The number of people aged 65 and older is expected to increase from 790,000 to 1.4 million in 2048, so around 24% of New Zealanders. Let’s face it; most of us will grow old in cities.
It was once assumed that seniors who could afford to would move to the suburbs, live in a gated community, or spend their days relaxing at a beachfront summerhouse. For many of us today, this is too expensive. Staying in cities might also mean staying close to family and friends, and where we grew up or raised children.
 
Most of us don’t want to move around in old age. Those who downsize are more likely to move to a smaller home within that same community. Some cannot move because of a lack of options, which plays it part in the housing crisis.

Since the turn of the century, most OECD countries have committed to reducing the number of people living in traditional institutional care in favour of ‘ageing in place’. New Zealand policies from the 2000s reflect this, where integrated health and disability support and home-based services championed senior independence and freedom.

Perhaps we’re stuck in the 2000s, though. Urban centres live the widening gap between the super-rich and poor. Retirees with financial security can access personalised care and upgraded housing, but those without it face challenges like long wait times for publicly funded support and below standard housing.

Generally, our urban spaces are not designed to meet the needs of older people, a growing issue as our population ages. Our cities often don’t enable older people to participate or be included in public life.

Ageing with dignity in cities (and beyond) takes more than just policy; it demands infrastructure. The entire community benefits when we design public places, land use, and spatial planning that are comfortable for older people and intentionally include them.

Why Inclusive Urban Spaces Matter

In 2022, the Office for Seniors released an age-friendly urban places guide outlining the city design practices that benefit older people. Director of the Office for Seniors Diane Turner says that making a community age-friendly doesn’t just help older people; it helps everyone.
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“It means that as people age, they can continue to live the lives they want  and stay connected to the people and things that matter to them,” she said.

The guide comes as part of the United Nation’s Decade of Healthy Ageing. Launched at the end of 2020, the collaborative plan is led by the World Health Organisation (WHO) and aims to accelerate global efforts to address the needs of our ageing populations. The WHO says that population ageing and urbanisation are two of the biggest social transformations of the 21st century.
Hamilton, New Plymouth, and Auckland are some of the New Zealand cities that have joined the WHO’s global network for age-friendly cities.
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Yet cities and communities rarely tackle these two changes at once by considering the older population in design processes, whether it’s accessible transport, public seating, or barrier-free buildings, to name just a few age-friendly features. How great is a city to live in if people cannot comfortably grow old there?

The ’15-minute city’ is one where someone can fulfil most of their daily life in a 15-minute radius of where they live. From Portland to Melbourne (with its 20-minutes neighbourhoods), these centres have strong local economies, more equitable and inclusive community spaces, lower transport emissions, better air quality, better health and wellbeing outcomes, the list goes on.
It’s a list that mirrors the changes needed to support urban seniors. They feature accessible transport, barrier-free buildings, public seating, and facilities to ensure safety and convenience. They encourage active living, social connection and culture. To create truly age-friendly cities is to address the systemic social issues of urbanisation.

The Case of Toyama City

Japan is the world’s leading ageing society. This year nearly one third of its population will be aged over 65. Since the 2000s, Toyama City has made an effort to be age-friendly, its Compact City Strategy focusing on age-friendly developed public transport, senior activities, and subsidised housing within a 500-metre radius of train stations to encourage city density.
Innovation is a key value for Toyama City. Known as the ‘City of Medicine’ since the Edo Period (1603-1868) its long been the centre for traditional medicine in Japan. Its age-friendly urban strategy sees this longstanding history for improving its citizens’ wellbeing enter a modern era.
 
Toyama is a global exemplar for senior urban spaces. City mayor Masashi Mori says the compact city plan approach is “all carrots, no sticks” where residents are encouraged to move around and get involved in their community, but aren’t punished for their inertia. Over 65s have travel passes that cut public transport costs, and many city museums and attractions offer free entry to grandparents with their grandchildren, as two examples.
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Mori looks at many metrics, and is encouraged by statistics like the proportion of over 65s in the city, which has steadily grown and remains above the national average. The proportion of Toyama requiring primary nursing care has also stayed flat at about 18.5%, a key figure for Mori that proves critics wrong.
 
Author: Ben O’Connell
Ref: Plus Living, 29 January 2025
https://plusliving.co.nz/urban-spaces-for-all/

Exercise
 
Movement helps a chest infection by loosening sticky sputum helping you to cough it up.
 
Move or exercise:

• on your feet walking, climbing, exercising
• from a chair swinging arms and legs up & down
• doing jobs about the house
• throw balloons/balls, stretch, swing or punch arms

​Huff Huff Cough
                     
Try a deep huff and feel the tummy working, huff again then follow this by a deep cough (you will still feel the tummy working).
This deep coughing will help clear the lungs.            

Warm moist air

Try a steamy shower. 
Close windows and door to make room steamy before you get in.  
The warm vapour and the vibrations of the water jets will loosen sputum. 
A warm spa or bath has a similar effect.
 
NB  Be careful when moving on wet surfaces
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Therapy Professionals Ltd
            Phone                         (03) 3775280,
            Email:                          [email protected]
            Website:                      http://www.therapyprofessionals.co.nz
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​Words can be helpful and uplifting, but also hurtful and frustrating depending on the situation. Here, we look at some words and questions to try to avoid when talking to a person with dementia.

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For a person living with dementia, being able to use language and communicate clearly can become more difficult over time. While the person living with the condition may have difficulties finding the right word, the words that other people use are important too. 
 
The type of difficulties a person will face as dementia progresses will be different for each individual, and the type and stage of the person's dementia will also be a factor. 
But good communication is key for all our relationships, and can make a difference to our quality of life. Rather than correcting or challenging someone with dementia, considering using these techniques to support your conversations:

1. Don’t try to jog the person’s memory: 'Remember when...?'

While it can be tempting to try and jog the memory of somebody living with dementia, this kind of question may highlight the fact that the person has memory problems.  It can also sometimes feel like the person is being tested.
This can be a frustrating or painful experience, and there’s also no evidence that prompting the person in this way will help them to recall or hold on to memories. It can be pleasant and comforting to talk about the past, however, it’s usually more helpful to lead the conversation and allow the person to join in. 

Try this instead:

Instead of posing a question, try leading with ‘I remember when…’. That way, the person can search their memory calmly without feeling embarrassed, then join in if they like.
 
2.  You don’t have to correct every mistaken belief: 'Nobody is stealing from you!'

When a person says something which you know is not true, your first impulse may be to correct their belief. This can be distressing for the person, as they are likely to be as convinced in their belief as you are in yours.

As dementia progresses, the person will find it hard to accept logic and so it may not be possible to convince them that their belief is incorrect. This can lead to confusion, bad feeling or arguments.

Try this instead:

Think about whether it is necessary to correct the belief at all. If it is not causing harm or anxiety, then you may not need to. If the belief is causing the person distress, comfort them and remind them they are safe. Try to keep your tone, body language and facial expressions calm and reassuring.

Gently encourage the person to shift their focus onto something they enjoy – even something as simple as a subject they like to talk about, or putting on a favourite television show. These distraction techniques can be very effective
 
3. Consider whether to remind the person of a death: 'Your brother died 10 years ago'

A person living with dementia may forget about a past bereavement or ask for somebody who has died. Reminding them of a loved one's death can be very painful, and they may react as though hearing the news for the first time all over again.

How to respond to these types of difficult questions will vary for different people in different circumstances, however, it's always important to show sensitivity and minimise any distress.

Try this instead:

For some people, encouraging them to talk about the person they are asking about can be comforting.  Distraction techniques can be useful, although try not to avoid the question if they keep asking, as this can cause the person to feel more anxious.

Find out how the person is feeling, sometimes asking about a particular family member or friend is due to the person having an unmet need, such as wanting comfort or reassurance.
 
4. Try not to let your emotions take over: 'I've just told you that'

It can be difficult answering the same question several times, especially when you are trying to keep frustration or upset from your voice.

However, reminding the person that you have just answered their question will not help them retain the information for next time, it is likely to just remind them of their condition. This can be distressing for you both. Bear in mind, that for them, it is likely to feel like the first time they have asked the question.

Try this instead:

Try to remember that the person cannot help repeating themselves. It is important for them to feel heard and understood.
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Answer repeated questions calmly and patiently, with an even tone of voice. If you feel the need, take a break, and remove yourself from the conversation for a while.

​5. Open questions can be hard: 'What did you do this morning?'

Avoid asking too many open-ended questions about the past, as it could be stressful for a person with dementia if they can’t remember the answer. While it might seem polite to ask somebody about their day, it’s better to focus on what’s happening in the present.
 
Try this instead:

Instead of asking them about their day, speak briefly about your day and give them time to ask you questions about it.

They might then offer information about what they have done. Talk to them about the present and use items in the environment such as photos or ornaments to stimulate conversation.
 
6. Some questions may feel like a test: 'Do you recognise me?'

It can be distressing when somebody with dementia doesn’t recognise you, especially if you have a close relationship with them. Remember that it is likely to be upsetting for them to not recognise people around them too.

Asking the person if they know who you are can make them feel guilty or anxious if they don't remember or offended if they do. 

Try this instead:

The way you greet somebody with dementia might change depending on the stage of their condition – judge for yourself but keep it friendly. A warm hello could suffice, or it may help to say your name and your relationship to them each time.
 
7. Too much information can be overwhelming: 'Let’s have a cup of tea now, then after that we can go for nice walk and get lunch and something else to drink in that café you like next to the big church in town.’
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Long, complex sentences can be difficult to grasp for somebody with dementia. It's difficult to process several ideas at once as cognitive abilities slow down, so it's better  give directions or instructions one step at a time.

​Try this instead:

Use short, simple sentences as much as possible. Avoid speaking too much in loud or busy environments, and wait until you have the person’s full attention before you start. During a conversation, give the person enough time to process what you are saying.
 
 
8. Try not to talk down to the person: 'I'll just help you use your little spoon there, love?'

‘Elderspeak’ - which can involve talking in a high-pitched voice, using words like ‘love’ or ‘deary’, and generally speaking to the person like they are a child - should be avoided.  This can be patronising and infantilising for a person with dementia. 

Try this instead:

Always remember the person behind the dementia.  It’s fine if the person needs you to speak slower than usual, but try to keep your tone of voice the same as with anyone else.  

Some people may like being called ‘love’ or ‘dear’, but unless you know the person it is usually best to use their name instead. This helps keep their dignity intact.
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Dementia NZ also has many information sheets to help in understanding dementia challenges as well as practical tips on how to approach these challenges while keeping the dignity of your loved one in tack.
 
 
Ref:     Alzheimer’s Society UK
https://www.alzheimers.org.uk/blog/language-dementia-what-not-to-say