Urban Design for the Elderly

I really thought that graduating would free up a lot of my time for writing since I no longer would be spending 72 hours a week in my studio; however, that amount of work filled up my hard drive and my Dropbox, so I spent most of my time since the end of classes cleaning those out. Hopefully though, now that that’s taken care of, I can spend more time working on the blog. And I did have enough time to check Twitter, where, a few days ago, I saw this post from Age Scotland, an elderly organization based in Edinburgh;

From Twitter.com.

While I do wonder if this only applies to Scotland, which generally has lower crime and worse weather (making it more slippery) than much of the United States, the idea really got to me, and I started wondering about urban design for the elderly. Senior’s fear of falling is not unfounded; according to healthcare design consultants Fuelfor, one in every three people over 65 experiences a fall-related injury, and of these fall injuries, one third result in death. What are the factors that make urban environments so unsafe for the elderly, and how can they be made safer?

One of the main issues is the way that the body changes as it ages, and how that affects a person’s mobility. David Lee gives a great summary of these changes and how they intersect with urban design in his 2007 MIT master’s thesis. Muscular degeneration makes it so that, as we age, we can’t move as quickly, and some people have a hard time moving their limbs any significant distance, leading to difficulty climbing stairs and, in some cases, a shuffling gate, which make even the smallest obstacles significant risks for tripping. Visual deterioration makes it hard for the elderly to see very far, and especially makes it difficult for them to see at night. Dementia, Alzheimer’s, and similar degenerative disorders may lead their sufferers to get lost or disoriented easily. These factors and others can lead to fear, which is a major deterrent for the elderly to get out of the house, whether it be of falling or other injury, violence or crime, or simply of getting lost. Unfortunately, many elders need the exercise and social stimulation that comes from being outside, and without it, their condition may decline further or be exacerbated.

Despite the fact that these things happen to virtually everyone as they age, we don’t treat it as a normal condition, but as a disability that the individual is principally responsible for, and not society. Despite laws requiring certain measures, access for the elderly and other disabled people are considered an afterthought (as an example, a bar I’ve been to here in Philadelphia has a small ramp that they pull out of a closet and put over the step at the entrance whenever a person in a wheelchair comes in, and this is comparatively good accessibility for many of the old buildings in Center City). Instead, Universal Design principles argue that people are disabled by their environment, through both physical and psychological barriers. Selwyn Goldsmith, in his book Designing for the Disabled, called this “Architectural Disability,” where the built environment creates conditions that are uncomfortable, inconvenient or unsafe for anyone. it is important to overcome this mindset so that we can think of the necessary changes not as accommodating a small group, but as providing all with their given right of access.

One of the largest problems related to access is the location of senior housing. Since it is not a largely money-generating use, and since it is a relatively new idea, there is little senior housing near urban centers, and more built on the urban fringe in areas with low land values or in suburban or even rural communities on cheap land. Julienne Hanson describes how, in the past, the elderly wanted to be close to the services of the city, but due to neglect and crime, these areas have been passed over for “greener” communities. Even those who choose to stay in the city find that they have few options for senior housing. As seniors loose their ability to drive, they find that these suburban locations don’t have amenities that can be accessed any other way, and either become dependent on others to drive them around or remain confined to their homes. Hanson argues that, rather than having secluded elderly communities, places should be inter-generational, safe, and accessible for all.

Once senior housing is located in mixed-use, inter-generational communities where seniors can walk to the services they need and interact with a variety of people, there are still a number of things that need to be done to make sure that the environment does not lead to architectural disability. There are a number of standards that are designed to guide universal design. Enrico Sassi and Elena Molteni came up with a system based on management, background, and space quality, and introduced the idea of the “small oasis,” or providing small interventions along a path for seniors to rest at, and provide examples of how these qualities could be applied in a number of places in Switzerland. Sandra Manley, in the Universal Design Handbook, laid out eight principles of universal design that apply to the city and street, including equitable use, flexibility in use, simple and intuitive use, perceptible information, tolerance for error, low physical effort, size and space for approach and use, and adding to human delight.

Based off of these principles, there are a number of specific interventions that can make the public realm more accessible to the elderly. One example Lee sites is how senior housing developers often use signage, landmarks, and distinct decor in hallways to help patients with dementia and similar issues find their way around. These techniques could easily be transferred to the city scale. Wayfinding signage is becoming more common, especially in city centers, and streets could easily be made distinct with different combinations of plantings, lighting, paving, building frontage, or other techniques. Some of the most common landmarks are institutional uses, including government and religious institutions, which can also provide special services to seniors.

Wayfinding sign in Napa, CA. From northbaydesignkit.blogspot.com.

There are a number of ways to help those with visual impairments to get around the city. Probably the most important is lighting. Older people often have trouble seeing at night, as do drivers, who could be less responsive to an elderly person crossing the street. Lighting is also generally a crime deterrent. Another visual cue are colored or textured pavements at transitions, such as curb cuts, to help seniors know that they should be expecting a transition as they walk.

This pavement gives both a visual and tactile cue to stop. From wikimedia.org.

Seniors also need to have transportation options, even after they are no longer able to drive themselves. This requires a dense transit network, which is more feasible in high-density areas. Many bus stops are not particularly comfortable places to wait. They need to have benches and a covering at least, so that seniors are not exposed to dangerous weather conditions. Most transit systems also are not able to make diversions from their designated route. Lee sites Brookline, MA’s Elderbus, which is able to make small diversions to get seniors closer to their homes, as an example that makes it easier for elders to use public transit. Many fixed-route transit systems, including subways and trolleys, are accessed by steps, which make them harder for seniors to use. Above-ground systems can take advantage of ramps to get seniors to loading level, while subways or elevated rails would probably be better off using elevators.

A ramp allows wheelchair loading on Salt Lake City’s TRAX light rail. From heatizon.com.

Probably the most common issue among the elderly is that of general mobility. How do seniors know that they can walk safely and efficiently from one place to another? There are a few higher level issues to address before you can get into specific interventions. First is the idea of a network. The dendritic street network of the suburbs makes it hard to walk directly, even to nearby locations. Walkers, regardless of age, are served better by a grid or web of paths. These don’t necessarily have to all be full streets; they can follow the fused grid plan where a grid of pedestrian paths is overlaid on a dendritic street system for cars.

Pedestrians are particularly sensitive to inclement weather. This includes both the threat of dehydration and heat stroke in warm climates, and the threat of ice and snow in colder areas. This is partially addressed by having mixed-use communities where seniors don’t have to travel far to reach their destinations, and by having a dense transit network where they could be in a climate-controlled vehicle for most of their trip. In addition to these, shelters of some type could be regularly spaced throughout a city. This could be as basic as a covered bus stop. It could be heated in cold climates or even have cooling misters in warmer ones.

A “cool zone” in Houston. From stephanieandtrent.blogspot.com.

This can also include maintenance, especially in northern climates. Snow needs to be cleared from sidewalks and ice melted for safe traveling. There is also a common problem of streets being sloped such that they shed water into the curb cuts at crosswalks, forming large puddles that force seniors to either go around them or through them.

Barriers can be psychological as well as physical. Regardless of other interventions, if a senior has to cross a street with fast-moving traffic, they are not going to feel safe. General traffic calming measures will make the public realm safer, both physically and psychologically, for the elderly.

Having networks of certain types of spaces also can extend a senior’s walking range. Frequent benches can allow a senior to stop and rest along their way. Public restrooms, or a system to show which stores have available restrooms, can make it easier for those who frequently have to use the bathroom to travel. A network of many small green spaces, rather than a few very large ones, allows elders with limited mobility greater access to nature and recreation. These also become frequent gathering places for the elderly to meet friends and family.

Pavement is very important for the safety of the elderly. Loose, slick or sticky pavements pose a distinct slipping of tripping risk to elders, but any sidewalk that is not well-maintained can create cracks and potholes that are unsafe for the elderly. Brick, which is often used as a pavement to try and spruce up a sidewalk, is particularly risky, since it is often not laid on a rigid base and can lead to a very uneven surface. Brick or stone pavement may be better used, not in the main path of the sidewalk, but in a buffer area with trees and benches that would further separate pedestrian from vehicular traffic. Wider sidewalks are particularly good for the elderly, because it allows them to travel at their own pace and allows faster pedestrians room to pass them. While widening sidewalks, it is also a good idea to narrow vehicular lanes, to make street crossings shorter and safer. If a municipality is unwilling to actually narrow traffic lanes, they can use curb extensions, which extend the sidewalk over a parking lane at intersections, to narrow the effective crossing distance while doing little to diminish vehicular capacity.

Bulb-outs in Berkeley, CA. From techtransfer.berkeley.edu.

Seniors need designated places to cross the street, where they know that they will be safe. Basic crosswalks accomplish this well enough, but only if they have a corresponding curb cut so that people don’t need to step off a 6-inch curb to reach the crosswalk. Curb cuts can’t be too steep either, or they present their own falling hazard. A better solution, although one rarely seen so far, is the raised crosswalk. This raises the crosswalk to the same level as the curb, making it easy for pedestrians to cross and forcing cars to slow down as they go over the bump.

Raised crosswalk in London’s Hyde Park. From pittsburghparks.wordpress.com.

A number of seniors also reported to Lee that they had trouble crossing the street in the allotted time. Many times, this isn’t even a case of old people walking slowly, but of lights changing very quickly. Even I have trouble getting across Market at 5th Street, or Columbus at Race, here in Philadelphia. The priority should be for pedestrians, the most vulnerable of travelers, to get across in a safe amount of time. Cars can wait. In fact, in some places, lights for pedestrians and cyclists allow them to cross before the light for cars turns green, such as at 36th and Market and Philadelphia, and almost everywhere in Denmark.

Benches appear a number of times in these recommendations, because one of the most important thing for seniors to get around the city is the opportunity to rest. But not all benches are created equal. Benches with backs are generally more comfortable, and arm rests give seniors something to lower themselves with while sitting down and something to push off of while standing up. It is better to have benches that sit with their back against something, such as a wall or a planter, and that face some sort of people-oriented activity, whether it be a sidewalk, park or playground, so that the elderly can people watch and so that multiple people can see the sitter, ensuring their safety. Although the people Lee interviewed were not terribly concerned with style, they did prefer wooden benches, which don’t retain heat and water the way metal or concrete benches do. Traditional wooden benches are more recognizable and more likely to be used than some other design.

An elderly lady finds the perfect bench in New York. From Ed Yourdon.

The reader familiar with urban design would notice that many of these recommendations to make a place better for the elderly would also make it better for people in general. As our population ages, and as seniors become a larger voting block than they already are, let us hope that they will use their new power to demand environments that will be better for all of us.


About Dave Munson
This blog is about architecture, cities, and myself.

2 Responses to Urban Design for the Elderly

  1. Age Scotland says:

    Many thanks for this excellent blog post on the design of urban environments and how they affect older people.

    Our charity has been working on an ending isolation campaign to ensure that more older people are socially connected and have the ability to get out and about. We believe that urban design needs to be age-friendly, from in and around people’s homes, to local neighbourhoods and wider urban environments.

    Your post has highlighted many of the issues that older people face, from lack of time to get across the road, to falling fears, to poorly designed crossings. Research by I’DGO (Inclusive Design for Getting Outdoors) in the UK has shown that well-designed environments make positive differences to older people’s well being and quality of life.

    Perhaps an interesting point is that inclusive design can benefit everyone, not just one particular demographic or section of society. Well-designed walkways, crossing points, pavements, entrances and traffic controls benefit pedestrians as a whole. We want to get more people out and about and active in Scotland – a positive urban environment can only help with this!

  2. Karen says:

    I appreciate handrails where there are even one or two steps into a building – and I’m not really disabled. But I find comfort in making sure I’m balanced and not likely to fall when I go up or down steps.

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