Creative Ageing Cities

Ageing population and rapid urbanisation are the two major demographic shifts
in today’s world. Architectural designs and urban policies have to deal with issues
of an ever larger elderly population living in the cities, especially in old urban
neighbourhoods, while also taking into consideration the evolving lifestyles and
well-being of the diverse elderly demographic. Being able to continue living in
these existing urban neighbourhoods would thus require necessary interventions,
both to adapt the changing needs of the ageing population and to improve the
deteriorating environment for better liveability.
Creative Ageing Cities discusses the participation and contribution of the ageing
population as a positive and creative force towards urban design and place-making,
particularly in high-density urban contexts, as observed in a collection of empirical
cases found in rapidly ageing Asian cities. This book is the first to bring together
multidisciplinary scholastic research on ageing and urban issues from across top
six ageing cities in Asia: Singapore, Seoul, Tokyo, Taipei, Hong Kong, and
Shanghai. Through these case studies, this book gives a good overview of the
diverse challenges and opportunities in the various Asian urban contexts and offers
a new perspective of an ageing and urban design framework that emphasises
multi-stakeholder collaboration, inter-generational relations and the collective
wisdom of older people as a source of creativity.

Keng Hua Chong is Assistant Professor of Architecture and Sustainable Design

and leads the Social Urban Research Groupe (SURGe) at Singapore University
of Technology and Design. His works are included in International Perspectives
on Age-friendly Cities (2015) and Growing Compact: Urban Form, Density and
Sustainability (2017).

Mihye Cho is Assistant Professor of Humanities, Arts and Social Sciences

(HASS) at Singapore University of Technology and Design. She has written
about urban studies, cultural studies, ageing, and education.
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26 Creative Ageing Cities

Place Design with Older People in Asian Cities
Edited by Keng Hua Chong and Mihye Cho
Creative Ageing Cities
Place Design with Older People
in Asian Cities

Edited by Keng Hua Chong

and Mihye Cho
First published 2018
by Routledge
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British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
Names: Chong, Keng Hua, 1977– editor. | Cho, Mihye, editor.
Title: Creative ageing cities : place design with older people in
Asian cities / edited Keng Hua Chong and Mihye Cho.
Description: Abingdon, Oxon ; New York, NY : Routledge, 2018. |
Series: Routledge advances in regional economics, science and
policy ; 26 | Includes bibliographical references and index.
Identifiers: LCCN 2017050155 | ISBN 9781138676725 (hardback) |
ISBN 9781315558684 (ebook)
Subjects: LCSH: City planning—Asia. | Population aging—Asia. |
Urban elderly—Asia. | Older people—Services for—Asia. | Older
people—Housing—Asia. | Urban policy—Asia.
Classification: LCC HT147.A2 C74 2018 | DDC 307.1/216095—dc23
LC record available at https://lccn.loc.gov/2017050155
ISBN: 978-1-138-67672-5 (hbk)
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Contents

List of figures vii

List of tables xii
List of contributors xiii
Foreword: silver tsunami – paradigm
shift – new urban creativity xiv
M I C H AE L M . J . FIS CH ER
Acknowledgements xxvi
Abbreviations xxvii

Introduction 1
KEN G H U A C HO NG A ND MIHY E CH O

PART I
Singapore 17

1 Reclamation of urban voids and the return of the

“kampung spirit” in Singapore’s public housing 19
KEN G H U A C HO NG

2 A case study in re-imagining healthy communities 47

S W EET F U N WO NG

PART II
Taipei 61

3 Regenerating public life for ageing communities

through the choreography of place-ballets and the
weaving of memory tapestries 63
M I N J AY KAN G
vi Contents
PART III
Seoul 93

4 Fostering government–citizen collaboration and

inter-generational cooperation: the alternative
neighbourhood regeneration project in Jangsu, Seoul 95
J I Y O U N KI M A ND MIH Y E CH O

PART IV
Hong Kong 119

5 Participatory action research: public space

design by older people 121
J AC KI E YAN CH I KWO K

6 A participatory design experience with older people:

case study of participatory design in the HKSKH
Tseung Kwan O Aged Care Complex project 145
RO B ERT KI N MING WO NG, CR Y S TA L MA N CHONG HO,
AN D G W Y N E T H WING L A M CHA N

PART V
Shanghai 159

7 New prototype for ageing-in-place in megacities:

an empirical study of Shanghai 161
D O N G YAO

PART VI
Tokyo 183

8 Community design to prevent solitary death

in super-aged Japan 185
TO S H I O O TS U KI

Conclusion 205
M I H Y E CH O A ND KENG H U A CHO NG

Index 212
Figures

I.1 Percentage of population aged 65 or over in selected

Asian countries. 2
I.2 Old-age dependency ratio in selected Asian countries. 3
1.1 Social lives in kampungs: (a) varying levels of informal public
spaces in front of a Malay kampung house; (b) a kopitiam in
a Chinese village, where men would idle collectively. 22
1.2 New Town structural model. 23
1.3 A precinct centre, with playground, hard court and shops. 24
1.4 (a) Void deck gambling pit stop along HDB slab block;
(b) self-initiated chess playing area under HDB point block;
(c) idling at vehicle drop-off porch. 30
1.5 (a) Re-appropriation of void deck Senior Citizens’ Corners
by older residents in Jurong West; (b) fixed rows of seats in
front of television shelf at the same void deck. 31
1.6 Sectional diagram illustrating four types of liminal space:
(1) extended living rooms at staircase landings; (2) self-made
Senior Corners at void decks; (3) gardens “in my front yard”;
(4) communal farmland at the edge of the estate. 33
1.7 (a) Staircase landing turned into common living room by
elderly men; (b) floor plan of staircase landing. 34
1.8 (a) Multigenerational working and social space at staircase
landing for women; (b) floor plan of staircase landing. 35
1.9 (a) Senior Citizens’ Corner self-made by older residents;
(b) unwanted exercise equipment and children tricycles
salvaged and repaired by the older men, free for other
residents to use; (c) ground floor plan of creative
reclamation of void deck in Dover. 36
1.10 (a) Void deck makeover by older residents; (b) a corner filled
with tricycles, scooters, a miniature slide, a rocking chair for
the young, and wheelchairs for older people; (c) ground
floor plan of creative reclamation of void deck in Yishun. 37
1.11 A pot of soup or dessert prepared every day for the community. 38
viii Figures
1.12 (a) Self-initiated community space adjacent to ground
floor residences – former backyard garden with timber
decking; (b) present front yard garden with new concrete
tile flooring installed by Town Council and re-designated
as ‘Resident Corner’; (c) Christmas celebration at the new
‘Resident Corner’ with neighbours; (d) ground floor plan
of ground-up community gardens adjacent to residential
unit in Toa Payoh. 40
1.13 (a) Communal farmland initiated by the elderly
community at the periphery of Clementi neighbourhood,
occupying space previously owned by the Malaysian
railway company; (b) site plan. 41
2.1 Service loci for patients and public in the north of
Singapore, 2010. 48
2.2 Shifts in service offerings by AHS, 2016–2017. 49
2.3 Red-roofed HDB flats around Chong Pang City. 51
2.4 Wellness Kampung @115, 260, and 765. 53
2.5 Early concept of supported self-management communities. 54
2.6 Resident-led exercise at Wellness Kampung@115. 55
2.7 Breakfast after daily workout. 56
2.8 Deepavali celebration. 57
3.1 Taiwan’s total population change and forecast (1981–2061). 64
3.2 Medium forecast of the shrinking-cum-ageing
status in Taiwan. 64
3.3 The transition from ageing to aged to super-aged
society in Taiwan. 65
3.4 Comparison of the global ageing trend. 65
3.5 Variation of Taipei’s municipal population (1981–2015). 66
3.6 The historical map of 1904 highlighting the three
neighbourhoods of Bopiliao, South Airport, and Ka-la̍   k-á
within the district of Wanhua, where the future Wanda
MRT Line is expected to cut through. 72
3.7 Aunt Kei Tzu behind the confectionery cabinet of Hsiu-ying
Teahouse greeting regular customers. 74
3.8 The transformation of the Bopiliao neighbourhood and
the alley that accommodated its place-ballet. 75
3.9 The South Airport neighbourhood and the different phases
of the modernist resettlement housing and public housing. 77
3.10 South Airport public housing clusters as a showcase of
modernist housing implementation. 78
3.11 The daily operation of the inter-generational SAA LOHAS Land. 81
3.12 The cross-generation SAA Wiser Ball game in the Youth Park. 82
3.13 The Dong-yuan Street arcade space that accommodates
the casual encounters and daily greetings of the neighbours
and the passers-by. 84
 Figures ix
3.14 The participants and their social imagination of the arcade
space in the Dong-yuan arcade project. 86
3.15 Local narratives shared in the publications of Ka-la̍   k-á newsletter. 87
4.1 Landscape of Jangsu Village. 99
4.2 (a) Location of Jangsu Village in Seoul, Korea; (b) map of
Jangsu Village. 100
4.3 Dilapidated houses and steep alleyways. 102
4.4 Dongne Moksu Workshop. 105
4.5 Renovated house under the design guideline. 107
4.6 A new community house. 108
4.7 A wooden bench where older residents spend time together. 109
4.8 Museum exhibition in 2014. 110
4.9 Gardening in Jangsu. 111
5.1 The location of Tseung Kwan O. 130
5.2 Informal facilities at Duckling Hill: Rain shelter. 131
5.3 Informal facilities at Duckling Hill: Flower planters. 131
5.4 Informal facilities at Duckling Hill: Benches. 132
5.5 The map of the Duckling Hill hiking route. 132
5.6 Types of facilities (green icons) and popular activities (red icons). 134
6.1 The traditional design model involves solely the architects
for almost the whole process, from concept design through
detailed design to site work and inspection. Social workers
and elders are in a more passive role in the whole process
and are invited to join only in the final stage of completion
and celebration. 146
6.2 The participatory design model breaks through the
traditional design model by emphasising the involvement
of all stakeholders throughout the whole process,
including the design training sessions and mock-ups,
to reach an inclusive design solution. 147
6.3 Older people exploring the space by arranging some pieces
of model furniture. 148
6.4 Older people learning to use pens and tracing paper to
turn their ideas into sketches. 149
6.5 Designers and other groupmates sharing their views
on the preliminary design. 149
6.6 Each group is given the opportunity to present their
elder-friendly furniture design to the others, leading to
a greater exchange of ideas among all participants. 150
6.7 Social workers and users are testing the mock-up of booth seats. 151
6.8 Older people enjoying the completed booth seats, which
were made with their input. 152
6.9 Movable cabinets to cater to wheelchair users. 153
6.10 Reception counters made with two different levels to
suit wheelchair users. 154
x Figures
6.11 A recess in the reception counter as cane or umbrella holder. 154
7.1 Diagrams of double-aspect individual ageing theory. 164
7.2 Comparison of older people’s preferred place to grow old. 165
7.3 Spatial diagram of community-based integrated
senior facility. 169
7.4 (a) Pilot projects in Shanghai meet the characteristics
of CISF prototype; (b) the Senior Care Home of Weifang
Jiedao; and (c) V-care station in the Wanke City Garden. 173
7.5 Distribution of existing jiedao-level public facilities in
Siping Road Jiedao. 175
7.6 Distribution of public facilities with potential of senior
service in Siping Road Jiedao. 177
8.1 Projected future trends in population and number of
households in Japan. 185
8.2 Japanese trend of the percentage of aged people aged 65
and older compared with other ageing countries. 186
8.3 Change of lifespan in Japan. 187
8.4 Preferences of where the elderly in Japan prefer to live
when physical function declined. 188
8.5 Number of single households 65 years old and older
who were found dead in their houses in Tokyo. 189
8.6 The Regional Comprehensive Care model. 190
8.7 An example of the transformation of the population structure
of a new town built in the suburban area of Tokyo in 1980. 191
8.8 Demographic transformation of Yukarigaoka New Town. 192
8.9 (a) Detached house with modern, contemporary design;
(b) detached house with traditional design. 193
8.10 (a) Akabane-dai Housing Development built in 1962;
(b) old apartments were replaced by large-scale
apartments in Akabane-dai Housing Development. 195
8.11 Greenbelt Museum opened a half-century after the
town was launched. 197
8.12 (a) Exhibition of old daily objects collected in the
Age Exchange community centre of London;
(b) exhibition of old daily objects collected in a
community centre called Age Exchange, Kita-Nagoya City. 198
8.13 The empty shop renovated by students and old daily
objects put up for exhibition. 198
8.14 (a) Exhibition of an amateur photographer living in Akabane-dai;
(b) an old man who often came to see the exhibition. 199
8.15 (a) Workshop about making slippers from old clothes;
(b) workshop about painting on umbrellas; (c) a picnic in
the housing estates that attracted different generations. 200
 Figures xi
8.16 (a) Face-to-face housing connected with covered wooden deck;
(b) Care Zone and Normal Zone; (c) Community Care
Temporary Housing in Kamaishi City. 202
8.17 (a) Ochakko on the deck in Kamaishi; (b) a laundromat
where single old men are witnessed to chat. 203
C.1 Five constellations of urban development and design
framework towards the creative ageing city. 210
Tables

4.1 Status of households and residents in Jangsu. 103

5.1 Empowerment-oriented social work practice: the
theoretical model and the process. 126
5.2 Categories of suggestions for activities and facilities. 136
5.3 Integration of theories and practices: the empowerment-oriented
social work approach and the participatory design workshop. 140
7.1 Function chart of community-based integrated senior facility. 172
Contributors

Gwyneth Wing Lam Chan is Design Manager in the Development Department

of Hong Kong Sheng Kung Hui Welfare Council.
Mihye Cho is an Assistant Professor in the Humanities, Arts and Social Sciences
Pillar at Singapore University of Technology and Design.
Keng Hua Chong is Assistant Professor in the Architecture and Sustainable
Design Pillar at Singapore University of Technology and Design, as well as
a Principal Investigator for Social Urban Research Group (SURGe).
Michael M.J. Fischer is Andrew W. Mellon Professor in the Humanities and
Professor of Anthropology and Science and Technology Studies at the Mas-
sachusetts Institute of Technology, and Lecturer in the Department of Global
Health and Social Medicine, Harvard Medical School.
Crystal Man Chong Ho is Design Manager in the Development Department
of Hong Kong Sheng Kung Hui Welfare Council.
Min Jay Kang is an Associate Professor in the Graduate Institute of Building
and Planning at National Taiwan University.
Jiyoun Kim is a researcher in the Institute for East Asian Studies at SungKong-
Hoe University.
Jackie Yan Chi Kwok is Research Fellow in the Department of Applied Social
Sciences at Hong Kong Polytechnic University.
Toshio Otsuki is Professor in the Department of Architecture and a member
of the management committee of the Institute of Gerontology at the Uni-
versity of Tokyo.
Robert Kin Ming Wong is Project Development Director in the Development
Department of Hong Kong Sheng Kung Hui Welfare Council.
Sweet Fun Wong is Chief Transformation Officer at Alexandra Health System
and concurrently the Deputy Chairman, Medical Board of Yishun Community
Hospital, as well as Senior Consultant, Geriatric Medicine at Khoo Teck Puat
Hospital.
Dong Yao is Associate Professor of Architecture, Assistant Head of Architecture
Department, and Vice Director of the Academic Development Institute of
College of Architecture and Urban Planning at Tongji University.
Foreword
Michael M.J. Fischer

Silver tsunami – paradigm shift – new urban creativity

Midwifing emergent, yet new forms of life is challenging institutionally, financially,
architecturally, psychologically, culturally, and socially. But as this brilliant volume
of detailed case studies illustrates, one can use ethnography-in-the-meantime to
experiment and innovate at the community level before, or especially while,
trying to scale up to citywide planning. Ethnography-in-the-meantime is a set
of tools for attention to those details that matter, and to processes of social
decision making and implementation, of how each of these challenges can be
iteratively modified. Emergent forms of life do not just unfold according to
preformed patterns but require work, both conceptual (in theory) and localized
(in practice).
The ageing of societies and the silver tsunami – the increasing speed of the
ageing of societies, the demographic shift towards a larger proportion of people
over 70 or 75 worldwide,1 especially in Asian cities and societies led by Japan,
Singapore, Hong Kong, Taiwan, Korea, and China – has been on the United
Nations and other policymakers’ horizon for at least three decades.2 How will
societies support the projected health care costs as the percentage of workers
to seniors declines? How can urban rent structures be changed so that the
elderly are not pushed into the spatial and economic margins of cities? Above
all, what kinds of fulfilling lives can we all look forward to as life expectancy
lengthens? The Baby Boomers (or baby boom generation born just after World
War II) are now entering their seventies. They lead the cresting of this silver
tsunami. They are also potentially a qualitatively different kind of generation
of seniors than those who came before: healthier, more active, and less likely
to be content to withdraw into playing supervised bingo, inactivity, or indi-
vidualized religiosity. Perhaps, instead, the Boomers will help formulate creative
new kinds of social living arrangements. Even in traditional terms this period
of life, after householder duties are done, is often thought of as a period in
which both men and women can become more socially creative than they
were while burdened with making a living and raising a family. Such social
creativity must extend also to the issues of the increasing numbers (but not
necessarily percentages) of elders with various degrees and forms of dementia,
 Foreword xv
disability, and needs; to slowing the onset of such problems and to care for
them in ways more distributed, less debilitating for their caregivers and less
upsetting (economically, psychologically) for everyone. The emergent, yet new
forms of social life will be made by harnessing a heterogeneity of individual
talents and age cohorts into new living arrangements that are social, not merely
individual solutions to vibrant communities, what this volume calls creative
ageing cities.
This volume makes a series of interesting pragmatic suggestions regarding
the five principles and eight areas that make for ageing-friendly cities identified
by the United Nations (see note 2). Since then, a series of buzzwords have
peppered both the planning and the community organizing literatures (Introduc-
tion), each new buzzword shifting attention: from age-friendly to ageing-friendly,
from ageing-in-place to ageing-in-community, from active ageing to creative
ageing, from needs-based approaches to rights-based approaches (rights to the
city), from providing for seniors to providing with them in participatory planning
that is meaningful, meaningful in place-making and meaningful in social empow-
erment to own, care for, and improve the environments in which one lives, and
from design for elders to universal design, inter-generational forms of mutual
helping, and sustainable and evolving social creativity.
One of the key paradigm shifts that this volume insists upon, especially given
these demographic shifts, is moving from the idea that cities can be best revital-
ized by a focus on attracting a creative class of young high-tech “creatives” (as
in advertising creatives), implying a cycle of always finding new young residents,
often gay or LGBTQ (lesbian, gay, bisexual, transgender, queer) singles or pairs
without children. As gay individuals age, they can become marginalized, not
unlike other ageing populations.3 Hence this volume explicitly counter poses
the buzzword “Creative Cities” that has powered much recent urban planning,
with Creative Ageing Cities.
Insistence on the agency of residents and the search for alternatives to knock
down, displace, and rebuild approaches to urban renewal provide two further
key ethnography-in-the-meantime inquiries in the present volume. Demolition
and starting anew comes with a high price in social capital – that hard to
metricize collection of services that grow out of experience, familiarity, knowing
the operable social networks (and how they extend beyond the immediate
community), as well as the psychological terrain of the encrusted character and
patina of local usages.
Using case studies in six different urban environments – Hong Kong, Seoul,
Singapore, Shanghai, Taipei, and Tokyo – the present volume attempts to learn
from ongoing organic processes of neighbourhood renewal as not only residents
but also homes and built environments age. The case studies look for ways to
upgrade and incrementally improve the capacities for ageing-friendly urban
environments and also to improve the resilience and capacities of the social
fabric more broadly, not just for elders (universal design). These cases provide
experimental models of spaces that can be modified for application elsewhere
for other kinds of circumstances. Lessons learned from Jangsu in Seoul
xvi Foreword
(Chapter 4), for instance – a steeply sloping neighbourhood built up from an
informal housing settlement over the decades, now home to a community of
craftsmen and providing a site of interest for tourists at the base of an old
fortress – may not be transferable whole scale to a neighbourhood of high-rise
buildings. And yet there may be strategies that apply, say, across pedestrian
bridges between buildings linking community services (as with the elaborately
linked pedestrian ways vertically and horizontally on the mountain slopes of
Hong Kong) or that extend the kind of open-to-the-community elder care
facilities described for Shanghai by Dong Yao (Chapter 7).
Architects and urban planners have long talked of user-centric design and
participant design, but these terms have often been token add-ons to processes
that remain firmly in the control of the planners, architects, and engineers rather
than meaningfully in the hands of the residents who will live in the resulting
“deliverables.” Meaningful here are social empowerment, taking ownership, and
imprinting one’s environment with one’s own meanings.

Place-making
One of the place-making images from Chapter 1 on Singapore that often
returns to me in thinking about making places liveable and that brings with
it a wry smile is that of the older men, “uncles” in Singapore’s familial patois,
placing their plastic chairs along the path by the vehicle drop-off porch at a
Senior Activity Centre. Chong Keng-Hua calls it the “car-porch guard post”
scene. They schmooze and kibbitz, chatter and exchange commentary among
themselves. But, Chong points out, they are also enacting their age-appropriate
civic role as a neighbourhood watch group, creating a safe environment for
returning school children and other members of their community. In older
kampung or village days, they would have done this at the attap-covered but
open-walled coffee shop. It is the kind of function that the urbanist Jane
Jacobs made much of in her famous 1961 book, The Death and Life of Great
American Cities. It is a function that the women in Chong’s “gambling pit
stop scene” and the men in the “chess playing” scene and, in a slightly dif-
ferent way, the “chess hideout scene” perform. All of these depend not just
upon the public seeing-and-being-seen positioning but also upon the ability
to move furniture around, an insistence on informality, particularly against the
official habitus of making everything orderly. No, the men will not play on
the fixed concrete chess tables placed by the builders for their use but will
make their own informal ones “using simple low tables, stools, boxes and
even cable spools” in corners behind the mailboxes (cosy but still visible), or
along the covered walkways. No, they will not move their now 9-year-old site
for chess games along the walkway to a Resident’s Activity Room where they
won’t block the path. More than just the Jane Jacobs function of marking
and protecting their communities, these informalities are an everyday politics
of insisting on making living spaces and socialities one’s own, not the planners’
or social engineers’.
 Foreword xvii
In the high-rise Housing Development Board flats of Singapore, Chong
illustrates, people do this on the landings, on some of the wider corridor-
balconies, and in community gardens along the sides of the housing estates, or
even on the front yards of first-floor apartments. These are all not quite technically
legal and sometimes have to be insisted upon against managers and police tasked
with keeping things uncluttered and orderly.
As the volume concludes, drawing on examples from the case studies, a
place – a quilt for remembering the deceased and for storytelling, a pavilion for
resting and socializing, a corner garden, a care centre, a workshop, a walking
path, and a neighbourhood – serves as a public realm where older people
perform and are recognized as users, residents, and citizens rather than as mere
recipients of social welfare.

Community development trajectories

Communities are building not just typologies but learning organizations com-
posed of double helixes of continuity and innovations, experimenting and figuring
out what works best for those who make up the community. The case studies
here provide a number of different kinds of typologies of community develop-
ment and thus also different kinds of strategies for social empowerment and for
care of the ageing residents and ageing built environments. In rapid urbanization
processes in Asia, Africa, and Latin America, informal communities called vari-
ously gecondu (Turkey), favela (Brazil), hakobang settlements (Korea), bopiliao
or “skin peeling shacks and alleys” (Taiwan), or more neutrally “informal settle-
ments” often have begun as squatter settlements after war, disaster, or migration
from impoverished hinterlands and gradually were hardened from tents or
sheeting to stone and brick, legalized, allowed political representation, eventually
municipally serviced with water and electricity. Among the cases in this volume,
Jangsu in Seoul and parts of South Airport in Taipei began that way, as did
overcrowded swaths of post–World War II Singapore. In other cases, modern
post–World War II housing and post-disaster emergency housing was built for
the displaced and have now become overcrowded and decayed (sections of
South Airport, parts of Shanghai). In Singapore, modernist public housing has
gone through life cycle changes, with new, taller high-rise buildings replacing
older ones and with moving residents into the new buildings before demolishing
the older ones (Chua, 2017). New forms of urbanism are today being sought
especially with the silver tsunami in mind. In Singapore, the Lien Foundation
has solicited ideas for new elder-inclusive architectural arrangements beyond
what currently exists, and both architectural firms and voluntary organizations
have conducted experiments in the participatory design both of senior building
common spaces and external community spaces. In Seoul, the city government
has experimented in physically rotating the mayor’s office through different
communities to get input for participatory budgeting (Douglas, 2016a, 2016b,
2017). These are early-stage efforts to insert local community creativity into
larger urban governance.
xviii Foreword
The case of Jangsu, Seoul, is particularly interesting in being both bottom-up
and laterally inspired, that is, by elders trying to improve things themselves, by
the Alternative Regeneration Research Team, and by the social enterprise Dongne
Moksu (or “village carpenter”) started by an ART civil activist who moved to
Jangsu and recruited other young staff to live in renovated houses as renters
or occupant-owners. These new residents involved older residents with experience
in construction, and all then began to stimulate suggestions from other residents,
and eventually this activity was formally recognized by the government, bringing
further subsidies, municipal services, and community spaces including a coopera-
tive dining room and cafe.
An important mediator of community-level experiments to larger audiences
can be through university departments of architecture and urban planning where
professors and research students leave the premises of the university to help
support and facilitate communities, social service agencies, and localities in order
to build innovative social infrastructures. The activities reported by Min Jay
Kang of his group and others at the National Taiwan University Graduate
Institute of Building and Planning (Chapter 3) is particularly impressive, both
the effort which ultimately failed to prevent developers from targeting Bopiliao,
but which nonetheless must have provided those involved with important
community-building skills, and the extraordinarily successful organizing by the
elected chief (li) of the South Airport Apartments to provide “meals on (moped)
wheels,” create a community kitchen to produce those meals, set up a food
bank that accepts community service labour as payment, transform an old
building into a vibrant community centre, organize elementary school children
to play sports with elders, and set up a storytelling house for seniors to share
and “retrieve their dignity.”4 The sheer variety and inventiveness of activities
designed to aid four different communities in Taipei – from making and screening
short films in public places about the neighbourhood (to stave off developers
destroying the Dong-yuan market in Ka-la̍ k-á , putting up plaques about the
history of buildings and turning those stories into a local opera group’s scripts,
protecting an old tea house, transforming older buildings into several community
centres – are not only impressive in themselves but a response to the failures
of traditional urban renewal strategies for the degraded, historic Báng-kah area.
Kang elaborates two important techniques of ethnography-in-the-meantime:
paying attention to “place-ballets” (patterned choreographies of use, by different
groups of people, and their changing rhythms over the course of the day) and
“memory tapestries” (stories affectively attached to places that give them depth
of meaning, not just as history but as future-oriented inspirations for renewed
creativity). As Kang notes, memory tapestries can be psychologically and thera-
peutically rich, literal mural or quilt projects but also more generally embodied
understandings of place “in restructured social relations and creative cultural
programmes of the local area.”
Similarly, there are mediating efforts between community and municipality
by faculty and students at the Graduate Institute of Gerontology at the University
of Tokyo (Chapter 8), Hong Kong Polytechnic, Hong Kong University’s Sao
 Foreword xix
Po Centre of Aging, the Hong Kong Jockey Club’s sponsorship of four university
gerontology units to launch age-friendly campaigns, and the Hong Kong Council
of Social Service’s encouragement of the city’s 18 district councils to organize
local activities to meet the eight goals of the WHO’s Ageing Friendly Cities
guidelines.
The point is not to provide for imagined elders or even to survey their desires,
do focus groups with them, or do minor participant design (all of which can
be helpful as initial but only initial tools), but to point to a generational sea
change, the so-called silver tsunami that is about to break upon us, in which
younger, energetic, and adventurous seniors will take their living environments
into their own hands in many different unforeseeable ways, along with the needs
of their more disabled cohort members. It is perhaps to them that we might
find ourselves looking in a few years for new ways of addressing some of the
more intractable problems of living together in ever denser high-rise cities.
Younger planners and architects have roles to play in facilitating such inventive-
ness, as do foundations and charities in helping to fund such experiments and
as do public housing authorities.5

Spatial politics
One of the lessons learned from the very different Singapore and Seoul cases
is that people often desire the right to create their own spaces, making them
meaningful in the context of their own lives, and that this desire cannot be
satisfied by even the most well meaning provision of standardized services and
fixtures. There is, of course, a deeper motif legible to any Singaporean, as well
as to residents of Hong Kong, Seoul, Taipei, Tokyo, and elsewhere: the struggle
for the right to politics in the small- “p” sense of the word, in the sense of the
right to everyday living in the way one wants as along as one doesn’t hurt
others (or rights to the city). Although the “authorities” in the Singapore case
(Chapter1) –Town Council managers, Town Council committees, the Housing
and Development Board, and so on – are gradually learning to be more flexible
(as in the simple putting up of a plaque over an informal gathering place on a
void deck, described by Chong, that confirms it as a Senior Residents Corner,
or the agreement that the Clementi community garden could remain in place
under a new contractual understanding), this remains, as Chong puts it, constantly
contested spatial politics. Gradually, the governance structures must learn to
include different conflict management mechanisms, other than blind removal
orders of resident innovations just because they have received a few complaints,
which in turn causes public outcry and ridicule of the governance structures.
Chong recounts some of the many instances of place-making that have been
swept way because unnamed persons have complained, leading in turn to
newspapers and others ridiculing the governance.
The coming silver tsunami will probably herald changes in governance modali-
ties and may well become a creative source for the redevelopment of spaces
beyond the relatively limited ones of corridors, landings, front lawns, and side
xx Foreword
spaces. Interiors, too, need creative thinking of redesign with flexible walls and
furniture but also maybe cooperative forms of ownership that can redevelop
large areas, much as shop house redevelopment has been allowed to break
through walls, forging new architectural typologies, including perhaps more
mixed-use topologies, with services at various levels, not just on the ground
floor, and perhaps flyovers or bridges and monorail connections across buildings
as is tentatively (or only notationally) developed in the high-rent (but HDB)
Pinnacles Towers or such condominium worlds as The Lace and Moshe Safti’s
gigantic Sky Habitat in Bishun (Singapore).
Achieving all this requires new business models (from the household level to
corporate ones), but surely the expertise of the silver tsunami can be put to use
there as well.

Replacing religion
It is always an oddity for outsiders to notice that although much of Singapore’s
sociality, voluntary welfare systems, and sense of altruism is rooted in religious
organizations, such organizations never play a role in discussions of public policies
such as those surrounding the silver tsunami, ostensibly because Singapore is
resolutely (and rightly should remain) a secular form of governance, which does
not mean that its populace is not religious.6 The discussion of health care by
Sweet Fun Wong is the only chapter in this volume to acknowledge this role
of religious organizations and their own transformation from “an authoritarian
influence that helped to manage disputes, taught values, and took care of aged
and destitute” into more social-work voluntary organizations.
Singapore promotes religious freedom (as a private and community set of
rights), regulates religious organizations, and depends upon them where
government services are inadequate. The longitudinal research on the efficacy
of various sorts of intervention to delay the onset of dementia, depression,
isolation, and suicide among the elderly, done by Prof Kua E.E. Hoek (2017),
for instance, is supported with funding and some volunteer personnel by both
the Presbyterians and the most important Chinese Temple in Singapore. There
is a quiet fear that more open acknowledgement of the role of religious
organizations in preserving the social fabric could become conflictual rather
than strengthening a common future of tolerance and solidarity (as happened
when, briefly, religious education was introduced in schools and then quickly
removed (Chua, 2017]). It is a parallel or even a part of the struggle between
allowing urban communities to self-organize and be regulated. Older folks
notoriously are not necessarily more tolerant, but they do have experiential
skills in getting along when there is pressure to do so, and Singapore’s housing
policies and ministries for religious oversight have tried to foster the living
together of different ethnic and religious communities (or “racial” ones, as
the local, increasingly antiquated plural society idiom has it for a society of
many immigrant groups, not merely the four bureaucratically recognized ones:
Chinese, Indian, Malay, and Other).
 Foreword xxi
Community care
Sweet Fun Wong presents a fascinating preliminary account of nurturing “well-
ness kampungs” in Singapore, that is, nurturing buddy relationships and care
for chronic disease victims in the home and local community. This both takes
the burden off hospital emergency rooms but, more importantly, builds resilient
social fabrics especially for senior citizens, otherwise in danger of being left
isolated amidst rapid social change. Like the Regional Comprehensive Care
model in Japan of which Otsuki writes (Chapter 8), this is a way of filling in
the holes in the health care networks. St Luke’s ElderCare – a voluntary welfare
organization founded in 1991 originally by volunteer Christian doctors and
nurses and eight churches and Christian organizations, now a government-funded
community hospital focused on geriatric care – is an important component of
the collaboration that Wong writes about, along with the Alexandra Health
System Network, in fostering this community-based strengthening of health
care. To strengthen the community extension effort, to mitigate places where
care falls between the cracks of public and private medical care, and to increase
the ability of researchers to chart useful medical indicators or behavioural pat-
terns, there is also a renewed push by the Singapore government to mandate
private health care providers to join the national medical records system. Digital
technologies increasingly will help mediate health and community and are
technologies that the ageing generations will increasingly be comfortable with.
Two other community-based care efforts in the current volume’s case studies
are TACEL (Tseung Kwan O Association of Concern for Elderly Livelihood)
in Hong Kong (Chapter 5) and the Community Care Temporary Housing
concept in Japan for post-earthquake emergency housing that focuses on the
needs of elders (Chapter 8). The latter is particularly focused on the problem
of solitary deaths of elders in Japan, exacerbated in displacements after disasters
such as the 2011 Tohoku Earthquake, tsunami, and nuclear meltdown in
Fukushima Prefecture. Otsuki points out the rising costs of care for the elderly
has already meant that promises of free medical care for those over 70 introduced
in 1973 have been modified first in 1983, raising the age to 75 and requiring
co-payments, and again in 2000 with long-term care insurance premiums to be
paid by everyone over 40 in order to have access. The aesthetically pleasantly
designed post-disaster temporary shelters he describes are intended also as
experimental models for designing living arrangements that foster community
and prevent the isolation that leads to suicides and dying alone. One of the
interesting challenges Otsuki lays out is that the architectural solutions are still
slightly mismatched because of the life cycle of families, as well as that of the
housing stock they occupy (expanding with children, then contracting as children
move out). He provides an example of a new town being built using demographic
models to design a diversity of housing types within developments, which don’t
yet quite match the dynamics of families but which the reconfigurable architecture
from the temporary housing models might address (that is, reconfiguring the
housing, particularly the semi-public spaces between housing, over time rather
xxii Foreword
than the families moving). In a striking case of ethnography-in-the-meantime,
Otsuki describes how efforts to draw elders in the temporary housing into
socializing spaces worked for women but not for men and that older single men
tended to find one another, insofar as they did at all, in the benches at the
laundromat. Gender dynamics, of course, should by now be obvious to architects
and planners, but the specifics of how spaces will find their uses are less amenable
to planning than to experimental ethnography as explored by their residents or
users, adapting them over time. In the case of the redevelopment of the modernist
danchi (housing estate) Akabane-dai (developed, like Taipei’s South Airport
housing estate, on the land of a former army base), difficulty in breaking social
relations and efforts to build anew a sense of community in the new apartment
buildings have led to a series of experiments (again not unlike those in Taipei
and elsewhere) to curate a museum of nostalgia items, as well as spaces for
photography and crafts that combine memory tapestries and new place-ballets.
A fuller comparison of the work of Singapore’s Housing Development Board
and the Japan Housing Corporation (now Urban Renaissance Agency) would
be worth fuller investigation for lessons to be learned from various redesign
experiments.
More generally, there is the now East Asia–wide planning rubric taken from
Japan, called in Japan Machizukuri (or Maeul-Mandeulgi in Korea and SheQu-
YingZao in Taiwan), for citizen- or resident-led movements to improve their
communities, said to have begun in post-earthquake and later post–Korean War
contexts.7 After the 1923 Great Kanto Earthquake that devastated much of
central Tokyo, university campuses moved to what would become the town of
Kunitachi, and when bars and clubs began to open to a clientele of American
GIs during the Korean War, the community organized to claim an Education
District designation which would limit use of buildings for adult entertainment.
Similar community movements were picked up elsewhere, and the term became
more generic. More specifically keyed to elders is the Ibasho Cafe, founded by
Dr. Emi Kyota, incorporated as a non-profit in 2010 in Washington, D.C., and
developed in Ofunato (Iwate Prefecture), devastated by the 2011 Great East
Japan Earthquake and tsunami. Ibasho Cafe is a centre where elders can come
together to do projects, hang out, develop their sense of belonging and purpose,
and contribute their skills and knowledge to society.

Paradigm shifts, silver tsunami, creative ageing cities

While there are a number of sources of current paradigm shifts towards what
this volume calls Creative Ageing Cities – failures in previous strategies (high-rise
buildings in Seoul’s Jangsu, axis realignment in Taipei’s Wanhua Báng-kah
district, suburban large nursing homes in Shanghai); practicums in graduate
architecture and urban planning departments (Taipei, Hong Kong); new initia-
tives by municipalities (Hong Kong); and research initiatives by Lien Foundation
and Housing and Development Board (HDB) (Singapore Lien Foundation and
the HDB putting out tenders to architecture and design firms to experiment
 Foreword xxiii
with retrofitting building spaces through senior citizen involvement in participa-
tory design); and United Nations–led policy agendas and guidelines – the
underlying social pressure is coming from a demographic shift often called the
silver tsunami which is forcing new thinking about health care, housing, social
resilience, and community vitality.
This elegantly produced casebook makes a major contribution by getting us
to think in detail, on the ground, about how ongoing organic innovations can
generate new urban models for the coming decades and for social arrangements
we want to live in, whether in high-rise densities (Singapore), conserved neigh-
bourhoods resistant to profit-driven development (Taipei; see also Liu, 2016),
self-help civic engagement supported by government (Seoul), post-disaster
community care-oriented temporary housing (Tono and Kamaishi Cities, Iwate
Prefecture, Japan), participatory design and social empowerment workshops
cognizant of social and political contexts (Hong Kong), or micro-scaled com-
munity-based integrated senior facilities in converted shops, sports facilities, and
other building types (Shanghai). Along the way are fascinating ethnographic
and historical observations that localize and enliven but do not determine our
understandings of how place-making is shaped, such as the contrast between
Malay kampung (stilt houses with verandas for men and kitchen areas for women
but laid out with respect to one another with varying degrees of public interven-
ing spaces) and Chinese houses (next to one another along linear paths, demar-
cated with fences); or open coffee houses and markets as visual foci making the
community legible to itself; or the suggestion that the role of religion shifts
from authoritarian influence to social work and social infrastructure beyond
denominational or temple congregation; or the provision of tools and workshop
spaces for seniors who know how to work with their hands and who can
contribute to retrofitting, repairing, and building community facilities (Hong
Kong, Taipei, Singapore); or attention to spaces that attract “regulars” (Taipei,
Singapore, Jangsu) and to elders who continue to run shops or build stairways
(Hong Kong, Taipei). New emergent forms of social life do not mechanically
unfold by themselves but can be midwifed by ethnography-in-the-meantime,
attending to process as capacity building (not just to finished facilities for users
to adapt themselves to) and attending to the choreographies of place-ballets
and memory tapestries of heterogeneous histories.
Read this book: it will change how you see the cities around you and their
potentials for new emergent forms of life involving multiple generations and
interdependencies on scales both large and small.

Notes
1 As both retirement age and the age of the Boomers creep up into the seventies,
it seems that to use the old 60 or 65 years as a definition of elders or the aging
society is out of date.
2 Ageing-friendly cities were put on the United Nations agenda in 1991 with five
principles: independence, participation, care, self-fulfillment, dignity (Resolution
A/RES/46/91). In 2002, the Madrid International Plan of Action on Ageing
xxiv Foreword
(MIPAA) established guidelines for the “building of a society for all ages,” fol-
lowed in 2007 by the World Health Organization (WHO) Global Age-friendly
Cities Guide that identified eight areas of urban life that constitute an ageing-
friendly city: outdoor spaces and buildings; transportation; housing; social participa-
tion; respect and social inclusion; civic participation and employment; communication
and information; and community support and health services. In 2010, the WHO
Global Network for Age-friendly Cities and Communities (GNAFCC) was estab-
lished to facilitate the exchange of information, resources, and best practices. In
June 2017, Paris became the 500th city to join the network with its ageing-friendly
initiatives.
3 Hu, Winnie, “Gay and Growing Old with Few Housing Options.” The New York
Times, 4 July 2017, A15 (www.nytimes.com/2017/07/03/nyregion/housing-lgbt-
seniors-new-york-city.html?_r=0).
4 For a complementary account, see John K.C. Liu’s September 29, 2016 lecture
at the Centre for Liveable Cities in Singapore. Liu provides a history of participa-
tory planning in Taiwan after the lifting of martial law in 1987 and the flourescence
of civil society associations, particularly the history of his own Building and
Planning Research Foundation, which he set up upon his return from the United
States at the National University of Taiwan, acknowledging as well two other
important non-governmental organizations focused on housing issues, OURS and
Tsui Mama. The Foundation has been involved in some 500 projects, and the
case study he presents is of Treasure Hill in the heart of Taipei, a site somewhat
like Jangsu in Seoul that became reconstructed one-third for the original now
aging residents, one-third as an artists’ village, and one-third as hostels for young
people. He touches on some of the problems encountered both in creating a
workable mix of groups and especially the work of dealing with multiple govern-
ment agencies (fire codes, seismic codes, etc.) and training community organizers.
One of the success stories that Mihye Cho, one of the editors of this volume,
has also reported on elsewhere is of a vacant and overgrown building that the
community turned into centre with shared tools for repairing things or helping
with construction, food preparation and distribution, and socializing.
5 Each urban environment will have a different mix of such facilitators and municipal
regulations that may need updating. In Singapore, for example, see Chua (2017)
for an extended discussion of the financing of the housing markets. The Lien
Foundation has commissioned one of the editors of this volume to produce a
volume on ideas for out-of-the-box ageing-friendly and aging-in-community design
for Singapore in order to help the Housing Development Board and private
developers generate new ideas.
6 See in particular Chapters 6–10 on church, Hinduism, a Chinese’s temple’s history,
Buddhism, Islam in Lim and Lee, eds. (2016).
7 Shun-ichi J. Watanabe, “The Historical Analysis of the ‘Kunitachi Machizukuri
Movement’: Its Nature and the Role of Professor Shiro Masuda” (www.fau.usp.
br/iphs/abstractsAndPapersFiles/Sessions/36/WATANABe.pdf).

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in Asia’, in H Ranga, MK Ng, J Chase, and Libby Porter (eds), Insurgencies and
revolutions: reflections on John Friedmann’s contributions to planning theory and
practice, Routledge, New York.
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Douglas, M 2016b, ‘Creative communities and the cultural economy – Insadong,
chaebol urbanism and the local state in Seoul’, Cities, vol. 56, pp. 148–155.
Douglas, M 2017, From corporate globopolis to progressive cities in Asia – alternative
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resilience, World Bank & Global Facility for Disaster Reduction and Recovery,
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Acknowledgements

The idea of this book stemmed from numerous discussions during the beginning
years of Singapore University of Technology and Design (SUTD), where faculty
across different disciplines were challenged to address pressing issues in the
world through new designs and perspectives. Professor Kristin L. Wood and
Professor Christopher L. Magee played an important role in scoping and initiating
this project, for which we are thankful. We are grateful for the generous support
from SUTD-MIT International Design Centre (IDC) for this study, under the
research project Creative Aging City. Special thanks go to the staffs from IDC –
Dawn Chia, Rosnizawati Binte Sani, and Ifraim Sofian Faylasuf – for their
support especially for the Creative Ageing Cities Symposium during the 4th
SUTD-MIT IDC Design Summit in January 2016. Most of all, we would like
to thank Professor Michael M.J. Fischer, our collaborator for this project, for
his mentorship and friendship throughout these past few years of research,
providing us with great insights into this topic. Finally, we particularly want to
thank Ha Tshui Mum (Summer) for her capable assistance in the preparation
of this book and all the past researchers of SUTD Social Urban Research Groupe
(SURGe) – Dr. Kien To, Dr. Sunghee Shin, Debbie Loo, Zheng Jia (Judy),
Denise Tan, Yu-Lin Ooi, and Hai-Yin Kong, without whom this book would
not be possible.
Abbreviations

ADL activities of daily life

AHS Alexandra Health System (Singapore)
ARRT Alternative Regeneration Research Team (Seoul)
CAI Committee on Ageing Issues (Singapore)
CISF Community based Integrated Senior Facility (Shanghai)
CNY Chinese Yuan Renminbi (Shanghai)
ESCAP Economic and Social Commission for Asia and the Pacific
(Bangkok, Thailand)
GRC Group Representative Constituency (Singapore)
HDB Housing and Development Board (Singapore)
HKCSS Hong Kong Council of Social Service (Hong Kong)
HKSKH Hong Kong Sheng Kung Hui Welfare Council (Hong Kong)
IMC Inter Ministerial Committee (Singapore)
JHC Japan Housing Corporation (Tokyo)
LIA Landscape Improvement Agreemen (Seoul)
LOHAS Lifestyle of Health and Sustainability (Taipei)
MCA Ministerial Committee on Ageing (Singapore)
MCDS Ministry of Community Development and Sports (Singapore)
MOGAHA Ministry of Government Administration and Home Affairs (Seoul)
MOH Ministry of Health (Singapore)
NGO non-governmental organisation
NIMBY not in my backyard
NPTD National Population and Talent Division (Singapore)
NTD New Town Development (Seoul)
NTU-GIBP National Taiwan University’s Graduate Institute of Building and
Planning (Taipei)
OECD Organisation for Economic Cooperation and Development
OSRI On: Space Research Institute (Seoul)
PA People’s Association (Singapore)
PAR Participatory Action Research
RC Residents’ Committee (Singapore)
SAA South Airport Apartments (Taipei)
SAGE Society for the Aged (Hong Kong)
xxviii Abbreviations
SLEC St Luke’s ElderCare Centre (Singapore)
SMG Seoul Metropolitan Government
SRO single-room occupancy (Taipei)
TACEL Tseung Kwan O Associationi of Concern for Elderly Livelihood
(Hong Kong)
UNDESA United Nation Department of Economics and Social Affairs
UR Urban Renaissance Agency (Tokyo)
URSs Urban Regeneration Stations (Taipei)
WHO World Health Organization
Introduction
Keng Hua Chong and Mihye Cho

Can ageing cities be creative?

Since the turn of the millennium, the notion of ‘Creative City’ (Landry, 2000;
Florida, 2002) has directed urban development from increasing productivity
towards fostering creativity. To attract the relatively young and mobile talents
(the so-called creative class) who are expected to drive innovations in the new
creative economies, cities around the world have been competing in attractive
job opportunities, iconic architecture, and vibrant urban life in the past decades.
While these developments brought about urban renewal much needed in many
post-industrial downtowns, the movement, as pointed out by critics, has often
led to the gentrification of originally ‘authentic’ neighbourhoods, losing the
diversity and distinctiveness that the creative class craves, segregating social groups
through privatising public spaces, increasing housing market pressures, and
generating more socio-economic inequality (Peck, 2005; Kagan and Hahn, 2011).
Furthermore, such an urban regeneration model focusing on place-making for
the younger population also did not account for the fact that urban populations
are rapidly ageing at the same time in most of these developed cities.
Ageing population and rapid urbanisation are the two major demographic
shifts in today’s world. By 2050, all regions of the world except Africa will have
nearly a quarter or more of their populations at ages 60 and above, and by
then, 66 per cent of the world population is projected to live in cities (UN,
2014, 2017). Urban policy and architectural design will now have to deal with
issues of an ever larger ageing population, as well as ageing living environments,
while taking into consideration the diverse lifestyles and expectations for well-
being. To continue living in the existing urban neighbourhoods requires necessary
interventions both to adapt the changing needs of the ageing population and
to improve the deteriorating environment for better liveability (Phillipson, 2004;
Gilroy, 2008; Beard and Petitot, 2010; Buffel, Phillipson, and Sharf, 2012).
In order to imagine a more realistic and positive future of cities, we propose
to conceive urban design by linking the two contemporary urban challenges –
ageing and creativity. Our book, Creative Ageing Cities: Place Design with Older
People in Asian Cities, highlights the contribution and participation of ageing
populations as a creative force towards urban design and place-making, particularly
in rapidly ageing Asian cities, and outlines a new design framework to invite
various stakeholders, especially older people, to co-create urban neighbourhoods.
We propose that ‘ageing’ and ‘creativity’ should be complementary concepts, as
2 Keng Hua Chong and Mihye Cho
we attempt to understand the diverse experiences about ‘becoming aged’ in cities
and to reveal how people make sense or make better use of their surrounding
places as they age, through critically examining various forms of creative process
and emerging social-spatial constructs. This book builds upon more recent
scholarships that depart from the narrative of ‘creative class’ to a more sustainable
practice of ‘social creativity’ (Sasaki, 2010; Wilson, 2010; Kagan and Hahn,
2011). Rather than referring to creativity as a particular labour force, it approaches
creativity as an innovation-making capacity, both individually and collectively.
With this in mind, it argues for the ‘normalisation’ of an ageing population and
the advantages that could be gained by bringing the ageing population and their
experience into the perspective of city making (Kresl and Ietri, 2010).
In this respect, this book examines the actual constraints, opportunities,
processes and options to make liveable places that facilitate ageing, through case
studies in diverse neighbourhoods in Asian cities. By 2050, Asia will become
the oldest region in the world, with some 922.7 million elderly aged 65 or
over, accounting for 62 per cent of the global elderly population (Menon and
Melendez, 2009, pp. 293–296). Nevertheless, within Asia, different countries
are at different points of demographic transition both in timing and speed.
Figures I.1 and I.2 show the percentage of population aged 65 or over and

40

35
Percentage of populaon aged 65 or over

30

25

20

15

10

0
1950 1975 2000 2015 2025 2050

World Populaon Singaopore Taiwan Republic of Korea

Hong Kong China Japan

Figure I.1 Percentage of population aged 65 or over in selected Asian countries.

Source: United Nations, Department of Economic and Social Affairs, Population Division, 2017
 Introduction 3

80.0

70.0

60.0
Old-age dependency rao

50.0

40.0

30.0

20.0

10.0

0
1950 1975 2000 2015 2025 2025

World Populaon Singaopore Taiwan Republic of Korea

Hong Kong China Japan

Figure I.2 Old-age dependency ratio in selected Asian countries.

Source: United Nations, Department of Economic and Social Affairs, Population Division, 2017

old-age dependency ratio (ratio of elderly population aged 65 or over per 100
working population aged 15–64) in the top ageing countries in Asia. East Asia
will age earlier and faster, led by more developed countries like Japan and South
Korea, followed by newly industrialised economies such as Hong Kong and
Taiwan. Singapore is the earliest among Southeast Asian countries to experience
an ageing population, yet her rate of ageing is the fastest in Asia. China’s large
population is also starting to face a serious impact due to ageing.
Ageing trends affect a huge range of socioeconomic realities in a given society,
including job market, migration, living arrangements, urban infrastructure, health
care, and social policies (Eggleston and Tulkapurkar, 2010). Empirical analyses
are employed in this book to focus on exploring the relationship between local
particularities and specific design and place-making that each locale adopts.
Special attention has been paid to the participation of older people in such
place-making processes in order to investigate their contribution to locally
specific, sensible, workable and desirable design. Through the studies of six
selected Asian cities – Singapore, Seoul, Tokyo, Taipei, Hong Kong, and Shanghai – all
of which face a significant ageing process, this book examines how people
creatively adapt the new urban realities of ageing in terms of urban design and
place-making, towards an emerging trend of creative ageing.
4 Keng Hua Chong and Mihye Cho
By putting together these case studies, the book proposes a new urban develop-
ment and design framework that puts emphasis on the continuous residency of
inhabitants and collective wisdom and experiences of residents as a source of
creativity. Creative ageing puts forward multi-stakeholder collaboration and inter-
generational relations in urban design and place-making. Often, ageing-concerned
policies tend to emphasise old people’s independence and self-support as part of
‘active’ ageing. However, such emphasis can problematise the inevitable depen-
dence and passiveness of the life-stage as being dependency prone. As dependence
and passiveness are part and parcel of ‘normal ageing’, we argue that future design
should aim for the alleviation of the dependency of older people rather than its
elimination. As Kochera and Bright (2006) observed, “[P]ositive outcomes for
older people involve more than independence” but must “include the ability of
older people to function and remain active in the setting of their choice and to
continue to enjoy their desired level of support and interaction with other people”
(p. 35). For that, creative ageing embraces ‘interdependence’, which would in
turn contribute to the ageing-well of the whole society. Therefore, we need to
revisit the existing notions of ‘age friendliness’, ‘ageing in place’, and ‘active
ageing’ in order to offer a new perspective on creative processes to achieve both
‘independence’ as well as ‘interdependence’ in existing ageing neighbourhoods.

Ageing in urban environment: evolving

concepts and applications
We note three general trends in the discourses that relate ageing to urban
environment and that are relevant to this book.

From age-friendly to ageing-friendly

The term ‘age-friendly city’ was first used by the World Health Organization
(WHO) when the Global Age-friendly Cities project was conceived in 2005.1
Building on WHO’s earlier ‘active ageing’ framework (2002), the age-friendly
city concept was defined as one that “encourages active ageing by optimising
opportunities for health, participation and security in order to enhance quality
of life as people age” (WHO, 2007, p. 1). Fitzgerald and Caro (2014) added
that the age-friendly city “offers a supportive environment that enables residents
to grow older actively within their families, neighbourhoods, and civil society
and offers extensive opportunities for their participation in the community”
(p. 2). While it builds on the earlier concept of ‘elder-friendly communities’,
defined by Alley, Liebig, Pynoos, Banerjee and Choi (2007) as “places that
actively involve, value, and support older adults, both active and frail, with
infrastructure and services that effectively accommodate their changing needs”
(p. 1), the ‘age-friendly’ concept differs in that it emphasises “design for
diversity”, hence going beyond ‘elder-friendly’:

(I)t should be normal in an age-friendly city for the natural and built
environment to anticipate users with different capacities instead of designing
 Introduction 5
for the mythical ‘average’ (i.e. young) person. An age-friendly city emphasises
enablement rather than disablement; it is friendly for all ages and not just
‘elder-friendly’.
(WHO, 2007, p. 72)

The resulting checklist – Global Age-friendly Cities: A Guide (WHO, 2007) – was
then used as a tool to help identify age-friendly features in each city.2 Different
terminologies were nevertheless used in different regions when referring to
developing an age-friendly environment, such as “age-friendly community” in
Canada (Menec, Means, Keating, Parkhurst, and Eales, 2011; Golant, 2014),
“liveable community” in the United States (Kochera and Bright, 2006; Ball,
2012; Howe, 2012), and “lifetime neighbourhood” in the UK (Harding, 2007;
Bevan and Croucher, 2011). This is not a major issue, as it actually highlights
the range of policies and initiatives, emphases and approaches employed by
researchers and policymakers (Lui, Everingham, Warburton, Cuthill, and Barlett,
2009, p. 117; Steels, 2015, p. 46). In fact, more specific and contextual age-
friendly planning and design guidelines were developed and applied in the
United States (Kihl, Brennan, Gabhawala, List, and Mittal, 2005; Ball, 2012)
and UK (Harding, 2007; Handler, 2015). Diversity and variations of applications
could also be observed in various municipals’ projects and community initiatives
around the world, in response to the particularity of city characteristics and
contexts, in terms of population density, climate, topography, social and civic
organisation, health and social services, transportation and traffic, crime rate,
etc. (Buffel et al., 2012, pp. 601–606; 609–611; Fitzgerald and Caro, 2014,
pp. 4–6; Caro and Fitzgerald, 2015).
Diversity across places and heterogeneity within the community are therefore
critical in the age-friendly discourse, as recognised by Lui et al. (2009) in their
review of age-friendly literature. Buffel et al. (2012) critically questioned “the
use of a universal checklist of action items as a starting point for creating
age-friendly communities” (p. 606) and argued for a shift in achieving age-
friendliness from making an ideal city to understanding the “actual opportunities
and constraints in cities for maintaining quality of life as people age” (p. 601).
Buffel and Phillipson (2016) also pointed out diverse and complex forms of
urbanisation in the world, such as the accelerating urbanisation in Africa and
Asia and the need to take into account such variety when applying age-friendly
concepts (p. 98).
Surveying across all the key features of age-friendly policies and initiatives,
both Lui et al. (2009) and Steels (2015) concluded a need for an integrated
physical and social environment. They advocated a model of participatory,
inter-sectoral, and collaborative governance because “an enabling social environ-
ment is just as important as material conditions in determining well-being in
late life” (Lui et al., 2009, p. 118). A positive social environment can provide
opportunities and support for education, learning, employment and volunteering,
and participation in community activities (Scharlach and Lehning, 2013). Oppor-
tunities could also be created to involve an ageing population in the planning
and regeneration of neighbourhoods, while benefitting from their experience,
6 Keng Hua Chong and Mihye Cho
their attachment to neighbourhoods, and their involvement in community
organisations (Buffel et al., 2012, pp. 606–611; Buffel and Phillipson, 2016,
p. 98). More recent studies highlight the importance of inter-generational
opportunities for social inclusion, interaction, and integration in order to bring
benefits to all ages building on the foundation of lifetime ageing-well (Howe,
2012; Steel, 2015, p. 48). It has been observed that such ‘ageing-friendly’
communities promote the well-being and inclusion of older persons, as well as
strengthening community integration and social capital (Scharlach, 2012; Schar-
lach and Lehning, 2016).
The ‘ageing-friendly’ community is defined as “one where older residents can
continue to engage in life-long interests and activities, and enjoy opportunities
to develop new interests and sources of fulfilment, and receive necessary supports
and accommodations that help meet their basic needs” (Lehning et al., 2007).
It departs from age-friendly concepts in two ways.
First, beyond physical and social, the notion of the ‘ageing-friendly community’
introduces the psychological dimensions of ageing, summarised in five concepts
derived from lifespan developmental psychology: (1) Continuity (ability to
maintain established patterns of social behaviours and social circumstances, so
as to preserve internal psychological structures and health-promoting activities),
(2) Compensation (availability of products and services to meet the basic health
and social needs of individuals with age-related disabilities), (3) Connection
(opportunities for meaningful interpersonal interactions that foster reciprocal
support and maintain social connectedness), (4) Contribution (lifelong need to
feel that one is making a positive impact on one’s environment), and (5) Chal-
lenge (age-appropriate opportunities for physical, intellectual, and social stimula-
tion to ward off the physical and mental decline caused by lack of stimulation)
(Scharlach, 2012, pp. 28–29).
Second, it addresses diversity and variation issues through physical and social
infrastructures that are designed for multiple-family, mixed-use, and community
integration as residents age (Scharlach, 2012, p. 29). It thus takes into account
the process of ageing rather than the distinct features needed by the aged and
builds on the resources of different age groups for reciprocal benefits. Such
perspectives are indeed useful in planning and design especially for older, less
resourced communities in facilitating ‘ageing-in-place’, a concept that we will
discuss next.

From ageing-in-place to ageing-in-community

Over the last three decades, the so-called ageing-in-place movement has gained
prominence globally (Vasunilashorn, Steinman, Liebig, and Pynoos, 2012). The
term ‘ageing-in-place’ can be understood as the general preference by older
persons to grow old and remain independent in their familiar environments for
as long as possible (Heumann and Boldy, 1993). Two factors, as pointed out
by Callahan (1992), have contributed to this movement: the explosive growth
of homeownership after World War II and the perception that it was unnecessary
 Introduction 7
for many older people to go into nursing homes, when they can actually remain
in their own homes. At the policy level, ageing-in-place is also considered more
cost-effective than institutionalised care (WHO, 2007).
Research on ageing-in-place has generally focused on housing and support
systems (service and technology) in order to enable older persons to continue
living in their existing environments (e.g. Pastalan, 1990; Golant and LaGreca,
1994; Taira and Carlson, 1999; Rowles and Chaudhury, 2005; Vasunilashorn
et al., 2012), as well as the intertwining relationships with the older persons’
sense of place and attachment to familiar places (Smith, 2009; Gardner, 2011;
Wiles, Leibing, Guberman, Reeve, and Allen, 2011; Rowels and Bernard, 2013).
However, recent studies have begun to critically examine the practice of ageing-
in-place and its negative experiences faced by older people, such as weak social
networks, isolation, loneliness, lack of accessibility, variations in life satisfaction,
dwindling choices, helplessness, and boredom, particularly worsened by the
suburban sprawl (Sixsmith and Sixsmith, 2008; Thomas and Blanchard, 2009).
Thomas and Blanchard (2009; Oswald, Jopp, Rott and Wahl, 2011), further
deconstructed the ‘false choice’ between institutionalised long-term care driven
by a biomedical perspective on ageing and an idealised vision of ageing-in-place,
and hence proposed a third approach: ageing-in-community.
In fact, the idea of community living was already mentioned in earlier literature
on ageing-in-place (Callahan, 1992). However, it was only recently that the
latent benefits of the community and its social capital became more apparent.
Ageing-in-community is defined as “people working together (to) create mutually
supportive neighbourhoods to enhance well-being and quality of life for older
people at home and as integral members of the community” (Thomas and
Blanchard, 2009; Black, Dobbs, and Young, 2012; Greenfield, Scharlach,
Lehning, and Davitt, 2012; Blanchard, 2013a; Scharlach and Lehning, 2013;
Baker, 2014). The ‘community’ here refers to “a small group of people who
voluntarily choose to rely on each other and to be relied upon over an extended
period of time” (Thomas and Blanchard, 2009). The concept works based on
three premises: first, a smaller, clustered, village-like context that offers daily
social connections; second, people of all ages and abilities who share the belief
in ongoing efforts towards a common good; and third, a network of informal,
voluntary, reciprocal relationships found in everyday life that forms the social
capital. This would then lead to an inclusive, sustainable, healthy, accessible,
interdependent, and engaged community (the six qualities of ageing-in-com-
munity) (Thomas and Blanchard, 2009).
Several cases in United States have since been documented and categorised
into typologies, including shared housing (private living units with communal
living areas), clustered living community (or co-housing, either elder centric or
inter-generational, that comes with shared amenities such as library and laundry),
and the ‘Village Model’ (non-profit organisation to vet and organise programmes
and services for older residents) (Thomas and Blanchard, 2009; Blanchard,
2013b; Baker, 2014). Such an approach is particularly attractive to the ageing
middle-income Boomers, as they face higher costs of living, stagnant wages, job
8 Keng Hua Chong and Mihye Cho
insecurity, decreasing home values, skyrocketing costs of long-term care and
health care, and changing family structure, i.e. fewer children to depend on,
unlike previous generations (Blanchard, 2013a). They are less hopeful of retire-
ment and are thus looking for an affordable, viable alternative.
Ageing-in-community not only provides this alternative, it also offers them
opportunities to make a difference and to give back to society by ‘helping other
older folks’, to continue to age-in-place by being self-reliant, to gain better
respect from other age groups, to stay connected with events and activities, and
to continue to be mobile and active (Black et al., 2012). Indeed, the movement
goes beyond independence, self-reliance, and individualism in the traditional
concept of ageing-in-place and focuses more on interdependence, mutual support,
and collaboration, transforming from a physical location of ‘place’ to an intangible
network of relationships (Blanchard, 2013b). In the United States, the Baby
Boomers also bond better with friends and are considered to be the ‘cultural
creatives’ – “people who buy with their values; are involved in community
organisations and social and political activities; find innovative solutions in creating
their environment; and who place a high value on the quality of their life situ-
ation” (Paiss, 2008, quoted by Blanchard, 2013a). This leads to our next discus-
sion, ranging from active ageing to the emerging creative movement.

From active ageing to creative ageing

As mentioned, a central theme underlying the concept of age-friendly environ-
ment is the idea of ‘active ageing’, originally developed during the United
Nations’ Year of Older People in 1999 and further elaborated by the WHO
(2002) (Buffel et al., 2012, p. 599). In Active Ageing: A Policy Framework
(2002), the WHO defined active ageing as “the process of optimising opportuni-
ties for health, participation and security in order to enhance the quality of life
as people age” (WHO, 2002, p. 12) and stressed that the word ‘active’ refers
to “continuing participation in social, economic, cultural, spiritual and civic
affairs, not just the ability to be physically active or to participate in the labour
force” (WHO, 2002, p. 12). The term was adopted to convey a more inclusive
message than ‘healthy ageing’ (Kalache and Kickbusch, 1997), recognising the
factors affecting older people beyond health care and shifting away from a
“needs-based” approach (which assumes that older people are passive targets)
to a “rights-based” approach (which recognises the rights of older people to
equality of opportunity and treatment) (WHO, 2002, p. 12).
However, building on Lawton and Nahemow’s (1973) ecological perspective
of ageing,3 most studies on active ageing have been focusing on the relation-
ships between the neighbourhood context and health, particularly physical
activity and mobility in older people (e.g. Fisher, Li, Michael, and Cleveland,
2004; King et al., 2005; Michael, Green and Farquhar, 2006; Berke, Koepsell,
Moudon, Hoskins, and Larson, 2007; Brown et al., 2008; Clark et al., 2009;
Lee, Ewing and Sesso, 2009; Beard and Petitot, 2010; Zeitler, Buys, Aird, and
Miller, 2012). Urban design factors elaborated in these studies include
 Introduction 9
maintaining footpaths, provision of bus shelters and nearby bus stops, creating
destinations attractive to older people (such as local shopping and services),
which can result in older persons feeling less isolated, and helping to enable
mobility and walkability (Steels, 2015: 48). While WHO acknowledged that
“ageing takes place in the context of others” and that “interdependence as
well as intergenerational solidarity . . . are important tenets of active ageing”
(WHO, 2002: 12), it is apparent that the focus is still on individual “autonomy”,
emphasising activities related to daily living (ADL) and “living independently
in the community with no and/or little help from others” (WHO, 2002, p.
13), which explains the research trend. Our proposal of a ‘creative ageing city’
thus aims to fill this gap.
Our idea of ‘creative ageing city’ continues the investigation on the relation-
ships between the neighbourhood context and the well-being of older people.
Furthermore, it highlights interdependent and inter-generational living with one
another, how their ‘social creativity’ (Sasaki, 2010; Wilson, 2010) – an alternative
source of creativity through collective wisdom and experience – contributes to
the ‘neighbourliness’ of the place and so helps to conceive a more socially and
culturally sustainable design.
This concept is to be differentiated from the concept of ‘productive ageing’,
which promotes an older person’s contributions to society in social and economic
capacities (Butler and Gleason, 1985; Morrow-Howell, Hinterlong, and Sher-
rand, 2001; Holmerova et al., 2012). While creative ageing also leads to the
opportunities to remain productive in later life and to contribute to one’s
community, its key focus is not productivity but creativity. Thus, its emphasis
is steered away from economic activities and the perception of working (whether
it is full-time or part-time employment, caregiving, or volunteering).
This concept is also to be differentiated from other definition of creative
ageing used in the creative arts discipline, where arts-based activities (such as
painting, dance, music, and drama) are deployed to improve the health and
well-being of older people, especially in the context of cognitive impairment
(Elliott, Grant and Morison, 2010; Grant, Elliott and Morison, 2012; Vogelpoel
and Jarrold, 2014; Klimczuk, 2015). Although participatory arts could also be
employed by older people as a medium, it is only one of many ways in the
‘creative ageing city’ concept to achieve better sense of place for the community.
While the premise is similar, that is, access to the arts as a human right, the
‘creative ageing city’ concept adopts a much wider approach towards the con-
struct and design of social and physical environment, emphasising the access
and appropriation of urban spaces (choice) and the right to participate in decision
making concerning their environment (voice).
Our concept of ‘creative ageing city’ is closely related to the ideas of ‘con-
tribution’ and ‘challenge’ in the ageing-friendly lifespan development psychology
model and to that of ‘interdependence’ and ‘engaged’ in the social movement
towards ageing-in-community. It refers to an ongoing process of discovering
one’s potentials, negotiating and collaborating with one another for making a
shared physical and social environment befitting the changing needs of a
10 Keng Hua Chong and Mihye Cho
community as its residents age. It emphasises a necessity to integrate what we
call the social creative capital into urban design methodologies and processes
in order to co-facilitate and co-develop a more gradual, adaptive, and innovative
place-making process and suite of design strategies. It fosters multi-stakeholder
collaboration, which combines self-help, civic participation, expert engagement,
and governmental intervention. Ultimately, it aims to come up with specific
design ideas suited for a locale.
The idea of ‘social creative capital’ stems from the notions of ‘social capital’
and ‘social creativity’ – “the collective and relational nature of creative practice,
where divergent thinking, trans-disciplinarity, co-ownership, heterogeneous
knowledge production, boundary-spanning, technology-brokering, collabora-
tion, dialogue and reflexivity, are all important features” (Wilson, 2010, p. 373).
Social creativity “challenges the authorship and authority of knowledge, and
considers our relationship with different kinds of knowledge, focusing attention
on how this knowledge is shared, learned and communicated” and encouraging
“actionable crossing of boundaries . . . through participative learning and
inventive co-creation of social and economic justice” (Wilson, 2010, p. 373).
This notion also builds on the concepts of ‘social structure of creativity’, where
a “flexible network system of small scale production facilities” and “regional,
grass-roots capability” are harnessed to “find solutions to social exclusion prob-
lems” (Sasaki, 2010, p. S4).
Such a social turn towards creativity has been formulated to rethink the
creative thesis which focuses on a labour force as an engine of urban develop-
ment. We find this social approach towards creativity highly relevant and appli-
cable to understanding the dynamics between creativity, ageing community, and
the urban environment. It revisits publicness of knowledge production and
sharing and focuses on ordinary people other than creative individuals. The
following chapters document and analyse cases in Asian cities that explicate such
characteristics. It is with these case studies that we aim to conceptualise a new
design framework towards creative ageing cities.

Overview of the book

Two chapters about Singapore examine place-making and community empower-
ment efforts in high-rise and high-density living environments under centralised
planning. In order to tackle housing shortage in the 1960s, the Singapore
government undertook massive housing development to build high-rise public
housing estates. While people came to live in affordable and comfortable houses,
the community space and lifestyles embedded in kampungs (villages) disappeared.
The authors revisit the importance of community space and lifestyles to cope
with the trend of rapid ageing in Singapore.
The chapter on Taipei explores older people’s engagement in the neighbour-
hood conservation project. The project demonstrates the coupling of residency
rights and ageing-in-place as a protest against developmental and profit-oriented
urban development in Taipei. This chapter reveals the precarious life of the
 Introduction 11
urban underprivileged, including older people, and the multi-narratives of place
memory. The Taipei case provides an opportunity to reflect on the intercon-
nection between residency stability, ageing-in-community, and the role of design
in strengthening it.
Seoul’s case explores how older tenants and squatters in an impoverished neigh-
bourhood have drawn on diverse resources to prevent displacement. The authors
show that neighbourhood design projects functioned as a concrete occasion to
combine self-help, civic engagement, and governmental intervention – in other
words, to form multi-stakeholder cooperation. This chapter demonstrates that the
notion of ageing-in-place might provide an alternative framework for urban regen-
eration – one that places more emphasis on the continuous residency of inhabitants,
progressive transformation and repair, recycling and the reuse of built forms.
The two chapters on Hong Kong illustrate the attempts to involve older
people, seeing them not merely as passive participants but as co-creators of
solutions in the making of their own neighbourhood and living environment.
While Hong Kong has been promoting the idea of age-friendliness in the city,
the focus is mainly on physical infrastructure and health services. The authors,
coming from different backgrounds of social works and architecture, show how
design workshops, when appropriately programmed and facilitated, could
improve the design process, empower older people and achieve better-quality
environment, whether it is a hiking route or an aged care complex. Both chapters
challenge the traditional roles of designers and social workers, advocate
empowerment, and highlight the initiative and contribution of older people in
place-making.
Chapter 7, on Shanghai, explores the challenge of pursuing ageing-in-com-
munity in the contexts of dense megacities. Megacities experience space shortage
in downtown areas, and neighbourhoods in downtown areas are often against
the establishment of care centres due to the fear of a degradation in property
value. The built structures of the inner city areas, developed a long time ago,
would require refurbishment and could be repurposed and utilised for nursing
homes and day care facilities, but this seems a poor utilisation for land whose
property values are so high. This chapter questions whether care facilities detached
from families, friends, and communities of older people could secure the con-
tinuity of social life, which is essential for ageing-in-community. The author
proposes the provision of multiple ageing services via the appropriation of
existing public facilities in downtown areas.
Finally, the chapter on Japan showcases what could be potentially the future
of many ageing Asian cities, when people aged 65 or over represent more than
a quarter of the population. In this ‘super-aged’ society, the conversation begins
to shift from ageing to dying. Particularly, the author examines the phenomenon
of old people dying alone in the city and experiments on how design could
help to prevent such a tragic situation. Instead of building large-scale eldercare
facilities, the author proposes well designed small spaces that offer more natural
settings for everyday encounters among people living together, which could
serve as precedents for other ageing cities.
12 Keng Hua Chong and Mihye Cho
Through these chapters, we hope to present a range of creative approaches
towards ageing in Asia, while working towards a design framework for a creative
ageing city. We wish that this book will provide learning not only among ageing
Asian cities but also for cities experiencing ageing in other regions or in the
future.

Notes
1 Beginning with 33 participating cities, the project has since been renamed Global
Network of Age-friendly Cities and Communities and has reached out to 454
cities and communities in 37 countries to date. See www.who.int/ageing/projects/
age_friendly_cities_network/en/; https://extranet.who.int/agefriendlyworld/
[30 May 2017].
2 The guide details desirable features in eight topic areas, namely outdoor spaces
and buildings, transportation, housing, social participation, respect and social
inclusion, civic participation and employment, communication and information,
community support and health services, in order to support older people through
more accessible and inclusive infrastructure, services and social environment in
the city (WHO, 2007).
3 The ecological perspective articulated the “dynamic interplay between individual
adaptation and environmental alteration to maintain optimal functioning in older
age” (Lawton and Nahemow, 1973; quoted by Plouffe and Kalache, 2010, p. 734
and Beard and Petitot, 2010, p. 430).

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