Aging and Disability

By Olga Krassioukova-Enns, Laura Rempel, Colleen Watters and Christine Ogaranko
Canadian Centre On Disability Studies

Recent studies show that Canada’s population is aging. It is estimated that in 2001, there were 3.92 million Canadians seniors (age 65 and over). It is anticipated that as the baby boomer generation (people born between 1946 and 1965) ages, the number of seniors is expected to reach 6.7 million in 2021 and 9.2 million in 2041 (nearly one in four Canadians). Seniors are the fastest-growing population group in Canada overall, with the most notable increase occurring among the oldest Canadians. In 2001, more than 430,000 Canadians were age 85 and over, and this age group is expected to increase to 1.6 million individuals by 2041, or 4% of the overall population (Health Canada, 2002).

There is evidence that as population ages, the rate of increases, demonstrating a direct relation- ship between the two. The Participation and Activity Limitation Survey (PALS) 2006 conducted by Statistics Canada was designed to collect information on adults and children who have a disability. The survey defines disability as self-reported limitations in everyday activities due to a physical or psychological condition or to a health condition. The data revealed that among children ages 0 to 14,  3.7%, reported a disability, with the rate increasing to 11.5% among individuals aged 15 to 64, and further increasing to 43.4% among persons aged 65 and over. Furthermore, more than half (56.3%) of persons aged 75 and over reported having an activity limitation (Statistics Canada, 2007). However, an aging population does not account entirely for the increasing rates of disability. Other factors such as changes in the perceptions of Canadians towards their limitations and an increased willingness to report them all contribute to the increased disability rates.

Despite the evidence showing the increasing numbers of seniors experiencing disability, senior and disability sectors have historically been addressed separately in both the health and social service and policy realms. As a result, barriers have been created to receiving supports and services needed to attain quality of life. Combined approaches to service delivery and policy development are necessary to ensure that seniors with disabilities can fully participate in the community.

A more unified approach to the design of communities is also needed in Canada to make them more “livable” for all generations and cultures. A universally designed built environment addresses a diversity of needs and abilities and ensures community growth, sustainability and participation. There are many key building blocks to create a livable community, such as transportation; housing; infrastructure; the design of streetscapes, green space, recreation and cultural areas; and inclusive practices and policies. In many cases, we have done well with making changes to our public spaces; however, some areas are sadly lacking. One of the key areas is housing. Most people desire to remain in their own homes and communities as they age, but current housing stock and community design often prohibit this. Stairs, bathrooms that are difficult to use, lack of sidewalks and community design features that connect to stores, restaurants and other amenities make full participation very difficult not only for those with disabilities but for all ages and abilities. Not only do we need to address new housing and new community design, we need to address existing housing and neighbourhoods and how to deal with modifications to these. Transportation is another major issue as many Canadian communities lack adequate services to meet the growing demand of seniors with disabilities. Support is another key issue.

There are currently several projects initiated by government and non-government organizations examining issues related to aging or disabilities, but no initiatives bring these sectors together. The intent of the project “From research and knowledge to better practice: Livable communities that are inclusive for seniors with disabilities” (2008-09), led by the Canadian Centre on Disability Studies (CCDS) and funded by Human Resources and Social Development Canada (HRSDC), was to develop an evaluation and planning model to assist communities to measure key elements in the community to determine the degree to which the community is livable and inclusive of seniors with disabilities.

The model’s development stemmed from an extensive environmental scan of community-based evaluation initiatives in the disability and seniors sectors; a comprehensive review of the literature; an analysis of the common principles, elements
and indicators comprising existing tools in the field; and previous research conducted by CCDS on people with disabilities who are aging (2007-2008) and caregivers with disabilities (2008).

The model for Livable and Inclusive communities consists of concepts that are central to the model as well as processes and tools that are used in the implementation of the model in communities. The concepts include: 1) elements that make up a livable and inclusive community; 2) principles that act as a guide when examining the elements; and 3) processes including one to measure livable and inclusive communities and the other to plan livable and inclusive communities. There are three aspects associated with the implementation of the model including:

1) the community evaluation tool that outlines the elements, principles and associated indicators to be measured, the space for data collection results, and identification of the implications of the results; 2) a process to measure the indicators and collect the data; and 3) a facilitated planning process to transfer the evaluation findings into actionable steps. The model emphasizes the inter-relationships not only between the principles and the elements, but also between the elements themselves. The general premise of the model is that the principles and elements described can be adapted and applied to different priority populations because the central principles and elements of livable and inclusive communities applies to all citizens of a community. In this case, the principles, elements and indicators have been developed with a focus on the interests of seniors with disabilities, but are applicable to the needs and interests of all community members. The term “livable and inclusive community” is premised on the for all of its citizens regardless of their abilities, and values:

• Every community, whether rural or urban, should offer the same opportunities

• A community’s social and physical environments have a direct correlation to its citizens’ overall health, well-being and quality of life, and should be addressed in tandem to meet citizens’ needs.

Livable communities are assessed by the level of quality of life they offer to their citizens, including a place that fostersgood schools, housing, public transit and jobs; takes a sustainable approach to environmental, cultural and human resources; encourages a broad range of physical, cultural, social and economic opportunities; and takes a context-sensitive approach to planning and development impacts (Montgomery County Planning Department, 2003).

An “inclusive community” is one that is open to individuals of all identities, and one where they can take part in the community as they feel safe and empowered to do so; their voices are heard; and their contributions are acknowledged and valued (McMaster University, N.D.). Participatory planning and decision-making are at the heart of an inclusive community(Maxwell, G., 2007).

The principles are a collection of morally based standards that act as a guide to the measurement of the elements. They are purposely broadly stated so that they can be easily incorporated into the measurement process. The principles are:
Participation, Community Connections, Leadership, Sustainability, Universal Design, and Affordability.

Based on a review of the literature, it was determined that livable and inclusive communities consist of ten common elements. The six principles listed above act as a guide when examining each element and determining the degree to which it reflects livable and inclusive communities. Just as the principles are connected with the elements, each element is interconnected with another. In other words, if change occurs within one element, than another element is impacted. For example, if accessible homes (element) for seniors with disabilities are built on the outskirts of a community, then reliable transportation(element) needs to be available in order to use necessary support services (element). The elements are as follows: Housing, Transportation, Support Services, Health and Well-being, Education/ Training, Spiritual/Cultural, Leisure/Recreation, Outdoor Environment, Employment/ Jobs, and Volunteerism.

The CCDS Project Team tested the developed model for Livable and Inclusive Communities, evaluation and planning
tools and processes in three Canadian provinces within two communities, one rural and one urban, in each province.
The pilot sites in which the model was implemented included: Fort St. John, B.C.; 100 Mile House, B.C.; Rossburn, Man.; Selkirk, Man.; Waterloo, Ont.; and Woolwich, Ont.

The process to implement the evaluation tool was participatory and multisectoral in nature. The planning process was
based on translating the knowledge gained through the evaluation exercise, such as noting the absence of policies, and transforming this information into actions. The Regional Team leaders and some Working Group Members attended a
Think Tank in Winnipeg (March 26-28, 2009) to assess the effectiveness of the model, evaluation and planning tools, and processes. They also developed a “Blue Print for Action” that outlined areas in need of action, at the provincial and
national levels. By engaging in this project, communities and seniors with disabilities benefited in numerous ways, including:
• Fostering participation and leadership
at the grassroots, program and policy
levels
• Developing a plan to meet the needs
of present and future residents of the
community
• Strengthening existing partnerships and
establishing new partnerships among
planners, policy-makers and citizens in
implementing community development
projects
• Increasing the knowledge of community
stakeholders in community evaluation
and planning processes that can be
applied to various target areas

There is evidence that the model for Livable and Inclusive Communities can assist urban and rural centres to evaluate,
plan and take action towards ensuring our communities can offer an improved quality of life to seniors with disabilities
in Canada.


For more information and resources, contact
the Canadian Centre on Disability
Studies: www.disabilitystudies.ca, 56 The
Promenade,Winnipeg, MB, R3B 3H9, tel:
204 287-8411, TTY: 204 475-6223, email:
ccds@disabilitystudies.ca.