Intergenerational age friendly ecosystems for inclusive ageing

This project expands on the Intergenerational and Age-Friendly Living Ecosystem (AFLE) initiative led by Sixsmith, Fang and Hamilton-Pryde. The AFLE project, funded by the Scottish Universities Insight Institute, highlighted a need for clear definitions, context and guidelines for implementing an ecosystem approach to age friendly design.

In the current study, a Rapid Realist Review (RRR) was conducted to systematically search and synthesise existing knowledge on the application of ecosystem approach to promoting the community participation of older people. The review question was: How can age-friendly ecosystems support the community participation of older adults? The search strategy was based on 3 key concepts: ‘older people’, ’ecosystems’ and ‘community participation’. Search terms were derived from these concepts and modifications were made as necessary using: Index terms, Boolean operators (AND/OR) and truncations (e.g. old*). 11 databases were searched reflecting gerontological, social science, health and social care knowledge: Ageline, ASSIA, Cinahl+, Google Scholar, Scopus, Social Care Online, PsycINFO, Open grey, Cochrane reviews, Web of Science. Screening and selection: 2823 records were identified after de-duplication and initially screened by abstract and title using a set of inclusion and exclusion criteria, 126 retrieved and a full text screening performed resulting in 14 selected sources (designated * in references section) in the final pool included after full text.

Findings from the RRR are organised around mechanisms, context and outcomes.

Key ecosystem contexts to plan with are:

• Interconnectedness: working across sectoral boundaries, to promote community participation of older people.
• Collaboration
• Positive political landscape
• Local geographical and virtual
• Identified function of the ecosystem to encourage participation: challenging ageism

Key ecosystem mechanisms are:

• An existing need for the ecosystem is evidenced
• Authorisation from different organisations and political sources is achieved
• Resources are appropriately allocated
• Barriers (for example: financial, social, health, expectation and policy barriers) and facilitators (for example: motivation, ownership and control, strive for equity and diversity)  to ecosystem success have been identified and actioned.
• Inclusive Place Making: making diversity visible and valued amongst older people.
• Participation: Ensure older people participate in ecosystem research and action.
• Ageism: challenge ageist narratives at policy, community and individual level.
• Evaluation of Ecosystem Performance: develop success indicators for evaluation.

Key outcomes of ecosystems for encouraging older people’s community participation:

• Little evidence of the value or effectiveness of ecosystem model in increasing older people’s community participation
• One study identified increased digital engagement via an ecosystem approach.
• Ecosystems were said to:
  • facilitate political commitment to solving challenges of ageing
  • improve active ageing across the lifecourse,
  • improve chances of successful ageing
  • increase the age friendliness of communities
  • encourage feelings of belonging to community and develop social capital

However, no evaluations were undertaken to evidence this.

A consultation event was held with 28 participants representing health and social care, 3rd sector and policy contexts. This event suggested a need to develop more debate and more inclusive intersectional and cross-sectional ways of working between professionals, practitioners, and local residents whereby more control and assets are placed in community hands to avoid tokenistic participation. Development of engagement mechanisms were also suggested such as community hubs and people’s assemblies. Learning from existing good local practices and interventions was advised.

Toolkits to support the development and maintenance of community participation of older people were sought and while none were found specifically in this area, three were identified as useful: one based on developing ecosystems CityZen), one on general community participation (The Community Toolbox) and one on older people’s engagement in planning and development processes (The seniors toolkit).

Key recommendations from the project were identified as:

• Use a multi-layered ecosystem development approach at individual, social, organisational and policy levels.
• Assess older people’s community needs
• Develop interconnected and collaborative working
• Consider social and placemaking as an active component and aim for strong social capital norms
• Focus on equity and diversity and challenge ageist narratives
• Gain political commitment
• Develop success indicators

Final remarks

It was challenging to complete such an ambitious project in such a short timeframe. We used weekly meetings to solve problems quickly and keep the project on track.

The employment of Debbie Menezes and Marianne Cranwell, and securing the voluntary work of Isaac Chau, considerably enhanced this project and enabled the final deadline to be achieved. Their work on this project was immense.

We developed a publication plan to kick start publications derived from this work.

Follow up activities

We planned to submit a large proposal on the community participation of diverse older people. This has been developed in collaboration with 4 other universities and 7 stakeholder organisations. The proposal has been costed at £1.6m (2nd stage) and was submitted to the ESRC in December 2021. We are waiting to see if this has been successful.

We have several journal article publications planned but pressure of work has delayed further development of these.

• Supporting documents to attach: A retrospective summary report (max 2 pages), along with photographs and/or video; or a “blog-post”    format that can be used to publicly report on the project via the ISSR website.

We have produced a glossy final report and this is attached to this submission entitled: Age Friendly Ecosystems for Community Participation: A Rapid Realist Review

• Project programme documents in PDF format which can be linked for download as part of the  public report above.

Our final report is publicly available via its DOI and can be downloaded from the University of Dundee Discovery portal.