well-be- a reality for some and a genuine possibility for many ing of older individuals. It also strengthens social cohe- others! sion in the society and solidarity between generations, While we celebrate living longer, in better health, and and improves financial sustainability of public welfare with increasing security, there is a broad social and soci- systems. Under such conditions, care for the elderly is etal responsibility to question how such benefits can be seen as a positive—much less a burden—and a source sustained and spread to other regions around the globe to empower older people to free themselves from depen- and to be participated in and shared by wider segments dency and social isolation. of our societies. The challenges can be summarized as A key prerequisite to the formulation of any success- follows: to identify and promote strategies at all levels ful and sustainable strategy is good data. Advancements

20 in data collection allow accuracy in The AAI was produced for the goals of reducing gender disparity the measurement and assessment of United States by AARP researchers (in in positive experiences of successful the baseline position, as well as for close consultation with the author). aging. the measurement of progress and the The AAI for the United States fol- evaluation of the impact of policies, lowed the same methodology as used Domains and Indicators of the institutions, and behavioral changes. to calculate the AAI for EU countries. Active Aging Index For instance, access to high-quality Because of data consistency issues The definition of active aging data allows us to draw a full picture that exist between Europe and the encompasses many facets. Most of active aging outcomes for the cur- United States, it was necessary for importantly, it includes participa- rent generation of older people across some indicators to be replaced with tion in the labor market as well as different domains of their lives. That the closest available proxy. Overall, other unpaid productive activities, said, some caution may be in order: the international comparability of and also the ability to live healthy, the evidence generated on active the indicators between EU countries independent, and secure lives. aging can only be as good as the data and the United States can be termed Clearly, the data needed to capture it is built on, and there is an ongoing as satisfactory. these domains of living is multifar- need to improve the quality of survey The AAI offers a wide range of ious and complex. The indicators data to make issues of aging, gender, users (policy makers, researchers, needed to construct the AAI must and socioeconomic class visible. The students, and businesses) a flexible capture the employment experi- insights required are the ability to framework that helps to depict the ence of older people, before and highlight how aging experience at contribution of older people, and to after retirement age, but also their the individual level are combined draw out lessons from policies, pro- unpaid activities toward care provi- with higher levels of activities (paid grams, and institutional differences sion to family members and volun- and unpaid), improved health (phys- across EU member states and the teering. Other data required relates ical and mental), and a greater degree United States. In its design, the AAI to the physical, social, and finan- of autonomy and self-reliance. draws from the definition offered cial security of older people; their The 2012 European Year by the World Health Organization access to health and dental care; (EY2012) carries a special signifi- (WHO) during the Second World education, training, and access to cance in this respect, as it has put a Assembly on Ageing, bases itself on information and communication renewed focus on the potential of the strands of the EY2012, and uses a technology (ICT); and information active aging as a policy strategy.2 methodology similar to the Human on those aspects that determine the Most notably, in the framework Development Index of the United enabling age-friendly environments of activities of EY2012, the United Nations Development Programme. of a country. The strength of the AAI Nations Economic Commission for One of the major benefits is that analytical toolkit is that it brings Europe (UNECE), the European the AAI enables credible compari- together all these perspectives, Commission's Directorate General sons between EU countries and the offering policy makers a sound base for Employment, Social Affairs and United States and quantifies the dif- to devise evidence-based strategies Inclusion and the European Centre ferential extent to which older people to manage the challenges of popula- Vienna jointly undertook a major have realized and can further real- tion aging. research project to collect evidence ize their potential in the multiple Framed by these considerations, on active aging outcomes across 27 domains that determine their active the AAI used the following four European Union (EU) countries by aging experiences. In this pursuit, domains: employment; participa- constructing the composite quan- the AAI also offers a transversal tion in society; independent, healthy, titative measure called the Active breakdown by gender in order to and secure living; and capacity and Aging Index (AAI).3 highlight the specific public policy enabling environment for active

THEJOURNAL | 21 the big picture

aging. Figure 1 (page 19) displays the show is that even the top performing FIGURE 2: hierarchy for systematically deriving countries, with a value of 44 percent, RANKING OF COUNTRIES a quantitative overall index for active must aim for further improvements. BY THE OVERALL AAI aging, starting by using 22 indicators In contrast, the four countries at FOR TOTAL POPULATION placed under four domains. the bottom of the ranking—Greece, (Includes All Domains, 2012) Although the first threeHungary, Slovakia, and Poland— domains are traditional subjects have a larger gap (in excess of 70 per- of measurement of active aging, cent), and thus require greater policy SWEDEN 44 the fourth domain (capacity and and coordination efforts to promote UNITED STATES 44 enabling environment) is inno- active and healthy aging experience DENMARK 40 vative. It looks beyond the actual of their old age population. IRELAND 39 active aging experiences and takes It is important to understand UNITED KINGDOM 39 stock of the health and human cap- that although the numerical values NETHERLANDS 39 ital of older people within their cul- of the overall index look similar, FINLAND 39 tural, economic, and social setting. they nonetheless reflect different CYPRUS 36 It recognizes the importance of the experiences across the four domains LUXEMBOURG 35 individual capacities of older peo- within a country. For example, GERMANY 35 ple as well as the quality of the age- the joint top position of the United AUSTRIA 35 friendly environment in which they States (with Sweden) in the over- CZECH REP. 34 live in determining their diverse all AAI ranking can be explained, FRANCE 34 experience of aging. in part, by the high index value the PORTUGAL 34 United States achieved for the first BELGIUM 33 Key Findings of the AAI domain (employment) and also ITALY 33 Using the overall index, Sweden and for its top position in terms of the ESTONIA 33 Denmark are neck and neck with capacity and enabling environment SPAIN 33 the United States in the top three for active aging. Ireland, in contrast, LITHUANIA 32 places, with three western European scores the top ranking only in the MALTA 31 nations (Ireland, the United second domain (participation in ROMAINIA 31 Kingdom, and the Netherlands) society), but does not feature even in SLOVENIA 31 next, followed by Finland. With the the top 10 countries in the employ- LATVIA 30 exception of the Czech Republic, ment domain. The United Kingdom, BULGARIA 30 the current position of the central on the other hand, has a high rank- GREECE 29 and eastern European countries is ing in employment but do not fea- HUNGARY 28 at the bottom of the ranking; these ture among the top ten with respect SLOVAKIA 28 countries are found to show a clear to participation in society. Such POLAND 27 potential for further improvements differences across countries offer with respect to active aging. mutual learning in terms of good Obviously, the figures pro- policies and programs that promote vided by the AAI do not tell a com- active and healthy aging in different plete story. But they do allow a basis contexts. for a cross-country comparison, The index also reports separately an analysis of differences across the active aging experience of men active aging dimensions, and the and women, which allows a strong means for identifying, on a coun- focus to be brought to an evaluation try and regional basis, the pol- of differential aging experiences by icy priorities for future progress. gender. The AAI, when viewed for Notwithstanding this, what the gender differences within a country, index values for these countries do indicates a clearly higher untapped

22 TABLE 1: RANKING OF EU MEMBER STATES AND THE UNITED STATES, ON THE BASIS OF THE AAI AND THE DOMAIN-SPECIFIC INDICES Men and Women Together

Capacity Independent, and Enabling Participation Overall Employment Healthy and Environments in Society Secure Living for Active Aging

United States United States United States United States United States 44.0 41.4 23.0 74.8 70.0

1. Sweden 1. Sweden 1. Ireland 1. Denmark 1. Sweden 44.0 41.0 25.2 79.0 69.5

2. Denmark 2. Cyprus 2. Italy 2. Sweden 2. Denmark 40.2 36.1 24.1 78.7 66.7

3. Ireland 3. UK 3. Luxembourg 3. Netherlands 3. Netherlands 39.4 35.5 22.6 77.7 61.6

4. UK 4. Portugal 4. Sweden 4. Finland 4. Luxembourg 39.3 35.3 22.6 76.6 61.6

5. Netherlands 5. Estonia 5. France 5. Germany 5. UK 38.9 34.4 22.4 75.8 61.4

6. Finland 6. Denmark 6. Netherlands 6. UK 6. Ireland 38.8 34.0 22.4 75.7 60.8

7. Cyprus 7. Finland 7. Finland 7. Ireland 7. Finland 36.3 32.0 22.4 75.7 60.7

8. Luxembourg 8. Romania 8. Austria 8. Luxembourg 8. Belgium 35.1 31.4 21.4 74.7 60.3

9. Germany 9. Netherlands 9. Belgium 9. France 9. France 35.0 31.4 20.4 74.6 57.8

10. Austria 10. Germany 10. Denmark 10. Slovenia 10. Austria 34.9 31.2 20.1 74.4 57.5

THEJOURNAL | 23 the big picture

FIGURE 3: GENDER DIFFERENCES IN THE OVERALL AAI All domains together

-3.4 SWEDEN -3.1 UNITED STATES -4.6 DENMARK -4.4 IRELAND -3.8 UNITED KINGDOM -6.5 NETHERLANDS FINLAND 0.3 -8.6 CYPRUS -6.8 LUXEMBOURG -4.0 GERMANY -5.7 AUSTRIA -5.7 CZECH REPUBLIC -1.6 FRANCE -4.3 PORTUGAL -4.5 BELGIUM -5.3 ITALY ESTONIA 1.4 -3.7 SPAIN -1.3 LITHUANIA -8.1 MALTA -4.1 ROMAINIA -4.8 SLOVENIA LATVIA 2.0 -3.3 BULGARIA -5.4 GREECE -2.7 HUNGARY -4.3 SLOVAKIA -3.5 POLAND

WOMEN FARE WORSE THAN MEN WOMEN FARE BETTER THAN MEN

potential for women in almost all age-friendly environments for older This work offers advancement countries. This is particularly so in people. Policy makers, research- over previous work in several ways: the two southern European coun- ers, students, businesses, and civil it takes into account consideration tries (Cyprus and Malta), but also society partners now have access of the human capabilities required (surprisingly) in the Netherlands and to a flexible framework that can be to experience active aging. It also Luxembourg. used to highlight the important highlights the multidimensional contributions older people are mak- characteristics of the active aging Conclusions ing to their communities, and to phenomenon, by including mar- The AAI provides an opportunity draw lessons from the experiences ket and nonmarket contributions for an assessment of and goal set- of older men and women in diverse of older people in a single measure. ting for activity, participation, policy and institutional contexts of Finally, it provides internationally independent living, and enabling countries. comparable quantitative evidence on

24 the relative position of EU countries 1 For more discussion, see World Health Organisation, "Active Ageing - A Policy and the United States with respect Framework", A contribution of the World Health to the untapped potential of older Organization to the Second United Nations World people in various aspects of active Assembly on Ageing, Madrid, Spain, April 2002; A. Walker, “Commentary: The Emergence and aging. Although to date the AAI has Application of Active Ageing in Europe,” Journal of focused on the current generation Ageing and Social Policy, 21(1) (2009), pp. 75–93; and A. Walker and T. Maltby, “Active Ageing: A of older people, there are only good Strategic Policy Solution to Demographic Ageing reasons for extending such analyses in the European Union,” International Journal of to other age groups—and so look to Social Welfare 21 (2012), pp. 117–130. incorporate the life-course perspec- 2 Council of the European Union,“Council tive in the numerical assessment of Declaration on the European Year for Active Ageing and Solidarity between Generations active aging. People’s well-being and (2012): The Way Forward,” 17468/12, SOC Asghar Zaidi their empowerment at all ages must 992, SAN 322, Council of the European Union, Asghar Zaidi is Professor of remain the focus of all active aging Brussels, 7 December 2012. International Social Policy, strategies. 3 For a detailed description of the Active Aging University of Southampton. He is The point about the usefulness Index and its findings, see A. Zaidi, K. Gasior, also Senior Advisor at European M. M . Hofmarcher, O. Lelkes, B. Marin, R. Centre Vienna; Visiting Senior of internationally comparable evi- Rodrigues, A. Schmidt, P. Vanhuysse, and E. dence is of crucial future importance. Zolyomi, “Active Ageing Index 2012: Concept, Fellow at CASE (London School of Economics); and Research The AAI allows the development Methodology and Final Results,” (2013), Methodology Report Submitted to European Affiliate at the German Institute of benchmarking of country per- Commission’s DG Employment, Social Affairs and for Economic Research (DIW formance, and this (it is hoped) Inclusion, and to Population Unit, UNECE, for the Berlin). Previously, he was project: “Active Ageing Index (AAI),” UNECE Grant will incentivize countries to look at No: ECE/GC/2012/003, Geneva, the European Senior Economist (OECD, Paris); policies and programs that other Centre for Social Welfare Policy and Research, Economic Adviser (Department for Work and Pensions, London) countries have adopted, and learn Vienna, March 2013. and research officer (London from those experiences — both posi- School of Economics and tive and otherwise. In the same vein, University of Oxford). His recent AARP should look to capture active acknowledgements research interests span active aging experiences within the United aging, well-being of older people and issues linked with financial States by constructing an AAI for The results reported in this article for 27 EU countries are derived from the methodology report and social sustainability of its individual states. Such an index of the Active Ageing Index project, submitted European public welfare systems. will feed more targeted responses to to European Commission’s Directorate-General Within the framework of the 2012 Employment, Social Affairs and Inclusion, and to European Year, he coordinated experiences of active aging within Population Unit, UNECE, for the project: “Active each state, as well as inform strategic Ageing Index” (AAI), UNECE Grant No: CE/ Active Aging Index Project. During 2013, arising out of collaboration plans at the federal level. The index GC/2012/003, Geneva, European Centre Vienna. The work reported here also benefited greatly from with HelpAge International and provides a snapshot of the aging the input and advice of members of the UNECE a group of international experts, landscape across Europe and the Active Ageing Expert Group during the two meet- he developed the first ever ings in May 2012 and October 2012. Comments United States and so it is a power tool received from Ralf Jacob and Kasia Jurczak (both index to measure the well-being to inform decision making at, not just from Directorate-General for Employment, Social of older people on a worldwide scale, called Global AgeWatch the national level, but also at regional Affairs and Inclusion, European Commission) and Vitalija Gaucaite Wittich and Evita Sisene (both from Index. His recent academic levels, while giving abundant oppor- Population Unit, UNECE) at various stages of the publications include books on project had been extremely valuable and are also tunities for reflection from the evi- aging, pensions and health in acknowledged here. Thanks also go to Sean Terry, dence collected — for collaboration, Oxford Brookes University, for his comments and Europe; on mainstreaming aging; sharing best practices, and learning suggestions. The views expressed in the article are on microsimulation modeling those of the author and not necessarily shared by and on the well-being of policy lessons. • the European Commission, the UNECE, or AARP. older people.

THEJOURNAL | 25 feature A MILLION VOICES Paul Ladd | HEAD, TEAM ON THE POST 2015 DEVELOPMENT AGENDA, BUREAU FOR DEVELOPMENT POLICY, UNDP, NEW YORK

26 THEJOURNAL | 27 illustrated by julia rothman feature

The Millennium Development The global conversation Goals (MDGs) are a set of eight 1 simple goals that aim to improve the lives of the poorest people in has responded to a thirst the world. Introduced soon after the historic United Nations Millennium for engagement by all Summit in 2000, they have helped to steer governments and others people to shape their toward policies that make faster progress on meeting essential future, and provided a host needs like education, health care, gender equality, and access to food of good ideas on how and water. They have mobilized additional funding and helped to governments, businesses, allocate that funding in a better way. Substantial progress has been made on many of the goals. Income and civil society can help to poverty has been halved thanks mostly to rapid progress in Southeast make that future a reality. Asia, millions more children have been able to get into primary school, than 1.5 million people all over the Overall, the global conversation and tremendous progress has been world have engaged in 100 national points to two main findings. First, made on increasing the number dialogues, 11 thematic meetings, and the issues covered by the MDGs are of people with access to improved an online portal that includes a still important for people the world drinking water. But progress has survey on global priorities called MY over, but the goals and targets that been slower on other goals such as World. The global conversation has governments employ can be refined reducing maternal mortality and responded2 to a thirst for engagement and deepened. Second, people improving access to sanitation. Of by all people to shape their future, point to a range of issues that affect particular concern, there have been and provided a host of good ideas on their lives but are not covered by wide variations in progress—across how governments, businesses, and the current set of goals and targets: countries, within countries, and for civil society can help to make that decent jobs and livelihoods; better different groups of people. future a reality. governance; respect for the planet The MDGs will expire in 2015, The results of the consultations and environment; and the freedom and the focus of the UN system and have been captured in an important to live without the fear of conflict, governments at this time is to make UN report released in September crime, and violence. as much progress as possible on the 2013, titled "A Million Voices: The But what do the consultations current set of goals. At the same time, World We Want," and have helped to tell us about the specific issues that discussions have already started on inform other key reports including are most important for older people? what might replace them, includ- that of the UN Secretary General’s The national dialogues have ing on a new set of goals and targets High-Level Panel on the Post-2015 provided a set of incredibly powerful that support poverty eradication and Development Agenda. A search- and rich stories about how the lives development that is more sustainable. able consultations database allows of older people can be improved. In The various agencies of the people to find out more about the Burkina Faso, older people lamented UN have been supporting this issues they care most about. In addi- the lack of doctors that could treat process by providing evidence on tion, the votes of the 1.2 million the particular illnesses they faced. In what has worked and what has people that have taken part in the Costa Rica, older people recounted not with the MDGs, and by facili- MY World survey can be separated how they fear being assaulted when tating a “global conversation” on by country, gender, education level, they collect their pensions. In the the world that people want. More and age. Philippines, older people demanded

28 GLOBAL PRIORITIES Nearly 40,000 people over the age of 61 have taken part so far in the MY World Survey. Their top seven priorities are identical to the top seven priorities of all global participants, albeit in a different order.

ALL GLOBAL PARTICIPANTS OLDER PEOPLE

1. A Good Education 1. Better Healthcare

2. Better Healthcare 2. A Good Education

3. Better Job Opportunities 3. An Honest and Responsive Government 4. An Honest and Responsive Government 4. Access to Clean Water and Sanitation 5. Access to Clean Water and Sanitation 5. Affordable and Nutritious Food 6. Affordable and Nutritious Food 6. Protection Against Crime and Violence 7. Protection Against Crime and Violence 7. Better Job Opportunities

THEJOURNAL | 29 feature

AN HONEST AND RESPONSIVE GOVERNMENT ACCESS TO CLEAN WATER AND SANITATION

“We have a huge need for a government “We can no longer allow water and sanitation that is really concerned with the people's to be treated as commodities, or as simple necessities. With this goal, we can meet matters of charity. Water and sanitation are various other goals. With a government human rights. As long as it is not treated as that is honest and transparent, we can such, there will be no accountability for the resolve various problems…” deprivation and denial suffered by millions, and no meaningful progress in international -14-year-old Participant, National Consultation, Brazil efforts to expand safe access.”

-Participant, National Consultation on Water

A GOOD EDUCATION BETTER JOB OPPORTUNITIES

“Development is achieved through human “In Africa….People working in the formal capital and investment in education. sector account for 10 or at most 15 percent. Yet, everyone agrees that our education The rest in most countries are somehow system is failing, as it is focusing on working somewhere, either in agriculture or quantity instead of quality, and unsuited informal sector. That huge part of employed to the needs of developing countries people is largely poor not because they are and their labour markets.” not doing anything, but because whatever they are doing, their productivity is so low -Opinion Leaders Focus Group, Mauritania and incomes are so low they are actually working poor.”

-Participant from Tanzania

AFFORDABLE AND NUTRITIOUS FOOD BETTER HEALTHCARE

“Hunger, food insecurity and malnutrition “A universal health coverage system should can be ended sustainably by 2025. The be elaborated to reach all the citizens and eradication of hunger and malnutrition must inhabitants of the country, regardless of be definitive and irreversible based on the their current social security status. The right of everyone to safe, sufficient, Universal health coverage would include nutritious and affordable food. This vision is access to hospitals and care structures achievable. Bold, effective action is urgent in remote areas, as well as awareness on and both a moral and political imperative.” health issues among vulnerable groups, and affirmative measures for preventive -Madrid Global Thematic Consultation on Hunger, health care. In this approach, there would Food Security and Nutrition be room from a qualitative measurement of health services.”

30 -National Consultation Report, Lebanon policies for a better economic people to remain productive and gain environment so that they could get access to better jobs. The findings decent jobs and contribute to growth. have important implications for And in Mozambique, grandparents policy. “Better job opportunities” described the challenges they ranks 13th in countries with very faced when raising their orphaned high levels of human development, grandchildren. but 4th in countries with low human The articulation of this set of development. This is likely to reflect complex concerns is supported by the availability of pensions in the votes captured in the MY World richer countries and other welfare survey. Nearly 40,000 people over the measures that subsidize fuel and age of 61 have taken part so far. Their transport. These measures can top seven priorities are identical to ameliorate the fear of having to work the top seven priorities of all global far beyond a normal retirement age. participants, albeit in a different The High-Level Panel report order. In first place for older people makes an important recommendation comes “better health care,” followed on how we track progress for all closely by “a good education,” groups in the future development and “an honest and responsive agenda to ensure that no one is government.” These three options left behind. The report argues that Paul Ladd are chosen by about 60 percent much greater attention needs to Paul Ladd joined UNDP in of voters. “Access to clean water be paid to collecting timely and 2006 and currently heads the and sanitation” and “affordable high-quality data. Where the goals organization’s Team on the Post- 2015 Development Agenda. and nutritious food” come next, ultimately chosen by governments followed closely by “protection are of particular importance for Previously, he had led UNDP’s against crime and violence” and older people, better data will let us policy team on inclusive globalization—covering issues “better job opportunities.” For the see whether commensurate progress of trade, development finance, larger set of global voters, “a good is also being made for them in each and migration—as well as the education” comes first, and “better country. group that prepared UNDP’s job opportunities” places third. There are still two years left contribution to the September For older people in low-income before governments will decide on a 2010 Review Summit on the Millennium Development Goals. countries, “better transport and new framework to replace the MDGs. From 2008–09, he provided roads” sneaks into the top seven There is still plenty of time left to support to the Office of the UN priorities. For middle-income express your opinion; take part in Secretary-General in New York on countries, “protecting forests, rivers, the global conversation, and help to the financial and economic crisis and oceans” rises to seventh place. create a better world! and the UN’s engagement with the G20. While the priorities of older For more information, visit: people around the world do not differ www.myworld2015.org • Before his New York assignment, greatly from those of other groups, Ladd was a policy adviser on the specific needs of older people international development for the UK Treasury, including the period change according to the theme. building up to and through the Health care needs to be appropriate UK’s Chair of the G8 and European to the challenges that typically Union in 2005. face people as they grow older, and lifelong learning opportunities allow

THEJOURNAL | 31 “This ‘longevity economy’ is AARP new ground...where we have ON THE never been in history. It is SCENE bursting with opportunities, which we’ve only begun to realize. How we anticipate and adapt to these changes will determine whether longer

1 lives will also be better lives.” Robert Romasco president aarp

2 3 1 AARP delegation meets with Chinese Vice Premier Ma Kai to discuss opportunities for collaboration with experienced workers, demographic and social policy at Zhongnanhai, Beijing, China, November 2013. 2 Lina Walker, Director of Health, AARP Public Policy Institute and Tad Masuda, Director Representative for International Affairs, Japan NGO Council on Aging join the panel at Asia Society's Aging in Healthcare: An East West Dialogue, NY, September 2013. 3 Debra Whitman, Executive Vice 4 President, AARP Policy, Strategy and International Affairs discusses the benefits of age-friendly communities at the 2013 AARP- UN Briefing Series on Global Aging at UN Headquarters, NY, February 2013. 4 AARP Board Member Fernando Torres-Gil (center), Josh Collett and Bradley Schurman (right) of AARP International meet with Senior Partners leadership during World Congress on Gerontology and Geriatrics in Seoul, Korea, June 2013.

32 5 7

6 8

5 AARP's Network of Age-Friendly Communities gathers in “Elder abuse is not just an Washington, DC, October 2013. American problem. It is a 6 AARP President Robert Romasco and Kristian King of AARP Public Outreach participate in the 23rd global problem. And AARP is Annual Observance of International Day of Older Persons at UN committed to working with the Headquarters, NY, October 2013. international community to 7 AARP Vice President for International Affairs Josh Collett address it. We continue to gain welcomes returned Peace Corps volunteers at the Volunteering Abroad session during AARP's insights from other countries Life@50+ event in Las Vegas, NV, and other organizations about May 2013. 8 AARP and the US Mission to the ways to prevent elder abuse – UN co-sponsor World Elder Abuse Awareness Day in NY, June 2013 (left to right) Terri Roble, Deputy ideally before it ever happens.” US Representative to the ECOSCOC UN; Kathy Greenlee, US Assistant Debra B. Whitman Secretary for Aging; Dr. Alice aarp Executive Vice President for Siu-Ping Wong, Minister for Policy, Strategy and International Affairs Seniors, Canada; Dr. Debra Bailey Whitman, Executive Vice President, AARP Policy, Strategy and International Affairs.

THEJOURNAL | 33 HEALTH LIVING WELL WITH DEMENTIA George McNamara | HEAD OF POLICY AND PUBLIC AFFAIRS, ALZHEIMER'S SOCIETY UK

Dementia-friendly communities offer services and support to people with dementia, allowing them to live fuller, more productive, and more independent lives.

Across the UK, cities, towns and villages are leading of people with dementia will increase from 115 to 135 the way on a new path to becoming dementia-friendly million by 2050. Doing nothing is not an option. communities. Alzheimer’s Society, working with others, Research into how well people with dementia are have set out on an ambitious agenda to make living well living continues to show that much more needs to, and with dementia a reality, starting with one community at more importantly can, be done to improve this picture. a time. In England, Wales and Northern Ireland, a renewed focus The dementia-friendly movement hinges on the is being placed on the importance of community involve- growing recognition that health and social care alone ment and what this means to people with dementia.1, 2 cannot tackle the dementia challenge. In England, close Alzheimer’s Society’s new report, "Building Dementia- to 670,000 people are living with dementia. Across the Friendly Communities: A Priority for Everyone," (2013) UK, 800,000 people have dementia, and within the next found that too many people with dementia do not feel ten years, this number will be more than one million. a part of their community, nor do they think society is Two thirds of people living with dementia currently live geared up to help them live well. People with dementia in the community, and the demands of the condition are want to live in communities that support them in achiev- putting unprecedented financial pressure on the health ing the things that matter to them. Yet, just being able to care system. Dementia costs the UK economy £23 billion keep doing everyday tasks, such as shopping or visiting per year and a third of these costs are born by informal the library, tend to stretch beyond their reach.3 or family caregivers. The international urgency to act on The report focused on what being dementia- dementia cannot be ignored, either. New estimates from friendly means to people affected by the condition. Alzheimer’s Disease International suggest the number Overwhelmingly, people with dementia who were

34 DEMENTIA-FRIENDLY COMMUNITIES

Dementia-friendly communities empower people with dementia to have high aspirations, confidence, and the knowledge that they can contribute.

illustration from alzheimer's society uk

THEJOURNAL | 35 living well with dementia

ensures consistency and quality in A dementia-friendly the program. In the village of Debenham community needs to in rural Suffolk, local people have pulled together to recognize that recognize and act on the dementia is not just a national prob- lem; it is personal, and support for views and the voice of people with dementia must be pro- vided locally and supported by the people with dementia and community. The project is now up and running, offering a comprehen- their caregivers. sive set of volunteer-based dementia services to the local area. Such projects are starting to generate results and make an impact surveyed lack the confidence to get Minister’s initial ambition for 20 for people living with dementia. out in their local area and sadly, a communities to be working towards Economic modeling conducted for third of people living with demen- becoming dementia-friendly has Alzheimer’s Society also found that tia leave the house less than once been exceeded, with over 50 areas dementia-friendly communities are a week, and one in ten leave their having expressed interest in the places that will save money. By house less than once a month. Ten program. ensuring that people with dementia areas of focus emerged from the One way of getting involved is live independently for longer and research. A dementia-friendly com- by signing up with a local Dementia avoid the crisis points that end up munity needs to recognize and act Action Alliance. These local alli- in hospitals or early admission into on the views and voice of people with ances or similar action groups care homes. For every one person dementia, and their caregivers. Early bring together diverse stakeholders who is able to live at home rather diagnosis, and personalized and including bus companies, taxi firms, than in residential care, there is a integrated care must be the norm. police, fire and rescue services, high saving of £11,296 per year or £941 per Community solutions that promote streets, local authorities, charities, month. independence and early interven- care providers and health trusts, Yet, there is still some way to go tion are critical. There is a significant faith groups and schools. Crucially, to realize these savings. In England, role for improving access to trans- all Dementia Action Alliances are less than half of those living with port and for businesses and services centred around the views of people dementia have a formal diagnosis, to become responsive to the needs of with dementia and their caregivers. but local projects are showing how to people with dementia. Communities are now being make a difference to those numbers. Alzheimer’s Society is a leader invited to sign up to a formal rec- Alzheimer’s Society ran two early in the creation of dementia- ognition process to demonstrate diagnosis pilot projects to increase friendly communities. In England, their commitment and actions. This diagnosis rates. By targeting media the Prime Minister has appointed provides a framework, alongside to highlight the issue of under-diag- a Champion Group of leading civic flexibility, to enable communities nosis, engaging with local stakehold- organizations and businesses and to provide what matters for people ers and running dementia awareness emergency services to oversee this with dementia in their community. events throughout the community, work, and practical steps are being A set of foundation criteria has been there has been a dramatic improve- taken, both locally and nationally, developed for local areas to work ment in the uptake of information to ensure that people with demen- towards and by registering online, on early diagnosis and the number tia are afforded the best quality of communities can use and display of people acting on concerns about life. The response from communi- the ‘working to become dementia- dementia. Referrals to memory clin- ties has been impressive. The Prime friendly’ recognition symbol, which ics have risen and 60 percent of GP

36 practices reported an increase in the The business is also taking practical size of their dementia registers over steps, such as new booking arrange- the period of the pilot project. ments, to help caregivers and people Alzheimer’s Society is also sup- with dementia. National examples porting an ambitious program to include work in the banking sec- create a dementia-friendly genera- tor; Lloyds Bank has been working tion. Twenty-two schools and col- with 24 other financial services to leges in England have committed to develop a financial services charter raise awareness and understanding to help staff recognize, understand of dementia among young people. and respond to customers with An evaluation has found wide ben- dementia. efits in schools, at home, and in the Addressing dementia will community. These are related not require a concerted and collabora- only to a greater understanding and tive effort from all sectors of society. awareness of dementia, but also to Individuals, businesses, community pupils' health and lifestyles, global and civic organizations can all take perceptions of older people, and action on dementia to improve the understanding of caring roles and lives of quality of life for people the challenges caregivers face. Many with dementia. While a dementia- of the activities, such as creating friendly community cannot exist life story books, also had a positive in the absence of a high quality and impact on people living with demen- integrated health and social care tia. A Dementia Resource Suite is system, it is only through working George McNamara now available for all schools, provid- together towards the creation of George McNamara is Head ing guidance on dementia learning dementia-friendly communities, that of Policy and Public Affairs at across the curriculum. people with dementia will be able to Alzheimer's Society UK. He is currently supporting the Supporting all of this work, live well with the condition. implementation of the Prime Alzheimer’s Society is also running a For more information, visit Minister's Challenge on Dementia, national initiative to create a network www.alzheimers.org.uk. • in particular the creation of of one million Dementia Friends dementia-friendly communities. across England by 2015, with paral- He has held senior policy 1 Alzheimer’s Society (2013). Dementia 2013: positions at the British Red lel programs under development in The hidden voice of loneliness. Alzheimer’s Cross, Action for Children, the Wales and Northern Ireland. Across Society. London. UK Parliament and civil service. the country, Dementia Friends 2 Alzheimer’s Society (2012a). Dementia 2012: Champions are being trained to A national challenge. Alzheimer’s Society. offer a 45-minute information ses- London sion at which interested people will 3 Alzheimer’s Society (2013). Building Dementia become Dementia Friends. Sessions Friendly Communities: A Priority for Everyone. have been held across workplaces, including an impromptu one at Glastonbury Festival. Businesses are getting involved too, from the local level to the national. As part of their commit- ment to make Salford a demen- tia-friendly community, drivers at Mainline Seven Taxis will become Dementia Friends by the end of 2014.

THEJOURNAL | 37 HEALTH A GLOBAL EPIDEMIC

Alzheimer’s Disease International (ADI)

Most governments remain woefully unprepared for the dementia epidemic, with only 13 countries implementing a national dementia plan.

Dementia is a truly global epidemic which This increase in numbers will also see knows no social, economic, financial or geo- a significant rise in costs for dementia care. graphic boundaries. Around the world, people Estimated to be $604 billion annually in are living longer and as a result it is forecast 2010, the global cost of dementia will escalate that by 2050, 135 million people will be living proportionally with numbers affected, with with dementia globally. a proportionately larger impact on low and Alzheimer’s Disease International recently middle income countries. published a policy brief for heads of govern- ment called ‘The Global Impact of Dementia International Cooperation 2013-2050’. This brief updates global demen- Will Be Essential tia prevalence figures for the first time since Most governments remain woefully unpre- ADI’s 2009 World Alzheimer Report. The brief pared for the dementia epidemic, with only 13 focuses on new evidence of prevalence rates countries implementing a national dementia emerging from China and the sub-Saharan plan. A global action plan is needed in col- African region, applying these to the latest UN laboration with governments, industries population projections. and non-profit organizations like Alzheimer What emerges is an even greater shift in associations. This will significantly enhance dementia prevalence and proportions from research efforts and work on better models of high income countries to low and middle care and support. In addition, all governments income countries. By 2050, 71 percent of peo- should initiate a national dialogue regarding ple with dementia will live in low and middle future provision and financing of long term income countries compared to 62 percent policies. today — an increase of 246 percent between Evidence suggests that public health 2013 and 2050. Today, 32 percent of people campaigns that target chronic illnesses with dementia live in G8 countries, and by such as diabetes, cancer and heart and lung 2050, this will shrink further to just 21 percent. disease can also have an impact on dementia

38 GROWING INEQUALITY rates. These include campaigns on smoking, underactivity, obesity, hypertension and healthy diet. 62% 71% ADI’s vision is an improved quality of life for people with dementia and their families throughout the world. We believe that the key Today 2050 to winning the fight against dementia lies in a unique combination of global solutions and local knowledge. Post the 2013 G8 Summit, we must continue to break down barriers percentage global dementia sufferers to effective research, promote rapid and in low and middle income countries equal access to promising technologies and treatments. For the 44 million people living with 32% 21% dementia today, we need to implement strat- egies to improve access to timely diagnosis, nurtured by a good standard of care and structured by a system of person-centered Today 2050 case management. This can only be done with a greater understanding of the disease and acceptance of people living with dementia in our societies. All societies must become percentage global dementia sufferers dementia-friendly. in g8 countries ‘The Global Impact of Dementia’ is a joint effort between The Global Observatory for Ageing and Dementia Care at King's College London, and ADI.

About ADI We believe that the key Since its founding in 1984, Alzheimer’s Disease International has grown from four to winning the fight members to be the international federation of more than 79 Alzheimer associations. against dementia lies in Representing people and nations on all con- tinents, the organization has become the a unique combination Global Voice on Dementia. ADI believes that the key to winning the fight against dementia lies in a unique asso- of global solutions and ciation of Global Solutions and local knowl- edge. As such, it works locally, by empowering local knowledge. national Alzheimer associations to promote and offer care and support for people with dementia and their carers, whilst working globally to focus attention on the epidemic and campaign for policy change from govern- ments and the World Health Organization. These are the pillars of ADI’s mission. For more information on ADI, visit http://www.alz.co.uk/ •

THEJOURNAL | 39 HEALTH THE G8 COMMITMENT AARP Attended the G8 Dementia Summit, Where Countries Pledged to Find Treatment by 2025

Sarah Lenz Lock | SENIOR VICE PRESIDENT FOR POLICY AARP POLICY, STRATEGY AND INTERNATIONAL AFFAIRS

Here leaders and experts from the world’s eight Leaders and experts strongest economies have committed to attack demen- tia like the global epidemic it is — recognizing the more from the world’s than $600 billion spent annually on informal, social and medical care is only expected to grow as the world’s eight strongest population ages. As the G8 ministers stated, “nearly 60 per cent of people with dementia live in low and middle economies have income countries so the economic challenge will inten- sify as life expectancy increases across the globe.” The committed to attack decision to coordinate efforts amongst these countries to find ways to prevent, delay and treat the condition, dementia like the and to implement ways to improve life and care for those with dementia, is the first step to combat dementia like the world combined to fight HIV. global epidemic it is. Why optimism? In addition to the sense of a bat- tle joined, increased attention and research funding by the individual governments, the ability and willing- Dementia is a pretty sobering subject, with 35 million ness to mine data and freely share information holds people suffering from the disease around the world, and the promise of the world learning more quickly about this number expected to double every 20 years. That risk factors, causes and the most effective therapies and already is almost the equivalent of AARP’s entire mem- interventions. The inclusion of people with dementia bership in the United States today. However, as I par- participating in the summit points to how much they ticipated in the world’s first G8 summit on dementia on themselves can contribute to improved knowledge, and behalf of AARP in December 2013, London was bustling the reduction of stigma, exclusion and fear. There was with the fast approaching holiday season, and the sense explicit recognition that prevention strategies could be outside and inside Lancaster House, was one of infec- developed and utilized at the societal and personal lev- tious optimism. els. Participants in the summit discussed the tantalizing

40 suggestions that we can reduce the incidence of the condition through 1 lifestyle interventions such as greater physical exercise and reduc- ing vascular risk factors. Summit participants demon- strated that they understood dementia was not only a ques- tion of individual suffering, but it also impacted the family, friends, employers and broader society. In the very first item listed in the Declaration arising out of the Summit, the ministers from the UK, Canada, France, Germany, Italy, Japan, Russia and the United States agreed to “call for greater innovation to improve the quality of life for peo- ple with dementia and their carers while reducing emotional and finan- cial burden.” Employers were present and spoke about the increasing strain caregiving for those with demen- 2 1 Delegates met for two days at St. James Palace, London. tia puts on their work force and on the companies that employ them. 2 UK Prime Minister David British Telecom’s Paul Litchfield Cameron addresses the summit. spoke about his company being aware that more and more current workers are beginning to suffer from cognitive impairment. But the even larger challenge was the number of employees with elder care responsi- bilities. They numbered roughly the same as those needing to provide child care. He also pointed out that companies who think about help- ing their customers need to offer products and services that can be accessed by those with a dementia disability. Researchers discussed that dementia was not just one single disease, but instead it was a broad range of complex neurodegenera- tive diseases from mild cognitive impairment to full blown dementia resulting in enormous social burden to patient, family and society.

THEJOURNAL | 41 the g8 commitment

The G8’s express recognition The Summit included 170 dele- that “dementia is not a normal part gates from all G8 countries, made up of aging” takes the desperation out of government, nonprofit, for profit, of what can be a debilitating syn- including health and pharmaceuti- drome. Instead, it puts it in the light cal industry leaders, and academics. that there is something possible to In 2014 to 2015 a series of sum- be done. We can make things bet- mit legacy events will be held glob- ter — now for those struggling with ally. In March, the UK will hold an diseases resulting in dementia, and event on getting greater investment in the future for people and society. and finance in innovative care. This In his closing address to the will be followed by an event in Japan summit, UK Health Secretary Jeremy on what new care and prevention Hunt quoted Nelson Mandela, say- models could look like, plus an event ing, “it always seems impossible until hosted by Canada and France on it’s done.” Secretary Hunt ended the industry partnerships between aca- Summit with a familiar slogan, simi- demia and industry. The G8 coun- lar to that of Nike, also present at the tries will then meet in the United Summit: “let’s do it!” States in February 2015 to review Organized by the UK as part of progress and prioritize further their G8 presidency, summit lead- research. ers agreed to a series of measures The optimism that it is possible to tackle the growing global crisis. to improve the lives of those living These included: with dementia and the people caring for them now, at the same time work- Sarah Lenz Lock „„A significant increase in the ing for more effective treatments Sarah Lenz Lock is Senior Vice amount spent on dementia re- and the illusive cure, will only be President for Policy in AARP’s search and the number of people realized with concerted effort of all Policy, Strategy and International Affairs (PSI) where she helps involved in clinical trials and those in a position to make it possi- position AARP as a thought leader studies. ble. All those 35 million people with addressing the major issues facing dementia now and their caregivers older Americans. Working on „„Develop an international action need the focused attention of the behalf of PSI, Sarah integrates and plan for research – in particular world’s resources now. The optimis- coordinates policy within AARP to help assure policy consistency to identify current gaps and how tic goal for a better future in 2025 is and maintain AARP’s social to fill them only 11 years away. • mission.

„„Share information and data from studies across the G8 countries and work together to get the best return on investment

„„Encourage open access to all publicly-funded dementia research

„„Appoint a Global Envoy for Dementia Innovation to drive innovation in care and treat- ment, and coordinate efforts to attract new sources of finance

42 THEJOURNAL | 43 HEALTH DESIGNS ON DEMENTIA A UK-Based International Center of Expertise Improves the Lives of People with Dementia in Innovative and Practical Ways

Professor June Andrews | DIRECTOR, DEMENTIA SERVICES DEVELOPMENT CENTRE, UNIVERSITY OF STIRLING, SCOTLAND photo: getty images

44 female, I will have a 50 percent chance of Cases of dementia having dementia. How will I be looked after? Although there are children and will likely double in working-age adults with dementia, the majority of those affected are old or very the next 20 years. old women. Scientists may find a cure in the In developing meantime, but because the changes in the brain that cause dementia are long countries, it will term, I may still not escape it. Finding a cure for Alzheimer’s won’t help those increase even faster. with vascular dementia, Lewy Body dementia, alcohol-related brain damage, or any number of underlying conditions The theme of the December 2013 G8 with different causes and mechanisms. If meeting in London, England, was future services try to use the current hos- dementia. Anyone who is interested in pital and home-based models of care, we health, workforce, and finance issues for will run out of beds and people to look the aging population of the planet should after the patients in those beds. have listened. In developed countries Epidemiologists may have slightly over- like the UK, dementia costs more than estimated the prevalence, and public cancer, heart disease, and stroke com- health measures may be slightly reduc- bined. This was estimated at £23 billion ing some of the risk factors by controlling in 2011. Although people argue about the smoking and managing some diseases exact figures, it is highly likely that cases that predispose to dementia. But the pic- of dementia will double in the next 20 ture is still gloomy. years. In developing countries, this will So where is the good news? Research increase even faster. One problem may shows that much of the disability in peo- be that we are spending more than we ple with dementia is actually caused by need to because we are focusing wrongly other people and environmental issues. on medical solutions when the problem is Dementia impairments include memory largely nonmedical. loss and difficulty in learning and under- The Dementia Services Development standing things. We know that the Centre (DSDC) at the University of impairments of dementia do not build up Stirling is at the heart of a worldwide at the same rate as the underlying disease movement to improve services for people processes. You may find brain damage in with dementia. Because of a reduction in people who had no symptoms, and quite the relative population of younger people severe symptoms in people with mild in some countries, there is anxiety about damage. whether or not there will be enough At the DSDC, we help people learn health and social care workers to care for about what can be done to reduce symp- the increasing number of individuals toms, even though we probably cannot with dementia. By the time I am 90, as a yet affect the speed of the damage to

THEJOURNAL | 45 designs on dementia

1 2

1 The DSDC Virtual Hospital Entrance features high-levels of natural lighting, color-consistent unpatterned flooring and automatic doors that are easy to see against their frame.

2 The DSDC Virtual Garden/Outdoor setting features frequent resting places, landmarks to help identify the door, and color and tone contrast between furniture and

photos: dsdc ground surface. brain tissue. Many of these non- Most famously at the DSDC, we worse. In the UK, it is not unusual for medical responses can be put into focus on the effect of design of the an acute hospital episode for a per- action by families and individuals, environment. Hospital environ- son with dementia to stretch out thus delaying the need for care. Care ments are particularly harmful for longer than expected, and to end workers can also use them to main- people with dementia. In acute hos- with the loss of their home and tain a person’s strength and inde- pital settings, patients with demen- admission to an institution. pendence. This saves money while tia are sometimes sedated to deal However, some of this is avoidable. also enhancing the lives of those with their stressed behavior, and A good example of this is the affected. they may miss out on eating and effect of light. In some cases, getting The things that can reduce drinking as they sleep through meal the light right in the environment symptoms of dementia include times. Often there is no one to talk to can make more difference than keeping up with exercise and social and nothing to do during the long medication in dementia. First, all activity. Nutrition and hydration days in the hospital. Research shows older people have yellowing of the are also crucial. In later life, we all that patients with dementia often cornea of the eye that restricts need to be aware of the value of refuse pain relief, even when they vision. They need light at much keeping good health through man- clearly could use some. All of these higher levels to see the same as aging other conditions such as dia- factors make patients with dementia younger people. If you cannot easily betes, depression, blood pressure, vulnerable to depression and delir- remember where things are, it helps and obesity. Advice and support ium while they are in a hospital. The if you can see where they are. for family caregivers on how to net effect is that an expensive mod- Remembering, then, is not quite so provide personal support for the ern intervention, which is intended crucial. Second, sleep is affected by person with dementia is at the heart to help, actually causes more harm diurnal rhythms in the body that, in of our work. and makes dementia symptoms turn, are affected by the hormone

46 melatonin. If the production of this and anxiety. For each of these, the hormone is disrupted, it can cause DSDC has published 10 non-pharma- nocturnal wakefulness. People who cological hints based on evidence of are already confused get up in the what works. Our research shows that night and may wander into danger— health and social care staff are not or at the very least frighten and provided with undergraduate or pre- worry their household. Melatonin is registration education on the practi- naturally produced in the body as a cal issues that affect families, even result of light falling on the retina of if they do get some academic input the eye. In older people, daylight into dementia. Families ask, “Why exposure needs to be increased did no one tell us this before?” The because of the thickening of the cor- answer is because they did not know nea that reduces the efficacy of light. themselves. If you can expose a person with A major challenge is getting dementia to daylight, particularly in health and social care staff to take the early part of the day, you can dementia seriously and make the help reduce nocturnal disturbances. diagnosis. At the time of writing— Simple design changes or changes in even with a national program in routine can thus make a significant England called the Prime Minister’s difference to two important demen- Challenge, which has been running tia symptoms. Currently, not many for more than a year—the number health or social care professionals diagnosed has only increased from make recommendations about 42 percent to 45 percent. This means lighting or daylight exposure to fam- more than half of those affected do ily caregivers or people with demen- not even know what is causing their tia. Exposure to daylight is often problems. Diagnosis is the key to June Andrews impossible in hospitals. getting help, so failure to diagnose is Information about dementia- a significant problem. In Scotland Professor June Andrews is friendly design is freely available and Northern Ireland, the diagnosis director of the Dementia Services from DSDC through their website at: rate is closer to 75 percent. This is an Development Centre at the University of Stirling. She was http://dementia.stir.ac.uk/design/ indication that, within a very simi- awarded the Chief Nursing virtual-environments. Checklists are lar health care system, better diag- Officer’s Award for Lifetime available to help anyone introduce nosis rates can be achieved. Achievement and received design ideas that will reduce stress What makes a dementia- the prestigious Robert Tiffany for a person with dementia and friendly community is anything that International Award. She headed the Royal College of Nursing help them overcome the difficulties can prevent unnecessary depen- in Scotland and directed the associated with the condition. dence and stress for a person with Centre for Change and Innovation Advice on assistive technology dementia and their caregivers. The within the Scottish government is available to download at: DSDC works with regions to help in addition to her career in the www.dementiashop.co.uk/node/287. them make the necessary and some- National Health Service. She advises health departments and If we are able to keep people at times very personal commitments service providers around the home longer through design, what to making this happen. Whether it is world, and is a trustee of the Life help and advice will they and their the fire chief or the chief executive Changes Trust, an independent families need to stay well during this of the health system, everyone needs charity disbursing grants totaling time? Research shows that there are a to work together using the research £50 million across Scotland. She is also the nonexecutive small number of common but occa- evidence that is available. The DSDC director of Target, a real estate sional hazards that families find hard is committed to this work. investment trust. to manage. These include aggression, For more information, go to wandering, sleeplessness, agitation, www.dementia.stir.ac.uk •

THEJOURNAL | 47 HEALTH CAMPAIGN TO END LONELINESS Helping People to Maintain and Create Personal Connections in Their Later Life

Kate Jopling | DIRECTOR, CAMPAIGN TO END LONELINESS Anna Goodman | POLICY & RESEARCH OFFICER, CAMPAIGN TO END LONELINESS

Humans are, by nature, social creatures. number of older people that will experience Although we can be perfectly happy in our loneliness. own company, we can all experience loneli- We have long been aware of the link ness—that unwelcome feeling of lack or loss of between loneliness and poor quality of life companionship—whatever our age. Although in older age from research (Bury and Holme, loneliness should not be considered an inev- 1991) and overwhelming anecdotal evidence. itable consequence of aging, we must recog- However, there is a growing international nize that our vulnerability increases as we evidence base that shows loneliness is also grow older. harmful to our physical and mental health. In 2011, researchers looking across 25 An American study demonstrated that weak European nations found that loneliness social ties are as large of a risk factor for early increases with age. The proportion of people mortality as smoking 15 cigarettes a day reporting loneliness varied across nations; (Holt-Lunstad et al., 2010). Researchers in the for eastern European countries, it was 20–34 Netherlands found a 64 percent increased percent of their older population, with levels risk of clinical dementia among lonely indi- in Ukraine described as “exceptionally high.” viduals (Holwerda et al., 2012). Research in Levels were lower in northern and southern the former countries of the Soviet Union Europe, mostly below 10 percent, but still found feeling lonely was connected with a significant proportion of the population poor, self-rated health (Stickley et al., 2013). (Yang and Victor, 2011). Of course, loneliness In the UK, studies have linked loneliness and is not just a European issue: Age Concern depression (Green et al., 1992). New Zealand recently launched a campaign We believe that loneliness should be an after research found that 50,000 older people issue for health and care services as well as in the country are severely lonely (LaGrow et communities and individuals. Dr. Hanratty, al., 2012). As the worldwide population con- senior clinical lecturer at the University of York, tinues to age, we face a rise in the absolute seconds this in the Journal of the Royal Society of

48 As the worldwide population continues to age, we face a rise in the absolute number of older people that will experience loneliness.

LONELINESS IN THE UK

On average, 10 percent of the UK population aged 65+ 1 out of 10 are often or always lonely.

of older people feel trapped in 12% their own home 17%of older people are in contact with family, friends, and neighbors less than once a week

11%of older people are in contact with of all older people (more than family, friends, and neighbors less 5 million) say television is than once a month 50% their main company

THEJOURNAL | 49 campaign to end loneliness

50% People in the UK with stronger social relationships had a 50 percent increased likelihood of survival.

Medicine, stating: “For loneliness and UK Oxfordshire, Independent Age, Harms Health campaign, launched social isolation in older adults to be Manchester City Council, and Royal in April 2012, mobilizes local activ- taken seriously by practitioners and Voluntary Service and Sense. ists to help us raise awareness across policy-makers, we need to … [focus] The campaign has taken time to England. more closely on the risks to public develop its strategy to ensure that our health” (Valtorta and Hanratty, 2012). work complements and enhances Case Study: existing efforts to tackle loneliness. Essex County Council Campaigning to End Loneliness We focus on influencing changes in After Loneliness Harms Health in the United Kingdom policy and practice; we believe that began in Essex, the County Council The Campaign to End Loneliness is directing our efforts in this way will developed a unique “Isolation Index” a network of national, regional, and result in the greatest overall change using commercial demographic local organizations and individuals for lonely people, and will create the data to determine which commu- working together through commu- right conditions for those working nities are most affected by loneli- nity action, good practice, policy, directly to tackle the issue. With a ness. Eleven common factors were and research to tackle loneliness in growing number of organizations identified including “widowed,” older age in the UK. Launched in now interested in tackling loneliness, “visually impaired,” and “struggling February 2011, the campaign now the partners have decided to pursue financially.” has a network of more than 1,000 three main activities going forward. The 11 variables were then supporters, 425 of which are orga- mapped to identify clusters of nizations predominantly offering Campaigning and influencing households that were potentially activities or support to older people. The first is acting as an indepen- vulnerable to loneliness and iso- The rest are individuals who feel dent voice to challenge and support lation. The initial exercise showed passionately about this issue. Five commissioners of health and social 55,000 households were statisti- partner organizations form a man- care to address loneliness in their cally likely to be isolated, or at high agement group to direct the long- communities alongside other public risk of loneliness (Campaign to End term vision of the campaign: Age health challenges. Our Loneliness Loneliness, 2013).

50 Learning Network policy agenda had been a “spring- "Addressing loneliness and Our network of more than 1,000 board” to getting new research isolation amongst older supporters has demonstrated a real funded. people makes a positive appetite for better information of, difference. It's low cost evidence on, and examples of good Initial Changes in but addresses more than practice in tackling loneliness in Policy and Practice one problem; It moves us older age. Our second stream of work Since our launch more than two and from a story of deficit to brings them together in a learning a half years ago, we have seen the network to improve effectiveness and start of an important policy shift one in which older people partnerships. We translate research in local government toward initia- are no longer regarded and share case studies through our tives that will address loneliness. as a drain, rather their publications, events, and regular Our recently published three-year contribution is valued." briefings. evaluation also found evidence that -John Wilderspin the campaign has encouraged and National Director for Health and Case Study: Mindings enabled charities and commission- Wellbeing Board Implementation Mindings is an innovative technol- ers to improve their existing ser- ogy-based service that uses social vices or establish new schemes. "The benefits to health media to enable families to stay In June 2013, we found that 61 and quality of life of connected, even when separated by out of a possible 152 areas (which addressing loneliness distance. Mindings uses captioned included county, city, and borough are clear. For example, photos, text messages, calendars, and councils) had at least recognized more so families can communicate that loneliness or isolation was an reduced depression and more easily and frequently. Stuart issue for their local population. increased physical Arnott, cofounder of Mindings, Thirty-three of these areas had activity. Both of these recently told the campaign that by taken the next step of creating an are major consequences “informing people about how seri- action plan to address the issue. for the control of some ous an issue loneliness is—particu- This indicates that local authori- long term conditions. larly in the mainstream media—you ties are moving away from seeing There are also significant really created the groundwork for loneliness as a “tea and sympathy” potential QIPP saving; us. I was literally able to see from issue toward recognizing it as some- for examples, reduced last summer onwards people really thing they have a responsibility and prescribing costs and beginning to get what Mindings was capacity to address. emergency admissions." about” Our supporters are reporting an improved understanding of lone- -Dr. Shikha Pitalia Building the Evidence Base liness in older age, and a growing GP, United League Commissioning Localities in St. Helens and Finally, we have an active research number say that the campaign has Wigan, North hub of academics and researchers influenced them to improve exist- with whom we work in partner- ing services for older people. Solid ship to develop the evidence base evidence, well communicated by on loneliness, and make research campaigners and organizations, has relevant for service providers and started to create a case for change commissioners. One member of among commissioners of services the research hub told us that rais- for older people, as well as the orga- ing loneliness further up the public nizations that run these services.

THEJOURNAL | 51 campaign to end loneliness

Challenges for Campaigners, Bury, M., and Holme, A. 1991. Life after Ninety. Research, Policy, and Practice London: Routledge. Campaign to End Loneliness. 2013. Essex County As the Campaign to End Loneliness Council Isolation Index. Available at http://cam- moves forward, we still face a num- paigntoendloneliness.org/toolkit/casestudy/ ber of challenges. essex-isolation-index/ (Accessed July 8, 2013.) There are still several signifi- Cohen, G. D., et al. 2006. “The impact of Kate Jopling cant gaps in the research literature professionally conducted cultural programs on the physical health, mental health, and social Kate Jopling is director of the about loneliness and isolation that functioning of older adults,” The Gerontologist 46 Campaign to End Loneliness, a (6): 726-734. http://gerontologist.oxfordjournals. have consequences for practitioners. network of organizations working org/content/46/6/726 A recent roundtable conference at through community action, good the British Society of Gerontology Green, B. H., Copeland, J. R., Dewey, M. E., Shamra, practice, research, and policy to focused on some of these. V., Saunders, P. A., Davidson, I. A., Sullivan, C., and tackle loneliness in older age. McWilliam, C. 1992. “Risk factors for depression Jopling has a background in policy Contradictory or missing evidence in elderly people: A prospective study,” Acta and political strategy, having Psychiatr Scand 86 (3): 213–7. http://www.ncbi. on what (and how) interventions worked as a consultant in the nlm.nih.gov/pubmed/1414415 really work to reduce an individu- voluntary sector, particularly in the al’s loneliness, and the link between Holt-Lunstad, J., Smith, T. B., and Layton, J. B. 2010. fields of ageing and equality. She loneliness and health service use, “Social relationships and mortality risk: a meta-an- spent 7 years working for Help the alytic review,” PLoS Medicine 7 (7). e1000316. doi: Aged, building the organization’s were highlighted. Addressing these 10.1371/journal.pmed.1000316 public affairs capacity, and gaps is a key concern but will require developing its policy expertise. wider funding and commitment to Holwerda, T. J., Deeg, D., Beekman, A. van Tilburg, T.G., Stek, M. L., Jonker, C., and Schoevers, R. achieve. 2012. “Research paper: Feelings of loneliness, In addition, the community of but not social isolation, predict dementia onset: Results from the Amsterdam Study of the Elderly organizations committed to tackling (AMSTEL),”Journal of Neurology, Neurosurgery and loneliness face challenges in making Psychiatry. doi:10.1136/jnnp-2012-302755 the case for interventions in these La Grow, S., Neville, S., Alpass, F., and times of austerity. We know that Rodgers, V. 2012. “Loneliness and self-re- lonely individuals are more likely to ported health among older persons in New Zealand,” Australasian Journal on Ageing 31 visit their general practitioner (Cohen (2): 121–3. http://onlinelibrary.wiley.com/ et al., 2006) and enter residential care doi/10.1111/j.1741-6612.2011.00568.x/abstract early (Russell et al., 1997), but we Russell, D. W., Cutrona, C. E., de la Mora, A., and need to build on this evidence and Wallace, R. B. 1997. “Loneliness and nursing home continually make the case for invest- admission among rural older adults,” Psychol Aging 12 (4): 574–89. Anna Goodman ment in loneliness services. As we turn to the next 3 years of Stickley A, Koyanagi A, Roberts B, Richardson E, Anna Goodman is the policy the Campaign to End Loneliness, we Abbott P, et al. (2013) Loneliness: Its Correlates and research officer at the and Association with Health Behaviours and Campaign to End Loneliness. She are hopeful that our priorities of evi- Outcomes in Nine Countries of the Former Soviet manages the learning network, dence-based campaigning, support- Union. PLoS ONE 8(7): e67978. doi:10.1371/jour- nal.pone.0067978 coordinates a research hub, and ing services to learn, and building helps to translate evidence into the evidence base will keep loneli- Valtorta, N., and Hanratty, B. 2012. “Loneliness, development materials for frontline ness in older age high on the public isolation and the health of older adults: do we organizations. Prior to joining the need a new research agenda?” Journal of the Royal Campaign, Goodman completed policy agenda. Society of Medicine 105: 518–22. • the Adult Social Care Graduate Yang, K., and Victor, C. 2011. “Age and loneliness in Management Trainee Scheme 25 European nations,” Ageing and Society 31 (08): at the National Skills Academy 1368–88. for Social Care, and worked for the English Community Care Association.

52 HEALTH LONGEVITY DIVIDEND Lessons from Okinawa

Bradley Willcox and Donald Craig Willcox | CO-PRINCIPAL INVESTIGATORS, OKINAWA CENTENARIAN STUDY photo: getty images

THEJOURNAL | 53 longevity dividend

Past studies suggest that 1 while genes are important, the majority of the variation in healthy life expectancy is non-genetic.

Heart disease is the leading cause of mortal- ity for both men and women in the United States, accounting for one in every four deaths.1 Coronary heart disease is the most 1 Twin gerontologists Drs. Willcox with world's oldest common type of heart disease, killing more twins, Kin-San and Gin-San, than 385,000 people annually and costing from Japan, aged 105 years. the United States $108.9 billion in health care services, medications, and lost productivity.2 The World Health Organization (WHO) age-related diseases by currently available has estimated that 80 percent of coronary risk factor modification. In order to quantify heart disease (CHD) could be prevented the potentially achievable population-wide by improving three health behaviors: eat- benefits of such an approach, Olshansky and ing habits, physical activity, and tobacco colleagues (2007)5 estimated that delaying use (World Health Organization, 2005)3. common age-associated disease in Americans Highlighting the importance of a healthy by just seven years would decrease the age-spe- diet, a recent study that assessed 17 major cific risk of disability and death by 50 percent, risk factors found that composition of the allowing a substantial improvement in both diet made up the largest cluster of risk factors life and health expectancy. The authors call responsible for death (26 percent) and the this the “longevity dividend”. highest percentage of disability-adjusted life From an epidemiology of aging per- years lost (14 percent) in the US (US Burden of spective, wide variability exists in the global Disease Collaborators et al. 2013)4. prevalence of age-related diseases. Past stud- Due to the key role that diet plays in a ies suggest that while genes are important, wide range of age-associated diseases, as the majority of the variation in healthy life well as higher risk for nutritional deficiencies expectancy is non-genetic. That is, dietary as people grow older, the potential for inno- habits, physical activity, smoking and other vative dietary strategies to improve health risk behaviors, access to health care, immuni- outcomes in older populations merits urgent zation and other public health practices, and attention. other social determinants of health, account for the majority of risk for age-related morbid- Achieving Healthy Aging: ity and mortality. The Longevity Dividend Supporting this contention is epidemiolog- Substantial population health gains may be ical research that has focused upon risk factors possible if we can delay the onset of common for healthy aging. A recent study showed that

54 THE OKINAWA DIET Okinawa has often been called a “Blue Zone,” a concept that refers to a demographic and/or geographic area with high population longevity. Blue Zones diets tend to be rich in green leafy and yellow root vegetables, legumes, fruit, and whole grains but low in saturated fat, trans fat, and sugar.

illustrated by julia rothman

avoiding nine common risk factors in habits than Americans, such as stroke was reduced from the lead- mid-life may increase odds of healthy the Japanese (and in particular the ing cause of death to number three. aging into octogenarian and nonage- Okinawan-Japanese) have already Concomitantly, for Japanese men narian years by over four-fold (Willcox delayed typical age-related diseases and women aged 55 to 79 years, mor- et al. 2006)6. Moreover, nutritional and are reaping a “longevity divi- tality declined by over 80 percent epidemiological research on risk dend”8. The Okinawans, in fact, not between 1950 and 19799. Moreover, factor modification as well as dietary only live longer but, most impor- they did not merely exchange one intervention studies have shown that tantly, have seven more healthy cardiovascular disease for another. the health benefits of shifting to a years of life than Americans8. The Their low rates of coronary heart healthier dietary pattern can be sub- fact that the Japanese lagged behind disease declined still further. stantial and in some cases may rival other developed nations in the first Current Japanese rates are about that of pharmacotherapy (Jenkins et half of the 20th century and subse- one third that of Americans. al. 2005)7. Therefore, it stands to rea- quently became the world`s longest Unraveling the mystery of this son that a population-wide shift to a lived people by the latter half is due, unique CVD profile was the basis healthier dietary pattern could facil- in large part, to focused investment for the Ni-Hon-San study10-11. This itate significant delays in age-related in public health programs with important study began in 1965 by disease and decrease the risk of dis- strong nutritional components and comparing Japanese in Nippon ability and death—allowing for sub- innovative dietary strategies.9 (Japan) to second and third genera- stantial improvement in both lifespan Compared with the United tion Americans of Japanese descent and healthspan. States and Europe, the high stroke in Honolulu and San Francisco, rate but low coronary heart disease respectively. The Honolulu Heart Longevity Lessons rate in Japan constituted a unique Study cohort of aging men is from the Far East cardiovascular disease (CVD) pro- still being followed today (as the Illustrating the potential of this file, which presented unique public Kuakini Hawaii Lifespan Study approach, some long-lived popu- health challenges. However, after a and Healthspan Study)10. These lations who practice better health concerted public health campaign, studies explore the genetic and

THEJOURNAL | 55 longevity dividend

Conclusions: What is the Take Away There is preliminary Advice for Americans? Americans are on the right track by giv- evidence that the “Blue ing up smoking and reducing sodium intakes, however, the USDA indicates that Zones” share some many adults lack sufficient dietary fiber, calcium, magnesium, potassium, and the antioxidant vitamins A (as carotenoids), common healthy eating 8 C, and E . Interestingly, what the typical American diet lacks in nutrients (partic- patterns, principally ularly potassium, magnesium, vitamin C, and carotenoids) and fiber is abun- low calorie plant-heavy dant in the traditional Okinawan dietary staple—the sweet potato8. The nutrient diets that are calorie deficiencies experienced by many aging American adults could be rectified, to poor, but nutrient dense. a large extent, by supplementing the American diet with readily available sweet potatoes. These are commonly raised in the southern United States (col- lifestyle factors associated with healthy loquially referred to as “yams.”) aging and longevity. Other important Cross national comparative stud- cross national comparative studies of ies have revealed that populations (or cardiovascular disease included the sub-populations) with low rates of mortal- Seven Countries Study and MONICA ity from cardiovascular disease not only (Monitoring Trends and Determinants live longer but also tend to have higher in Cardiovascular Disease), INTERMAP, numbers of oldest-old and/or long-lived ERA-JUMP, among other studies.9-11 individuals, such as centenarians. The Research has suggested that low most remarkable of these populations rates of coronary heart disease were have been referred to as “Blue Zones,” due, in large part, to dietary factors. This a concept that refers to a demographic includes higher consumption of foods and/or geographic area with high popu- from plant and marine origin, lower con- lation longevity and originating from the sumption of animal foods (with accom- blue color on demographic maps12. There panying saturated fatty acids), as well as is preliminary evidence that the “Blue high intakes of n-3 polyunsaturated fatty Zones” share some common healthy eat- acids (mostly fish and seaweeds), and ing patterns, principally low calorie plant- soybean products.9-11 Declining stroke heavy diets that are calorie poor, but rates in Japan have been attributed prin- nutrient dense. These diets tend to be rich cipally to healthier serum cholesterol green leafy and yellow root vegetables, profiles, reductions in blood pressure, legumes, fruit, and whole grains but low and less smoking.9-11 This resulted from in saturated fat, trans fat, and sugar.12,13 a combination of public health and per- This is good news for older sonalized interventions to bring down Americans. It indicates that populations sodium intake, to better balance diets, to already exist who have been success- bring about smoking cessation, as well as ful in keeping cardiovascular and other to improve hypertension detection and age-associated diseases at bay through medical treatment. traditional diets and through public

56 health efforts that include innovative dietary strategies that can correct excesses or defi- ciencies. Focused public health efforts that engage major stakeholders, including indus- try and government, can educate, promote, and implement healthy dietary habits and by doing so we might substantially expand the “Blue Zones”. •

1 Kochanek KD, Xu JQ, Murphy SL, Miniño AM, Kung HC, 2011. National vital statistics reports;60(3). Bradley Willcox

2 Heidenreich PA, Trogdon JG, Khavjou OA, et al, 2011. Bradley J. Willcox MD, MSc, trained in Medicine at the University Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart of Toronto, Internal Medicine at the Mayo Clinic, and Geriatric Association. Circulation;123:933-44. Medicine at Harvard Medical School. He is Professor and Director of Research at the Department of Geriatric Medicine, 3 World Health Organization, 2005. Preventing chronic diseases: John A. Burns School of Medicine, University of Hawaii. He is a vital investment: WHO global report. Who Press, Geneva. also Principal Investigator of the NIA-funded Kuakini Hawaii LIFESPAN and HEALTHSPAN Studies at Kuakini Medical Center 4 US Burden of Disease Collaborators et al., 2013. The State of US Health, 1990-2010: Burden of Diseases, Injuries, and Risk and co-Principal Investigator of the Okinawa Centenarian Study Factors. JAMA. Aug 14;310(6):591-608. at Okinawa Research Center for Longevity Science, where he studies genetic and environmental factors that influence 5 Olshansky, S.J., Perry, D., Miller, R.A., Butler, R.N. 2007. healthy aging. Pursuing the longevity dividend: scientific goals for an aging world. Ann NY Acad Sci., 1114:11-13. Donald Craig Willcox 6 Willcox, B.J., He, Q., Chen, R., et al., 2006. Midlife risk factors and healthy survival in men. JAMA. 296, 2343-2350. Donald Craig Willcox, PhD is Visiting Professor in the Department of Geriatric Medicine at John A. Burns School 7 Jenkins, D.J., Kendall, C.W., Marchie, A., et al. 2005. Direct comparison of a dietary portfolio of cholesterol-lowering foods of Medicine, University of Hawaii. He is also Professor of with a statin in hypercholesterolemic participants. Am. J. Clin. International Public Health and Gerontology at Okinawa Nutr. 81, 380-387. International University in Japan. Dr. Willcox is a fluent speaker of Japanese and has extensive cross-national 8 Willcox, D.C., Willcox, B.J., Todoriki, H., Suzuki, M., 2009. The experience in epidemiological approaches to healthy aging. Okinawan diet: health implications of a low-calorie, nutri- He is Co-Principal Investigator of the Okinawa Centenarian ent-dense, antioxidant-rich dietary pattern low in glycemic load. J. Am. Coll. Nutr. 28: Suppl. 500S-516S. study, a 30-plus year study of the genetic and environmental correlates of exceptional longevity. Dr. Willcox also serves 9 Iso. H, 2011. A Japanese health success story: trends in car- as research consultant for the National Institutes on Aging- diovascular disease, their risk factors, and the contribution of funded Hawaii Lifespan Study and Kuakini Hawaii Lifespan public and personalized approaches. EPMA;249: 49-57. Study and sits on the scientific advisory board of the Koruchem group and several other corporations involved in 10 Sekikawa A. et al, 2012. Coronary Artery Calcification by Computed Tomography in Epidemiologic Research and producing nutritional and personal-care products intended Cardiovascular Disease Prevention. J Epidemiol:1-11. to support a healthy lifestyle.

11 Willcox BJ, Suzuki M, Donlon TA, He Q, Grove JS, Masaki K, Willcox DC, 2013. Optimizing Human Health Span and Life Span: Insights from Okinawa and Hawaii. Ann Rev Gerontol Geriatr. 33(1): 133-170. acknowledgements 12 Appel, L., 2008. Dietary patterns and longevity. Expanding the Blue Zones. Circulation. 118, 213-215. Drs. Willcox would like to acknowledge the Founder and Co-Principal Investigator of The Okinawa Centenarian Study, Dr. Makoto Suzuki, 13 Davinelli, S., Willcox, D.C., Scapagnini, G., 2012. Extending with whom they have co-authored multiple scientific manuscripts healthy ageing: nutrient sensitive pathway and centenarian over the past two decades, as well as the New York Times best-sell- population. Immun. Ageing. 9:9. ing books, The Okinawa Program and The Okinawa Diet Plan. For more information on The Okinawa Centenarian Study please see www.okicent.org.

THEJOURNAL | 57 global innovations

Weifang University and Texas A&M University-Corpus Christi: Sharing Best Practices of Elder Care Through International Exchange

For thousands of years, filial piety was instance, China’s population of want them. Statistically speaking, China’s Medicare, Social Security, and individuals aged 60-plus is expected utilization of institutional care in China LTC. Today, this ancient LTC policy is to increase from 185 million to 487 is increasing. But it remains unclear if quickly becoming incompatible with million by 2050, rising from 10 percent seniors genuinely prefer institutions or China’s modern society and economy. of the population to 35 percent, have no other options and are turning Chinese policy makers are challenged according to the China National to institutions as a last resort. with finding a culturally sensitive Committee on Aging. Census data solution to improving its LTC system in from 2010 shows the proportion of In order to gain the skills needed to order to conform to the global standard Chinese aged 14 and younger has care for China's aging population, of care. Compounding this problem fallen to 16.6 percent, compared with Weifang Vocational College (in is a lack of LTC infrastructure and 22.9 percent recorded in the 2000 eastern China) participated in an workforce policies typically needed to census. Also, current fertility rates administrative exchange with Texas sustain a LTC system. China's modern are lower than 1.5 children per couple. A&M University-Corpus Christi, LTC system is in its rudimentary These statistics indicate the dire need College of Nursing and Health stages and is still being organized for a new LTC policy. If trends continue Sciences. Professor Liz Sefcik at and regulations being established. If and no updates are made to LTC policy, Texas A&M University-Corpus Christi no changes are made, China’s rapidly there will not be enough young people involved with the exchange, was aging population may find it impossible to perpetuate the current system. quoted saying: “This partnership to receive quality care in the future. developed because their population LTC reform in China is an important Today, attitudes — especially among is growing so rapidly in the older issue because there are many lessons young people — are shifting toward adult section.” China is interested in Western nations can learn. independence and autonomy in living increasing the educational level of arrangements. This has reduced the its nurses. And well-educated nurses China has one of the oldest LTC stigma associated with institutional can provide leadership in caring for systems in the world. For generations, care, which often is the only LTC the aging population. Adequately cultural norms placed the burden of option for seniors. By 2015, China trained nurses can also educate providing LTC on younger generations. plans to increase the number of beds the community on LTC options and Under this quasi-LTC system, children in institutional facilities from 18 to provide physical and psychosocial were obligated to provide basic care 30 beds per 1,000 people. However, needs for the elderly through their and cohabitate with their parents and this may not be the panacea for work with skilled care agencies. The grandparents. However, demographic China’s LTC problems. China lacks the exchange is helpful because Chinese and socioeconomic changes are supply of adequately trained health participants hope to gain a specialized significantly reducing the acceptance care professionals needed to staff education that can improve their of this “traditional elder care policy.” these facilities. Additionally, adding ability to care for the elderly upon This poses a unique challenge. For more beds is only useful if seniors returning home.

58 1

The idea for an international student program with Texas A&M University-Corpus Christi, originated during a meeting between Texas A&M University-Corpus Christi administration and a delegation of officials from China on July 18, 2013, at Texas A&M University- Corpus Christi campus. Dr. Sefcik, GNP-BC pitched the idea initially to house the student program within the School of Nursing and Health Sciences. Yong Pan, the president of REES Star Continuing Care Group, LLC, translated this request to representatives from Weifang 2 Vocational College and also helped activate their interest in an exchange focusing on gerontology.

The administrators from Weifang Vocational College and administrators from Texas A&M University-Corpus Christi, Vice Provost, Dr. Paul Meyer, and Dean, Dr. Mary Jane Hamilton, signed a collaboration memorandum of agreement on July 18, 2013. In the future, the two schools plan on collaborating on a nursing degree program, study abroad programs, research programs, seminars, workshops, and more faculty and student exchanges. In addition, the 3 1 Lab Demonstration two universities hope to collaborate on 2 Delegation from Texas A&M international research to enlarge the University-Corpus Christi and body of nursing knowledge regarding Weifang Vocational College gerontology. At the very least, both 3 Left to right: Xiaonan universities hope to achieve a better Cao, Chairman, Dr. Bunny cultural understanding of each other. Forgione, Associate An advantage for students in the Dean, Dr. Mary Jane Hamilton, Dean, Dr. Paul United States is that by understanding Meyer, Vice Provost Chinese culture and values, the level of care for Asian patients in the United States can increase. http://nursing.tamucc.edu//index.html

THEJOURNAL | 59 COMMUNITY AARP’S AGE-FRIENDLY NETWORK

AARP's Network of Age-Friendly Communities work supports the efforts of communities to become Great Places for All Ages. We believe that communities should provide such fea- tures as safe, walkable streets; better hous- AARP's Network ing and transportation options; access to of Age-Friendly key services; and opportunities for residents to participate in community activities. Well- Communities provides a designed, livable communities promote bet- framework to help ter health and sustain economic growth. And they make for happier, healthier residents – of communities better all ages. prepare for aging The Age-Friendly Communities program provides a framework for AARP to engage populations. local officials and community stakeholders in preparing for an aging population. Launched in April 2012, the network is affiliated with the World Health Organization’s (WHO) Age- Friendly Cities and Communities Program – adapt. Many of our AARP members tell us they an international effort geared toward helping feel a deep connection to their communities cities prepare for global population aging. In and are intent on staying put for years to come. less than a year, the AARP network has grown Through the Age-Friendly Communities net- from an initial eight participating states to 20 work, local elected officials gain an oppor- participating communities in 11 states. We tunity to learn more about the needs of an expect to see continued growth in communi- aging population and are held accountable for ties enrolling throughout the coming years. leading their communities towards change. Communities participating in the Age- Communities also benefit from being part of a Friendly Network enter into a phased process global network in which they can connect and that begins with assessing the needs and pri- learn, ultimately allowing then to take true orities of the community. They then create ownership of continued growth and measur- an action plan that is tailored to the com- able improvement. munity’s needs. Finally, they implement the Age-Friendly Communities rely on top to action plan, and make continual improve- bottom and peer to peer alliances to be effec- ments based on the results of progress reports tive. The two examples that follow show how conducted at the end of five years. In each political leadership and grassroots action are phase, involving older residents is critical both essential ingredients of great places to age. and required – typically through the devel- For more information about AARP’s opment of an Advisory council and engaging Network of Age-Friendly Communities, visit volunteers. www.AARP.org/livable • As our population ages and people stay healthy and active longer, communities must Amy Levner, Manager, AARP Home & Family portfolio

60 8 AGE-FRIENDLY DOMAINS

Community Support Civic Participation and Health Services and Employment

Outdoor Space Social Participation and Buildings

An Age-Friendly Community

Transportation Communication and Information

Housing Respect and Social Inclusion

THEJOURNAL | 61 aarp's age-friendly network

1

new york WESTCHESTER

COUNTY IMPROVES photo: jenn cummins 1 AARP volunteers survey STREET SAFETY New York City intersections for pedestrian safety to make the It all started with one intersec- 100 volunteers three months later. To case for needed improvements. tion. One day, a community group date, nine of those intersections have approached AARP and asked for been improved as a result of those assistance with making improve- efforts. more age-friendly. Helping to set the ments to a challenging intersection “This effort is a great way to get stage for county’s across New York to in Westchester County so people residents involved and empowered,” follow suit by becoming age-friendly. could cross safely. The intersec- Commissioner Mae Carpenter of This continued success led tion was at Manhattan Avenue and Westchester County's Department of the New York State Office of AARP Tarrytown Road in Westchester Senior Programs and Services said. to work with community partners County. The neighborhood included “Walkability audits take a great deal statewide to put on a week-long event some low income housing and of planning, and cooperation among called "Complete Streets Week" senior housing on the north side of multigenerational participants. Now, where more than 2000 volunteers the roadway while the south side Westchester has made changes in from AARP and community partners had all of the shopping and other partnership with AARP — what bet- surveyed 600 intersections across amenities. ter way to demonstrate how an age- the state. The improvements to local AARP staff did an assessment of friendly community can successfully roadways are ongoing and the num- the roadway and noticed some sim- inspire, create and maintain good ber of local ordinances continues ple improvements that would make work?” to grow across the state. These local a big difference to the local residents This work is a great illustration efforts complement the New York and drivers. We wrote a letter to the of a partnership between a local State Complete Streets law that was local Department of Transportation government and AARP and how passed in 2010, and numerous local officials responsible for the roadway changes that can improve people's Complete Streets ordinances that are intersection and received, almost lives in a community can be made a direct result of this work. immediately, a response that the swiftly. The work is ongoing and AARP continues local level intersection would be improved. to build on this work it was no sur- engagement with members, volun- Within three months’ time, new prise that Westchester County was teers and community partners to countdown signals were up, new one of the first communities to join continue to identify and improve curb cuts installed with tactile strips, the AARP Network of Age Friendly intersections that are dangerous to new crosswalks were laid down and Communities. Since they have cross in neighborhoods across New new stop lines for motor vehicles. joined, they have passed the county York. One intersection helped change This success lead to 18 additional Complete Streets law and are cre- a county and a state. • intersections across Westchester ating an ongoing dialogue with the County being surveyed by more than community about how to become Beth Finkel, State Director, AARP New York

62 2 3

2 Wider and better-constructed sidewalks, shade trees, and other improvements all add to the value of the city and encourage residents to walk and utilize alternative forms of transit.

3 A typical street scene in Austin, TX.

texas There could be no better environment to begin working locally in Austin on age-friendly AUSTIN ADAPTS TO issues with this leadership and with the need to change so firmly AGING POPULATION established. AARP Texas introduced AARP’s Network of Age Friendly In his annual State of the City projections for Austin. The Austin- Communities and the WHO’s eight address in March 2012, Austin Round Rock Metropolitan Area has domains of livability to the Mayor’s Mayor Lee Leffingwell issued a call experienced a phenomenal 48 per- Task Force on Aging. It was evident to bring together government, busi- cent growth over the past 13 years, that there was synergy between the ness, and nonprofits to address “one making it the third fastest growing domains and the framework the of Austin’s biggest challenges: our area in the nation from 2000-2010 task force was creating for Austin. rapidly growing aging population.” and the fastest growing area from By the fall of 2012 the Mayor’s He announced the authorization of 2010-2011. The city has received Task Force was willing to support a the Mayor’s Task Force on Aging in national attention due to the growth recommendation that Austin join response to Austin’s rapidly increas- of the aging population in particu- the network and the initiative was ing aging population with the intent lar: the Austin-Round Rock area has publicly announced in January 2013. of building public awareness, ana- the fastest growing population of As the population of Austin lyzing the current resources and pre-seniors (adults age 55 – 64) in the continues to grows and age, the city opportunities for growth, and cre- nation and the third fastest growing must adapt to serve the changing ating a set of strategic recommen- population of adults age 65 and older. needs of its residents. AARP Texas dations to accommodate this ever It is projected that by 2040 nearly 20 looks forward to being a partner in increasing population. percent of the Austin-Round Rock that work. • The Mayor’s action was area population will be comprised of prompted by demographic trend seniors. Bob Jackson, State Director, AARP Texas

THEJOURNAL | 63 COMMUNITY

64

illustrated by julia rothman SUPPORTING AGE-FRIENDLY EFFORTS Louise Plouffe and Ina Voelcker | INTERNATIONAL LONGEVITY CENTRE (ILC), BRAZIL

seriously committed to becoming more age More than 1000 friendly and want membership in the network to support their efforts. New sub networks have municipalities sprung forth as well. WHO has worked closely with engaged partners to channel energies and throughout the world expectations of enthusiastic members into a sustainable and effective network. At the same have joined the WHO time, the “bottom-up” force of networks and networking continues to influence the shape Global Network of Age and directions of age friendly initiatives in dif- ferent parts of the world. Friendly Cities and A Global Network Defining Itself From the very beginning, leaders of munici- Communities. palities and other levels of government looked to WHO to provide ongoing leadership to guide and vet efforts to develop more age- The World Health Organization (WHO) Age friendly settings, using the Guide as a starting Friendly Cities Guide (2007) was originally point. The budding network of engaged com- developed as a policy and practice tool to munities in various countries provided advice raise local awareness of various barriers fac- to WHO to create a standard implementa- ing older people in urban settings and to stim- tion process, based on what was working ulate concerted local action to make cities well in their respective locations. This advice and communities more age-friendly1. What included establishing “top-down,” “bot- resulted was a groundswell of enthusiasm tom-up,” and horizontal networks involving not only to act locally, but also to connect and older people within the community. The spe- engage with age friendly actors in other com- cific steps are to get the formal commitment munities globally. of the city council or mayor; create an advi- In the six years since WHO launched sory committee with representatives from the the Guide, more than 1,000 municipalities public, nonprofit, and business sector; involve throughout the world, individually or as part older people as equal partners in all aspects of state or national networks, have joined the of the project; conduct an assessment of the WHO Global Network of Age-Friendly Cities community´s current level of age friendliness; and Communities. These communities have and develop an action plan with indicators.

THEJOURNAL | 65 illustrated by julia rothman supporting age-friendly efforts

A concern from the beginning was to reconcile having standards Face-to-face contact is vital worthy of recognition for cities in more developed countries with to create real bonds and support and encouragement for cities with fewer resources in less stimulate ideas and action. developed countries. Again, the pooled experience of the early WHO network provided a viable solution. attracted about 700 delegates and in Costa Rica, Chile, Argentina, Becoming part of the global devoted attention to the innovative Uruguay and Brazil, as well as in network entails commitment to an projects taking place in communi- Portugal and Spain. However, at ongoing self-development process ties. At both meetings, WHO and the present, only Costa Rica and Chile with action plans and indicators local hosts sponsored participation have the committed leadership of specific to the community. from partners in developing coun- the national government. A statewide Another issue raised by early tries, including in Africa and Latin Age-Friendly São Paulo was launched adopters of the Age Friendly Cities America and the Caribbean, in order in 2012, and in Argentina, initia- initiative AFC was the label “cities.” to support age-friendly community tives in three cities are coordinated In fact, many of the first commu- initiatives there. through ISalud University in Buenos nities that embraced the initiative Aires. The success of these sub net- successfully were towns and villages. Linguistic and Cultural works will depend on the availability In smaller locations, key players Sub Networks of dedicated leaders, the extent of from different sectors can be mobi- The Francophone Network of sharing among members, and avail- lized more readily than in cities with Age Friendly Cities was created ability of mechanisms to support less permeable organizational stove- at the Dublin meeting in 2011. regular exchange. pipes. Towns and villages needed to Bringing together officials from be able to identify with the global ini- French-speaking AFC communi- Healthy and Age-Friendly tiative and to be recognized by WHO ties from France, Quebec, Belgium, Cities in Europe as part of the movement. The voices Switzerland, and Africa, this group In Europe, an initial impetus and of these players influenced WHO to builds on linguistic and cultural model for the global Age Friendly adopt the more inclusive term “age affinity to strengthen collaboration Cities network was the Healthy friendly cities and communities.” and to advance the WHO global Communities movement launched network in francophone countries. by WHO a few decades ago. About International Age Friendly City Currently led by the city of Dijon, 1,200 European cities belonging and Community Conferences France, the Francophone Network to this network undertake a thor- Virtual communication is fine, but held its first conference there in 2013. ough self-assessment on several face-to-face contact is vital to cre- Backed by committed members and indicators of health and then regu- ate real bonds and stimulate ideas supported by strong national net- larly report to the WHO European and action. Two international con- works, the Francophone network Regional Office on their actions ferences, one in Dublin, Ireland is well-positioned to thrive and to to improve the health of the city’s (2011), and the second in Quebec assist new members. residents. Public health officials of City, Canada (2013), have met this The Ibero American Age- member cities gather to monitor goal. Co-hosted by Ageing Well Friendly Cities Network was set up progress and to periodically steer Network Ireland, the Dublin con- at the Quebec City meeting, with efforts to new areas of focus or pop- ference drew 400 participants and Spanish- and Portuguese-speaking ulation groups. The WHO “Healthy focused on start-up issues. Two delegates from Latin American Cities” Certification is a matter of years later, with the collaboration of countries, the United States, and civic pride in Europe. the government of the province of Portugal. National, state, and munic- Officials of European cities Quebec, the Quebec City conference ipal-level initiatives are developing wanting to become more age-

66 friendly expected a similar struc- the WHO criteria for the global tured process and formal recognition network. The milestones approach from WHO. As the number of age- links a network of committed friendly cities has grown, the desire communities within a province for both these urban development to the Pan Canadian Age-Friendly networks to collaborate has led to a Communities Network coordinated project recently supported by a grant by PHAC, and through PHAC the from the European Commission to communities become recognized harmonize “Age-Friendly Cities” as members of the WHO global with “Healthy Cities.” network. A product of the reference group Louise Plouffe Age-Friendly Communities is the Age-Friendly Communities Louise Plouffe is a senior policy in Canada Canada Hub, which provides a analyst with 24 years of experience In Canada, all 10 provinces are “one stop” access to information, in aging policy research for the now engaged in the initiative, with sharing, and exchange. Organized government of Canada, the World Health Organization, and currently a combined total of more than 850 by the Canadian Association on with the International Longevity communities on the road to becom- Gerontology and academic centers Centre (ILC) Brazil in Rio de Janeiro. ing age-friendly. Many of these engaged in age friendly community With Alexandre Kalache, she led communities are towns and villages development and research, the hub the preparation of the World Health with high proportions of older peo- features regular webinars on topics Organization´s Age-Friendly Cities: A Global Guide. Louise obtained ple. This achievement is the result of interest, posts of community her PhD in psychology from the of commitment by provincial gov- initiatives and news items, “who’s University of Ottawa, Canada. ernments, working and networking who” inventories of people and orga- with municipalities, organizations nizations engaged in age-friendly for older people, and other non- community action and Canadian government organizations (NGOs) resources and research studies. within their own jurisdictions. It is also the fruit of successful network- Conclusion ing across jurisdictions (federal, The WHO Global Network of Age- provincial, and municipal) and with Friendly Cities and Communities the public sector. has expanded impressively in a short With provincial partners, the time. Besides providing real and Public Health Agency of Canada virtual spaces for sharing resources, (PHAC) established a National the network has positioned itself Reference Group comprising not only as the guide, but also as the provincial officials, older people, reference, for age-friendly action. academics, NGOs, and representa- This has been achieved by using the Ina Voelcker tives from municipal governments experience and expertise of mem- Ina Voelcker is a researcher and from national municipal bers and building on existing alli- at the ILC-Brazil. With a BA in and planning associations. This ances and affinities. • Gerontology (Vechta University, national network is a source of Germany) and an MA in Public expert knowledge and key advice to Policy and Aging (King´s College, 1 World Health Organization. 2007. Age-Friendly United Kingdom), Ina has guide the initiative. Cities: A Global Guide. Geneva: WHO. conducted policy research and Support and guidance from analysis at HelpAge International. the reference group was important Following an internship at WHO in deciding to establish a national with Alexandre Kalache and “milestones” approach to imple- ouise Plouffe, Ina applied the Age-Friendly Communities mentation that is consistent with approach in João Pessoa, Brazil.

THEJOURNAL | 67 6 COMMUNITY BEST PRACTICES Age-Friendly Examples from Australia, Canada, Hong Kong, Ireland, South Korea, Taiwan, the UK, and the USA

Open Spaces & Buildings Transportation In age-friendly Macon Bibb, Georgia, USA, feedback Seoul’s subway system is the largest in terms of miles from older people has given a local historic park a new covered, in the world. To make it more accessible to lease of life. Involving older people helped catalyze seniors they introduced several age-friendly adaptations change and attract funding to create a more accessible, including; elevators at each subway station, platforms more attractive and usable green space. Residents of with automatic gates, real-time subway arrival times on all ages can enjoy new benches, clear and well-marked LCD screens and comprehensive voice announcements entrances and wider, shaded paths reaching into its cen- on trains. The priority seating for seniors is rigidly ter. Planned new traffic calming measures will make the enforced by all and is a stand out feature of the Seoul park easier to reach as well as to use. subway culture.

In the UK, the City of Manchester’s Age-Friendly Design As part of its efforts to become age-friendly, Canberra, program is developing a set of age-friendly design guide- Australia has lowered the age of eligibility for its free lines which will evolve over time and address a range of public transit card, from 75 to 70. The benefit now covers design issues, from a park to bus timetable. A partner- 9,000 more city residents. A new electronic taxi smart- ship with the Manchester School of Architecture and card will also make payments easier for clients of the Manchester School of Art along with the engagement of city’s Taxi Subsidy Scheme, most of whom are frail older older people is central to the program, which is overseen adults. by a forum made up of older people and professionals in urban design and planning from across Manchester and the UK.

68 Respect & Inclusion Housing In the UK, the City of Manchester’s Age-Friendly Design The Hong Kong Housing Society set up the Elderly program is developing a set of age-friendly design guide- Resource Center to promote the concept of aging in lines. These will evolve over time and cover a range of place to the community. The resource center and web- design areas, from parks to streets, transport informa- site offers education, training, assessment and advice tion, seating, footpaths and cycling. A partnership with on age-friendly housing design to improve the quality of the Manchester School of Architecture and Manchester life of older Hong Kong residents. School of Art along with the engagement of older people is central to the program. This is overseen by a steering The City of Portland, Oregon in the US has brought group comprised of older people and professionals in age-friendly concepts into its city planning process. The urban design and planning from across Manchester and city is prioritizing new accessible housing in close prox- the UK. imity to ‘neighborhood hubs’ where existing services, transit and amenities make it easier for people to live In Australia, Canberra’s annual ‘Life’s Reflections’ pho- independently. tographic competition and exhibition generates positive images of older Canberrans for public exhibition and use in Government publications. It involves residents of all ages and serves to highlight the important place held by older canberrans in the social fabric as parents and grand- parents, workers, volunteers, friends and neighbors.

THEJOURNAL | 69 best practices

An age-friendly city encourages active aging by optimizing opportunities for health, participation and security in order to enhance quality of life as people age.

Communication & Information Civic Participation & Employment Mobile phones and the internet are critical for most peo- London, Ontario in Canada used the whole age-friendly ple to stay connected. However, not all older people are process as an opportunity to engage its older residents familiar with new technologies. Age-friendly Melville, and community members as volunteers on their age- Australia delivered IT and Mobile phone training ses- friendly task force. The task force helped put together sions by young people to their older residents. Both par- the city’s Age-Friendly London Three-Year Action Plan ties reported benefitting from the experience. and are now involved in working groups, under the eight domains, to help make the plan a reality. In Louth, Ireland, information for older people in a “One Stop Shop” format was the single most important issue The Australian Capital Territory has produced age- for older people consulted on its age-friendly strategy. A friendly business guides which support local businesses booklet on services for older people was developed first, be accessible and attractive to employees as well as cus- followed by a website and a network of ‘parlors’ which tomers. The guides provide information on the benefits provide information face-to-face. of employing older workers, with tips on recruitment, retention and training.

70 Health & Community Social Participation Family caregivers are rarely prepared to take on the roles Sheds offer social activities based around making they do, and can often feel overwhelmed. The Caregiver things, aimed mainly at older retirees and widowers. Coaching Program was launched by Westchester Age-friendly Melville in Western Australia, Louth and County, New York’s Department of Senior Programs Kildare in Ireland have both supported men’s sheds. In and Services as part of their Age-Friendly program. Louth the men’s shed also built new bus shelters, identi- Volunteer coaches are trained by professionals to give fied by local older people as a transport priority. individual support to family caregivers through regular telephone conversations. This support can be essential Where centers for older people to meet and socialize to helping caregivers make informed decisions. do exist, if they aren’t physically accessible, they aren’t used. AARP volunteers in Austin, Texas lobbied the local In Taiwan, Hondao Foundation’s All in One program government to change a dangerous intersection and recruits a group of four caregivers to serve 6-12 house- crosswalk outside a senior center which had rendered it holds in the community where older people need support. inaccessible by foot. By delivering care in small groupings, the service aims to be more comprehensive, cost effective, consistent, and For more information about any of these initiatives to build and maintain community and social links. contact Natalie Turner, Senior Advisor, AARP Office of International Affairs at [email protected]. •

THEJOURNAL | 71 best practices

germany GRIESHEIM BECOMES A ‘SEATABLE CITY’

Our ability to get around changes as we grow overcome to make Griesheim a better place for older and walking becomes more and more older pedestrians? important. Being able to reach a destination In the interviews and walking through by foot or not influences the decision to go the town, Professor Meyer and his team found somewhere enormously. Unfortunately most that older people had three key needs: communities are not ready for the growing ‘go slower’ generation. When the design of pub- „„ Meeting friends lic spaces does not encourage seniors to walk, many choose to stay home and in turn may „„Being part of the community and, become disconnected from their community. Griesheim is a German town with a pop- „„Taking a rest to recharge for the next part ulation of 28,000 located in the heart of the of the walk Rhine-Main area, 30km south of Frankfurt. A well-known resident, Professor Bernhard He then asked himself what was one Meyer, of the Department of Social Work and important and simple thing which could Social Pedagogy of the Protestant University help meet all of these needs? And the answer of Applied Sciences, has introduced to was a bench. There were already benches in Griesheim the concept of the ‘seatable city’. It Griesheim, but usually they were in destina- is a great example of how small adjustments to tion points, in public places such as parks or public spaces can have significant benefits for squares. However this did not solve the prob- residents of all ages. lem of seniors being able to walk to those Meyer recognized that along with age-re- places without a rest on the way. lated cognitive changes such loss of vision Meyer and his team created a map of the and hearing, older people also slow down and most frequented paths and favorite places of experience greater strain on the bones and older pedestrians. This map became the base- joints; making it more difficult to navigate by line to refurnish the town with the seating to foot through increasingly complex traffic and extend the range and regularity of walking for street design. In trying to better understand its senior residents. Offering adequate seat- the needs of senior pedestrians, Meyer reached ing solutions at their favorite places, such as out to local seniors and stakeholders to learn the local cinema and other central points of why and where seniors in Griesheim walk. The interest where they could observe community question he asked was: What hurdles must be activities or take part in them.

72 1 2

1 Professor Meyer demonstrating one of the new seating solutions.

2 Map of Greisham showing the location of street ‘furniture.’ photos: professor bernhard meyer

Benches were only part of the solution. The city offers Other structures were added to major paths which could provide a ‘rapid rest’, e.g. bicycle adequate seating stands which also doubled as a seat or a new type of high stool where people of all ages, could solutions at take a break without actually sitting down. In keeping with the WHO age-friendly favorite places, domains, the ‘seatable city’ addresses aspects of outdoor spaces and buildings where quality such as the local of life is often lost if communities disregard their senior’s walking habits. cinema and other For more information about Griesheim, the seatable city, email Professor Meyer: central points [email protected] • of interest. Frank Leyhausen, Head of Think Tank Deutsche Seniorenliga

THEJOURNAL | 73 global innovations

The Jiminy Wicket According to James, the metric he uses to judge the program’s success is what he calls “smiles per hour.” James estimates the program has created more than Project: Connecting 400,000 smiles in Denver alone, and thousands more Through Croquet around the world. After Maxwell’s passing in 2009, James left his lucrative career to devote more time to Jiminy Wicket. Currently, In October 2007, James Creasey received news from the the program is being scaled so it can be implemented United Kingdom that his 84-year-old father, Maxwell, had worldwide. The 5-year goal is to expand to 2,500 schools suffered a stroke and was diagnosed with vascular dementia. in five countries. This condition would gradually strip him of his memory, speech, and capabilities. James wanted to spend more time Through Hoops to Hope® is an intergenerational croquet with his father but had a highly demanding job managing a a program in which students and seniors play together. Denver-based company for a New York City pension fund. Jiminy Wicket hopes to raise $400,000 in order to expand this program to 100 schools in 10 cities across the Every 10 weeks, James would spend two weeks with his United States in 2014. father in the United Kingdom. Maxwell’s condition was deteriorating, and James feared the summer of 2008 Alzheimer’s knows no borders. Each World Alzheimer’s would be his father’s last. Day, participants on three continents participate in the Jiminy Wicket World Cup. Celebrities, seniors, families, Growing up, Maxwell played croquet a couple of times. and caregivers increase awareness for Alzheimer’s by That summer, while vacationing in Cornwall, James made playing croquet. sure his father had an opportunity to play one more game. James says his passion to serve others keeps him However, something unexpected happened, and that game working hard to expand the program, improve lives, and led to many more. Croquet made Maxwell smile and also make people smile around the world. If the program’s helped him reconnect to society — if only for a game. expansion goes as planned, readers can expect a Jiminy Wicket program in their community within the next “When golf was gone because it was too precise; ping few years. pong was too fast; cards, Scrabble, and chess were all too complicated, we could still have a heartfelt connection and Alzheimer’s disease cannot be prevented or cured and smile playing croquet.” is the sixth-leading cause of death in the United States. The estimated annual cost of Alzheimer’s care in the As Maxwell’s health deteriorated, his desire to play croquet United States is $200 billion, including $140 billion in persisted. James saw the profound, positive impact croquet costs to Medicare and Medicaid. With the number of was having on his father’s life and imagined how he could patients expected to rise as baby boomers age, it is replicate the experience to improve the lives of others. possible for annual costs to exceed $1.1 trillion by 2050. The Jiminy Wicket program offers promise, and the With help from the Denver Alzheimer’s Association and increase in quality of life that participants suffering from Denver Croquet Club, James started a program called dementia receive is something worthy of more research Jiminy Wicket. The program has three goals: and consideration.

„ „Increase awareness www.jiminywicket.org „„Decrease stigmas Brandon Cheslock, Intern „„Make people smile AARP Office of International Affairs

74 1

2 3

Jiminy Wicket playing croquet with students and seniors.

1 Vi Senior Living, Colorado

2 Oakham School, England

3 New Dawn Memory Care, Colorado

THEJOURNAL | 75 MONEY RECOGNIZING AGE-FRIENDLY EMPLOYERS

AARP is pleased to announce the 2014 employers. Two employers have won the AARP Best Employers International award three times and six employers have Award. The Award is given to innovative won the award twice. Employers range employers around the world who value an from small and medium enterprises, to age-diverse workforce. The deadline for large multi-nationals. Fifteen nations Award applications is April 26, 2014. have participated. Since AARP launched the program To apply or learn more about in 2008, 99 employers have submitted 136 this prestigious Award, please visit applications. AARP has given 46 awards www.aarpinternational.org/bestemployers and one honorable mention to 37 different

76 past winners

BMW Group DSW21 National Environment Agency Industry: Automotive Industry: Municipal Government Industry: Government Location: Munich, Germany Location: Dortmund, Germany Location: Singapore Employees: 69,518 Employees: 1,904 Employees: 3,338 Percentage > 50: 23.1% Percentage > 50: 32.3% Percentage > 50: 47.9%

Bundesagentur für Arbeit Elkerliek Hospital Raffles Institution Industry: Government Industry: Hospital Services Industry: Education Location: Nürnberg, Germany Location: Helmond, Netherlands Location: Singapore Employees: 95,900 Employees: 2,226 Employees: 545 Percentage > 50: 35.2% Percentage > 50: 29.3% Percentage > 50: 15.6%

Centrica plc Jena-Optronik, GmbH Salzburg AG für Energie, Verkehr Industry: Energy Industry: Aerospace und Telekommunikation Location: Windsor, United Kingdom Location: Jena, Germany Industry: Energy and Infrastructure Employees: 27,564 Employees: 145 Location: Salzburg, Austria Percentage > 50: 14.8% Percentage > 50: 42% Employees: 2,136 Percentage > 50: 34.2% Daikin Industries Lam Soon Edible Oils Sdn Bhd Industry: Industrial Equipment & Industry: Food The Co-operative Group Commercial Machinery Location: Shah Alam, Malaysia Industry: Grocery Retailing, Location: Osaka, Japan Employees: 1,456 Financial Services, Travel, Employees: 8,149 Percentage > 50: 20.1% Agriculture, Funeral Services Percentage > 50: 24.2% Location: Manchester, United Marks and Spencer plc Kingdom DB Services Industry: Retail Employees: 95,448 Industry: Railroad Services Location: London, United Kingdom Percentage > 50: 24.6% Location: Berlin, Germany Employees: 63,992 dbservices Percentage > 50: 33.23% Employees 10,160 Percentage > 50: 45% National Australia Bank Industry: Financial Services Location: Melbourne, Australia Employees: 27,460

THEJOURNAL | 77 MONEY ADDRESSING AGING IN KOREA Advocating for the Best Employer Award: Senior Partners, Seoul, Korea

Eun-Kyung Park | CEO, SENIOR PARTNERS

Korea is aging faster than any other only support selective citizens due to its society in the world. According to the insufficient budget. This has aroused 2013 demographics data released by the a very controversial debate amongst Korean government, the 65-plus popula- the political parties in Korea, and the tion reached more than six million for the citizens took part in it. More attention has first time, comprising 12.2 percent of the been focused on postponing the official total population. Of course, this ratio is retirement age, and the government and not as high as that of Japan (23 percent), politicians have passed a bill to postpone Germany (20.8 percent), United Kingdom the retirement age to 60 years old. The (16.6 percent), Russia (13.1 percent), and logic behind the bill was to give more the United States (13.1 percent). What is time for aged workers to prepare for the notable, however, is how fast the society post-retirement life and to lower the is aging; by 2020, the rate will increase societal cost of retiring senior citizens. to 15.7 percent, surpassing the United Abiding by the new bill, all business States and the United Kingdom. By 2030, entities with over 300 employees in Korea it is expected to rise to 24.3 percent, mak- are mandated to gradually postpone the ing Korea the oldest society in the world. retirement age to 60 by 2016, whereas the Responding to such an aging current average retirement age is 55. phenomenon, Korean citizens have The reason why the public is so become more interested in government sensitive about policies toward the policies toward the elderly. One of the elderly is because senior citizens are most popular issues is the basic old- not well prepared for old age. According age pension for 65-plus citizens. The to government figures, less than one- current government called for the full half (45.8 percent) of the population enforcement of pensions for all 65-plus between 55–79 years old receives some citizens in its presidential election form of pension. The average pension pledge, but has modified the pledge to allowance is only 380,000 KRW ($360) per

78 month. Although earning a steady income through a job would be an Such low preparedness alternative, the employment rate is fairly low (30.1 percent), and the wage level for older workers is not for old age in Korea has high either (77.7 percent compared to the average wage level for all ages, put a great deal of and the level for older female workers is only one-half the average). pressure on the public Such low preparedness for old age has put a great deal of pressure sector. However, many in on the public sector. However, many in the private sector see this as a the private sector see this new opportunity—most notably the financial industry. The major as a new opportunity— financial firms have created various retirement preparation products, primarily focusing on providing most notably those in the inheritance, tax, and investment consultation services, as well as financial industry. products preparing for national pension schemes or personal retirement savings. distribution industry as well. The the Expo is organized annually by Middle-aged consumers have consumer goods industry perceives Senior Partners (AARP participated responded enthusiastically to the 50-plus age group as a potential as a global partner). During this financial products specificallygrowth market, which has resulted year’s event, where 20,000 50-plus designed to help people prepare for in the launching of new products that citizens attended, attention was old age and offer the elderly diverse meet the needs of the elderly. There focused on items for active seniors. benefits. When the major banks in are even new online shopping malls The attendees’ area of interest has Korea introduced financial products just for senior citizens. Considering expanded from health and other for the elderly, $567 million flooded how seniors might be less familiar limited segments to broader areas the market. Koreans are now more with the online environment, these surrounding how to spend old age active than ever in preparing for old shopping malls provide product more actively. They have shown age, which is evident in increased consultation, procurement, and interest in leisure, employment, participation in pension schemes. payment by phone when necessary. volunteer opportunities, and While there was hardly any interest According to The 2013 Retail Industry investment, which reflects their will in 2007—the year the reverse Yearbook, published by the Korea to have control over their golden mortgage was first introduced to the Chain Stores Association, the ratio years instead of relying on others. market—more and more people are of the purchasing power of 50-plus A change in senior citizens, now paying attention to the fact that customers to the total purchasing themselves, is also fairly significant. the number of the mortgage holders power has increased from 22.3 Being passive citizens before, they has quintupled in the past 5 years. percent in 2011 to 33.9 percent in are now more active and dynamic, Immediate annuity, where holders 2012. demonstrated by an increased deposit large amounts of money and Likewise, Korea’s social interest willingness to voice their opinions draw from the enrollment year, has in the elderly has increased, which in public. For example, the 50-plus also been popular amongst recent became even more evident during population actively supported retirees. the 2013 Seoul International Senior then-presidential candidate Geun- There has been an effort to Expo, held in October. The largest Hye Park during her presidential attract elderly customers in the private senior industry exhibition, campaign. Since her government

THEJOURNAL | 79 addressing aging in korea

1 2

1 20,000 50-plus citizens 3 attended the 2013 Senior Expo, where attention was focused on products and serivces for active seniors such as Wii Fit. 2 Ribbon cutting at the 2nd annual Seoul International Senior Expo, October 2013 3 The attendees’ area of interest has expanded from health and other limited segments to broader areas surrounding how to spend old age more actively.

80 was inaugurated, older Koreans have result of an increased interest in aged continued to raise their voices about workers. Going along with these various policies regarding the rights developments, Senior Partners, of the elderly. This new paradigm together with AARP, is making indicates that the elderly can take every effort to extend the age- the lead in changing Korea’s societal friendly culture. As an international format. partner of AARP, Senior Partners In Korea, however, there is is encouraging corporations and no strong community for retired organizations to participate in people such as AARP. Individual AARP’s “Best Employer’s Award.” communities rooted in a common Although a Korean has yet to residential area, religion, or hobby win this award, I am certain that are present. But as senior citizens there will be numerous Korean become more familiar with winners in the near future; many modern technology, such as social Korean corporations are creating networking services and mobile innovative jobs that are suitable devices, this is expected to change. for aged workers, building social Active senior citizens are absorbing network infrastructure to include new technology and culture older workers in the information quickly, expressing their opinions loop, and making lifelong education publicly and forming their own opportunities to promote stable life Eun-Kyung Park communities. Online communities after retirement. Eun-Kyung Park is the head for the elderly are also growing Aging is an undeniable of Senior Partners, a senior- rapidly. Yourstage.com, an online phenomenon in Korea. The specialized platform operating portal website operated by Senior government, along with the private company established in 2007 that Partners for 50-plus users, has sector, is focusing on the changes leads the senior industry in Korea. 400,000 subscribers. This number that stem from such a phenomenon. Senior Partners covers a range of areas in the senior industry may not seem significant yet, but its There will be more policies focused and includes programs such as potential for growth is increasing on, and more goods and services Yourstage.com (an online portal along with the rise in senior citizens’ designed for, the elderly. Some website for senior citizens); the Internet and smart phone usage. people view this situation anxiously; Seoul International Senior Expo (an It is worth noting that different they say that the social conflicts exhibition that shows the present and future of the senior industry in forms of media are emerging to associated with an aging population Korea); a retirement preparation represent the voice of the elderly. In may become more complicated, class (a stepping stone to 2012, the first issue of Senior Chosun, or there may be another economic successfully prepare for the post- the first magazine in Korea to target crisis. However, more people realize retirement life); Senior Chosun (a 50-plus readers, was published, that an aging population presents magazine where seniors can voice their concerns); and Home Instead and two other monthly magazines an opportunity. I do not view the Senior Care (nonmedical home will publish their first issues later aging phenomenon as a crisis, and care services that help seniors live in 2013. Senior Chosun is published I strongly believe that it is an excellent at home as long as possible). chance to explore new opportunities. by Chosun Media, which has the Recently, Senior Partners, along largest daily newspaper circulation Of course, such an optimistic with AARP, has made efforts in Korea, and Senior Partners. perspective necessitates proper to advance the age-friendly Social debate focused on preparation and befitting efforts. I organizational culture in Korea. advancing the age-friendly dearly hope that support from the Senior Partners plans to globalize, using its local and international government and active investment organizational culture has also network to provide consultation become more active. The new bill from private corporations will be services to foreign corporations postponing the official retirement encouraged. • that wish to enter the Korean age, as mentioned above, is also the market.

THEJOURNAL | 81 MONEY TREASURING THE SILVER WORKFORCE Best Employer: NEA, Singapore

Gloria Chin | DIRECTOR HUMAN RESOURCES NATIONAL ENVIRONMENT AGENCY, SINGAPORE

expectancy1 increases over the years, the More than 43 percent career lifespan for many Singaporeans has likewise been extended beyond the of NEA’s 3,800 national retirement age of 62. The shortage of manpower to staff employees are aged operations pushes businesses and organizations in Singapore to continually 50 and above, with the evaluate their hiring policies. Similarly, at the National Environment Agency (NEA), we have been looking at ways of oldest employee being attracting new talent while developing the skill sets of existing employees. 75 years old. Like many organizations in Singapore, NEA, whose mandate is to ensure a clean and green environment in Singapore, is faced with the challenge of Singapore has one of the fastest-aging a growing silver workforce and changing populations in Asia. In 2012, about 10 per- population needs. More than 43 percent cent of Singapore’s population was over of NEA’s 3,800 employees are aged 50 and the age of 65. By 2030, this percentage is older, with the oldest employee being 75 expected to double. Therefore, Singapore years old. With the changing profile of faces the challenge of accommodating NEA’s employee population as well as this changing age demographic. Singapore’s labor market, NEA has put Predominantly an Asian society, in place a number of Human Resources family remains a strong support system (HR) programs and practices to promote for the older population in Singapore. and support senior employability. NEA is However, as health-adjusted life guided by the following HR key directives

82 1 2

1 Mr. Tan (center) with his team of junior officers.

2 Mr. Yap Swee Kin, age 71, conducts vector control checks at Pulau Ubin, an island off the shore of Singapore.

where age management programs Over the years, NEA has NEA’s staff training, oversee or are concerned: increasingly recruited more mature guide NEA’s R&D efforts, and men- employees. Between January and tor younger officers, as well as distill „„Age-Neutral Recruitment August 2013, 15 percent of new hires and document NEA’s core expertise. Practices were aged 50 and older. The oldest As a result of NEA’s senior- „„Active Re-employment employee recruited was 68 years friendly re-employment policy, „„Active Learning old. This demonstrates NEA’s best- more than 90 percent of NEA „„Active and Healthy Living fit principle in matching suitable employees are re-employed upon „„Awards based on Merits candidates to the job, regardless of reaching the statutory retirement age. age of 62. Such staff are offered the Age-Neutral Recruitment A case in point is Yap Swee Kin, same position or given positions Practices 71, who in 2007 was hired at the age of that are less physically straining, Encouraging age-neutral recruitment 66 as an environment health officer. or consulting work when they are practices benefits NEA as it does not Yap enjoys sharing his knowledge re-employed. further limit itself as Singapore faces a with his younger colleagues as it One such employee is Tan Joo shrinking workforce2. NEA therefore gives him a sense of satisfaction. Thai, 68, who used to work as a works with the Council for 3rd Age, medical inspection specialist in Community Development Councils, Active Re-employment NEA’s Radiation Protection and Employment and Employability Mature employees are considered to Nuclear Science Department. Institute, recruitment agencies, and be a valuable asset in meeting NEA’s With his expertise and valuable other sources to actively reach out objective of achieving environmen- knowledge, Tan was re-employed to mature workers who are looking tal sustainability in Singapore. Their as a consultant. He finds his current for employment. Applicants are not rich life experiences add diversity work meaningful as it allows required to indicate their age on the to how issues and challenges are him to share his knowledge with application forms so that the hir- viewed and addressed, while their younger officers while he continues ing departments will not be biased wealth of experience and knowledge to contribute to the health care against older workers. enables them to help spearhead community.

THEJOURNAL | 83 treasuring the silver workforce

NEA also recognizes that employees and Re-Employment” course and other have different needs at different stages related courses to help them prepare for of life and is prepared to support them their retirement. and welcome them back when they are ready for further re-employment. This Active and Healthy Living was the case for Avtar Singh (s/o Gurdip With more than 43 percent of NEA Singh), 64, who retired in November employees aged 50 and older, the “keep fit, 2010 to pursue his interest in religious stay healthy” mantra takes priority. Senior studies. Singh was rehired by NEA’s employees have different needs and are Department of Public Cleanliness in June motivated in different ways than younger 2011. When asked about his thoughts on employees. In designing HR policies and coming back to NEA, he said, “I treasure programs, it is thus important to consider the opportunity NEA has given to me to these diverse needs. For example, at a continue employment after retirement. recent annual health screening organized It reflects that NEA values the experience by NEA, mature employees were given and wisdom of a mature workforce who free tonometry tests for glaucoma (eye can cascade their know-how to younger screening) and spine screenings. To fur- colleagues. I find a lot of satisfaction when ther promote active living, NEA also orga- my subordinates and younger colleagues nizes subsidized activities for children progress under my guidance. Personally, and grandchildren of employees during I like to keep myself active by continuing school holidays. to work and continuing to learn new NEA’s Sports and Recreation Club things. HR and my supervisors have given (SRC) organizes low-impact fitness me great support and encouragement to classes, such as Tai Chi, which are open continue working and I appreciate that.” to NEA’s retirees. Retirees are also given access to NEA’s gym and badminton and Active Learning squash courts. NEA champions lifelong learning for all For example, Tan Hock Siew, 67, has staff, regardless of age. In designing the been an active member of the NEA SRC training programs for its employees, since his retirement. He visits the gym NEA takes into consideration the orga- at NEA’s Environment Building twice nization’s requirements and the specific a week and plays badminton with his needs of the employees. As of August 15, ex-colleagues at least once a week. At just 2013, 35 percent of the training slots were two dollars a month, Tan is able to enjoy taken up by staff aged 50 or older. modern gym and sports facilities. He To ensure that older workers are not feels that it is important for a retiree like left behind, NEA constantly encourages himself to still keep fit and active. its older workers to continue to increase their skill sets to meet current and Awards Based on Merits future needs. In 2011, NEA embarked The current compensation structure for on a job redesign exercise for a group NEA employees is performance-based. of employees, of whom 93 percent were Employees will receive performance aged 50 or older. In redesigning the job, bonuses and merit increments based special attention was paid to the fact on their performance, regardless of age. that the majority of the employees were Promotion is also dependent on one’s mature workers. For example, booklets performance. Even after their retirement given to them are printed in bigger and during their re-employment, officers fonts. NEA’s employees aged 55 or older will continue to receive merit increments also take the “Plan Now for Retirement and bonuses based on their performance.

84 3 5

3 NEA's senior workers participated 4 in various courses with their peers.

4 Mr. Avtar Singh was recently interviewed by CNBC Asia on senior employability for a program titled "Ageing in Asia."

5 Mr. Tan is a frequent user of NEA's SRC gym.

Senior employees have different needs and are motivated in different ways than younger employees. In designing HR policies and programs, it is important to consider these diverse needs.

THEJOURNAL | 85 treasuring the silver workforce

What Our Partners and Mature About National Employees Have to Say Environment Agency In close partnership with our Formed on 1 July 2002, the National two unions, we are able to work Environment Agency (NEA) is the seamlessly in caring for our silver leading public organization respon- workforce. This is what our union sible for improving and sustaining representatives have to say: a clean and green environment in Singapore. The NEA develops and “NEA has not neglected the needs spearheads environmental initia- of a maturing workforce. Besides tives and programmes through its employability, NEA management partnership with the People, Public also supports union initiative to and Private sectors. It is committed organize healthy aging talks to pre- to motivating every individual to pare the mature workforce on tips to take up environmental ownership keep fit and healthy.” and to care for the environment as a way of life. - Mr Ong Sin Tiong, Executive Secretary for By protecting Singapore’s Amalgamated Union of Public Daily Rated resources from pollution, Workers (AUPDRW) maintaining a high level of public health, and providing timely meteorological information, the “NEA is a good employer. It takes NEA endeavors to ensure sustainable good care of its employees over 50 development and a quality living years of age. Most of such employees environment for present and future have been happily working in NEA generations. for many years taking pride in their NEA won the AARP Best work in caring for the environment. Employers for Workers Over 50 Gloria Chin In addition, NEA recruits into Award–International in 2011. • service many employees above 50 Gloria Chin has 20 years of HR years old. It believes that age is not a experience, both in the public and 1 Health-adjusted life expectancy is an estimate private sectors. She started her disadvantage in its recruitment pol- of the number of years a person is expected to career with two leading statutory icy. In fact, it is a positive element in live, free from disability or disease. For more boards—Housing & Development information on Singapore’s population and its decision-taking.” vital statistics, visit: http://www.moh.gov.sg/ Board and Inland Revenue content/moh_web/home/statistics/Health_ Authority of Singapore—before - Mr Ma Wei Cheng, General Secretary for Facts_Singapore/Population_And_Vital_ moving on to the health care Statistics.html. industry, where she worked in Amalgamated, Union of Public Employees the National Healthcare Group. 2 (AUPE) Singapore faces a declining old-age support There, she started up a new health ratio. In 2030, the ratio of elderly citizen to citizens in the working age band of 20–64 care cluster, the Jurong Health years of age will be 1:2.1 http://population.sg/ Services, in 2009. She joined NEA With the support of NEA’s key-challenges/#.UlZnS1Pc5uQ. in July 2011. management and union partners, NEA is able to continually ensure a better work-life for its senior employees.

86 MONEY RESPECTING MATURE WORKERS Best Employer: Michelin North America

David Stafford | CHIEF HUMAN RESOURCE OFFICER, MICHELIN NORTH AMERICA

We are leading a four-generation company that recognizes the need for talent management at all ages.

Nearly 40 years ago, Michelin began its tire of their careers — the average tenure of our manufacturing operations in Greenville, South employees aged 50 and older is 23.5 years. Carolina, with a group of talented employees Our programs that benefit mature work- who helped build our presence in the United ers and demonstrate one of our core values, States from the ground up. respect for people, have led to continued rec- Today, with those years of history behind ognition by AARP. Since 2001, Michelin has us, we are leading a four-generation company been recognized six times as one of AARP’s that recognizes the need for talent manage- Best Employers for Workers Over 50 in the US. ment at all ages. This requires us, like many To better understand what we have in other companies, to adapt and innovate place, I’d like to highlight three areas of focus to meet the needs brought on by changing at Michelin: talent management, health and demographics. Nearly 40 percent of our US wellness, and returning retirees. employees are aged 50 and older, and they are a critical part of our talent management strat- Talent Management egy. The knowledge and experience they bring, Whether fresh out of school or well into their as well as the skills to mentor our younger gen- careers, we hire employees not for a job, but erations, is invaluable. This mature workforce for a career. Our unique talent management has been with Michelin for most, if not all, system and robust learning and development

THEJOURNAL | 87 respecting mature workers

We see returning retirees as a win-win, allowing retirees to continue to work if they wish, and allowing the company to benefit from the knowledge and expertise gained over a career with the company.

programs allow employees to grow, salaried personnel in our manufac- they have personally benefited from develop, and accept new responsi- turing facilities began their careers Michelin’s focus on health and well- bilities throughout their careers. as wage employees. ness. Over the past 5 years in the We manage careers for all of our Career mobility—the oppor- United States, we have moved to an employees. As an example, high-po- tunity to change fields midcareer— innovative, award-winning health tential employees and senior man- is an exciting part of working at and wellness initiative, Choose agers are given additional resources Michelin. I am a good example of Well-Live Well, which encourages for development so we can prepare this; I began my career as a mate- employees and their families to take for future staffing at the senior or rials science engineer and am now charge of their health. executive level. Salaried employees chief human resource officer—a This year, we launched an have access to a job advertisement job I have embraced because of my enhanced incentive program for system that allows them to apply passion for managing and devel- employees and their spouses or for positions interesting to them. oping people. We know one of the domestic partners to earn health Wage employees are encouraged main reasons employees stay at care funds based on individual to become qualified on posts or Michelin for their entire careers is health outcomes. This also allows equipment outside of their area, and because they are constantly chal- them to earn progress incentives we also have career management lenged with new opportunities. the following year. Results are so workshops at our manufacturing far successful, demonstrated by the sites to encourage wage-to-salaried Health and Wellness fact that participation in our per- progression in areas where there Our employees—across age demo- sonal health review and biometric is interest. About one-third of the graphics—consistently tell us how screenings is close to 90 percent.

88 By focusing on health and from the knowledge and expertise wellness, we have continuously gained over a career with the developed programs to energize company. Within the past several our employees and their families years, Michelin has bolstered the to develop healthy lifestyles. An returning retiree program. In many example of one way we have pro- cases, we have utilized retirees for vided resources: in 2010, we opened their expertise in the areas where the first Michelin Family Health they worked before they retired; Center at our headquarters in by giving us additional staffing Greenville, to provide convenient or resources, they have filled and affordable access to a full suite critical needs. In addition, we have of quality health care services. had returning retirees lend their The Michelin Family Health expertise to lead projects or study Center is available to all active opportunities for the future. The employees—even if not covered returning retiree program also by a Michelin medical plan—and allows returning retirees access to all spouses or domestic partners, additional benefits. All retirees stay retirees, and dependents over age connected to Michelin through two who are covered by a Michelin a retiree Web forum that allows medical plan. For most, eligible plan them to see company news and David Stafford members pay 50 percent less than encourages discussion among them David Stafford is the chief human they would for the same services at to answer any questions or concerns resource officer for Michelin in-network providers, and all labs they may have. North America. He has worked are provided at no cost. The center is In conclusion, the commitment for Michelin for nearly 30 years. staffed and managed by the nation’s to the well-being and development Mr. Stafford also serves on the Area Commission for Greenville leading workplace health provider, of our employees is not just a local (S.C.) Technical College and on Take Care Health Systems. Two strategy—it is one of Michelin’s six the Advisory Board for the School more centers were opened at our major global ambitions for 2020. of Engineering and Science at manufacturing and research and We are always searching for Clemson University. development sites in Greenville and ways to make improvements in our Ardmore, Oklahoma, and Michelin is commitment to our employees. building a fourth center in Lexington, We are proud of the programs we South Carolina, where the company already have in place that have has two manufacturing sites. allowed us to be an employer of choice in the communities where we Returning Retirees are present. We believe Michelin is a When our employees retire, they place where people want to work and have the opportunity, after a period have a long, fulfilling career. Every of time, to express an interest in day, we have examples of employees returning to work at Michelin as part who do a great job and demonstrate of our returning retiree program. our values of respect—probably We see returning retirees as because we know that, as part of the a win-win, allowing retirees to Michelin family, we share the same continue to work if they wish, and journey to care about giving people allowing the company to benefit “a better way forward.” •

THEJOURNAL | 89 global innovations

Koureisha Ltd.: Redefining Flexible Retirement Opportunities

A human resources (HR) firm in Japan called Koureisha many older persons can enjoy their work, meet with Ltd.—Japanese for Elderly Inc.—is redefining flexible groups, communicate with others and maintain their retirement opportunities for older workers in Japan. social bond.” Founded in 2000, Koureisha offers a unique employment placement service to businesses by matching older A company contracting with Koureisha can take workers with temporary staff positions. Japan has one of advantage of cost benefits older workers provide. For the oldest demographic profiles of developed countries; example, an experienced worker hired through Koureisha the largest age group is between 60 and 64 years old. eliminates long wait costs needed to fulfill a temporary Japan’s population over the age of 65 makes up 24 position, which is already provided at a lower cost percent of the total population, according to the CIA because Koureisha employees work part time while Factbook. A spokesman from Koureisha highlighted the benefitting from pension withdrawal. demographic aging as a unique business opportunity for older workers. He said, “People now have 80 years Koureisha offers placements in a variety of companies, to live, and their post-retirement lives are twice as long mostly in gas business–related positions, or other office as 50 years ago. It is not exaggerating to say that their positions such as facilities management, maintenance, post-retirement lives are too long just to be engaged in or general office work. Koureisha has placed workers at leisure activities without working. In addition, a number local Tokyo utilities companies but also larger national of people say that it is financially difficult to live only on brands, such as Panasonic and Sharp. The business has pension because their post-retirement lives have become grown sustainably since its inception in 2000, and is now too long.” more than 45 million yen ($500,000) worth of service. As Japan’s population continues to age, Koureisha’s business Koureisha workers are matched with companies based looks to expand and provide flexible and affordable labor on interest and their skill set. The increased income from an experienced older age demographic. from part-time work provides extra financial security in addition to the pension withdrawals. Working also gives www.koureisha.co.jp older workers opportunities for social interaction and provides tasks to keep them engaged and active. The Nicholas Barracca, Intern company “provides various opportunities so that AARP Office of International Affairs

90 photos: koureisha 1 great dealof experience “Older peoplewitha treasure of society.” and knowledge are the mostvaluable -Kenji Ueda, Chairman, Koureisha

2 1 2 office work. maintenance, orgeneral facilities management, office positionssuch as related positions, orother mostly ingas business– in avariety ofcompanies, Koureisha offersplacements Kenji Ueda Koreisha Chairman THE JOURNAL

| 91 PERSONAL TIME TIME WORTH SHARING The Growing Popularity of Multigenerational Travel

Eduardo Schutte | SENIOR VICE PRESIDENT GLOBAL SALES SERVICES & DISTRIBUTION, HILTON WORLDWIDE

92 illustrated by julia rothman members’ travel expenses, and they value the quality time the trips afford. Overall, evidence suggests that for boomers, to travel in multigenerational groups is to Boomers are live. increasingly engaging Reconnect and Recalibrate in multigenerational Many adults older than 50 say family travel is a top priority. Because families travel because they are more spread out geographically than value the quality time ever before, travel is the only way for many modern, mobile families to physi- the trips afford. cally get together. The opportunity to reconnect with friends and family moti- vates their leisure travel, and by travel- ling in a group, boomers can connect with children and grandchildren in one trip. Hans Christian Andersen said, “To travel The desire to spend time with family is to live.” What does that mean for the affects the types of trips that boomers boomer generation – adults ages 50 and often take. AARP’s research shows older? Like most people, boomers are Americans ages 50 and older are taking adjusting to changing priorities as life multiple weekend trips close to home continues to become busier, more com- instead of one long-distance annual plex and more fragmented. Families vacation. They want to travel to see their live farther apart, jobs demand longer grandchildren and their friends, and to hours and more travel, and digital tech- celebrate significant milestone events – nology ensures constant connectivity. birthdays, weddings, anniversaries, In response to these shifting circum- graduations, new jobs and retirements – stances, boomers are adapting. Research with the ones who matter most to them. shows that the way boomers travel, and Research from the US Travel the reasons they travel, are different than Association shows adults older than age they were decades ago. 55 are more likely than any other age Every boomer’s travel experience is group to say that family vacations are unique; some are road warriors, while worth the time and expense for the others are once-a-year vacationers. But opportunity to bring together multiple regardless of frequency or travel style, generations. And grandchildren feel sim- many polls rank travel as boomers’ No. 1 ilarly: children who travel with their leisure activity, for a variety of reasons. In grandparents say they value the quality fact, AARP found that boomers have time they get to spend with them during driven much of the growth in travel over vacations, and that it makes them closer. the past 40 years, and that boomers travel more than other age groups. Relax and Unwind According to industry analysts, A “Visit California” white paper on mul- boomers are not only fueling a general tigenerational travel also tells us the increase in travel, they’re also fueling the frenetic pace of modern life, with its increase in multigenerational travel – distractions and scheduling demands, traveling in groups with three or more infringes on quiet evening and week- generations. Boomers may have the end family time. This makes travel more financial means to pay for other family important than ever, as an opportunity

illustrated by julia rothman THEJOURNAL | 93 time worth sharing

to disconnect from technology and of four adults 55 and older still have more likely to say they’re inter- reconnect with loved ones. Boomers vivid memories of vacations from as ested in domestic and international simply want time to decompress – young as 5 years old, and 85 percent affairs and are more likely to vote. an opportunity that oftentimes only say they still reminisce with family Most respondents believe travel travel can provide. about trips taken years ago. makes people more tolerant and This is traveling. And the idea provides a better understanding of Experience New Things that travel memories are some of the the world. Boomers possess many of Research shows that, just like other most vivid shows there is something these qualities too; they have consis- travellers, multigenerational travel- magical about these experiences. tently high voting rates and express lers are looking for new experiences Boomers travel for reasons as indi- interest in seeing historic places. — beautiful, awe-inspiring scenery, vidual as each person, and each The survey’s results, and our novel places and different, unusual deserves an avenue through which nearly 100-year history as a premier cuisine. These memorable travel to make travel aspirations travel hospitality company, show that experiences often come about by realities. travel is important. And what do we chance: discovering a phenomenal do with things that are important? restaurant frequented by locals; wit- The Value of Travel We share them. nessing a vibrant display of culture A few years ago, Hilton Worldwide The Hilton HHonors program is courtesy of an off-the-beaten path conducted a study aimed at under- an example of a loyalty program that stroll; or seeing a travel companion’s standing why people travel and what offers a fast way to earn free nights smile, or laugh, frozen in memory. they gain from it. We found that peo- and other rewards and gives mem- Travel can also be a time to ple who travel are more engaged and bers flexibility in choosing how to enjoy the finer things in life or to active citizens. They volunteer, give redeem points. We help members reacquaint oneself with long-forgot- money to charitable organizations, turn their hotel stays, flights and pur- ten places. Research from the US and invest more in art and culture chases into memorable travel experi- Travel Association shows three out in their communities. They’re also ences worth sharing and allow them

94 Three out of four adults 55 and older still have vivid memories of vacations from as young as 5 years old, and 85 percent say they still reminisce with family about Eduardo Schutte Over the past twenty years Eduardo trips taken years ago. Schutte has built a successful and ascending professional career in the Hospitality Industry, during which he has occupied various positions in Marketing, to share their points with others, so travel easier and more accessible. Sales, Revenue Management and Distribution. Eduardo has worked that families can travel the world This is why we partner with brands for Grupo Posadas (the largest together, across generations. and organizations like AARP. We Hotel company in Latin America), When we think about new ways offer travel tips and resources for our TravelClick, and LXR (a Blackstone to make our HHonors program rele- members that ensure they’ll get the company) where he co-led the vant, we keep our members older most out of their travel — and they’ll Profit Optimization area for 35 high-end resorts. than age 50 in mind. We know that do it in the most cost-effective way. these members are typically more We offer co-branded credit cards, so Eduardo, first joined Hilton affluent. They are more likely to be members can earn HHonors Points Worldwide as VP of Distribution & Channel Management, where interested in golf, gourmet foods and and redeem them for reward nights. he was responsible for 3rd Party visiting historical places. At Hilton We also offer up to 10 percent off our channel strategy and performance, Worldwide, we use that knowledge to best available rate for AARP mem- and has now been appointed as create promotions that will appeal to bers at hotel locations around the SVP of Global Sales Services & them. We also know 50+ consumers world. Distribution where he will manage all the functions and business value luxury – we see that in their Our mission is to fill the earth processes that support and enable houses, cars and travel accommoda- with the light and warmth of hospi- the Global Sales organization. tions. Overall, they feel that they’ve tality. Our properties help us do it. worked hard and worked long, and Our people help us do it. And Eduardo holds a bachelor degree in Hotel Management and a Masters they’ve earned it. We try to make HHonors helps us do it. We believe in Business Administration (MBA) luxury upgrades available for them, the world would be a better place if from the University of North and to provide hotel properties that we all had a well-worn passport – and Carolina at Chapel Hill. Eduardo offer that luxury experience. we’re working hard to make that hap- enjoys running and travel and lives We view ourselves and the pen. The experiences of traveling are in South Florida with his wife Diana and three children Isabella, Matias HHonors program as advocates for experiences worth sharing – over and and Lucia. today’s traveller. We want to make over again, across generations. •

THEJOURNAL | 95 PERSONAL TIME FINE PRINT New Magazine Oma Aika Appeals to Finland's 50+ Population

Anna-Liisa Hämäläinen | EDITOR IN CHIEF, OMA AIKA MAGAZINE

96 We spent a full year researching the interests, values, problems and dreams of people aged 50 and over.

Finland is one of Europe’s fastest-aging nations. 1979. Aimed at older people of both genders, It has a population of 5.4 million, with almost this general interest magazine has been a huge one-half, or 2.6 million people, now aged 50 and success. Legal and financial pieces by expert older. Women’s life expectancy is 83.5 years, contributors are a major reason for subscribing. men’s 77 years. Two years ago, Aller Media Finland began to Finland has 1.46 million pension recipients. research this media segment. Full retirement age is between 63 and 68 years, Apart from Oma Aika, there are just two but the average age at retirement is just over 60 magazines in Finland aimed at the 50-plus age years. Plans to reform the pension system and group. Both are lifestyle magazines for women. raise the minimum retirement age are being They contain hardly any commentary on hotly debated. social issues, and do not offer legal or financial Older people in Finland today are healthier, information. We spent a full year researching wealthier, and more active than ever before. the interests, values, problems, and dreams Each year, they spend €5 billion on their own of people aged 50 and older. We also had the needs. On their children and grandchildren pleasure of visiting AARP in Washington, alone, they spend €2.14 billion. They spend more DC, and New York. This tour gave us an on travel than other age groups. They buy more incredible amount of information about how to than one-half of all new cars. address 50-plus readers. Until now, this large group of people with strong spending power has gone unnoticed by We’ll Do a General Interest Magazine! advertisers. But now things are changing. We decided to launch a general interest magazine that comes out once a month. Its A Full Year’s Research main topics are finance and law; work and In Norway, Scandinavia’s largest magazine retirement; health and fitness; travel and publisher, the Danish-based Aller Media, has family; and human relations. Each issue has published a magazine called ViÖver60 since two strong interviews with opinion leaders

THEJOURNAL | 97 fine print

in politics, economy, culture, and Experienced Team of Journalists most celebrated comedians, Miitta entertainment. The magazine’s staff consists of Sorvali. We wanted to bring in a voice six journalists: five women and The launch of the magazine in that takes a stand on social issues one man. They all have their spe- March was a great success. The first and that is more energetic and cial area of expertise that supports issue sold 102,000 copies, which by youthful than in the two rival maga- the brand concept, such as social Finnish standards is a phenomenal zines. The sections in our magazine issues, health, culture, entertain- figure. that most clearly set us apart from ment, and travel. The oldest edito- The aim now is to build up an the competition are our finance rial staff member is 57, while the established base of subscribers, and law articles and our large travel youngest is 41. and figures are indeed showing section—two travel stories per issue Anna-Liisa Hämäläinen, and Art good growth. Advertisers have also and Finland's largest selection of Director Saara Tuomikoski, were become interested. offers from our providers. recruited in-house. Hämäläinen With most of its income gen- A lot of work went into deciding had 16 years under her belt as edi- erated from subscriptions, print on a brand name because we wished tor-in-chief of an interior decorating media is and will remain the most to avoid age or gender restrictions. and food magazine, but she comes important platform for Oma Aika. We decided on Oma Aika, which lit- from a strong general interest back- However, we are constantly work- erally translates as “Own Time.” ground. Tuomikoski likewise has ing to develop our online services Why this name? diverse experience in magazines. and social community; Oma Aika, People 50+ often say they finally for example, is available in a tablet have some time to themselves, some A Strong Launch in March 2013 version. For the time being, income time of their own. This is a valuable Oma Aika quickly gained recogni- streams from digital platforms have resource and helps them realize tion. A groundbreaking advertising been subdued. their lifelong dreams. campaign featured one of Finland’s

98 Readers Appreciate Sound personally. Readers also appreciate Reporting our in-depth personal stories about We are constantly listening to what merited people. our readers want. The most important reason is the WIIFM principle—that Aiming to Become the Most is, “what’s in it for me.” Respected 50+ Media Our financial and legal stories In March 2014, Oma Aika will cele- provide a direct and concrete ben- brate its first birthday. Our launch efit to our readers. The pieces in year has been a great success. The the legal section are all written by 50-plus audience wants a well- Anna-Liisa Hämäläinen a lawyer who specializes in family crafted, high-quality magazine. Anna-Liisa Hämäläinen has and inheritance law. It’s impossible The brand has reached its targets served as editor-in-chief of Oma to overstate the importance of this both in subscription and single-copy Aika (Own Time) since 2012. expertise. Legal pieces often rank sales. Media sales were up in the Hämäläinen joined Aller Media among the top three stories in our autumn. Our aim is to break even in Finland in 1996 and served as reader votes. A piece titled “When a our third year. Editor-in-Chief of Koti ja keittiö magazine (Home and Kitchen) Family Member Dies,” for instance, As well as developing the print from 1997–2012. She has an MSc was the second-most popular article side of the business, we are commit- in Journalism. She has worked in in that issue. ted to developing digital platforms, magazines in different journalistic In the health and fitness section, particularly blogs and social media. tasks since 1978. the focus is on health, not illness. Ultimately, we are aiming to This policy has stood us in good stead: become Finland’s most popular and our readers say our health stories are respected 50-plus media across all useful and of current interest to them platforms. •

THEJOURNAL | 99 PERSONAL TIME TALENT EXCHANGE Cooperation Promotes Sino-US Relationship

Zhang Jianguo | DIRECTOR, STATE ADMINISTRATION OF FOREIGN EXPERTS AFFAIRS; VICE-MINISTER, MINISTRY OF HUMAN RESOURCES AND SOCIAL SECURITY, CHINA

Strengthening talent exchange and cooperation between the two countries helps enhance mutual understanding and further develops bilateral relations.

On November 4, 2013, China's State economy, science and technology, education, Administration of Foreign Experts Affairs culture and health. They not only provide pro- (SAFEA) signed a Letter of Mutual Intent on fessional and technical support, but they cul- talent exchange and cooperation in Beijing tivate young talent and entrepreneurs. Experts with AARP and the International Executive also find valuable opportunities to display Service Corps (IESC). The three parties made their talents and to develop their careers. We the commitment to promote Sino-US tal- consider them close friends of the Chinese ent exchange and expertise. I believe this people. cooperation will build a new bridge for deep Most of the foreign experts working understanding and friendship, and carrying in China are familiar with two depart- out pragmatic cooperation between our two ments, SAFEA and China Association for countries and peoples. International Exchange of Personnel (CAIEP). Introducing foreign experts and under- SAFEA is a Chinese government depart- taking talent exchange is an important part ment in charge of foreign expertise exchange of China's reform. More than 500,000 experts and cooperation, including policy and plan come to work or start a business in China formulation, implementation of important every year, including a large number of cooperation projects, such as the high-level Americans. Foreign experts play an active role overseas talents introduction program of the in many areas of China's development, such as “Recruitment Program of Global Experts (1000

100 1 (Left to Right) Tom Miller, President and CEO, IESC; Talent Plan)” and other specialized Zhang Jianguo, Director, Zhang Jianguo talent exchange projects. CAIEP is a SAFEA; and Robert Romasco, President, AARP sign letter Zhang Jianguo is the Vice Minister national public service organization of mutual intent, Beijing, for Human Resources and Social for international talent exchange. China, November 4, 2013 Security and Administrator of the SAFEA and CAIEP treat each foreign State Administration of Foreign expert working in China as a family and cooperation between the two Experts Affairs. He also serves as the Vice Chairman and Secretary member and a sincere friend. We countries helps enhance mutual General for the China Association strive to create good working and understanding and further develops for International Exchange of living conditions for foreign experts bilateral relations. We believe this Personnel. in China, and an environment that program will help build a new model helps them develop their careers. of major-country relationship based China and the US share exten- on mutual respect and shared goals. sive common interests, and face We look forward to working with many common challenges. Given AARP and IESC to promote Sino-US this reality, potential opportunities bilateral talent exchange, to benefit exist for the two countries to carry our two peoples and to promote the out all kinds of talent exchange, progress of human civilization! especially between profession- For more information on the als. Strengthening talent exchange program, please visit www.iesc.org •

THEJOURNAL | 101 international aarp member column Life Reimagined

Richard Jorgenson and John Mashino are lifelong friends who utilize their background in aircraft maintenance on behalf of the ORBIS Flying Eye Hospital Plane.

There is a growing world-wide movement of people 50+ in the airframe and power plant classes. After grad- wanting to “stay in the game” and a new normal emerging uation, both men stayed in contact and enjoyed long with people wanting to work and give back in their later careers as mechanics for United Airlines. Jorgenson years. Every day 10,000 women and men a day turn 60 was the first to join the ORBIS team out of retirement in and many are asking themselves how to turn their later 2001, and worked for ORBIS without pay for more than years into their legacy years. These two mechanics are 7 years. He left retirement seeking adventure with the doing this in a very innovative and unusual way. ORBIS team, saying “there is something special about Jane Pauley, Emmy Award-winning journalist, has it—whether it’s the adventure or fear, it’s exciting to be been introducing incredible Life Reimagined stories from scared.” Years later, in 2007, Jorgenson called Mashino across the country in segments on NBC’s Today Show. after a mechanic left ORBIS and asked Mashino if he One of Pauley’s most recent segments highlighted two wanted to join the team. On the one hand, Mashino was former United Airlines mechanics who have taken on comfortably retired since 2002, enjoying his 13 acres in second careers in their retirement to battle a global pub- Washington State and “a beautiful view God gave me lic health issue. Richard Jorgenson and John Mashino … I’ve been well-blessed with a lovely view and a lovely are lifelong friends, both with nearly 35 years of aircraft place to live.” On the other hand, Mashino told Pauley, maintenance experience. They now utilize their unique what drove him toward ORBIS was that he was too deep skill for the ORBIS Flying Eye Hospital Plane. into retirement and becoming complacent; he found Jorgenson and Mashino met in trade school in himself attracted to ORBIS’s global work. Montana when they were 18 years old. Rich was first ORBIS is a nonprofit organization that works to interested in carpentry and John wanted to attend auto- prevent and treat blindness through hands-on train- motive trade school, but they both ended up enrolling ing, health education, and partnerships with health

102 1

2 3

1 Orbis International’s Flight Mechanics Rich Jorgenson and John Mashino give Jane Pauley, AARP’s TODAY Life Reimagined Contributor a tour of the Flying Eye Hospital while it was in for a ‘tune-up’ at the FedEx Hanger in Indianapolis. Jane Pauley profiled Rich and John as part of her award- winning NBC TODAY show series produced in partnership with AARP.

2 Jane Pauley sits in the engine of Orbis International’s Flying Eye Hospital DC-10 after interviewing flight mechanics Rich Jorgenson and John Mashino for TODAY. To see the segment which aired in November 2013 visit www.lifereimaginbed.org/janepauley

3 Orbis’ Flying Eye Hospital sits on the runway in Cameroon before the aircraft is transformed into an operating room and training hospital in West Africa.

THEJOURNAL | 103 international aarp member column

They have flown on missions to more than 60 countries around the globe, with multiple stays across Southeast Asia, Africa, South America, the Middle East, and the Caribbean.

care organizations around the world. According to same trip froze, overwhelmed with the experience of the ORBIS website, 285 million people worldwide are sight after treatment. Both men have had incredible per- visually impaired; 80 percent of medical cases are pre- sonal experiences growing up on Montana ranches, but ventable and treatable, but 90 percent of those visually they never thought they would travel as flight mechan- impaired live in countries where medical care is insuffi- ics as often as they do now. They have flown on missions cient or lack access to care. ORBIS operates a Flying Eye to more than 60 countries around the globe, with mul- Hospital in a converted DC-10 cargo aircraft donated by tiple stays across Southeast Asia, Africa, South America, FedEx, which provides volunteers and pilots to fly and the Middle East, and the Caribbean. While most flight support ORBIS’s global mission to address those medi- mechanics are stationary, Jorgenson and Mashino travel cal cases. The third generation of the ORBIS Flying Eye with the plane as their “own private jet,” ensuring the Hospital is based on a modular concept that incorpo- doctors have the tools to perform the operations while rates a classroom education center, operating room, fixing airplane issues on site, no matter the circum- laser treatment room, and recovery area all onboard stances. The overseas missions are a team effort led by the plane. The cargo plane’s capabilities allow remov- doctors and nurses to not only perform the operations able modules so they can be easily taken off the aircraft and procedures, but also leave behind their knowledge for upgrades. and knowhow after the Flying Eye Hospital departs. Opportunities with ORBIS have provided Jorgenson Jorgenson describes this not as the new retirement, and Mashino with an incredible experience that has but “the time to do something that you want to do. … It been rewarding for both of them. In his interview, really saddens me for people who retire and stop and are Mashino mentioned how the experience “has been terrified of getting old. Why do they do that? There are rewarding in many ways because this organization so many things to do.” Both men have sought adventure helps people, humanity, and I think that’s where you and are seeking to do more in their retirement years; receive the real reward.” Jorgenson mentioned the expe- there is no end in sight. As Mashino put it: “I’ve got an rience of his first overseas program in China, where the aunt that’s 105 right now, so it’s all up to the Lord.” first patient he saw jumped up and down in excitement For more information about the ORBIS Flying Eye after gaining back her sight. Another patient on the Hospital, visit: http://www.orbis.org. •

104 aarp and jane pauley YOUR LIFE CALLING

“AARP knows the future is bright for a generation that’s going to remain healthy and vital for 20, 30, 40 more years. AARP has the information and resources people need throughout their process of reinvention. This can be a time of great productivity, meaningful work, pleasure, creativity and innovation.”

-Jane Pauley, AARP’s contributor to “Life Reimagined TODAY”

No wonder everyone is talking about technology, but built a brick oven “reinvention.” Not only are life in his backyard to perfect the pizza spans getting longer, but research he now serves at Paulie Gee’s piz- shows people in their fifties and zeria in Brooklyn. Texans Bill and beyond are more vital in their out- Patty Southerland opened a culi- look than ever before and are ready nary school in Tuscany. Ken Wood’s for “more” — though they don’t wholly unexpected journey took always know what “more” is. In Your him from rural Maryland, where he Life Calling: Reimagining the Rest of made a living drilling wells, to West Your Life, Jane Pauley gives voice to Africa where his fresh water wells the longings and opportunities of are saving lives. Jane Pauley has been a familiar face on her generation. With insight and wit, Pauley morning, daytime and primetime television for more than 30 years. She served as the A familiar face on television includes her own story as well. Her co-host of TODAY from 1976 to 1989, anchored for more than thirty years, Pauley’s warm, original and often funny per- Dateline NBC for more than a decade and in award-winning “Life Reimagined spective makes this book a deeply 2004 became the host of her own daytime Today” segment on Today (NBC’s personal and rewarding read. Your program, The Jane Pauley Show. Pauley is the morning television show), has Life Calling is filled with practical recipient of numerous Emmy and other awards, including the prestigious Walter Cronkite profiled people who are show- ideas and motivation for anyone Award for Excellence in Journalism and the ing the way. Like Paul, 53, who felt who asks, “What am I going to do Gracie Allen Award from the Foundation of like an “imposter” in information with my supersized life?”• American Women in Radio & Television.

THEJOURNAL | 105 twitter shoutouts

AARP International @AARPIntl 8 Feb Opening Address by Wu Hongbo, Under-Secretary General, DESA, @UN, @AARPNY #agefriendly pic.twitter.com/ZMgKLldB

AARP International @AARPIntl 23 Jan Join the conversation Austin Texas joins AARP Network of Age-Friendly Communities throughout 2014 at shar.es/CqxfR via @sharethis @AARPintl

City of Philadelphia @PhiladelphiaGov 12 Mar Philadelphia is committed to accessiblity #globalaging #aging and access for seniors. Learn more here: http://journal.aarpinternational.org/ #betterworldcampaign a/b/2013/02/ci… #olderworkers Deb Whitman @AARPDeb 14 Jun #agefriendly #lifeat50 Recognizing World Elder Abuse Awareness Day @UN with @AARPIntl Undersec General Wu #retirement #longevity Hongbo notes that abuse is not the price of growing old #brainhealth #dementia #caregiving Erica Dhar @ericadhar 21 Oct #betterworldcampaign Americans support #lifelonglearning strong involvement in the UN: 88 percent say it is important MT @AARPIntl @ericadhar

106 AARP International @AARPIntl 28 May Bradley Schurman @mrshoreman 26 Nov @AARP Pres. Romasco discusses the business Age Management: Best Employers Lead the Way case for older workers at the #oecdforum. New huff.to/1c5vkDT via @HuffPost50 @OECD research due in July.

Natalie Turner @MsDCNat 11 Dec Jeremy Hunt, MP, UK Sec of State for Health quotes Mandela “It always seems impossible until it is done.” #G8dementia @AARPIntl @DonRedfoot

Life Reimagined @lifereimagined 1 Oct She’s survived everything from communism to breast cancer. Today, @Martina Navratilova continues to inspire: http://bit. ly/1h4x0lR

TAEN AgeEmployment @TAEN_Uk 7 Nov Josh Collett from @AARPIntl talking about Best International Employers Award #OlderWorkers #CIPD13 #ageing pic.twitter. com/CZsxXek4bJ

THEJOURNAL | 107 spotlight TOBY PORTER

name: Toby Porter Tanzania, Germany, Holland and recent accomplishment: profession: Chief Executive Officer, Spain. I plan to go to the Philippines I ran the London Marathon in April HelpAge International in the first week of December, and 2013, my first since the Marine motto: If a job's worth doing, it’s New York on the second week. If it Corps Marathon in Washington in worth doing properly. sounds crazy, its because HelpAge DC in 2006, and I was 15 minutes currently reading: Love in the is a global organisation, with a quicker this time, 7 years later. As Times of Cholera by Gabriel Garcia mission to improve the lives of older we say in HelpAge, Age Helps! Marquez people around the world! overlooked aspect of aging: following on twitter: @HelpAge_ hotel with the best club sandwich: "Older people” are the most diverse USA, @age_uk ,@HelpAge_USA, I don't know, I never eat them! But demographic in any population: 60s @AgelessAlliance - a US-based whenever I visit the States, I always to centenarians! colleague has just introduced me to make sure to visit a sandwich or positive aspect of aging: Aging @doris_roberts, who I am enjoying bagel shop for breakfast or lunch. certainly makes you focus on what’s as a great advocate for the rights of You guys are top in class! important and what’s not. older people in the United States. tech must-have: My iPad Bluetooth what you would tell your teenage hobby: Running. keyboard . I travel between home self: You are one of the luckiest favorite city to visit: New Delhi, in Oxford and the HelpAge Office people in the world. Make it count, India in London for four hours every day, every single day. recent travels: Since becoming with extensive international travel Chief Executive of HelpAge as well, and the keyboard hugely International on 30th September, I increases the speed at which I can have visited (in order) - Washington, write messages and documents, Ethiopia, Kenya, South Africa, which I do throughout my journey. AARP aims to help people live longer, healthier, more financially secure and productive lives by identifying the best ideas and practices on key policy issues. We convene international opinion leaders and policy makers to share their expertise and develop research on health and long-term care, older workers and retirement income, and livable communities. Through our international program, AARP fosters this global collaboration and, in the end, acts as a collaborator and catalyst to governments and decision makers in all sectors to help address and favorably shape the social and economic implications of aging worldwide. THE JOURNAL journal.aarpinternational.org