The future of elderly care is co-created

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Ophelie Durand

Dec 11, 2017 - reading time 6 mins

By Ophelie Durand


Ophelie Durand has worked as Policy and Project Officer at AGE Platform Europe since April 2012. She follows urban policies, including the European Innovation Partnership on Smart Cities and Communities, the Urban Agenda for the EU and the New Urban Agenda for AGE, and is involved in the secretariat of the Covenant on Demographic Change. Additionally, she takes part in several EU-funded projects on ICT, accessibility, access to public services and the ‘silver economy’.

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The European Commission said it expects the proportion of the EU’s population aged 65 and up to rise from 19% to 29% by 2070, while the segment aged 80 and over will increase from 5% to 13%. 

Grandfather and granddaughter riding in a bus

In a recently published report on aging, the European Commission said it expects the proportion of the EU’s population aged 65 and up to rise from 19% to 29% by 2070, while the segment aged 80 and over will increase from 5% to 13%. At the same time, 80% of older people already live in urban areas. Demographic shifts and urbanization have created important challenges that need to be addressed to ensure a good quality of life for all generations while reducing inequalities and combating social exclusion.


According to the World Health Organization (WHO), physical and social environments are the key determinants of whether people can remain healthy, independent and autonomous long into their old age. Cities, therefore, need to look at how to improve the likes of outdoor spaces and the built environment, housing and health services for older citizens.


Making cities more age-friendly will allow everyone to grow and get older in better health and to remain active and autonomous for longer. This contributes to lowering the gap between life expectancy and healthy life expectancy, which remains about 15 years for men and 20 years for women across the EU. This means we spend on average between 15 and 20 years of our later life with a disabling health condition.


Making cities smarter doesn’t just mean using new technologies for public service delivery and innovative infrastructure. It is also about creating opportunities and places where citizens can come together, move around easily and access the services they need. In that sense, cities can only be smart if they are also age-friendly.


Access to services, particularly health and social care, is an essential part of this process. Many concerns that older people and their caregivers raise are linked to the availability of sufficient good quality, appropriate and accessible care. There are many projects and pilot programs springing up across Europe that are pointing in the right direction, but more must be done in terms of engaging older citizens in the creation of new services if they are going to achieve the kind of take-up these challenges demand.

Developing age-friendly tools

Using technology to develop connected health can support person-centered interventions that meet individual needs. Thanks to the EU-funded project SUSTAIN, in Tallinn, Estonia the Foundation Alutaguse Hoolekeskus supports the access to and delivery of care by enabling all stakeholders (including health professionals, informal caregivers and family) to connect and share information online. Digital solutions offer huge opportunities to integrate provision in a way that enables older people to receive better care and live independently for longer.


The city of Tampere, Finland has developed an information office for older people. The service, called ‘Kotitori’, gathers home-care services from both public and private sources into a one-stop shop. Kotitori is available via multiple channels: a physical location at the city hall open for visits, a call center and an online portal.


The EU-funded Mobile Age project is developing a new program in the region of Central Macedonia in Greece. This application allows older people to easily find their nearest pharmacy and book appointments with doctors thanks to openly available datasets.

Beyond the doctor

Sensor-based technologies can transform the lives of older people in cities in ways besides the quality of their care. Following a WHO approach, Mobile Age is working with citizens in Bremen, Germany and Zaragoza, Spain to create age-friendly routes. This initiative makes it safer for older people to move around the city through adapted car speed and improved pavement provision, as well as more benches and public toilets. In Hamburg, Germany, the AGQua project set up digital bulletin boards on the city’s streets, providing information on health promotion activities available in the neighborhood alongside information on the weather, emergency services and cultural events.


Older people are more susceptible than the rest of the population to suffer from air and noise pollution. Air pollution can aggravate heart disease and increase the risk of a stroke, but it also has an impact on asthma and brain aging – there’s increasing evidence, for example, that air quality can cause Alzheimer’s disease and dementia. Taking again the example of the EU-funded Mobile Age project, the Greek region of Central Macedonia will provide its older citizens with an app that indicates the current level of air pollution based on available open datasets. This will help older people plan their day according to the air quality and avoid going outside during pollution peaks.

Co-create for success

The goal of smart cities, however, shouldn’t just be to digitalize public services and infrastructure to improve mobility and save on public spending. The challenges we face demand a more ambitious target – smart cities should aim to improve the quality of life of all urban citizens through developing smarter, better and faster services that respond to today’s demands. Co-creating smart age-friendly solutions is imperative given Europe’s demographic trends. This means listening to the citizens first, and then planning, implementing and evaluating the solutions alongside them.


Co-creation helps smart cities understand the diversity of needs of their older residents. However, since digital literacy is lower in this group, city planners must look for alternative ways to consult and involve older people in the co-creation of public policies. The goal needs to be to help older citizens overcome the fear, lack of trust, anxiety and frustration that have all been identified as barriers to social inclusion in studies focused on this demographic and digital technologies. Concerns about data protection are also high among this age group and must be tackled.


Before introducing disruptive digital public services, smart cities must make efforts to help older citizens understand why and how they can benefit from using these new initiatives. Seniors organizations have to be involved in the process to reach out to wider groups of older people and increase acceptance. This demographic will only use smart services if these are age-friendly by design and have been developed in an inclusive way with seniors’ diverse needs and desires in mind.


Building smart cities for everyone is a continuous journey. Through a co-creation approach, cities can become smarter as well as help everyone grow and age in better health and actively contribute to their community.



This article is co-written by Anne-Sophie Parent

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