“We need to collaborate to deal with the effects of an aging population”

The Netherlands is aging. And that affects all kinds of things. For example, the housing market, the healthcare system, the economy, the labor market and the pension system. In a series of articles, we discuss these topics based on interviews with an expert. This time researcher Femke Daalhuizen of the Netherlands Environmental Assessment Agency discusses the impact of aging on the design of neighborhoods and districts.

“Hold on tight; we are facing a double dose of aging,” Daalhuizen warns right at the start of the conversation. She is referring to the baby boomer generation, who will be leaving the labor market in the coming years, and who will probably need increasingly more care in the future. At least, the latter is a logical consequence of this large group of Dutch people getting older. “Research shows that people over the age of 75 are more likely to suffer from various and chronic ailments and decreasing mobility, which can increase the need for care and reduce self-reliance,” Daalhuizen explains.

90 percent of people over 75 still lives at home
That brings her to the issue of the housing market. “Older people are living independently to an increasingly advanced age; currently, more than 90 percent of all people over 75 lives independently, as does about two-thirds of people over 90. As the elderly become more disabled, a suitable home becomes an increasingly important prerequisite for continuing to live independently at home for longer. This specifically means that the home (after any modifications, ed.) must be easily accessible both inside and outside, without climbing stairs. And what did we find out? According to the Monitor Ouderenhuisvestiging 2022, there are 6.92 million homes in the Netherlands that are already suitable, or can be made suitable with a limited intervention, such as a stairlift. That amounts to 86 percent of the total housing stock of nearly 8 million homes in the Netherlands (in 2022).”

Seniors living at home put lock on housing market
But the growing number of seniors living independently, who are staying put, limits the sustainability of and flow through the housing market. Daalhuizen: “There is a reason why the elderly rarely move. They are comfortable in their homes, they are familiar with the neighborhood, the mortgage is paid off or their rent is ‘historically’ cheap and when they move, their expenses always increase. Actually, moving happens mostly when circumstances of life more or less force a move. But when you transition to the next phase of life (working towards retirement, ed.) and you are around 67, it is sometimes wiser to move to a more suitable home or living environment with sufficient facilities - supermarket, GP, pharmacy, public transport stops - and/or a social network nearby. That is easier to do when you are still fit and vital than when you are over 80.” Daalhuizen thinks it is wise for older people to anticipate this in advance. “A suitable home alone is not enough to continue living independently for longer.”

The cracks in the Knarrenhofjes (retirement villages)
This requires “action” by municipalities, provinces and the state. Daalhuizen: “Who is doing what? Who is responsible for what? You're talking about housing, about stores, but also about infrastructure, such as a good fiber optic network, and about prevention.” The latter, Daalhuizen believes, is an example of how something can fall between the cracks. “With prevention, you can think of small interventions, such as fall prevention courses and a good range of exercise (fitness for the elderly, ed.) and the pedicure (very important to keep walking well, ed.). Health insurers could take this up, but they see their responsibility more in health care and have other target groups to serve. The national government does provide some support with stimulating programs, but has decentralized the implementation of social support. Municipalities and corporations then? They look primarily at ‘housing’ and must ensure appropriate housing for the elderly through residential care visions. They could also choose to set out urgency criteria for any informal caregivers in housing ordinances.”

Who will pick up the gauntlet?
Daalhuizen tells us this raises the question of who will really pick up the gauntlet. “The same goes for fiber optics in smaller rural villages and municipalities to harness digital innovations. Is that something for the state, the municipality or the provinces? Or is it a commercial matter?” Daalhuizen’s point is that there are many parties involved in “elder-proofing” the residential environment. “But everyone tends to confine themselves to their own core task. This leaves a gray twilight zone. Sometimes a commercial party then swoops in with an initiative, such as Knarrenhofjes.” These are retirement villages where the elderly live together and make use of each other’s knowledge, skills and companionship. Daalhuizen thinks this is a good initiative. But she also sees cracks forming. “It takes a long time because of the permit procedures and the composition of the resident group. Moreover, new construction is relatively expensive housing and mainly for the happy few. And what if some age faster than others and need more help? How much solidarity will residents maintain then?”

Looking beyond just the core task
Daalhuizen sees more value in the residential service concept, in which the entire “environment” or neighborhood is set up for seniors. In Hoogeveen, Leeuwarden, Middelburg and De Bilt, among others, this is already a great success. “People live independently for as long as possible, and care and facilities are always nearby thanks to close cooperation between the various parties, who look beyond their core task.” Here the trick is to find out the care needs of the elderly, and then link these to an offer that local parties can provide. Good mutual cooperation is essential for this. Daalhuizen: “But in very practical terms, it also means, for example, that the municipality provides sufficient lighting and benches along footpaths, where the elderly can take a break when walking to the center. Sufficiently wide bicycle paths are also important; the elderly do tend to meander more than young people do. And stop lights at frequently used crosswalks could stay green for longer.”

Need for organized collaboration
Daalhuizen is convinced that it helps when parties join forces, especially in rural areas where aging is hitting hardest. “That is where the need for organized collaboration is the greatest.” In addition to municipalities and health care providers, she believes other parties can also make a relevant contribution. “For example, itinerant services such as hairdressers and pedicurists, but also the signaling function of postal and parcel services. If they signal that the curtains have been closed somewhere for a few days, they can alert care providers. In short, it means full cooperation to cope with an aging population.”

Aging theme
Previously published in this series of interviews with:

• Chief economist Thijs Knaap of APG about the influence of the gray wave on our economy and Peter Kentie (63), outgoing director of the Eindhoven city marketing organization Eindhoven365. Read the article here.
• Macro economist and senior strategist Maarten Lafeber from APG and retiree Aleid Smid (69) about the influence of the gray wave on the labor market. Read the article here.
• Actuary Caroline Bruls from APG and entrepreneur Appie El Hatri (61) about the influence of the gray wave on our pension system. Read the article here.
• Charles Kalshoven, macro economist and expert strategist at APG, about the influence of the gray wave on our housing market and Hetty Leijdekkers (71), who provides insight into her future housing plans. Read the article here.
• Patrick Jeurissen, professor of Affordability of Care at Radboud university medical center, and retiree and former healthcare employee Marianne van Keulen about the influence of the gray wave on our healthcare system. Read the article here.