Members of Ireland’s Ageing Well Network share a vision of an Ireland “that is the best country in the world in which to grow old,” and the Age-Friendly County Programme is one of the main vehicles we use to realize that vision. Our network is an independent group of 72 heads of organizations across government departments and agencies, older people’s nongovernmental organizations (NGOs), service providers, business leaders, and academics in the field of aging.
We recognized that many of the key factors that influence our quality of life are determined at the local level. We, therefore, needed to create a program that brought together the key decision-makers and influencers across the public, private, and voluntary sectors at the local level to work in partnership with older people to put in place imaginative changes that would have real impact on the day-to-day lives of all of us as we age in our own communities.
We needed to consult widely with older people and to create forums where they themselves could prioritize the changes needed and play a critical role in leading the implementation of change.
We were aware that we could leverage the excellent work that the World Health Organization had done in collaboration with 33 cities across the world, including New York City and Portland, Oregon, in developing the Age-Friendly Cities Guidelines.
In October 2007, we launched the idea of an Age-Friendly County Programme starting in one small local government area—Louth. It was based on five key principles:
- Given our complex needs as we age, achieving the best outcomes will require significant collaboration in planning and provision across the statutory, voluntary/community, and business sectors. The current economic climate clearly demands that we achieve the greatest efficiencies and effectiveness in provision.
- Older people are critical contributors to our society and a resource, not a burden. This view will require a major change in our conceptualizing of old age and a much deeper understanding of the heterogeneous nature of older people as a group.
- If we plan and design our communities with the needs of older people in mind, we end up with places that are much better for all of us to live in.
- As we plan, we need to address the needs of the current generation of older people, while at the same time taking account of the fact that the Baby Boom Generation and those who come after them will have very different needs and expectations.
- Planning for age-friendly communities needs to happen at two levels—individuals planning for their own future, where and how they want to live, and planning at a systems level. The current generation, especially the “older old,” have a critical role to play in alerting us to what that planning needs to take account of, if we herald their role as the “ambassadors from the future,” the ”canaries in the coal mine.”
We decided early on that a focus on age-friendly cities wouldn’t work in an Irish context, as we don’t have many large cities, and most people outside Dublin live in small cities, towns, or villages. Instead, our local government structure is based on local authorities, most of which operate at a county level. We knew we needed to work within the system if we were to embed the changes and achieve a sustainable, lasting initiative. Therefore, we work with the county manager, the effective chief executive officer of the local authority.
From the start we set out the operating context:
- The initiative would have to be embedded within existing infrastructure—in this case the County Development Boards—but would engage people not previously involved who passionately wanted to make change happen.
- Older people themselves would have to play a key role in leading and shaping the program. As there were no coalitions of older people’s organizations at the local government level, we would need to embark on an extensive community-based consultation leading to the development of an Older People’s Forum for each county, comprising the key organizations and individual leaders.
- There would be no additional resources to support the program in the context of the current economic crisis; therefore the emphasis would be on innovating existing services to achieve better outcomes more efficiently and on enabling NGOs and older people themselves play a key role.
At that stage we weren’t entirely sure what an “age-friendly county” would look like, what structures or resources were needed, or how to make it happen. We decided to adopt a “design and build” approach, trying the concept in one area before beginning the rollout at a national level.
We spent two years developing the program in Louth. We took the time to figure out what worked and what didn’t. From these lessons we developed the framework for a national program, which is currently being rolled out on a phased basis through our four regions. We recruited four regional managers on two-year contracts, whose role is to support the start of the program in a county until it becomes embedded. Their contracts are deliberately time limited to avoid dependence and ensure sustainability into the future. The program now involves a balance between what is common across all areas and what is customized locally to reflect different priorities and ways of working. The common elements of the program are set out below. Our ambition is that every local authority area in Ireland will have its own Age-Friendly County Programme, and recently the minister for local government committed to supporting that ambition.
The program has a common infrastructure, but it is designed to ensure that the strategy and plan for each county reflect the county’s priorities and ambitions. The following are the key elements of the structure:
National Integration Group > While the focus of the program is on what can be achieved at the local level, there is a National Integration Group whose function is to support the program’s rollout nationally and to help address any difficulties encountered. The group comprises assistant secretaries from four government departments as well as a local authority county manager, head of Older People’s Services in our national health service, and the executive director of the Ageing Well Network.
County Alliances > Each county’s program is led by an Alliance, chaired by the county manager, comprising the most senior decision makers from the key public, private, and not-for-profit agencies involved in providing supports and services to older people. They often include individual leaders and influencers in the community, with respected track records for achieving important societal gains. Representatives from the three forums described below—Older People, Service Providers, and Business—sit on the Alliance. Each Alliance usually establishes a smaller Executive Group, which meets more frequently and has responsibility for managing the implementation of the strategy, especially those projects involving a collaboration of agencies.
Older People’s Forums > Each Age-Friendly County initiative establishes a local Older People’s Forum as an early first step. The forum is open to all older people and their organizations. It is developed through a series of public consultations with older people at the town and village levels. The findings from these consultations inform the priorities of the Age-Friendly County Strategy, which is adopted by the Alliance. The forum exists to represent the views of older people within the Alliance. It also takes responsibility for implementing many of the changes identified through the consultation process.
Service Providers Forums > These forums bring together all organizations providing services to older people in the county, across the public, private, and not-for-profit sectors, with a view to exploring how to improve the range and quality of those services and make them more responsive to the expressed needs of older people. Intention is as follows:
- Map those services, identifying who provides what services, where, and to which groups of older people
- Review those services against the known needs of older people, as will be evidenced from a major countywide survey as well as other sources of information on needs and priorities
- Identify ways in which services might be provided in a more cost-effective way, removing any areas of duplication and prioritizing areas of greatest needs
Business Forums > These forums are designed to stimulate awareness among the business community about how best to grow their customer base by deepening their understanding of older people’s needs, preferences, behaviors, and attitudes. They comprise business leaders from the area who have an interest in responding to those needs and see the opportunities for businesses to benefit from the Age-Friendly County initiative.
County Strategy > The Alliances, following extensive consultation with older people, service providers, and others, develop an Age-Friendly County Strategy. The strategy contains specific commitments by agencies, service providers, and older people’s organizations, often in collaboration, to implement agreed changes—generally reflecting the priorities expressed by older people in the consultation process.
Baseline Study > A baseline study is conducted at the start of the program in order to assess the impact over time. A professional research company has worked with us to develop a questionnaire and a training program for older volunteers to conduct a household survey. These volunteers not only conduct the survey but are involved in group discussions afterward to analyze the findings and set priorities for future action.
WORLD HEALTH ORGANIZATION GLOBAL NETWORK OFAGE-FRIENDLY CITIES
It is heartening to know that we are not on this journey alone and to witness 42 cities and counties recently signing the Dublin Declaration, affirming their support for a range of actions including a commitment to participate in the Global Network of Age-Friendly Cities. The signing of this declaration, which took place as part of the First International Conference on Age-Friendly Cities in Dublin in September 2011, expresses the commitment of political leaders to make their communities more age-friendly and commits signatories to undertake a continuous cycle of improvement through a planning process that will be supported by participation in the World Health Organization’s Global Network of Age-Friendly Cities.
Anne is the Director of the Ageing Well Network, an independent organization that brings together heads of organizations and units from the aging sector, across government departments and agencies, businesses, ngos, and academia. The network is funded by Atlantic Philanthropies. It has two core aims. First, it seeks to reframe the agenda on aging, addressing the opportunities as well as the challenges of a rapidly aging population. Second, it acts as a catalyst and influencer for the key changes needed to realize the vision of “an Ireland that is one of the best countries in the world in which to grow old.”