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Promoting Inclusion in an Aging World

Imagine you find yourself living on your own, after years of being surrounded by loved ones and friends. Your house is devoid of conversation. The television is your closest companion. Even an encounter with a salesclerk would be a welcome relief from the solitude.
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Imagine you find yourself living on your own, after years of being surrounded by loved ones and friends. Your house is devoid of conversation. The television is your closest companion. Even an encounter with a salesclerk would be a welcome relief from the solitude. But while you may want to venture into the world, you are physically limited from doing so. And so, each day just brings more of the same. You have never felt so alone.

Such social isolation--a loss of the connectedness essential for well-being--is a daily struggle for many of the world's older men and women. And based on the findings in the Global AgeWatch Index report released earlier this month, we have a lot of work to do to prevent this problem from getting even worse.

The Global AgeWatch Index measures quality of life for those aged 60 and up in 96 countries around the world, looking at factors such as income security, physical and mental health, education and employment status, social connections, physical safety, and access to public transport.

Perhaps not surprisingly, it turns out that Afghanistan is the worst place on Earth to be a senior citizen. But challenges are evident even in Switzerland, which holds the number one slot.

While the country has invested in programs to improve quality of life for seniors, the monthly bill for elderly care in Switzerland can run between $5,000-$10,000, leading some aging Swiss to seek care in places far from home, like Thailand. Some analysts believe the solution is to build more nursing homes in Switzerland. But nursing home environments can contribute to social isolation, especially with insufficient numbers of trained and capable caregivers--which is already an issue for Switzerland, as it is elsewhere around the world.

It is time to have an honest conversation about combatting social isolation in an aging world. By 2050, older citizens will account for over 20 percent of the global population; in Canada, my home country, they do already. This greying of the population is happening fastest in the developing world. According to Global AgeWatch, "of 15 countries that currently have more than 10 million older people, seven are in developing countries."

What can we do to ensure older people in every country stay connected and engaged in their communities?

The AgeWatch report concludes that "success means building independence" for older people. And indeed, independence is an important step. But it will only work as part of a broader effort to reinforce belonging--one that addresses emotional well-being, the importance of community, and being valued at every stage of life. As human beings, we find joy and meaning in reciprocal relationships. If independence is defined as not needing the aid and support of others, it risks becoming a recipe for isolation instead.

Fortunately, there are some innovative models that can inspire a better way forward.

In a previous column, I described multi-generational housing arrangements in Germany and the Netherlands, where people at different stages of life live together, to mutual benefit. Another approach takes the multigenerational model from the home to the neighborhood at large, with communities that have been developed and designed to attract older people and young families alike. Oftentimes, strategies that support one cohort serve the other as well. For example, as a report from the American Planning Association noted, "a safe, well-maintained sidewalk benefits seniors desiring exercise or who no longer drive. At the same time it helps a young mother pushing a stroller or a child learning to ride a bicycle."

Those aging in place--growing old in the homes they currently occupy--have a natural community to turn to: each other. AgeWell, an inspirational program in South Africa, pairs older people who are physically able with others who cannot easily leave home. The visitors, called AgeWells, provide supportive health monitoring, and both sides benefit from companionship. Those who receive visits from AgeWell companions often exhibit a reduction in depression. And the AgeWells themselves say they love having the opportunity to continue to work and fulfill an important need within their community.

The Village to Village Network uses a similar concept. Their "Village Model"--already active in more than 150 communities across the U.S., Australia, and the Netherlands--provides seniors aging in place with a support network of other local seniors. A small membership fee grants access to resources including frequent social gatherings, rides for shopping or appointments, legal and medical recommendations, and assistance with paperwork, among others. Some Villages even partner with local youth groups, providing volunteers who help members around their homes.

Municipalities might help scale such community support by encouraging the creation of local Villages, or rallying local businesses to participate. In Japan, for instance, the Japan Post offers the Post Office Watch program, where postal workers perform regular check-ins for older citizens. In April 2015, the Japan Post announced a deal with Apple and IBM to take the service digital and provide more frequent, more efficient check-ins. The U.S. Postal Service has considered creating such a program itself. It's a model that could be replicated in many countries around the world.

These approaches are community-oriented, with a reliance on inter-dependence. And that's exactly the point. By its very definition, isolation is not something we can fight on our own. There is no shame in accepting that--but there is much to gain.