Hong Kong is at the epicentre of the challenge of an ageing world
Over the past decade, policymakers in many countries have begun to favour "ageing in place" solutions, which encourage people to remain in their homes for as long as possible as they get older. The trend has been driven partly by necessity, because of the increasing cost of providing sufficient residential care places, and partly by the growing preference of older people to remain in their own homes.
"Ageing in place puts a premium on making sure their environment is fit for purpose," says professor Chris Phillipson, a director of the Manchester Institute for Collaborative Research on Ageing. "People are ageing in neighbourhoods that undermine their independence and that has to be sorted out, both inside their homes and in terms of mobility and access to services and resources outside the home."
Many existing homes are too poorly designed to be adapted for older people, which is why there is a strong case for new homes to be built to "lifetime home" standards, offering features such as space for wheelchair access and the installation of stairlifts, argues David Sinclair, a director at London-based thinktank the International Longevity Centre. "The vast majority of older people live in generalneeds housing across the world. If you are talking about improving housing you can have the biggest impact and address the biggest need by helping the millions of people who will stay in their own homes."
In the Netherlands all new houses are now built to such standards, and in some parts of the country that is beginning to influence the long-term value of properties, says Joel Scherrenberg MRICS, principal of specialised valuation practice Scherrenberg Groep. "The ability to use the home for as long as you need it is an element of sustainability more broadly and where the market is in balance, sustainability is becoming increasingly important to buyers. Whether the house can be adapted for older people is one of the elements that they take into account, and therefore has an impact on value," he argues.
Meanwhile, technology could play a role in facilitating a better quality of life for people ageing in place, suggests Scott Eckstein, the Los Angeles-based MD of senior accommodation consultant Active Living International. "Digitalisation and the shared economy will make it easier for seniors to make connections with people like stayat- home moms who want to earn money by caring for them."
Earlier generations have chosen to retire to the seaside or country, or in the US to large purpose-built retirement communities. But today an increasing number of older people are favouring an urban lifestyle because they want to stay close to their existing family and social networks, amenities such as shops, and healthcare and cultural facilities, says Eckstein. "They do not want to retire to an island of old agers as their parents did. They will want to be around things, to volunteer, to see their kids, to go back to school, to travel."
However, many cities are poorly designed for an older population, as Sinclair explains: "Part of that is because the urban fabric takes a very long time to change, but another aspect is that a lot of economic imperatives for investing in the built environment are associated with work. For instance, transport networks are focused on getting people to and from work quickly."
The World Health Organization (WHO) has attempted to address the issue by founding a global network for age-friendly cities. Since 2015 participating cities have introduced measures such as better access to public transport, street seating and public toilets, clearer signposting, and initiatives to keep pavements free of obstructions. Enabling mobility is a crucial element of age-friendliness, says Phillipson: "When you ask older people what would most improve the quality of their life, transport is the thing that often comes up, usually access to a bus service where they have extra time to get on and off." Meanwhile, Eckstein suggests that if the predicted advances in autonomous vehicles eventuate, driverless cars will provide a more user-friendly, personalised means of transport for the elderly.
Graham Parry, group research director at property company Grosvenor, and author of the 2018 Silver Cities report on planning for an ageing population, says that while some property investors understandably choose to target their equity on growing cities with younger populations, inevitably those markets tend to be much higher-risk and less mature in terms of institutional capital requirements than established markets with ageing populations. He argues that investors who fail to grasp the opportunity presented by well-heeled senior citizens could be missing out: "The baby boomers will be the richest generation ever to retire. They have enormous spending power and they are probably going to be enjoying a longer period of retirement than previous generations."
That could be a boon for declining town centres if they can adapt to serving the needs of older people, suggests Sonia Parol, head of care and retirement living at east Midlands-based architect Urban Edge. "An active third age can contribute to both the economic and social life of the country and help retailers and the high street."
Not every older person will want – or have – the opportunity to age in place, so more specialist senior housing will be needed accommodate the growing aged population. "The baby boomers who are approaching retirement age now have completely different requirements and expectations to the generation before them, says Parol. "This is the right time to come up with new solutions."
Because senior housing is less efficient in its use of floorspace than general housing, it requires a different viability model, argues Laurence Liauw, a director at Spada Health Concepts and adjunct associate professor at the University of Hong Kong. "You can't value senior housing in the same way you value normal housing because of the functional and design differences," he says. "Surveyors need to push this with governments and developers to incentivise development. That difference has to be in the valuation of a project for it to be built, and it has to be funded with a different model."
Liauw says that in most developed countries older people are increasingly choosing retirement communities in preference to nursing home models of accommodation. "We see diversification towards retirement living that is more like a healthy lifestyle hospitality product for seniors, but with nursing care under the same roof so that there is a continuum of care for people to live well together, rather than a facility where you go to die." These facilities are often called continuing care retirement communities (CCRCs). CCRC schemes offer seniors the advantage of not having to move as their health deteriorates, but for some older people they still feel too segregated from the rest of society.
Eckstein predicts the emergence of more "naturally occurring" retirement communities, which he describes as "CCRC without walls", and which would be constructed near to existing town centres, or with their own newly created town centres. He suggests that settlements could be built with features that allow them to be adapted as the inhabitants age, with more care services gradually being bought in by the community as they grow older together.
Julia Park, head of housing research at architect Levitt Bernstein in London, foresees the growth of less institutional, grassroots-led co-living set up by older people who find themselves alone in later life and would prefer company – although she concedes that such schemes are difficult to deliver. Like other experts in the sector she sees the future of elderly housing in more integrated, multigenerational communities. "The breakthrough is that most of the accommodation for older people that is being built now looks like ordinary housing," she says. "Many of us are thinking of moving into towns as we get older, so we are likely to live in apartments with lift access in a mixed-generation block. They may be located on the lower floors and be slightly bigger than those for younger people, and there will be some sort of common space. The future of housing generally is a much more age-friendly model."
"China and Hong Kong are at the epicentre of the challenge of an ageing world," notes Spada Health Concepts' Laurence Liauw. "Japan's ageing population is nearing its peak, but Hong Kong has the longest life expectancy of anywhere in the world and China's curve is getting steeper. Governments must do something about this now."
While much of South Asia is experiencing a youth boom China's ageing trajectory is following that of the developed world partly because of the now-abandoned one-child policy says Liauw, threatening a slowdown in economic growth similar to that seen in Japan.
Meanwhile in Hong Kong the proportion of the population aged over 65 will leap from 18% today to 30% in 2040, predicts Marco Wu FRICS, former chairman of the Hong Kong Housing Society. In recent years the public housing provider has introduced pilot projects in an attempt to show the way forward. An ageing-in- place scheme has been established for residents of its subsidised housing blocks, which funds age-friendly adaptations and provides some health and social support. For the mid- and high-income brackets senior citizen residents' schemes have been trialled.
In a high-rise society with some of the most expensive property prices in the world, developing age-friendly housing is challenging. The supply of land in Hong Kong is insufficient to meet demand but many older people are reluctant to leave their communities for schemes built on cheaper plots further out of the city, says Wu.
He believes that Hong Kong's culture, in which it is usual for several generations of the same family to live in close proximity, may help the city to adapt as its population ages. "In the future we need to aim to create more mixed housing with blocks for the elderly close to blocks for the younger generation so that they can look after each other," argues Wu. "That is easier to do in the public sector, but if we are successful, I am confident the private sector will follow."