age-friendly community initiatives: lessons from …...age-friendly community initiatives: lessons...
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Andrea Austen, MASander L. Hitzig, PhDRaza M. Mirza, PhD
December 1, 2016
Age-Friendly Community Initiatives: Lessons from Toronto
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The Toronto Seniors Strategy 2
Introductions
Andrea AustenProject Lead
Toronto Seniors StrategyCity of Toronto,
Social Development, Finance and Administration
Sander L. HitzigScientist
St. John’s Rehab Research Program
Sunnybrook Research Institute
MemberNational Initiative for the Care of
the Elderly
Raza M. MirzaNetwork Manager
National Initiative for the Care of the Elderly
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OBJECTIVES
PILOT – AGING IMPROVEMENT AREAS INDICATORS
AGE-FRIENDLY COMMUNITY PROJECT – KENSINGTON CHINATOWN NEIGHBORHOOD INITIATIVE
Funding provided by the Government of Ontario
OVERVIEW OF THE TORONTO SENIORS STRATEGY
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The Toronto Seniors Strategy 5
Population Growth Forecast
The number of older adults is forecasted to grow by up to 60% in the next 20 years.
Source: Hemson Consulting Ltd. 2012
The City must be ready to address the growing number of diverse older adults.
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Primary CarePhysicians &
Family Health Teams
Non-Profit Housing
Providers
HospitalsCommunity
Health Centres
Community Care Access
Centres
Long Term Care Homes
LHINs
Ontario Ministry of Health and Long Term Care Ontario Ministry of Municipal Affairs and Housing
City of Toronto
Paramedic Services
City of Toronto Public Health
Community Support Service
Providers
City of Toronto Long Term Care
Community Support Services
City of Toronto – Housing Services System Manager
Toronto Community
Housing
Co-operative Housing
Providers
Rent Supplement
Program
Free Dental Services for
Seniors Program
• Ontario Health
Insurance Plan (OHIP)• Ontario
Drug Benefit Program
Ontario Seniors’ Secretariat
Reduced TTC Fares for Seniors
Seniors Programs 100% funded by municipal property tax base
City of Toronto Seniors Portal
Local Municipal Programs for Seniors Property Tax Assistance for Low-Income Seniors
ProgramSnow Shawling Services for Seniors
Seniors Community Transportation Pilot ProgramSeniors Centres & Recreation Programs
Seniors Library Programs
Accessible Transportation• Wheels Trans
Retirement Homes
Regulatory Authority
Affordable Housing Program
Veterans Affairs Canada
Human Resources & Skills Development Canada
Seniors CanadaHealth Canada
•Canadian Pension Plan •Allowance/Survivor Allowance
Program•Canadian Government Annuities•Guaranteed Income Supplement
• Old Age Security• International Benefits
• Compassionate Care benefits
Public Health Agency of Canada
Division of Aging & Seniors
National Seniors Council
• Veterans Priority Access to LTC beds (6 VPA beds in Peel)• Veterans Independence
Program (home care)• War Veterans Allowance• Health Care Benefits
•Registered Retired Savings
Plan•Tax-Free
Savings Plan
Canada Revenue Agency
Service Canada Veterans Affairs District Office
Canada Mortgage & Housing
Corporation
Banks & Credit Unions
Service Ontario
Federal Income Tax
• Age amount •Pension income credit
• Pension income-splitting revisions• Disability tax credit and disability amount
• Tax credit for medical expenses and private insurance premiums• Eligible dependent credit
• Caregiver tax credit
Ontario Ministry of Finance
Provincial Income Tax
• Guaranteed Annual Income System•Energy & Property Tax Credit• Sales Tax Transition Benefit
• Senior Homeowner Property Tax Grant
• Healthy Homes Renovation Tax Credit
Employers
• Registered Pension Plans• Proposed Registered
Pooled Pension Plans
LOCA
L G
OVE
RNM
ENT
PRO
VIN
CIAL
GO
VERN
MEN
TFE
DERA
L G
OVE
RNM
ENT
LEGEND
City of Toronto’s programs and services for seniors
Funding flow-through for Federal social housing programs
Overview of Government-funded Services for Seniors – City of Toronto Perspective*
*Adopted from Region of Peel
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The Toronto Seniors Strategy 7
What We Heard
Residents want an age-friendly approach to service delivery that supports people of all ages, including Toronto’s older adults, to live active, socially engaged, healthy, and independent lives.
“There has to be more support put in place to assist seniors in remaining
in their own homes.”
“[It is] important not to forget that a large majority of older adults are capable, active,
independent and a resource to the community. We are part of the solution as
well as the ‘problem.’”
The way in which government services currently are designed, resourced, organised and delivered, often disadvantages older adults who are vulnerable.
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The Toronto Seniors Strategy 8
Top 5 System Barriers
We do little to empower older adults and caregivers.1
We don’t know what we don’t know.2
We don’t talk to each other well.3
We plan in silos and not as a system.4
We plan for today and not for tomorrow.5
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The Toronto Seniors Strategy 9
Overview
• The Toronto Seniors Strategy outlines the beginning of an ongoing process to make Toronto more age-friendly.
• The Strategy was developed to achieve better results for older adults using limited resources.
• Focus is on issues that fall within the City’s authority to plan, manage, and deliver.
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The Toronto Seniors Strategy 10
WHO Age-Friendly Domains
To ensure alignment with other communities in Canada, the Strategy is organized using the World Health Organization’s framework for age-friendliness:
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The Toronto Seniors Strategy 11
Recommendations
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Issues Identified
25
RecommendationsProposed
91
RecommendedActions to Implement
For each theme, issues are identified. These are based on what we heard from consultations, insights from demographic research, and gaps identified after taking an inventory of what the City does currently.
From the 25 identified issues, we developed 25 broad recommendations to address each issue. These recommendations define the strategic direction the City will take to address older adult issues.
Each recommendation contains a series of short, medium, and long-term actions proposed by City ABCDs. These define the specific, implementable steps the City will take to accomplish each recommendation.
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The Toronto Seniors Strategy 12
Accountability & Monitoring
Each recommended action in the Strategy contains three key elements for accountability and monitoring:
Clearly identified lead program area withresponsibility to implement
Timeframe for implementation
Identified measure(s) to track the status of each action
The wellbeing of Toronto’s older adults in Toronto will also be monitored to provide context for the ongoing implementation of the strategy.
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The Toronto Seniors Strategy 13
Key Accomplishments 1.0
• 1,000+ new park and street benches• A new Services for Seniors in Toronto Guide• New training on how to recognize and support vulnerable
resdients for City staff• New event dedicated to the needs of older workers during
Workforce Development Month (October)• Expanded Paramedicine Program• $2.7M for home repairs • Larger print signs at intersections• $1.75M for community services in high-need TCH buildings• More time to cross the street at intersections with traffic lights
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The Toronto Seniors Strategy 14
Expanded Table Mandate
• Monitor implementation of 1.0
• Co-create 2.0
Implement
Monitor Report
Review Refine
Toronto Seniors Strategy
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Pilot – Aging Improvement Areas
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The Toronto Seniors Strategy 16
PILOT – Improvement Areas
• Five indicators were selected for preliminary analysis to identify pilot Aging Improvement Areas.
# of Seniors
OAS/GIS Rates
Rate of Seniors Living Alone
Rate of 1st Generation Immigrants
No Knowledge of Official Languages
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The Toronto Seniors Strategy 17
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KCN Age-Friendly Initiative
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TEAM
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Canadian Urban Institute
www.canurb.org
City of Torontowww.toronto.cawww.tcccto.com
Toronto Community & Culture Centre
http://www.torontocouncilonaging.com
Toronto Council on Aging
Funding provided by the Government of Ontario
www.nicenet.ca
National Initiative for the Care of the Elderly
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SELECTION OF THE KCN
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o High rate of older adults (65+ years; 2,561 ~ 14% of the community) who live alone (~ 40%).
o High rates of poverty
o High proportion of persons of Chinese descent with Chinese n.o.s, Cantonese & Mandarin being the top 3 mother & home languages.
City of Toronto identified the top 10 ‘Aging Improvement Areas’, with the KCN ranking #6.
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o KCN has one of the
highest poverty rates.
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ETHNICITY
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LANGUAGE
2323
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Funding provided by the Government of Ontario
KCN Action Plan24
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PROJECT STEPS
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SCOPING REVIEW
ENVIRO
SCAN
ACTION PLAN
4
Short-term & long-term strategies.
ACTION PLAN
2
Social / health resources –survey + qualitative interviews.
ENVIRONMENTAL SCAN
1
Social Isolation / Loneliness in Seniors.
SCOPING REVIEW
CONSENSUS MEETING
3
Identify priorities for promoting age-friendly principles.
CONSENSUS MEETING
Funding provided by the Government of Ontario
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SCOPING REVIEW
Practice
Policy
Research
EVIDENCE-BASE ON FACTORS CONTRIBUTING TO SOCIAL ISOLATION & LONELINESS
DEVELOP PRELIMINARY RECOMMENDATIONS / PRIORTIES AT THE PRACTICE & POLICY LEVEL
.
What is known about social isolation & loneliness in urban-dwelling Asian older adults? WHO
DimensionsPEER-REVIEW & GREY LITERATURE
Funding provided by the Government of Ontario
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KEY FINDINGS
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• More outreach by community services is needed.• Doing outreach through Chinese older adults.
• More advertising of community services.• Chinese-speaking community/health professionals.
1. Social Participation
2. Community Support & Health Services
3. Housing* (focus was on living arrangements)
4. Communication & Information
• Positive social support.• Public spaces for socializing.
• Living alone can be a risk factor to isolation & loneliness.
Funding provided by the Government of Ontario
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KEY FINDINGS
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• Financial security & command of English language helps civic participation & volunteering.
• Need for Chinese symbols & language on commercial & public buildings.
• Need for ample public areas for socializing.
5. Respect & Social Inclusion
6. Outdoor Spaces & Public Buildings
7. Transportation
8. Civic Participation & Employment
• Disrespect can come from family members (e.g., adult children).
• Unilingual signage / unfamiliar routes.• Inadequate & insufficient public transportation.
Funding provided by the Government of Ontario
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SURVEY & FOCUS GROUPS
SURVEY 100 CHINESE OLDER ADULTS IN THE KCN
FOCUS GROUPS WITH ~ 20 KCN OLDER ADULTS & KCN PRACTITIONERS*Expand on survey
findings
• Recruit a broad representation of Chinese older adults living in the KCN to obtain a depiction of facilitators / barriers to social participation.
1 HEALTH & SOCIAL SERVICES USED / RANKING OF PERCEIVED USEFULNESS
2 CHARACTERIZE SOCIAL WELL-BEING
RESIDENT PERSPECTIVES
Funding provided by the Government of Ontario
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CONSENSUS MEETING
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One-day consensus meeting to develop an age-friendly city action plan for the KCN
o 30 to 50 key stakeholders will be invited to participate in a one-day meeting to identify top priorities for promoting age-friendly principles in the KCN & develop an action plan (short-term & long-term goals).
o Priorities will be generated from the scoping review, survey data, focus groups & meeting attendees.
Funding provided by the Government of Ontario
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TRIANGULATION OF PRIORITIES EXAMPLE
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Funding provided by the Government of Ontario
PRIORITY OLDER ADULTS
PRACTITIONERS LITERATURE
More outreach by community services are needed
X X
Need for Chinese symbols & language on commercial & public buildings.
X X X
Need to understand the composition of older adults’ social networks & connections at home & in the community
X X
Programs & services that address issues of disrespect, ageism & filial piety in Chinese families.
X X
More opportunities for civic engagement & volunteering.
X X
Create accessible documents on municipal planning
X
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FINAL ACTION PLAN
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Action plan will be evidence-based & tailored for the KCN by taking in key perspectives
of all relevant stakeholders. o Help further the City of
Toronto’s age-friendly strategy.
o Serve as a template for future
age-friendly initiatives.
Funding provided by the Government of Ontario
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PROJECT TIMELINE
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1
2
4
5
3
Telephone surveys + focus groups with seniors in progress; End-date December 2016; practitioner focus group completed.
Host one day meeting on Thurs. March 2, 2017 to create action plan for the KCN.
Environmental scan completed.
Scoping review completed + accepted for publication.
Develop & disseminate action plan into different
formats for dissemination by Spring / Summer 2017.
MOVING FORWARD
Funding provided by the Government of Ontario
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For more information on the Toronto Senior Strategy, contact:
Sander L. Hitzig, PhD - E-mail: [email protected] MEMBER & KCN PROJECT LEAD
Raza M. Mirza, PhD – [email protected] NETWORK MANAGER
KCN PROJECT LEAD
Andrea AustenPolicy Development Officer
Social Development, Finance & Administration Division
E-mail: [email protected]: 416-392-5140
For more information on the Kensington-Chinatown Age-Friendly Initiative , contact:
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1
2
4
5
3
Need to Standardize conversations about “age-
friendliness” so we are able to move from homes, to
neighbourhoods, to communities, to cities, to
societies that are age-friendly
Difficult to assess, measure and evaluate
‘age-friendliness’: sets up dichotomy of age-
friendly and age-unfriendly
Lessons Learned (so far!)
Funding provided by the Government of Ontario
Need to promote reciprocal relationships: older adults engaged and participatingopportunities
The various lenses of vulnerability and inequity are difficult to capture in the current “age-friendly” framework
Focus on intersection of built and social environments: congregate dining
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