The Iron Lady’s dementia and the signal to cities

April 21, 2012 5 Comments »
The Iron Lady’s dementia and the signal to cities
Meryl Streep's portrays Margaret Thatcher suffering from dementia in The Iron Lady

Urban planning discussions focus on bike lanes and active lives. But what about old folks?

"Some day," I quipped at the announcement of my candidacy for city councillor in May of last year, "I hope to be an old man. My bootcamp instructor, however, says I already am one."

The politics of our aging society has lately been front and centre on my mind. Vancouver, like so many parts of western society, is faced with the challenge of our increasing average age. It's sometimes referred to as the grey tsunami, which has triggered a debate about the ability of our health care system to support the expected demand as Baby Boomers retire. However, have we equipped our cities to address this change? I would argue we have a long way to go.

My motives are admittedly selfish. As my quote above suggests I hope to be around for a long time to come. A day will arrive where the challenges of mobility will completely change the relationship many of us have to our surroundings. However, cities don't like to think of themselves as places filled with old people, so it's predictable when we devote few resources to thinking about aging.

Last night I watched The Iron Lady, a movie I found much more inspired than many critics. The expectation was of course this would be a political biopic, rehashing the battles of Margaret Thatcher's term as Prime Minister. The movie was condemned by Brits on all sides of the political spectrum – despite heaps of praise for Meryl Streep for her canny portrayal of the protagonist – for showing Lady Thatcher as an old women beset with a mental illness while she was still alive.

Unencumbered by any need to defend or criticize the policies of the Conservative government of the 1980s, I could judge the movie on its own merits. Seeing a woman who ascended to such heights in society left isolated, and without many of the cognitive abilities we take for granted, stirred up an emotional reaction in me. The Iron Lady is a much better film than I expected, perhaps because it focused on the consequences of Thatcher's individualism, and not her political decision-making.

Two close members of my family have dementia, and I know how much stress it places on families caring for them. At doorsteps across Vancouver last year I was alarmed by all the signs of dementia I saw, and the loneliness that results from it. The alarm bells are being rung loud by some on the growth rates of dementia in our society. I believe cities have an obligation to do much more to mitigate the impacts of aging, such as dementia.

So where to begin? The policy wonks who read this blog will have their own ideas, but here are a few of mind to start this conversation:

  1. Redouble our efforts on town centre development. I like Lewis N. Villegas' idea of identifying walkable 'quartiers' in Vancouver, for example. In the past decade town centre planning in Vancouver has happened in fits and starts. Instead of waiting around for city planners to drive that process, a more independent and thoughtful community-driven process might get underway. I know with more time and modest support I would like to bring together neighbours to discuss the future of our community. Walkability principles are well-understood, so how can we mobilize the priorities of a city around them?
  2. Build housing with seniors in mind. When you consider seniors you don't think staircases. Single-level apartments or ground floor units are the kinds of senior's housing we must add to the mix around town centres.
  3. Plan for commercial centres within walking distance that provide household staples. On Fraser Street we've recently benefitted from the new development at East 29th Avenue with a grocery store, drug store and coffee shop. Add a medical office and you have the full complement of services that a senior might need without having to rely on car or transit. I've heard it said that "there is a time in one's life when you no longer wish to make left hand turns in your car". Far too many Metro Vancouver boroughs do not have any kind of shopping within 10 minutes walking distance. (The opening scene in The Iron Lady interestingly has an elderly Thatcher slipping away from caregivers to buy some milk at a nearby shop).
  4. Improve the public realm for seniors. Take people out of their homes or their community, isolation and loneliness often follow. Bring people together and it's shown that we lead longer and healthier lives. Our public realm can play a part in this by providing better gathering places that welcome our seniors. A bench or a stoop where people can safely meet, read a book or watch children play is still a rare commodity in most Vancouver neighbourhoods. It's time to think outside the box and build welcoming spaces such as pocket parks on widened boulevards or perhaps church properties.
  5. Remove tax disincentives for home sellers. On this point I have much to learn, however my understanding is the profit and loss on capital gains for home owners drives down the incentive to sell one's home, particularly in our hyperinflated real estate market. As a result instead of seeing our "empty nesters" downsize to a more suitable home, people are holding on to their homes longer. With robust town centre development you get more apartment living within our residential communities. It's important that we create that choice, which would be good for the life cycle of neighbourhoods.
  6. The impact of assisted living policies for seniors. This is a controversial subject, but let's put it out for discussion. Currently if you are a senior needing health care, our medical system chooses to service seniors in their homes instead of building and maintaining more expensive long term care facilities. Most will agree this policy has been highly successful in reducing individual stress and lowering systemic costs. It has had an unintended consequence, however. Many of our seniors are "overhoused" as a result.

    As so many baby boomers enter their sixties, mostly with mortgages paid off long ago, the time to plan for downsizing might be just a few years away. When you do the risk-benefit analysis there's little incentive to leave a home near your friends and favourite shopping places. By the time you reach your late seventies or beyond (far more common for most of us today) uprooting yourself creates too many hardships. When you can depend upon health services delivered to your home, the need to move diminishes even further. No one would propose taking away assisted living services for those who need it. But with more housing choice for seniors in their neighbourhoods, can we foster a culture where less of us being overhoused?

Admittedly, Margaret Thatcher is a provocative device for triggering a discussion on city-making for seniors. But I believe the filmmakers wished to make a point about the fragility of the mind, and it made me think more about my future, and that of my family and my community. The fifth pedestrian death in Vancouver this year, a senior struck by a car in Kitsilano last weekend, is another signal to me that we must do more to improves the lives of seniors in our cities.

Urban planning discussions are dominated by those who are young and active, seeking bike lanes and places to play. Getting old isn't as sexy but it is nonetheless as important for our city-makers to consider.

- post by Mike




5 Comments

  1. Julia April 21, 2012 at 4:39 pm -

    I watched the Iron Lady last week and had an identical reaction.

    We have moved my Mom out of our family home at age 94. She was waaaaay over housed. Thank goodness, because that is now paying for her private health care. Otherwise we would be on a wait-list somewhere.

    You don’t have to be all that old to appreciate 1-6. Works for me too!

  2. Bobh April 21, 2012 at 7:02 pm -

    Good points Mike. You can do British Columbia a big favor by continuing work on this subject.
    Thank you.

    • Mike Klassen
      Mike Klassen April 22, 2012 at 9:55 am -

      Cheers, Bob. It’s a culture shift to be sure. Julia’s experience of moving out a 94-year old is precisely the kind of situation we should try to avoid. But if you’re in your relatively spritely seventies, what are the advantages of downsizing? Condos are expensive and rarely near where most of us live today in the suburbs. And after 60 I believe you can defer your property taxes against the value of the home.

      These are things we must put on the front burner for policy makers.

  3. Steven Forth April 21, 2012 at 7:45 pm -

    Our next door neighbour moved out of her house about 5 years ago at the age of 86, once she could no longer take care of the house and garden, She was still riding her bicycle though (perhaps a product of being Danish, she gave up her car in her early 70s). She was fortunate to be able to move into a home only a few blocks from us and continued to see us regularly, singing at our Christmas party about three weeks before she died.

    We are lucky to live in a place with at least some housing options for seniors but we need a lot more. We also need to design transit for seniors. And your point about having food stores in close walking distance is another good one.

    This will be an important theme over the next 30 years. Great post.

    • Higgins April 22, 2012 at 1:22 pm -

      “Our next door neighbour moved out of her house about 5 years ago at the age of 86, once she could no longer take care of the house and garden, ”
      Steven,
      By the look of most gardens, and the by the state of direpair they are in, front lawns in East Vancouver, mostly Asian, oh yeah, not true… they all feel like 86 years old with Alzeiheimer are living in there!
      Or they don’t like gardening!