Committed To Becoming More Age-Friendly
The Hague Netherlands
Ten questions concerning age-friendly cities and communities and the built environment published
In April 2021, a Ten Questions paper entitled “Ten questions concerning age-friendly cities and communities and the built environment” was published in the Elsevier journal Building and Environment.
Over the past decade, a multitude of age-friendly initiatives have been developed with the aim of making physical and social environments more favourable for older people’s well-being, health and ability to live in the community. This extensive article explores ten key questions associated with the age-friendly cities and communities’ movement, with a particular focus on the built environment and relevant technologies. It provides an overview of the history of the age-friendly cities’ movement and the underlying models, the aspects of the built environment that are relevant for age-friendly cities, the ways age-friendliness can be evaluated, and the interactions between age-friendly cities initiatives and other strategic agendas such as smart cities. The paper concludes by discussing future perspectives and possible directions for further development of the age-friendly movement.
The paper was authored by Prof Joost van Hoof (The Hague University of Applied Sciences and Wrocław University of Environmental and Life Sciences), Dr Hannah R. Marston (The Open University, Milton Keynes), Associate Professor Jan Kazak (Wrocław University of Environmental and Life Sciences) and Dr Tine Buffel (The University of Manchester).
The Hague, Wrocław and Manchester are among over 1100 cities which joined the Global Network for Age Friendly Cities and Communities of the World Health Organization. These cities follow a 5-year cycle of planning, implementation and evaluation. In conclusion, the Ten Questions paper provides ten steps to achieve an age-friendly cognizant environment, which can help cities in planning for and evaluating the quality of the built environment and technology.
This article is published as an open access paper, which means that it can be read and downloaded free of charge. Direct access to the article: Ten questions concerning age-friendly cities and communities and the built environment – ScienceDirect
Translated Municipal Action Programme Senior-friendly The Hague 2020-2022
Please find below the unofficial translation in English of the municipal Action Programme 2020-2022.
Special Issue about Age-friendly Cities published
In February 2021, a Feature Paper Special Issue entitled “Age-Friendly Cities & Communities: State of the Art and Future Perspectives” was published in the International Journal of Environmental Research and Public Health. This special issue features 30 contemporary contributions which relate to the Age-Friendly Cities and Communities initiative launched by the World Health Organization in 2007. Two of these contributions deal with research conducted in The Hague, namely the development of the Age-friendly Cities and Communities Questionnaire, and making documentaries with older people about their age-friendly living environment.
Picture @GetOud, The Hague
The key focus of this Special Issue is to provide a critical assessment and overview of the state of the art within the Age-friendly Cities arena. Published papers include an editorial, seven papers focusing on age-friendly neighbourhoods, cities, communities, and societies, three papers explore innovative approaches to housing, two papers concentrate on age-friendly transportation, four papers focus on innovative practices in the domain of cure and/or care for older citizens, four papers relate to respect and social inclusion, and nine papers focus on and consider the use and implementation of technology in an age-friendly city or community.
As a take home message, the guest editors, Prof Joost van Hoof (The Hague University of Applied Sciences and Wrocław University of Environmental and Life Sciences) and Dr Hannah R. Marston (The Open University, Milton Keynes) would like to emphasize the need for greater collaboration between disciplines in order to create a truly multisectoral actions for making our cities age-friendly for all generations. According to Prof Van Hoof, who also serves as the chairperson of the Knowledge Platform Age-friendly The Hague, “the contents of this Special Issue is one of the ways to expand and disseminate knowledge and to facilitate the actual age-friendly agenda and narrative further. Therefore, the contents of the total special issue may help other cities and communities on their way.”
All papers are published as open access papers, which means that they can be read and downloaded free of charge. Direct access to the special issue: https://www.mdpi.com/journal/ijerph/special_issues/Age_Friendly_Cities
Monitoring age-friendliness of The Hague 2020
Overall, the older citizens of The Hague value the age-friendliness of their city as well sufficient. They give high scores to their own homes; outdoor spaces and buildings on the contrary score significantly lower. People in the situation of having a lower income, health and mobility issues are less satisfied. These are the main outcomes of the monitoring assessment of the age-friendliness of The Hague, valued by The Hague older adults in the age-group of 65 years and above.
On January 29th, 2021, professor Urban Ageing of The Hague University of Applied Sciences, Joost van Hoof, handed over the report on the monitor of Age-friendliness of the City The Hague to the City Executive Kavita Parbhudayal. The report is the result of the joint activity of the Knowledge Platform Senior-friendly The Hague, that involves among others scientific and educational institutions, welfare organisations, businesses, older people’s council and public health administration.
From left to right: professor Joost van Hoof, chair Johan Overdevest, city executive Kavita Parbhudayal, chair older people’s council The Hague Gert van Capelleveen
Further reading (in Dutch only) Platform Seniorvriendelijke Stad Den Haag – De Haagse Hogeschool
The Age-Friendly Cities and Communities Questionnaire launched in The Hague
In early 2020, the municipality of The Hague awarded the consortium consisting of The Hague University of Applied Sciences, Hulsebosch Advies and AFEdemy to develop a questionnaire and run a representative survey on the perceived age-friendliness of the city among its older citizens. Part of this survey was the development of a validated questionnaire, which allows for an assessment of the perceived age-friendliness. In order to do justice to the superdiversity of the population of The Hague, the municipality also wanted a representative number of older Western and non-Western immigrants to be included in the sample.
The consortium started to review scientific and public sources to check whether a default questionnaire was already available. The search delivered several examples of questionnaires that either lacked transparency on the development and validation or did not measure the construct of age-friendliness as a whole. This made the consortium decide to develop and validate a validated questionnaire, coined the Age-Friendly Cities and Communities Questionnaire.
In order to develop the questionnaire, the consortium made use of the Consensus-based Standards for selection of health Measurement Instruments (COSMIN). The development consisted of the following four phases: Development, Initial validation, Psychometric validation and Instrument translation.
The theoretical basis of the questionnaire was the Global Age-friendly Cities Guide, published by the World Health Organization in 2007, and its accompanying Checklist. This guide published a model of age-friendly cities and communities, consisting of eight domains: outdoor spaces and buildings; transportation; housing; social participation; respect and social inclusion; civic participation and employment; communication and information; and community support and health services. The features of the Checklist formed the foundation of the items for the questionnaire. Additionally, questions on technology and the financial situation were added based on the literature review.
After several rounds of validation by different panels of regional, national and international experts and checks on the readability, a questionnaire of 64 items remained that was launched as online survey or questions for a telephone enquiry. On top of the 64 questions on age-friendliness, an extra set of demographic and policy requested questions were added. In the months June-September 2020, a number of 384 respondents of 60 years and over filled out the questionnaire. Some characteristics: 51% female, 74.4 is the average age, 59.9% home owners, 48.4% living with chronic conditions and 14.6% using a wheeled walker or wheelchair.
Based on the responses, the consortium performed a Confirmatory Factor Analysis as part of Step 7 of the COSMIN protocol (see figure below) to check the relevance and internal consistency of the questions. This finally led to 23 remaining questions that are valid to measure the entire construct of an age-friendly city. The 23 questions have been translated from Dutch into English.
The Age-Friendly Cities and Communities Questionnaire measures the views of older adults on the eight domains already defined by the WHO and on a relevant ninth domain, namely their own financial situation. The questionnaire is open for use on every geographical level and by every public authority, civil society organisation or any other who is interested. It might be necessary to culturally validate the questionnaire.
For further reading and contacts: https://www.mdpi.com/1660-4601/17/18/6867/pdf
Reference: Dikken, J. van den Hoven, R.F.M., van Staalduinen, W.H., Hulsebosch-Janssen, L.M.T., van Hoof, J. (2020) How older people experience the age-friendliness of their city: Development of the Age-Friendly Cities and Communities Questionnaire. International Journal of Environmental Research and Public Health 2020;17(18):6867 doi: 10.3390/ijerph17186867
The Age-Friendly Cities and Communities Questionnaire (AFCCQ) in English and Dutch
All Questions of the AFCCQ Can Be Answered on a 5-Point Likert-Scale Ranging from: −2 (Totally Disagree); −1 (Disagree); 0 (Neutral); 1 (Agree); 2 (Totally Agree). Q7 and Q8 should be recorded in the opposite direction.
Q1 My house is accessible to me.
Q2 My house is accessible to the people who come to visit me.
Q3 There are enough opportunities to meet people in my neighbourhood.
Q4 Activities and events are organised in places that are accessible to me.
Q5 The information about activities and events is enough for me and also suitable for me.
Q6 I find the range of events and activities sufficiently varied.
Respect and Social inclusion
Q7 * I sometimes get annoying or negative remarks because of my age.
Q8 * I sometimes face discrimination because of my age.
Civic participation and employment
Q9 I have enough opportunities to interact with younger generations.
Q10 I feel like a valued member of society.
Communication and information
Q11 Printed and digital information from the municipality and other social institutions is easy to read in terms of font and size.
Q12 Printed and digital information from the municipality and other social institutions is written in understandable language.
Community support and health services
Q13 The supply of care and welfare in my city is enough for me.
Q14 When I am ill, I receive the care and help I need.
Q15 If necessary, I can easily reach care and welfare services by telephone and in person.
Q16 I have enough information about care and welfare services in my neighbourhood.
Q17 Care and welfare workers in my neighbourhood are sufficiently respectful.
Outdoor spaces and buildings
Q18 My neighbourhood is sufficiently accessible for a wheeled walker or wheelchair.
Q19 The shops in my neighbourhood are sufficiently accessible with a wheeled walker or wheelchair.
Q20 I can easily get on the bus or tram in my neighbourhood.
Q21 The bus and tram stops in my neighbourhood are easy to reach and use.
Q22 My income is sufficient to cover my basic needs without any problems.
Q23 I live well on my income
Pdf with questionnaire in English: W2009 0640 SWE vragenlijst ENG Age-Friendly Cities_HR
Pdf with questionnaire in Dutch: W2009 0640 SWE vragenlijst NL Age-Friendly Cities_HR
2020: Monitor age-friendly city The Hague
In March, the municipality of The Hague assigned the consortium of The Hague University of Applied Sciences (professor Joost van Hoof, Urban Ageing), Hulsebosch Advies (Loes Hulsebosch) and AFEdemy (Willeke van Staalduinen) to develop and perform a Monitor Age-friendly City The Hague in 2020.
The monitor will make use of qualitative and quantitative research methods, to investigate the current state of The Hague as age-friendly city in general and will include more specific themes. A cooperation platform will be build of partners who advocate the interests of older adults or who will contribute to reflect on the monitor.
The monitor will result into an advisory report to the municipality. Relevant global, national and local trends and appropriate other research results will be part of the advisory report.
The main tasks of the consortium will be to define the specific themes of age-friendly city The Hague in close cooperation with older adults and civil servants. The consortium will develop a methodological framework of indicators for research and will provide the additional questionnaire. Focus group meetings will be held and about 500 older adults from The Hague will be interviewed taking into account the diversity of the older population in The Hague.
The initial planning is to deliver the report on November 30th of 2020. With regard to the current outbreak of CoVID-19 it is considered how to deal with these circumstances.
(picture is from samenkracht.nu)
2020: Older adults in The Hague choose the location of new benches
The Hague recently installed sixteen new benches across the city. They have been placed at those locations according to the wishes of older adults and people with disabilities. 38 existing benches got arm rests. The installation of benches is to support less mobile older adults who in this way can continue their daily walks if they have benches to rest upon.
The installed benches are based on the design of Mr. Van Alff, who worked until 1960 as head of urban parks in The Hague. The benches are made of wood. The seating surface is higher so that people more easily can sit down and stand up again.
Read the article (in Dutch only): city journal The Hague
2019 and 2020: Training older adults to advocate age-friendly environments
In 2019, the Municipality of The Hague was actively involved in the Erasmus+ AFE Activists project (www.afe-activists.eu). This Erasmus+ project aims to train older adults to advocate age-friendly environments in their own community. To achieve this goal, the project developed an advocacy training curriculum and organized a study visit to age-friendly city The Hague (October 7th-11th 2019).
The municipality hosted the study visit of 11 older adults from Lithuania, Germany, Austria and Italy to The Hague. The group visited several locations in The Hague, such as the iZi demonstration house (see pictures), community centres, library and SportCampus. Also they followed lectures and presentations from the municipality and The Hague University of Applied Sciences, Urban Ageing. In March 2020, a new delegation of older adults (including people from The Hague Older People’s Council) will visit Age-friendly City Udine in Italy.
Besides the study tour, the municipality of The Hague was the decor of the training of a group of 10 older people in local neighbourhood Transvaal in the frame of the AFE-Activists project. The training was provided by project partner AFEdemy BV. The learners actively worked on the concept of age-friendly environments, methods of advocacy, identifying local neighbourhood needs and creating an action plan. The plan is to broaden the group of participants and to install a neighbourhood older adults’ council. The council can be consulted by the municipality and other parties to better formulate local policies.
2019: Magazine OldGold (BladGoud) of The Hague 4 years age-friendly city has been released and translated into English
The Hague has been a member of the age-friendly city network for four years now and this seemed a good moment to make up the balance to provide a starting point for the new period. We do this with: OLD GOLD. The name says so much: a rich colour, something precious and attractive – and OLD. It is a magazine which is all about older people. Specifically the older people who live in The Hague!
You can read about what The Hague has done for seniors in the previous years. You find articles about other age-friendly cities around the world such as New York and Bangalore. You can find reports from 30 group discussions that around 500 people took part in during high teas; a look back over four years of Age-Friendly City The Hague; portraits of eight active and inspiring people living in various parts of The Hague who add to their own enjoyment of life every day as well as that of others, and much more. We hope you enjoy reading OldGold!
You can download the magazine here
2018: New City Executive: Dignified ageing in senior-friendly The Hague
After the local elections in March 2018, a new board of the City Council was elected and appointed. New city executive for Age-friendly The Hague has become Kavita Parbhudayal. She also announced to focus on digital innovation to ensure and achieve health and liveability for The Hague’s residents (article in Dutch).
2017: The Hague Age-Friendly City Conference, 2-4 October
Alderman Karsten Klein hosted the Age-Friendly City Conference on innovation, health and active ageing. He welcomed the many international guests in his foreword and speech: “As city executive we work closely with our residents, volunteers and businesses to create the ideal environment to promote the vitality, independence and social engagement of the people of The Hague. We drive this process in part with the use of technology and other innovations.” In The Hague Conference Guide is presented the city’s residents view on what The Hague means to them as Age-friendly city.
Photos: Valerie Kuypers
Photos: D’Article Enterprise
Joint Action six cities
During the conference representatives of the cities of New York (USA), Bangalore (India), Suzhou (China), Manchester (UK) and Frankfurt (Germany) cooperated with The Hague on 6 major themes regarding Age-friendly environments:
- Older people’s participation
- Ageing population
- Support and independent living with ICT
Photo Valerie Kuypers
The cities jointly identified the opportunities they share for above mentioned themes to the future of Age-friendly cities. They reached specific agreements to advance these opportunities together as trailblazers in the context of the existing WHO and Covenant on demographic change networks by working together as municipalities, businesses, residents and other professionals in the field. Finally they agreed to share these opportunities and to combine expertise originating from widely differing backgrounds with other cities in these same networks.
2016-2017: The Hague Age-friendly activities
Ageing vitally in the Age-friendly city. Every citizen of The Hague should have the opportunity to live as independently as possible and be able to participate in the community. Most people can live independently and do so without assistance, but due to old age, illness or a handicap at times it can be difficult. In 2016 the municipality of The Hague presented the results of the research on the eight domains of Age-friendly city life of the WHO.
To make the findings of the research “what do senior citizens find important in order to stay vital“ clear, the results have been turned into an infographic. Based upon the findings, additional research was done resulting in a district’s score being better or worse than others and the action program “The Hague Age-friendly City” was initiated.
To read more about what’s important to senior citizens of The Hague, please follow the link. Infographic The Hague Age-friendly City.
The Action Plan of municipal policy is based on three priorities:
- Improve vitality
- Reduce loneliness
- Encourage and facilitate continuous living in your own environment (instead of care facilities)
Essential in implementing these priorities is that The Hague doesn’t have a top-down approach, but tries to motivate the (senior) citizens and organisations of The Hague to have a particular role in this. As a local government The Hague tries to create an environment that encourages our citizens to take initiative and responsibility. Through partnerships with corporations, small and medium enterprises, and organisations, the municipality of The Hague creates alliances on specific themes. We facilitate these alliances through financial means from the municipality and our partners. Bottom line in every project or activity concerning the elderly is that it has to meet the needs and preferences of the senior citizens in The Hague.
Concrete actions are:
Vitality Award: The Vitality award is an award of appreciation for initiatives of citizens of The Hague to work towards a senior-friendly city. The Vitality award stimulates citizens of The Hague (both local residents and organizations) to be actively involved with the city. With your initiatives you inspire each other to remain vital and to combat loneliness. The initiatives, provided they are workable, may vary from small to large and must be applicable to a variety of themes such as: social restaurants, coaching in using new media or safe online payments, dementia-friendly shops but also ideas about the use of internet, a senior-friendly walking area or a walking buddy in the neighbourhood.
Prior to the award ceremony, gatherings in each city district are organized during which the submitted initiatives are presented and discussed. Also ideas that need some help from other parties, can be submitted. The Vitality ward brings together various parties from which collaborations may be formed.
With the help of good ideas and great initiatives the municipality can improve the liveability of the city even more. The Vitality award is presented in each city district to organizations or local inhabitants who develop initiatives to be active and involved with the city.
Veilig Vitaal (Safely vital) Photos: D’Article Enterprise
Month of Vitality: The Month of Vitality is a theme specifically aimed at senior citizens to participate and stay active. All sorts of activities are organized by various companies and organizations throughout the city. The activities they organize are described on the “Month of Vitality” website [www.maandvandevitaliteit.nl] and in a special festival newspaper insert. During the Month of Vitality, partners of the city and local organizations are called upon to organize activities for senior citizens. These activities can include sports, cultural activities or activities that stimulate senior citizens to be an active part of their communities such as classes that teach them how to use smart devices such as tablets and smartphones.
Common in The Hague: The platform ‘Common in The Hague’ [Doodgewoon in Den Haag] considers it essential that citizens of The Hague make conscious decisions with regards to the last phase of their lives. The objective of ‘Common’ is to expand the possibilities of dying a dignified death by the citizens of The Hague. The platform stimulates ‘becoming the director of your last stage of life. In collaboration with organizations in the field of healthcare and end-of-life care services, the platform wants to increase the awareness of this theme among the citizens of The Hague. And subsequently break the taboo regarding dying and death. The Platform ‘Common in The Hague’ is a connecting link between all institutions that offer services to citizens of The Hague concerning death.
Furthermore, the platform wants to reinforce the network of such institutions and optimize the collaboration.
Among the actions performed by the platform are the recording of life stories of people during their last stage of life, an activity which is performed by younger citizens. This happens during gatherings where people eat and talk to each other, such as several locations of Resto VanHarte. These life stories form a source of inspiration for events that are organized by the Platform ‘Common in The Hague.’
Golden plates: The Golden Plates [Gouden Bordjes], is an appreciation for excellent provision of meals in the elderly care. Among others, in accordance with the principle for the elderly by the elderly but also in cooperation with professionals of various professional backgrounds.
The Golden Plates are meant to continuously inspire institutions to improve the offer of meals. The Golden Plates started as an initiative in 2011 and celebrated its fifth anniversary in 2016 in cooperation with those that are active in the health care industry of The Hague and Deputy Mayor and Alderman Karsten Klein (Economic Affairs and Healthcare) and other professionals.
Photo: D’Article Enterprise
In 2012 the Golden Plates was granted the acknowledgment “Good Practice & Idea” by Genero. Genero (cooperation partner of Erasmus Medical Centre, Rotterdam-Rijnmond region) regards the Golden Plates as a support of the improvement of health care and welfare for senior citizens. The set-up of the Golden Plates aims at activities with regards to meals that in time will lead to an integral supply of care and support. Which then aims at an improvement of self-reliance. This also helps in combatting loneliness among senior citizens because it increases the number of opportunities for getting in touch with other senior citizens, in an attractive environment with good service.
Community against loneliness: As part of the ‘Community against Loneliness’ [Community tegen Eenzaamheid] various parties in The Hague look for solutions to combat loneliness. This results in surprising collaborations between organizations, companies and citizens. In December 2015, the green light was given to the Community against loneliness, during a Christmas lunch with 800 senior citizens on the Pier of Scheveningen.
The Community against Loneliness started as a collaboration of entrepreneurs, professionals and volunteers, who were all looking for chances and opportunities to combat loneliness. In recent past coalitions were created between ADO Den Haag (local soccer club), Xtra(welfare), Pathé cinemas, Buddy Network, Resto VanHarte, and migrant senior citizens. As this is only the beginning. The Community against Loneliness of The Hague is more to than meets the eye, and unexpectedly brings together people and organizations while adding brilliance to life.
Diverse The Hague: The Hague is a diverse city where citizens feel recognized and play a role which suits them. This ideal connects organizations that are active in advocacy, community service, sports, welfare, healthcare, education and government.
Staff members, volunteers and persons in need of care ask themselves: what does this mean for our organizations, what does it mean to me, what is needed to do that, who is of importance to do this?
Since 2009 these organizations have gone around with each other within Diverse The Hague [Divers Den Haag]. A lot has been accomplished already: organizations increasingly draw clients with diverse backgrounds, and services are more tailored to a diversity of people in the city. An increasing number of staff with a diversity of backgrounds find positions within these organizations. Knowledge and know-how is growing and within organizations a stronger and broader awareness for the need of connecting and staying connected at all levels in the ever changing city, is growing.
Hence, Diverse The Hague works on broadening both the number of organizations and their level of knowledge on the subject matter. Thus promoting the dialogue between organizations and people, both on the inside and out.
Photo Divers Den Haag
Cultural Canvas: Cultural participation of senior citizens forms an integral part of our policy as a senior-friendly city. Cultural participation does not only contribute to participating independently and actively in society. It also provides more possibilities to deliver tailor-made work and make connections between welfare organizations, healthcare providers on the one hand and cultural institutions on the other hand. To implement the above mentioned, we use our self developed Cultural Canvas. The Cultural Canvas is a triptych which is used by our partners to further promote cultural participation.
The triptych consists of the following: • What do senior citizens of The Hague consider important with regards to arts and culture; • A sufficient amount of inspiring examples; • What can healthcare, welfare and cultural institutions do to inspire senior citizens to do more with arts and culture.
Dementia Community Centres: The policy in The Hague also pays more attention to the support of vulnerable senior citizens who have problems with structure in their daily life. This at times combined with the symptoms of dementia requires that their informal caregivers provide them with activating daytime activities and social networking opportunities. In recent years dementia meeting places have been setup by healthcare and welfare providers as initiated by the municipality. In addition the city has setup day care facilities for senior citizens. In the next few years some of these facilities, as listed below, will be further developed. This is necessary because of the increasing number of independently living senior citizens with issues ranging from lack of a daily structure through dementia.
Facilities that require further development are:
• A close-knit network of day care centers in their own neighborhood where senior citizens and their informal caregivers can ask for support, coaching, and use of day care facilities in their nearby surroundings
• Centers where informal caregivers can count on contact with fellow sufferers and respite care.
2015: The Hague became a member of GNAFCC as first city of the Netherlands
Recent policy has focused on the domains participation, support and care. The participation element has been particularly successful in ensuring that more elderly people continue to take part in society or helping the elderly enjoy meaningful activities and engage them. The support element has helped those who require support among our ageing population to receive the right care and information on time. Through the care element, we have promoted systematic attention for the problems of intramural clients in healthcare institutions, focused more on dementia sufferers and devoted attention to the process of dying and the meaning of life. The elderly must be able to play an active role in society for as long as possible. This is primarily their responsibility, but where necessary the municipality offers support, help and care.
Because the elderly wish to live independently in their own living environment for as long as possible and maintain control over their lives for as long as possible, we wish to help the elderly remain vigorous for as long as possible. By focusing our policy on promoting a vigorous ageing population, it is not only important to know what we mean by vigorous, but also what the elderly need in order to be vigorous. Vigour will partly depend on the individual person. However, the physical environment of the elderly and their place in society can also play a role.
The Hague is the first city in the Netherlands to join the WHO Global Network of Age-friendly Cities and Communities. An age-friendly city adapts its structures and amenities to make them accessible to an ageing population with different needs and possibilities.The elderly know best what being vigorous means for them and what they need to remain vigorous. They formulate the conditions for remaining vigorous themselves. We involve the elderly in the municipal senior committee, we organise a senior citizen panel as well as group discussions. The WHO framework for Age-friendly Cities helps the elderly formulate the conditions for remaining vigorous. Based on the information provided by our elderly citizens, we focus on developing a structural programme: ‘The Hague, city for vigorous senior citizens’.