Dignity

and choice
An inclusive future for
our ageing population
May
2019
Contents

Foreword 1

Executive Summary 2

Recommendations for government 4

Introduction 6

How do Sydneysiders feel about ageing and retirement? 9

Meeting the housing needs of an ageing population 11

Transport to keep us socially connected and healthy 21

Planning principles for inclusive public spaces 26

Healthy and active ageing 28

Fostering social connection and good mental health 30

Tackling the dementia challenge 33

Conclusion 37
Foreword

For Sydney to be a great city, it needs to be inclusive and Older Australians are an important part of our city,
liveable for residents of all ages. This includes not just the communities and families. They enrich our lives and
city’s workers and younger families, but also those residents enhance our society. They deserve to experience Sydney as
who have contributed to this city’s success and now wish to younger generations do, and live with a sense of belonging,
retire in a place that they have come to call home. dignity, safety, enjoyment and community.

Retirees value the opportunity to participate in activities, Older Australians need meaningful choices and
stay connected to their community and still maintain their opportunities to live well. People desire connection- to be
independence. And, they also can enjoy the freedom that close to their families and their friends, and near the places
retirement provides without the hassle of home maintenance. that bring joy and meaning to their lives.

Planning for the ageing of our population requires a significant BaptistCare NSW & ACT has been serving and caring for
amount of foresight, not least because many of the major older Australians for 75 years. We support over 15,000
infrastructure projects, urban renewal projects and transport people across NSW and the ACT through more than 160
systems being built today will still be place when one quarter of our facilities and programs and we see firsthand how issues
population will be retirement age and one in seven will be over 75. such as housing affordability, transport connectivity and
We also know that the promotion of active and social ageing social isolation affect the quality of life of older Australians.
throughout an individual’s retirement is critical to reduced health Sadly, many older Australians face diminishing options
expenditures later in life and to achieving an overall better quality shaped by the difficulties encountered as they age and
of life for a city’s residents. Finally, we also know that the housing confront a reality that it is becoming more and more difficult
needs of an older population are likely to differ substantially from to live with dignity and security in Sydney.
those of the broader working population and young families.
This need not be the case. Our demographics and
Stockland is proud to support this work. Over 12,000 population is changing, and Sydney can and must adapt
residents call a Stockland retirement village their home and to meet these needs. We have a collective responsibility
we are focused on an increasing trend that is seeing seniors to support older Australians to live safely and happily in
looking for low maintenance, inner city lifestyles. our city.

As one of Australia’s top three Retirement Living Operators, This report canvasses many practical and effective
we are passionate about both the redevelopment and measures that can be implemented to ensure an inclusive
renewal of existing villages as well as creating housing future for our ageing population. Increased home care
choices giving older Australians the option to downsize and packages, affordable rental properties, safe and reliable
move into connected communities with centralised health transportation, inclusive and dementia friendly public
and lifestyle services. spaces and active living will ensure older Australians can
live a full life safely and happily with or near their loved
In supporting this research, Stockland acknowledges that the ones and with access to vital services. These are all
ageing of our population is not a phenomenon that is unique achievable goals.
to Sydney, nor are many of the changes we must make unique
to this city. In that vein, this is not a challenge we can resolve On behalf of all of us at BaptistCare, I thank the
without conscious and considerable action. We hope that policy Committee for Sydney for producing this research, and
makers across Australia will also embrace the recommendations ask policymakers to review the recommendations of
of this report in order to make all of our Australia cities and towns this report and give them the consideration they so
liveable and inclusive for older citizens. thoroughly deserve.

We are proud to present this paper and commend its Ross Low
recommendations to you. Chief Executive Officer, BaptistCare

Kirrily Lord
General Manager of Retirement Living Operations
and Legal Administration, Stockland
1
Executive
Summary

The ageing of our population presents a fundamental for seniors, whose property could help fill a shortage in two
challenge for how cities are able to function. Policy makers or three bedrooms for younger families seeking to enter
will need to embrace a paradigm shift that views city and the property market. For non-home owners, less than 1%
project planning through a lens where a full 42% of the of Sydney’s listed rental properties on the market, including
population sits outside of the working age bracket of 15-64. studio apartments, are affordable to either a couple or
This has implications for almost every area of public policy individual receiving the full aged pension. This has led to
and for all levels of government. a worrying increase in homelessness among women aged
55 and over.1 For those who are able to secure an affordable
This report provides a series of policy proposals to achieve rental property, tenancy laws make it difficult for them to
a more inclusive and liveable city. While many of the access government funded home modifications to enable
recommendations put forward are centred on the needs of them to age in place.
older residents, their implementation would have benefits for
the whole community. On transport and health, evidence suggests that two of
the primary reasons why older residents don’t use public
Central to this report are the dual themes of Dignity and transport more often is that it is not convenient and that it
Choice. This means policy makers will need to do more than doesn’t take them to where they need to go. By contrast,
to just provide the bare minimum. It is not enough to simply when transport on demand is provided, trials have shown
build more retirement housing if the only place where such that the primary destination for older users is to their local GP,
development is allowed to occur is on the isolated urban indicating that transport on demand may be undervalued in
fringe of the city. It is not enough to simply connect a bus terms of their potential contribution to preventative health
route to an area with retirees if that route is both infrequently outcomes and its associated health savings. Evidence also
and doesn’t take retirees to the places that they want to go. suggests that active ageing and walking is important for
It is not enough for communities to create new public spaces reducing health costs associated with a sedentary lifestyle.
if those same spaces don’t have sufficient seating or shading However, beyond a lack of frequent seating and shading,
for an increasingly elderly population. It is not enough to a substantial reason why more seniors don’t walk on the
develop a health strategy for seniors which ignores the sidewalk is driven by concerns that they could experience
mental health challenges of loneliness and social isolation. a fall if they are forced to share that sidewalk with bicycles
Finally, it is not enough to have a public policy strategy to deal and electric scooters. In that sense, a failure to provide more
with the ageing population but which doesn’t consider the separated bike paths may in fact be contributing to social
challenge of rising rates of dementia. Dignity and Choice is isolation and a lack of active ageing, creating future health
about recognising that wellbeing for seniors is directly linked expenditures for state budgets.
to the degree in which older individuals feel that they have
a say in where they can live, where they can go, and who On public spaces and mental health, research has shown
they can see. that investing in places where people can meet and be
social is critical to tackling social isolation and loneliness.
On housing, cities are witnessing the rise of community No less than one-third of older individuals already experience
opposition to retirement living and aged care facilities, either loneliness or severe loneliness,2 and COTA Australia
which not only deprives retirees of a choice in where they predicts that the number of socially isolated people will
will live, but which also increases the barriers to downsizing more than double by 2040.3 This has implications for health

1 BaptistCare, The most rapidly growing group of homeless Australians –

it’s not who you think
2 Minister for Aged Care, Ken Wyatt AM, Speech to the Tackling Aged Care
Mental Health & Social Isolation Conference
3 COTA, Social Isolation: Its impact on the mental health and wellbeing of
older Victorians

2 COMMITTEE FOR SYDNEY

policy as well, with international research confirming that To demonstrate the scale of the challenge confronting
people who are socially isolated or lonely are also more policy makers, the Committee for Sydney undertook polling
likely to report risky health behaviours such as poor diet, to determine whether Sydneysiders felt that their suburb
lack of physical activity, and smoking.4 Addressing this will catered to retirees and older people. Almost 50% of those
require a coordinated look at how planners design our town surveyed responded that it did not. Of those that rate
centres, streets and public spaces, while also looking at how their area poorly, more than half expect to leave the area
communities can make their social offering more inclusive to in retirement. Conversely, of those that rate their area as
elderly residents. catering well, 71% expect to stay in the area in retirement.
Affordability of support was identified as a core reason
Figures compiled by Deloitte Access Economics for Dementia behind why people may choose to simply leave Sydney, with
Australia calculate that the number of NSW residents living one-third of respondents worried that they would not be able
with dementia will increase from around 120,000 today to to support themselves in retirement. This number jumped to
roughly 300,000 in 2050.5 Many of the challenges identified 41% for women and 46% for people who are renting.
so far are doubly critical for those who have dementia.
International research has identified a full 35% of people The prospect of a such a large proportion of the city’s
with dementia had self-reported experiences of loneliness senior population being forced to leave, not by choice but
in the recent past.6 Ageing in place is also critically important by financial necessity, is one that should concern all policy
to delaying the onset and difficulty of dementia. Our urban makers. To ensure that such an outcome does not happen,
form and design must consider the needs of people with and that senior residents are given dignity and choice in how
dementia, and while towns like Kiama are leading the charge they live, the Committee for Sydney offers this paper as a
on this front, planning for dementia is an area that all local contribution to making a better city.
areas will need to put more effort into.

4 Age and Ageing, Social isolation and loneliness as risk factors for the
progression of frailty
5 Deloitte Access Economics, Dementia across Australia, 2011-2050
6 Turning Up the Volume: Unheard voices of people with dementia.

3
Recommendations

Recommendations for the Australian Government Federal Department of Social Services

• Prioritise allocations of home care packages which

Federal Treasury
provide service-integrated housing in retirement villages
• Encourage downsizing by establishing an age pensioners for people with dementia.
savings account scheme that would be made available to • Introduce an Australian version of the UK Government’s
age pensioners for investing any surplus funds from the Side by Side volunteer initiative, which encourages
sale of the principal residence, and for those funds to be younger people to buddy up with people with dementia.
exempt from the Age Pension assets and income tests.
This fund would be made available to fund aged care and
retirement village costs. Recommendations for the NSW Government

Federal Department of Health NSW Department of Planning and Environment:

• Increase per capita spending on aged care facilities, • Ensure that inclusionary zoning policies take into
while working with industry to identify how to improve consideration the need to design some social housing
the sector’s financial viability. for financially disadvantaged renting retirees.

• Increase the number of Home Care Packages on offer • Change tenancy legislation, placing the onus on landlords
with priority given to closing the gap for care packages to justify why federal government funded ageing-friendly
targeted at those with higher needs and disabilities. home modifications should not be allowed to occur.

• Ensure that a sufficient number of Home Care Packages • Update the NSW Apartment Design Guidelines to
are available to support the needs of a growing number encourage design that is more ageing and disability
of Australians living with dementia. friendly or more easily retrofittable to become
ageing friendly.
Federal Department of Education and Training
• Conduct a review into incentives for co-living
arrangements to boost affordable rental supply for the
• Develop a larger tertiary curriculum to ensure that
financially disadvantaged renting retiree.
Australia’s carer workforce is being adequately trained to
deal with the challenges of social isolation and dementia. • Amend the Retirement Living Act and Seniors Housing
SEPP to facilitate an easier pathway to development for
• Fund dementia education programs specifically targeted
retirement villages and aged care facilities.
at retirement village operators and staff.

• Provide support for the development of dementia NSW Family and Community Services
education programs specifically targeted at retirement
village operators and staff. • Audit the state’s public housing stock to determine what
proportion is appropriate in scale and design to meet the
• Fund universities to trial innovative pilots that involve older forecast growth in people living with dementia.
residents in both learning and the teaching of areas that sit
outside the standard curriculum.

4 COMMITTEE FOR SYDNEY

Transport for NSW • Plan public spaces in accordance with COTA NSW’s
Basic Principles for Age-Friendly Environments and
• Work with transport on demand trial providers to quantify Local Government NSW’s Integrated Age-Friendly
the number of additional trips taken by elderly residents Planning Toolkit.
for medical or social purposes and which may not have
occurred without a transport on demand offering. • Conduct an audit to identify deficits in shading and seating
availability, particularly in those areas with close proximity
• Ensure that public transport infrastructure and vehicles are to destinations for elderly residents such as shops, the
adaptable and designed to respond to the accessibility library, toilets and bus stops.
needs of older individuals.
• Develop local strategies to manage the forecast growth
• Set a target to expand public transport accessibility and in local residents living with dementia, drawing from
frequency in areas with high numbers of individuals aged Alzheimer Australia’s Creating Dementia-Friendly
70 and over, including on the outer fringe of Sydney where Communities: A toolkit for Local Government.
public transport offerings are already sparse.
• Ensure that social events are delivered in a way that
NSW Ministry of Health makes them accessible and welcoming for people living
with dementia.
• Expand the Active Living NSW partnership between
• Include in future Local Plans steps to ensure that each
the NSW Ministry of Health and the Heart Foundation
community will support an ageing population to age in
NSW branch to include additional resources specifically
place. This should include considering demand for aged
targeted at delivering better outcome for seniors.
care and retirement living.

Recommendations for Local Government • Relax planning controls for retirement living and aged care
developments which already provide community servicing
infrastructure internally.
NSW Local Councils
• Reduce parking minimums for retirement living and aged
• Invest in seniors-friendly exercise facilities in public parks, care facilities.
ideally co-located near children’s playgrounds.
• Consider the provision of on-site amenities in setting the
• Provide safe and walkable pathways for senior citizens that level of developer contributions in planning policies for
are separated out from car and bicycle infrastructure. retirement villages that support people with dementia
and/or developments that co-locate retirement villages
• Promote more ageing-inclusive social events which are
and residential aged care facilities that incorporate
both accessible to culturally and linguistically diverse
dementia-friendly design and environments.
demographics and affordable for disadvantaged residents.

5
Introduction

Around the world, advanced economies are grappling with transport and services using metrics that are calculated on
the challenges of an ageing population. Neither Australia nor the walking speed of an average healthy adult. Our footpaths
Sydney is exempt from this demographic shift. According to are often insufficiently wide, our public spaces are often
the 2016–17 NSW Intergenerational Report, the median age poorly shaded and lack the required seating to encourage
of a NSW resident increased from 29 in 1976 to 37 in 2015 active ageing and the creation of socially engaging places for
and will rise further to 41 in 2056. Roughly one-quarter of seniors. For Sydney to become a city that is inclusive for all,
the population will be aged 65 and over, almost 15% of the it needs to plan with an ageing population in mind.
population will be aged 75 or over, and there will be a 12-fold
increase in those aged 100 and over.7 There are other challenges that go beyond town planning.
It is well established that social isolation is a leading
Despite this, city shaping decisions are often made without contributor to poor mental health and that feelings of social
sufficient consideration of how our city will change over isolation increase as we age. It is also well established that
the coming decades. Our transport spending priorities social isolation has negative impacts for both physical and
continue to focus heavily on worker journeys to the city, mental health, and that it can sometimes speed the onset of
even though shifting demographics will result in a full 42% dementia. And yet discussions about ageing in place tend to
of NSW’s population falling outside the working age bracket focus overwhelmingly on the family home, while discussions
of 15–64. Active ageing and preventative health continue to about linkages with the community are too-often neglected.
be underrepresented in discussions around health policy,
despite health spending forecasts to grow by more than 6%
per year. Town planners continue to measure accessibility to

Proportion of the NSW population that is of working and non-working age

70%
Under 15
65% 66%
60%
65 and over
58%
50% Working age

40% Non-working age

42%
35% 34%
30%

20%

10%

0
1976 2015 2056

7 NSW Intergenerational Report

6 COMMITTEE FOR SYDNEY

Sociologist Ray Oldenburg once highlighted the social This has led to a worrying increase in homelessness,
importance of “third places”; those places where people especially among women aged 55 and over.9 For home
spend time between their home (‘first’ place) and their work owners, regulatory and taxation barriers disincentivise
(‘second’ place), including libraries, parks, churches, recreation downsizing and limit the likelihood that seniors will take
and health centres.8 These are the locations where people advantage of opportunities in the retirement living sector.
exchange ideas, have a good time, and build relationships. For older residents seeking to age in place, a shortage of
They are also those locations that are going to become Commonwealth Home Support Program (CHSP) Home Care
increasingly important as our population continues to age. Packages — the federally funded care and services which
Other cities are pursuing innovative new strategies to break enable older people to live independently in their own home
down the stratification of communities by age, generating — has seen a blowout in waiting times, while residents who
substantial social, economic and wellbeing dividends through live in aged care facilities face a sector beset by concerns
the creation of social, multi-aged precincts. Sydney should around financial viability. Ensuring that Sydney’s retiring
look to these cities for inspiration, both in terms of the social population has access to affordable housing across a diverse
infrastructure and the community programs that are delivered. range of typologies will likely require substantial cross
government support and a program of industry collaboration.
Catering to the housing needs of an ageing population will Failure to undertake the reform required to deliver on this
also be an important consideration for policy makers moving objective risks a scenario where many older residents
forward. The challenges are multi-faceted and differ largely in are forced out of Sydney through price and accessibility
scope depending on the housing profile of the demographic barriers, rather than by choice. To become an age-inclusive
in question. For non-home-owning retirees, Sydney’s rental city, Sydney must develop a housing strategy to support its
market provides very little affordability and even less security. ageing population.

9 BaptistCare, The most rapidly growing group of homeless Australians – it’s

8 Ray Oldenburg, Project for Public Spaces not who you think

7
The challenges identified throughout this report may appear Weekly income and net worth of households aged over 65
broad, but they need not be viewed through a negative lens years 2009-10 to 2015-16
which associates ageing with costs or complication. As
$ per week $'000
University of NSW Professor Henry Brodaty explained in a
speech to the Australian Human Rights Commission: 1,400 1,400

1,200 1,200
“Older Australians are active contributors. Almost half of
2015-16 2015-16
65–74-year-olds provide unpaid assistance to someone 1,000 1,000
outside the house. One-third are volunteering through
organisations, two thirds are in social or support groups, 800 2009-10 800 2009-10

and one-quarter, despite having relatively low incomes,

600 600
are financially supporting somebody outside their house
either a child or a younger relative.”10 400 400

Older Australians are also destined by demography to 200 200

become a larger share of the consumer and tourism market,
0 0
and they are retiring with more wealth than previous Average gross income Average net worth
generations. The average over-65 households in 2015–16 had
Source: ABS Household Expenditure Survey, Deloitte Access Economics
an average income 38% higher in nominal terms than those in
2009–10, while Australians over-55 own more than half of the
nation’s assets.11 A large proportion of that is creditable to the The challenge of preparing for an ageing population is
high home ownership rate of Australia’s older residents, 3-in- not a new discussion. The United Nation’s World Health
4 of whom own their home outright. The capacity to access Organisation (WHO) has produced a comprehensive
this equity presents a substantial economic opportunity framework for age-friendly cities that addressed the
for the cities and markets which evolve to become more demographic challenge through a variety of lenses.12
attractive to seniors. The cities which fail to do so are more The NSW Government in 2012 released its Ageing Strategy
likely to see that equity remain trapped and unused, or worse 2016–20 and is now undertaking a review of its future
still, shifted towards other more ageing-inclusive cities. It strategy.13 Several of NSW’s local councils have joined the
is up to Sydney to decide upon which side of the ledger it World Health Organisation Global Network for Age-friendly
wishes to sit. Cities,14 Local Government NSW has released an Integrated
Age-Friendly Planning Toolkit,15 and the Australian Local
Government Association has released a paper on Age-
Friendly Built Environments.16

This paper seeks to build on these documents by providing

new recommendations and perspectives to help guide
all levels of government in ensuring that their policies and
objectives remain fit-for-purpose.

12 Global Age-friendly cities: A guide

10 Professor Henry Brodaty, Rights Talk: Human Rights and Ageing – growing 13 Ageing Strategy 2016-20
old in Australia 14 World Health Organisation Global Network for Age-friendly Cities
11 Deloitte, Weekly economic briefing: Ageing consumers – will retailers still 15 Integrated Age-Friendly Planning Toolkit
love me when I’m 64 16 Age-Friendly Built Environments

8 COMMITTEE FOR SYDNEY

How do Sydneysiders
feel about ageing
and retirement?
Recently, the Committee for Sydney commissioned Ipsos to What Sydneysiders want vs. what they have
survey 1,000 Sydneysiders on their attitudes to ageing and
retirement. The findings are concerning — and demonstrate

100%
40%

60%

90%
50%
30%
20%

80%
70%
10%
that now is the time for a rethink about how our city is

0
planning for demographic change. It is clear that many people
are worried — and that aspects that people consider vital to Close to family & friends Overall: What
a good life as they age don’t exist in their local community. Sydneysiders
want
Fully one-third of Sydneysiders aren’t confident that they will Close to general health
Western CIty
be able to support themselves in retirement. This number
jumps to 41% for women and 46% for people who are Central City
Close of specialist health
currently renting. Eastern City

When asked whether their suburb caters to retirees and older A sense of community
people, almost 50% of those surveyed responded that it did
not. Of those that rate their area poorly, more than half expect Variety of shops & cafes
to leave the area in retirement. Conversely, of those that rate
their area as catering well, 71% expect to remain in their area
during retirement. Close to public transport

When asked what is important to them in retirement, there

Close to parks
is unsurprising consensus across Sydneysiders on many
aspects of a good community — 9 in 10 want to live close
to general and specialist health services, public transport, Close to wilderness
friends and family and a variety of shops and cafes.
Close to beaches/rivers
Interestingly, younger generations have a greater desire
to live near nature — including wilderness, beaches and
rivers. If this desire remains as younger generations age,
demand patterns for where older people would like to live
will change significantly. While people in Eastern Sydney generally rate their city
as catering well for when they retire — with good transport,
How confident Sydneysiders are that they will be able to shops and beaches — as you move further west, people rate
support themselves in retirement their local community worse. Western City residents feel that
access to specialist health services and diverse shops and
6% cafés is significantly lacking.
don't
know
12% 17%
not at all very confident Across all areas of the city, many people felt that their
confident
neighbourhood lacked some essential characteristics.
This was especially prominent with a lack of a sense of
community, but was also true of health services, transport,
23%
not very cafés and shops and access to friends and family.
confident
41%
some what
confident

9
10 COMMITTEE FOR SYDNEY
Meeting the housing needs
of an ageing population

A city cannot present itself as being all-ages inclusive if it has comes from living in a retirement village. The challenges
failed to deliver a sufficient scale and typology of housing for facing each demographic will be different in nature and as
its older residents. If by shortage, price, or impracticality, older such will require different policy solutions, but fundamental
residents are forced to leave Sydney, the city cannot fairly to all policy solutions should be an ambition to protect both
claim to be inclusive. choice and dignity in retirement. In short, whether our older
citizens remain or leave Sydney should be a function of
While some retirees do choose to pursue a sea-change or choice, not an outcome forced by necessity through a lack
tree-change, for those who wish to remain in Sydney but are of alternatives.
denied the opportunity to do so, relocation can often mean
disconnection from family, community, and a supporting
The renting retiree
social network. As will be examined later in this paper, the
question of social isolation is inextricably linked to the For those retirees unfortunate enough to neither own their
question of health, so any outcome in which a demographic own home nor have a substantial nest egg in retirement
is forced to sacrifice their social connections for ageing- savings, the private rental market can be a daunting place.
appropriate housing is an outcome which would have Less than 1% of Sydney’s listed rental properties on the
substantial costs for both our society and for government market, including studio apartments, are affordable to either
budgets. Sydney already faces a substantial challenge a couple or individual receiving the full aged pension.17 For
both with the provision of new housing supply and with the these individuals, once the regular flow of income from
provision of affordable housing supply more specifically. employment comes to a halt, so too do their rental choices.
This challenge will be amplified as the city’s population Their options become to either relocate far from their social
continues to age. networks, relegated to a few isolated outer-rim suburbs, or
Older Sydneysiders have diverse housing tenures and to retain those networks while seeing most of their pension
diverse retirement preferences. Many will own their own eaten up by rents, leaving little for basic necessities. When
home outright with no mortgage to their name, others will the dichotomy is between isolation or poverty, a choice may
be homeowners with a mortgage, while some will remain in well exist, but dignity does not.
the rental market. It is also true that regardless of the type
of housing tenure, different individuals will have different Unique rental listings suitable for Income Support households
preferences for how they retire. Many will prefer to age in
No. affordable & No. appropriate
place, opting for a sense of continuity and familiarity by
appropriate (30% (at 30% – 45%
remaining in the same house and location where they spent income) income)
their most recent years of life. Others might choose to remain
2018 result 41 (<1%) 1,418 (8%)
in the same community but will be happy to downsize in
order to access the equity stored in their home. Some will 2017 result 25 (<1%) 1,104 (8%)
prefer the comfort, convenience and social connection that
Change (2017-18) +16 +314

Source: 2018 Anglicare Rental Affordability Snapshot

17 2018 Anglicare Rental Affordability Snapshot

11
There is a gendered aspect to this challenge as well, Home care is easier for the humble home owner
with women over the age of 55 now the fastest growing
demographic experiencing homelessness, at a rate that Under the Commonwealth Home Support Programme, senior
is now more than double what is seen in comparable Australians can apply for a government subsidised package
countries such as the United Kingdom.18 Women who of care and services designed to help them age in place and
are today within the 55 to 64 age bracket are also facing live independently in their home for as long as they choose
retirement with savings that are on average 37% lower to do so. These Home Care Packages are made eligible for
than their male counterparts, leaving them with an average those who require coordinated services to help them age in
balance of just $196,000.19 As such, the failure to deliver place, and the level of subsidy increases according to each
affordable rental housing for the renting retiree is likely to individual’s level of care needs.25 They will typically include,
have a disproportionately large impact on women, which is but are not limited to, services to assist with:
made even more problematic given that women have a life
expectancy that is on average some 4.2 years longer than • Nutrition, hydration, meal preparation and diet
men.20 For these women, they need to make even less last • Mobility and dexterity
even longer, leaving them highly exposed to above inflation
rental increases when left to the whims of the private, non- • Transport and personal assistance
social housing market.
• Nursing, allied health and other clinical services for
Tackling the challenge of affordable rent for retirees is inextricably those with higher care needs
linked to Sydney's broader affordability crisis, but in order to
prevent the development of an intergenerational, geographical One of the more practical programs available is the option
chasm, affordable rental housing will need to be delivered to request subsidised home modifications. This can include
across all of Sydney and not just on its urban fringe. The modifications such as:
Committee for Sydney has long championed an inclusionary
• Installing ramps and rails
zoning policy for all of Greater Sydney as well as a variety of
measures to boost Sydney’s social housing asset base.21 22 23 • Widening doorways

The Greater Sydney Commission (GSC) decision to • Altering bathrooms and kitchens (e.g. lowering
incorporate Affordable Rental Housing Targets under bench heights)
Objective 11 of the Metropolis of Three Cities plan was a step
in the right direction.24 The NSW Government now needs • Relocating light switches and power points
to take on a more ambitious series of inclusionary zoning
• Installing emergency alarms, monitoring systems,
targets, while also moving to consider whether some social
and smart technology
housing should be reserved and designed for the financially
disadvantaged renting retiree. These mobility enabling modifications are simple enough
to work into a home care package for the humble home
owner, but challenges remain for the renting retiree, who are
18 BaptistCare, The most rapidly growing group of homeless Australians – legally prevented from receiving modifications without their
it’s not who you think landlord's consent. Given the insecurity of tenures in NSW, the
19 Australian Bureau of Statistics, 4125.0 – Gender Indicators, Australia, Sep 2018
20 Australian Institute of Health and Welfare, Deaths in Australia
remaining risk of no-fault eviction, and the well documented
21 A city for all – five game-changers for affordable housing in Sydney hesitance of existing tenants to report maintenance problems
22 An executive summary of the Committee for Sydney’s joint submission to
for fear of eviction, the likelihood of retirees to request
the Greater Sydney Commission & Transport for NSW
23 Social and affordable housing in NSW, a snapshot of innovative practice
24 Greater Sydney Commission, Housing is more diverse and affordable,
Objective 11 25 Australian Government, My Aged Care, About home care packages

12 COMMITTEE FOR SYDNEY

modifications in what is an already tight rental market is likely • One-third of elderly Australians who need help to live at
to be slim. In this sense, the humble home owner has ageing- home say they don’t get the assistance they need.
in-place advantages that is in practice denied to the renting
retiree, leaving those renters more exposed to falls or worse. • The average wait time into residential care in 2017-18 has
increased by 44% over the previous two years.
The upcoming Royal Commission into Aged Care should
examine how the existing Commonwealth Home Support • The percentage of primary carers satisfied with their
Programme can be modified to make it easier for those in government help has dropped, with less than half of
rental properties to take advantage of home modifications. carers satisfied with the range of services.
This should also include consultation with social and
The Committee believes that one outcome of the upcoming
affordable housing providers to determine whether additional
Royal Commission into Aged Care should be that federal
assistance can be provided to enable the modification of
funding for Home Care Packages be increased, with priority
some of the existing social and affordable housing stock.
given to closing the gap for care packages targeted at those
The NSW Government must also examine its own tenancy
with higher needs and disabilities. In delivering this increase,
legislation to identify opportunities to expand renter rights for
the Australian Government should anticipate additional
tenanting seniors, with a greater onus placed on landlords to
uptake from measures taken to increase the supply of home
justify why modifications should not be allowed to occur.
modifications in the rental sector. The Government should
For the humble home owner who wants to age in place, while also review whether the existing offering of packages is
modifications are more readily available, a different set of providing the diversity of services expected from both
challenges await. The number of consumers on the national recipients and carers.
queue for home care packages has grown by 40% in the last
Beyond modifications to existing homes, it would also be
year alone, with 127,000 people now on the waiting list for
beneficial for federal and state governments to consider how
services.26 While the Australian Government has increased
new housing supply can be developed in a way that makes
its investment in this area, the Council on The Ageing (COTA)
it easier to retrofit at a future date, both for older individuals
estimates that a further 30,000 packages need to be released
and for people living with dementia. At the state level, this
immediately to help relieve tension in the home care sector.27
should involve a re-examination of the NSW Apartment
The Productivity Commission has also warned that:28
Design Guidelines. Such a review need not focus on making
every new dwelling ageing and disability friendly. However,
26 2GB, Elderly home care waiting lists jump 40% apartments should be designed in such a way that ensures
27 Community Care Review, 10,000 home care packages funded
in $550 million aged care boost that potential future retrofits are possible.
28 Productivity Commission, 2019 Report on Government Services

13
Image: University of Wollongong, Desert Rose

To demonstrate how such housing can be delivered in A final area where the humble home owner can provide a
a sustainable and affordable manner, the University of solution to a broader policy challenge is in the area of
Wollongong and TAFE NSW have spent the past two co-living. During the research stage of this report, the
years designing, prototyping and building a housing Committee worked closely with The Australian Centre for
model which caters for the needs of an ageing population, Social Innovation (TACSI) on an examination of adaptive co-
supporting people living with dementia and other age- living as one option to provide safe and affordable housing
related disabilities. The Desert Rose prototype was so for the renting retiree. While TACSI's work in this space is
well developed that it was awarded second place in an ongoing, this report suggests that there should be further
international sustainability competition in Dubai. The examination of incentives to encourage empty nesters
Committee suggests that developers and retirement to make their spare rooms available for renting retirees
villages would do well to consider the design features of through dedicated co-sharing arrangements. This could
this prototype when developing future housing stock.29 be particularly beneficial for older retired women who for
financial reasons might be unable to afford their own rental
Ageing-friendly design is important because it reduces costs property, and which if given a choice, would prefer not to live
for government, which would otherwise need to provide even in a share-house with substantially younger tenants.
larger subsidies to relocate people into aged care facilities
at an earlier age. This is significant, because the ongoing The principle underpinning such an approach already exists.
shortfall in Home Care Packages is resulting in individuals AirBnB currently partners with the NSW Government to
being forced into residential aged-care facilities prematurely offer those with a NSW Seniors Card a $100 cash reward for
— further compounding the challenges facing that sector.30 becoming a new host. This program has delivered a useful
41% of residential aged care providers reported a loss during revenue stream for retired home owners to support their
the September 2018 quarter, while the proportion of facilities retirement, while also supplying more supply in the short-
making a cash loss is up substantially from the same period in term letting market. Such programs are also useful given
2017.31 As such, investments in boosting the number of Home that many seniors visiting Sydney may prefer to source
Care Packages is both fiscally prudent and socially desirable. their holiday accommodation from other seniors.
Equally, good housing and apartment design can reduce the
future retrofitting cost while extending the length of time that
an individual can age in place.

29 University of Wollongong Australia, Desert Rose blooms after taking out

second place with sustainable, age-friendly house
30 Older Persons Advocacy Network
31 Aged Care Financial Performance Survey

14 COMMITTEE FOR SYDNEY

Aged care and retirement villages: two different industries Both the aged care sector and the retirement village sector
facing similar barriers to success are inhibited by existing rules which act as a disincentive to
downsizing out of the family home. This is because when
Entirely separate to the challenges associated with ageing you qualify for the Age Pension, your home is not counted
in place and aged care are questions surrounding the as an asset. However, if you make a profit when you sell your
growing demand for retirement village living. There is home and downsize to a cheaper option, some of the profit
a common misconception that retirement villages and may be taken into account when Centrelink calculates your
aged care facilities are the same thing, though the reality Age Pension.
is that retirement villages and aged care are designed for
different stages of life and different people. Retirement The Committee agrees with the Productivity Commission that
village residents live independently, while residential aged the federal government should establish an age pensioners
care residents require daily assistance with personal care. savings account scheme that would be made available to
While some retirement villages may be on the same site as age pensioners for investing any surplus funds from the sale
aged care facilities, the payment structure for aged care is of the principal residence — and for those funds to be exempt
notably different to that of residential care, and the regulation from the Age Pension assets and income tests.34 These funds
surrounding both sectors is entirely different. could be drawn upon to fund living costs, retirement village
costs, aged care and other expenses.
Retirement villages exist to provide an alternative
housing choice for people aged 55 years or older through The Aged Care Royal Commission also provides a good
accommodation which also offers a range of health, leisure and opportunity for the government to examine the financial
support services. In a city like Sydney, where the equivalent of viability of the broader retirement sector, though it remains
20 years of housing supply is currently tied up in unoccupied likely that government spending will need to increase in
empty bedrooms, it makes sense to promote a housing sector this space. It is concerning that spending on nursing homes
which provides a way for asset rich but cash poor retirees per capita has fallen for the first time in half a decade while
to downsize out of the family home.32 A gargantuan 89% of wait times had more than doubled in a single year.35 While
people aged 50 or over have a spare bedroom available in their the federal government’s expansion of funding announced
current home.33 alongside the commencement of the Royal Commission
is a welcome step towards reversing this decline, with
How many "spare" bedrooms do you have in your current home? 41% of residential aged care providers having reported a
loss during the September 2018 quarter, more funding and
reform to enhance sectoral viability is likely to be necessary
and should nonetheless be considered as part of the Royal
None
11% Commission's investigation.36
3 or more
bedrooms Beyond the broader question of the financial viability of the
23%
retirement sector, new evidence suggests that there is a
1 bedroom
25% geographical mismatch between where retirement living
supply is delivered and where the demand is. The Committee
2 bedroom for Sydney’s report on Seeing the City identified that at
41% present, the only SA2 area within Greater Sydney where
individuals aged 75 or over are the most predominant age
group, is the area surrounding Castle Hill East.37 This is largely
due to the high concentration of senior living facilities within
Source: LJ Hooker, The Downsizing Dilemma that suburb. If our intention is to provide dignity and choice

34 Productivity Commission: Caring for Older Australians

32 Sydney Morning Herald, Twenty years of Sydney housing supply locked up 35 Productivity Commission 2019 Report on Government Services
in spare rooms 36 Aged Care Financial Performance Survey
33 The Downsizing Dilemma 37 Committee for Sydney, Seeing the City

15
Most common age demographic by region

This map reflects what we know about lifecycle stages and how they shape housing choice. 'Young workers’, that is persons aged 15–29
and 30–44 are concentrated in high rental areas with good accessibility to jobs. Meanwhile, households with young children (0-14) are
found in the more affordable outer suburban areas. Older people are primarily on the Northern side of the harbour.

in retirement location, it is evident that Sydney's existing The Committee notes that Objective 11 of that the Greater
suburbs will need to be more accommodating of aged care Sydney Commission's Greater Sydney Region Plan is to
retirement village developments. deliver more housing diversity and choice.40 For Sydney to be
considered an all ages-inclusive city, this objective will need
Two of the major challenges holding back the sector from to be embraced by providing a diversity of retirement living
delivering this supply are a growing level of community options for our senior residents and by synchronising SEPPs
opposition to new retirement-oriented development, and to meet that objective. Indeed, many of today's opponents
a shortage of appropriate land for delivering new facilities may appreciate ageing options in their local area in the years
within established suburbs. to come.
The Committee is concerned that some local councils have A second challenge is the limited amount of brownfield land
fallen prey to anti-development populist opposition, resulting available for providing new retirement facilities. The industry
in a remarkable situation where aged care and retirement is attempting to respond to this through the provision of
villages are repeatedly snubbed on the basis that they do multi-storey facilities, which has unfortunately exacerbated
not fit the existing character of the neighbourhood.38 Most community opposition to retirement-oriented development.
concerningly, this has filtered up to a state government level, An earlier decision by the Brisbane City Council to provide
with the NSW Government announcing in October 2018 that height incentives for developers to provide 1,000 new
it would amend the Seniors Housing State Environmental aged care and retirement rooms was abandoned following
Planning Policy (SEPP) to "protect the local character of an sustained community opposition.41 Such decisions undermine
area" by keeping "the intrusive incremental creep of seniors' a city's inclusivity for older residents, by denying them choice
housing developments in check".39 and dignity in retirement location.
The Committee is concerned by the language used to By restricting supply that matches the locational preferences
describe seniors' housing development and cautions both of older residents, the city is denying itself a double benefit,
state and local government to avoid prioritising the lifestyle both from the provision of badly needed residential care and
preferences of select local opponents over the very real from the additional capacity freed up through downsizing.
need to tackle the imminent and large surge in demand for Survey data has confirmed that location is the most important
retirement villages and aged care facilities. factor considered when downsizing, while size is the least

38 Sydney Morning Herald, ‘Inappropriate development’: Retirement village 40 Greater Sydney Commission Greater Sydney Region Master Plan,
proposals rile mayors Objective 11
39 Department of Planning & Environment, New seniors housing planning rules 41 Brisbane times, Council to stop developers building on privately owned
to benefit all sporting land

16 COMMITTEE FOR SYDNEY

Image: Stockland's Epping Retirement Village Development

important factor.42 The occupation of large family homes by substantial savings for the government arising from the
one-or two-person retiree households in areas that are often existence of retirement living facilities including:43
close to employment and services is a key contributor to the
housing affordability challenge. • Reduced aged care expenditure of $1.98 billion per annum
through retirement villages delaying the entry of residents
into aged care services
What is the most important factor in choosing a property to
downsize into? • A minimum of $177 million saved in health care expenditure
Property size every year as a result of residents requiring fewer hospital
4% and GP visits.

Services
Retirement villages can also be designed with broader
9% community benefits in mind. Stockland's partnership with
the Catholic Diocese to provide a development that joins
together a retirement village and a school in Epping is one
Appropriate Location
design 18% such example of how mixed communities can be developed
44%
through partnerships between the private sector and the
non-profit sector. The development will see the creation of
Price 25% a new multi-aged precinct which includes:44

• A one-stream primary school with provision for expansion

• A new residential community including 200 independent

Source: LJ Hooker, The Downsizing Dilemma
retirement living apartments, and 132-bed residential aged
care facility
While both the aged care and retirement villages play a
critical role in the delivery of housing for Sydney's ageing • Retail space
residents, any reforms undertaken to support the retirement
• Open space
village sector will have catalysing benefits that accrue by
delaying the entry date of people into a higher-care setting Given the lack of free land available in Sydney's established
supplied by the aged care sector. By strengthening our suburbs, such partnerships present an innovative way to
retirement village, policy makers free up fiscal capacity to provide a welcome benefit to the community while also
reinvest into aged care. helping to provide new retirement living choice in areas
where shortfalls presently exist.
For policy makers concerned about the delivery of a
30-minute city, boosting retirement living diversity in areas
of existing demand is also a sensible outcome. Overcoming
these barriers will benefit government as well. In its review
of the retirement village sector, Grant Thornton identified
43 Grant Thornton, National Overview of the retirement village sector
44 Stockland enters agreement with the Catholic Church for mixed use
42 The Downsizing Dilemma community in Epping

17
 CONSEQUENCES OF LESS RETIREES MOVING INTO RETIREMENT LIVING
4.9% of retirees in NSW move into retirement living, compared to the national average of 5.7%.

X +5
yrs

Fewer retirees living in custom-built Reduced access to services, social Retirees entering aged care on
Retirement Living dwellings connections, sense of community average 5 years sooner than those
and well-being living in Retirement Living

$
Health and aged care costs to Fewer established homes available Less jobs created in
Federal and State Governments to address broader housing supply construction and operations of
continue to grow and affordability Retirement Living villages
Bringing NSW and the ACT up to the national
average would provide savings of $650 million.

Source: Stockland submission to the Greater Sydney Commission Draft District Plans

However, even in those areas where community opposition Retirement living is social infrastructure, and while it is
is neutralised through innovative partnerships, substantial generally provided by the private sector, it must be planned
viability challenges remain. The retirement living sector finds for much in the same way a park or school is planned. As
it difficult to compete with mainstream property developers with the delivery of all social infrastructure, planning for
for sites, largely because it faces a range of costs that other growth in the retirement living sector will require coordinated
developers do not. These include: actions across multiple layers of government. The Greater
Sydney Commission should develop a retirement living plan
• The need to provide more accessible and adaptable designs and toolkit to be assist councils in preparing local housing
strategies for seniors. This toolkit should provide clear
• Compliance with the requirements of the Retirement
direction on zoning and planning reform to move away from
Living Act and Seniors Housing SEPP
a development preference for “highest and best use”, while
• Larger average unit sizes (reducing yield) identifying other reforms to ensure that retirement living can
remain both a viable option for developers and a competitive
• The provision of community infrastructure, communal land use.
and in-house medical facilities, all of which increases
construction costs. Delivering a sufficient scale of retirement living supply to
ensure dignity and choice across Sydney is also unlikely to
These additional costs and design requirements directly occur in an environment where the same planning controls
impact on the competitiveness of this sector and result which apply to standard residential development are also
in retirement village providers often being priced out of applied to retirement-oriented development. Planning
the market for potential new sites. This is especially true controls should be relaxed for developments which already
in locations that are desirable as large-scale apartment, provide community serving infrastructure internally. Parking
townhouse or mixed-use developments, which is often minimums for retirement living and aged care facilities should
where the greater demand to age in place is found. be sharply reduced, in part because the demographic being
serviced typically have a lower rate of car-use than standard
As identified in Stockland's submission to the Greater Sydney
developments, but also because the rise of shared mobility
Commission Draft greater Sydney Region Plan, this failure to
and mobility-as-a-service is now providing a more safe,
deliver retirement living supply is now resulting in indirect
reliable and viable alternative to the high costs associated
negative consequences for the state of New South Wales.45
with ongoing car ownership.

45 Stockland submission to the Greater Sydney Commission

18 COMMITTEE FOR SYDNEY

RECOMMENDATIONS • Update the NSW Apartment Design Guidelines to
encourage design that is more ageing and disability friendly
Federal Treasury or more easily retrofittable to become ageing friendly.

• Conduct a review into incentives for co-living

• Encourage downsizing by establishing an age pensioners
arrangements to boost affordable rental supply for the
savings account scheme that would be made available to
financially disadvantaged renting retiree.
age pensioners for investing any surplus funds from the
sale of the principal residence and for those funds to be • Amend the Retirement Living Act and Seniors Housing
exempt from the Age Pension assets and income tests. SEPP to facilitate an easier pathway to development for
This fund would be made available to fund aged care and retirement villages and aged care facilities.
retirement village costs.
NSW Family and Community Services
Federal Department of Health
• Audit the state’s public housing stock to determine what
• Increase per capita spending on aged care facilities, proportion is appropriate in scale and design to meet the
while working with industry to identify how to improve the forecast growth in people living with dementia.
sector’s financial viability.
NSW Local Councils
• Increase the number of Home Care Packages on offer
with priority given to closing the gap for care packages
• Include in future Local Plans steps to ensure that each
targeted at those with higher needs and disabilities.
community will support an ageing population to age in
• Ensure that a sufficient number of Home Care Packages place. This should include considering aged care and
are available to support the needs of a growing number retirement living.
of Australians living with dementia.
• Relax planning controls for retirement living and aged care
developments which already provide community servicing
NSW Department of Planning and Environment: infrastructure internally.

• Ensure that inclusionary zoning policies take into • Reduce parking minimums for retirement living and aged
consideration the need to design some social housing for care facilities.
financially disadvantaged renting retirees.
• Consider the provision of on-site amenities in setting the
• Change tenancy legislation, placing the onus on landlords level of developer contributions in planning policies for
to justify why federal government funded ageing-friendly retirement villages that support people with dementia
home modifications should not be allowed to occur. and/or developments that co-locate retirement villages
and residential aged care facilities that incorporate
dementia-friendly design and environments.

19
20 COMMITTEE FOR SYDNEY
Transport to keep us
socially connected
and healthy

To develop Sydney into a socially connected, ageing- to access their GP or public health services using the existing
inclusive city, policymakers will need to ensure that the public transport network. Survey respondents who cited this
transport links which hold it together are appropriately difficulty often also had substantially worse health outcomes
designed to service the needs of its senior citizens. This than those who didn't respond in this manner.49
is particularly important given the need to prevent social
isolation amongst the growing number of residents who will This matches local experience by Transdev, which found
be unable to, or who choose not to, drive. that the number one reason consumers cited for using their
transport on demand, point-to-point trial in Sydney was
According to the NSW Intergenerational Report, a full 42% of to access a local GP, with visits to social or entertainment
NSW's population will fall outside the working age bracket destinations a distant second. For these users, transport
of 15-64 by 2056.46 In the more immediate-term, many baby on demand was a game changer for their public health and
boomers are on the cusp of exiting the job market, which will quality of life, delivering a substantial improvement on the
result in a substantial shift in transit behaviours for a substantial existing, fixed public transport network. By enabling greater
component of the population. At present, much of our transport access to GPs and health services, larger healthcare costs
spending continues to focus heavily on worker journeys to in the future can be mitigated through early recognition
the city, and while such investments are both necessary and and intervention.
welcome, ongoing consideration will need to be given to the
evolving transit needs of the ageing population. Transdev's global Mobility Lab has identified another area
where transport on demand can help provide additional
Research has confirmed that the vast majority of older benefits for seniors. Transdev's paper on Mobility for
Australians want to remain mobile and live independently an Ageing Population rightly identified that for some
at home, but accessing transport is proving confusing and senior citizens:50
challenging for many — with insufficient public transport
entrenching dependency on family or community services.47 “The car is the tool that permits that freedom. They
Two consistently listed reasons that older residents don’t use are very attached to it. To abandon the car is a sign of
public transport more often are that it is not convenient and physical decline, almost of “social death”.
that it doesn’t take them to where they need to go.48 Survey
data from the UK has found that seniors often find it difficult

46 NSW Intergenerational Report

47 SBS News, Elderly struggle with transport: research
48 International Longevity Centre in the UK, The Future of Transport in an 49 Ibid.
Ageing Society 50 Transdev Lab, Mobility for an Ageing Population

21
Reasons for not using public transport given by those over 65

Not convenient
Does not go where they want
Their health prevents them
Difficulties with mobility
Infrequent
None is available
Unreliable
Too expensive
Too dirty
Fear of crime

0 5 10 15 20 25
% of respondents
Source: International longevity Centre, The Future of Transport in an Ageing Society

But it is not the physical loss of the car which concerns increased accessibility to GPs and medical professionals,
seniors so much as the dignity and choice to travel with ease an equally important health benefit can be found in the
to the same destinations as anybody else. Transdev’s Mobility enhancement of social connections and its associated
Lab noted that:51 improvements in physical and mental wellbeing.

“The elderly no longer want to be shut away, they want The potential for mobility-as-a-service and transport-on-
access to social and cultural life, to be subject to the demand systems to act as social connectors, especially
same requirements as everyone else and to benefit from for those who are no longer in possession of their drivers’
public services. What is fundamental from their point of license or who are less confident with their driving skills,
view is to be able to choose and not to be captive.” needs to be acknowledged by the NSW Government as it
evaluates the transport on demand trials currently underway
In this respect, it is not so much the car itself that seniors in Sydney. The NSW Government should work with service
value, but the social and cultural connections that it enables. providers including Transdev and Keolis Downer to conduct a
New transport on demand services being trialled by Transdev deeper analysis of additional trips taken for medical or social
in parts of New South wales provide an alternative transit purposes which otherwise may not have occurred without
mode for senior citizens wanting to engage with the social a transport on demand offering. It should then gather survey
and cultural life of Sydney. As is identified in a later section data to determine whether consumers who use transport on
of this report, a series of critical healthcare indicators for the demand services for those purposes also believe that the
elderly are directly influenced by each individual's level of availability of these services will deliver better physical and
social isolation and its commensurate rates of loneliness mental health outcomes as a result.
and depression. In that sense, while transport on demand's
most obvious impact on the health budget may come from

51 Ibid

22 COMMITTEE FOR SYDNEY

Even with the evolution of transport on demand and mobility 3. Traffic management systems must be integrated,
as a service, it remains likely that elderly residents will also dynamic (demand-responsive) and easily manageable.
to some degree continue to use traditional public transport
infrastructure. This will remain true particularly for so long as 4. Digital tools will need to be populated amongst
there remains an insufficient level of subsidy for transport on senior demographics to enable greater awareness of
demand operators to provide their services at a price point available transport.
that is accessible to less financially advantaged seniors.
5. Public transport will need to be attractive, safe and
For those citizens who continue to rely on traditional public
comfortable.
transport, services will need to be designed with an adequate
level of accessibility. Specifically, public transport will need Arup also recommends that permeability and public transport
to be adaptable and designed to respond to older people's stops density should assume a general reduction in average
needs. With regards to accessibility, this will need to include walking speeds and distances.
a move towards more universal access to low floor buses, as
well as raised platforms for stops across all public transport More broadly, town planners will also need to be cognisant
modes. Safety will need to be prioritised during on-boarding of the slower walking speeds of older Australians when
and disembarking to minimise falls, while signage and attempting to design more walkable suburbs and town
information will need to be displayed clearly and ideally with centres. The average walking speed of an average adult is
an audio assistance option to assist the visually impaired. some 4.8km/h, for people aged 65+ the average drops to
just 3.0km/h, while for people aged 80+ it falls further to
When delivering public transport, the NSW Government 2.0km/h.53
should apply the following principles developed by Arup for
Europe but which are equally applicable in Sydney:52 Older residents also need more places to stop and rest,
and a failure to provide appropriate seating along popular
1. Urban planning and transport planning must be effectively walking routes is likely to further disincentivise active ageing
integrated to adequately respond to the actual mobility and worsen health outcomes across Sydney’s community
needs of an ageing population. of seniors.

2. The urban environment must be safe, regular, well

designed and connected and free from physical barriers.

52 Arup, Shaping Ageing Cities 53 Ibid.

23
 Some of these challenges can be resolved by making it
Slower walking speeds of older people reduces their easier for seniors to downsize to areas with better proximity
access to local amenities and public transport to traditional services, but for others who are unable or willing
to do so, transport-on-demand is likely to take on greater
<65
importance. In that respect, the Committee commends
Transdev, Keolis Downer and Transport for NSW for their
4.8 km/h ongoing trials of transport-on-demand services. Such services
are already proving very popular with older demographics
and are likely to prove even more important in those areas
65+ where public transport alternatives are scant. As is the case
with other public transport, this form of transport is likely to
require an ongoing level of subsidy from the NSW Government,
3.0 km/h particularly to ensure that services remain affordable for
financially disadvantaged seniors. As identified earlier within
80+ this section, the costs of providing such services should not
be viewed on a purely fare-recovery basis, and investment in
transport on demand should be viewed more broadly as a tool
2.0 km/h to tackle social isolation and loneliness, while also expanding
access to important GP services, which can help reduce
Source: Arup, Shaping Ageing Cities pipeline healthcare costs through early intervention.

Even within well designed, walkable, many seniors still In the longer term, the arrival of fully automated vehicles
remain socially isolated because of a lack of access to will enhance the capacity of Sydney's ageing residents to
public transport which would enable them to travel longer access a more diverse range of areas in Sydney, especially
distances to places of social activity. A recent Infrastructure as they move beyond an age at which they might typically
Australia report identified that within Greater Sydney, there lose access to their license. The Committee welcomes
were over one million people in the outer suburbs who had the release of the Future Transport 2056 Connected and
zero access to reliable public transport routes within 400 Automated Vehicles Plan, and suggests that as an evolving
metres of their place of residence.54 For ageing Sydney document, Transport for NSW should develop more targeted
residents who wish to age-in-place in these suburbs, a dearth research which identifies the potential transport needs of an
of frequent public transport threatens to compound social ageing population in the era of increasing automation.55 As
isolation once individuals are no longer capable of driving. this technology is developed, the NSW Government will also
This is particularly problematic when you consider the reality need to consider how it can ensure that such mobility is made
that a growing number of renting retirees are at risk of being accessible to senior citizens of all income brackets, as part
forced into these locations through financial disadvantage of a broader, equitably and inclusive strategy to tackle social
and a lack of affordable rental supply in other parts of the city. isolation and expand access to health services.
Additional investment in bus networks could theoretically
expand the number of services to those outer suburbs, but it
remains unlikely that such networks will be able to densely
cover the entirety of Sydney’s geographic plain without
either sacrificing frequency and reliability, or by substantially
increasing costs to the taxpayer.

54 The Extent of Public Transport Disadvantage in Australian Cities 55 Transport for NSW, Connected and Automated Vehicles Plan

24 COMMITTEE FOR SYDNEY

RECOMMENDATIONS

Transport for NSW

• Work with transport on demand trial providers to quantify

the number of additional trips taken by elderly residents
for medical or social purposes and which may not have
occurred without a transport on demand offering.

• Ensure that public transport infrastructure and vehicles are

adaptable and designed to respond to the accessibility
needs of older individuals.

• Set a target to expand public transport accessibility and

frequency in areas with high numbers of individuals aged
70 and over, including on the outer fringe of Sydney where
public transport offerings are already sparse.

25
Planning principles for
inclusive public spaces

The Committee for Sydney has long been an advocate for urban are worth pursuing in their own right. For example, the NSW
renewal as an avenue to better public spaces. Such concepts Government has unveiled a policy to increase Sydney's tree
were first fleshed out in our landmark report on Making Great canopy cover from 16% to 40% by 2030 as part of its Five
Places: Density Done Well.56 In 2018, the Committee expanded Million Trees initiative.59 While all residents will benefit from
on this viewpoint with the release of Re-Balancing the City: Town additional shading and a corresponding reduction in peak
Centre Renewal for Sydney.57 In 2019, this conversation will be temperature during summertime, the benefit will be even
expanded further with new research which applies the principles more significant for Sydney's ageing residents.
of Density Done Well to Sydney's existing suburbs. Underlying all
of this research is an ongoing belief in the importance of inclusive Other planning decisions taken by local and state
public realm and amenity as a necessary precursor to securing government to assist the elderly will also come with ancillary
community support for development and urban renewal. benefits for the community. Levelled street-walks, more
frequent and accessible resting areas in public spaces, safe
This belief is also reflected in the Committee for Sydney's and secure pedestrian environments, a greater provision of
decision to form the Good Growth Alliance alongside the recreation and public facilities, parks and trails will all help
Community Housing Industry Association of NSW, the Sydney to deliver an ageing-inclusive environment with broader
Business Chamber, Homelessness NSW, the Property Council benefits for the community.
and Shelter NSW.58 Throughout 2019, the Committee will work
with this group by demonstrating the benefits of inclusivity- To assist councils in the delivery of age-inclusive places,
led and great, place-based housing growth as critical to COTA NSW has produced a list of Basic Principles for Age-
Sydney’s development. Friendly Environments.60 The principles document provides
not just a list of outcomes to achieve, but also a list of
This paper notes that great public spaces improve amenity for common outcomes to avoid when planning public spaces,
all users and not just older residents, though it is seniors who specifically with regards to footpaths, seating, wayfinding
feel to failures of design most acutely. Many of the planning and signage, toilets, and lighting. Some of these are
principles required to deliver an ageing-inclusive city have replicated below.
substantive value for the broader community and

A selection of basic design principles for age-friendly environments

Foothpaths Seating Wayfinding Toilets Lighting

To do Wide enough for two At regular intervals Large lettering, colour Toilet height and hand Even and placed to
mobility devices contrast & plain fonts rails should meet minimise strips of light
Protected from the
AS1428 requirements across surfaces
Street crossings at elements Continuously placed
same level as footpath if leading to a location One unisex toilet to Good lighting after dark
Accessible for people
from a distance allow carers to assist
with wheelchairs
To avoid Gravel or loose Seats without arm rests Placing wayfinding Locking accessible Placing trees and
surfaces signs where there is a toilets shrubs where they
Seats set too low
lot of visual ‘noise’ will grow under a light
Trip hazards Gravel or uneven paths
Not good for larger source.
Heritage-style fonts from the main path of
Shared spaces with people
travel. Reflective surfaces
cyclists or scooters
Source: COTA NSW: Basic Principles for Age-Friendly Environments

56 Committee for Sydney, Making Great Places: Density Done Well

57 Committee for Sydney, Re-Balancing the City: Town Centre Renewal
for Sydney 59 NSW Government, Five Million Trees for a greener Sydney by 2030
58 Good Growth Alliance, A Better Sydney and Stronger NSW 60 COTA NSW: Basic Principles for Age-Friendly Environments

26 COMMITTEE FOR SYDNEY

Landcom's Open Space Design Guidelines also provide to ensuring separate and distinct pathways for cyclists and
useful design principles relevant to age-friendly design for seniors, without unduly depriving either group of access to
open space areas and liveable communities.61 Such tools public open space.64
can be adapted for use by council staff in assessing public
domain plans, open space plans, and for devising suitable As a more immediate priority, local councils should also adopt
questions for consultation with the community about the following recommendations from the LGNSW Toolkit:65
proposed open space design.
• Undertake a review of the age-friendliness of council
Another important placemaking principle is the importance infrastructure, facilities, libraries and waste management
of recognising that spaces are shared and best delivered — This could be done be using Walk and Talk or other
when they are inclusive to all. The Heart Foundation NSW accessibility assessment tools to assess satisfaction of
has identified that as seniors continue to age, they become older people to determine conditions/age-friendliness.
less confident walking in their local neighbourhood due to
• Create age-friendly local planning controls — This would
fears that they might fall, particularly in areas where bicycles
ideally include age-friendly aims, objectives and strategies
are present.62 This is likely to become an even greater risk
being embedded into local planning controls.
as motorised scooters and bicycles grow in popularity. To
ensure that our public spaces are inclusive for both senior • Prepare age-friendly Master Plans, Public Domain
citizens and other active transport users, both local and state Plans and Urban Design Plans — These should provide
government should coordinate on the more rapid delivery input on urban design considerations for age-friendly
of separated, dedicated bike lanes which should also be environments. Ideally these would be developed with
made available to electric scooters and electric skateboards. input from urban designers and landscape architects who
Such investments should no longer be viewed as being are trained in understanding older people’s needs in the
purely beneficial to the cyclists themselves and will need to outdoor areas and interface with buildings.
be viewed in the context of protecting safe walkways and
spaces for an increasingly ageing demographic. By failing During the implementation of these recommendations, local
to invest in this infrastructure, policy makers risk delivering councils should seek to consult with the seniors within their
poorer health outcomes for two separate demographics, community to ensure that any audit reforms are appropriately
while at the same time undermining the development citizen-led.
of our public spaces as socially inclusive spaces for all
Sydney residents. RECOMMENDATIONS

Indeed, the NSW Government's $290 million investment

NSW Local Councils:
in parks and open spaces across Sydney is unlikely to be
as successful as it otherwise could be unless the NSW
• Plan public spaces in accordance with COTA NSW’s
Government is able to take commensurate action to make
Basic Principles for Age-Friendly Environments and Local
sure that Sydney's senior residents feel safe during the short
Government NSW’s Integrated Age-Friendly Planning Toolkit.
walk from their place of residence to these locations.63 To
address this, the Greater Sydney Commission should work • Conduct an audit to identify deficits in shading and seating
with local councils during the development of their ageing availability, particularly in those areas with close proximity
strategies to identify whether there are sufficient safe and to destinations that are attractive to elderly residents such
walkable pathways for residents to access these new and as shops, the library, toilets and bus stops.
improved open spaces. Attempts to connect the Government
Architect of New South Wales' proposed Green Grid with
dedicated cycle ways should also be undertaken with a view

61 Landcom, Open Space Design Guidelines

62 Noted during consultation with the Heart Foundation NSW as part of the
research for this paper 64 Government Architect of NSW, Sydney Green Grid
63 NSW Government, $290 million for more green and open spaces 65 Local Government NSW Toolkit

27
Healthy and
active ageing

Both the federal and the NSW Intergenerational Report have initiative to provide a pedestrian friendly, safe walking circuit
identified substantial costs associated with the ageing of in the city, with seating on route, maps in four languages, and
the population, the largest of which is a forecast increase links to common destinations for elderly residents such as
in health costs. Average health expenses per person aged shops, the library, toilets and bus stops.68
over 65 is around three times higher than those aged 65
or under, highlighting the need to encourage a lifestyle For councils seeking to leverage their existing local parkland
which involves more preventative active ageing habits. This to deliver better health results for an ageing community,
conclusion is supported by the World Health Organisation's research has found that outdoor exercise parks specifically
2015 World report on ageing and health, which emphasised designed for seniors can help them better enjoy life and can
that all the aspects of an older person’s environment need substantially improve muscle strength, balance, and physical
to work together in an integrated way if healthy ageing is to function, which are all risk factors for falls.69 Research also
be achieved.66 recommends that these exercise parks be co-located with
children’s playgrounds so that grandparents can exercise
Place Design Group considered the challenge of healthy while supervising their grandkids and vice versa.70
and active communities as part of its 2016 research on Age
Friendly Cities in Australia.67 The paper correctly identified Even if the infrastructure is in place to encourage active
the importance of walkable suburbs for encouraging active ageing, there will need to be a targeted strategy to
ageing, singling out the importance of protecting green encourage and promote more active lifestyles. On this front,
space to deliver intergenerational walkability across our the Australian Government’s recently announced Better
suburbs. The Place Design Group research also identified a Ageing Grants are a step in the right direction and worthy
particularly noteworthy initiative by a the City of Boroondara of continuation.71
in Victoria, which implemented a "Walk, Rest and Talk"
State and local government would also do well to partner
with industry and community organisations to deliver more
City of Boroondara's Walk, Rest and Talk initiative programs for older Australians that encourage physical
activity and wellbeing. While this could include some
degree of public subsidy for local pools or gymnasiums to
provide affordable seniors programs, it is also true that you
can encourage a more active lifestyle simply by providing
more ageing friendly activities and events within the
community, which will also have the dual benefit of reducing
social isolation.

Source: Place Design Group, Age Friendly Cities in Australia

68 City of Boroondara, Walk, Rest and Talk
69 Journal of Ageing and Health, A novel exercise initiative for seniors to
improve balance and physical function
66 World Health Organisation, World report on ageing and health 70 Ibid.
67 Place Design Group, Age Friendly Cities in Australia 71 Australian Institute of Sports, Better Ageing Grants

28 COMMITTEE FOR SYDNEY

The NSW Government should also expand the Active Living
NSW partnership between the NSW Ministry of Health and In just over 20 years from now, by 2040, there will be:
the Heart Foundation NSW branch to include additional
resources that are specifically targeted at delivering better
over

4.6 million
outcome for ageing citizens. The NSW Government and
Local Government NSW should also work with the Heart
Foundation to develop a Healthy by Design program people with
modelled on the successful Victorian initiative.72 Such a circulatory system
diseases
program would have the added benefit of broader health
over over

5 million 2.6 million

benefits for all members of the community.

Finally, both federal and state governments would do well people aged people with high
to acknowledge the findings of recent PwC research which
70+ or very high
warned that Australia's health and ageing sectors couldn't anxiety or distress
simply be 'scaled' up to meet growing demand, nor would
this secure the best outcomes for those cared for within Source: PwC, Practical Innovation: Closing the Social Infrastructure Gap in
the system.73 Health and Ageing

PwC warned that such an approach would quickly

RECOMMENDATIONS
swamp government budgets and has instead suggested
a series of practical actions and innovations, including
that governments: NSW Ministry of Health

"Transform the system towards a more holistic and • Expand the Active Living NSW partnership between the
outcomes focussed approach, making better use of NSW Ministry of Health and the National Heart Foundation
prevention and early intervention, all underpinned NSW branch to include additional resources specifically
by future demand and demographics – looking targeted at delivering better outcome for seniors.
after people closer to their homes and communities,
focussing and organising around outcomes that matters NSW Local Councils
to them (physical, mental health, social, financial etc.)”
• Invest in seniors-friendly exercise facilities in public parks,
Such a recommendation is consistent with the other ideally co-located near children’s playgrounds.
recommendations in this report, which seek to encourage
governments at all levels to evaluate their programs as part • Provide safe and walkable pathways for senior citizens that
of a holistic response to making Sydney inclusive for an are separated out from car and bicycle infrastructure.
ageing population.

72 Heart Foundation, Healthy by Design

73 PwC, Practical Innovation: Closing the Social Infrastructure Gap in Health
and Ageing

29
Fostering social
connection and
good mental health

As has been highlighted numerous times throughout this The impact of loneliness and social isolation on public
paper, one of the most substantial challenges that Sydney sector resources
will need to confront as its population continues to age is the
risk of social isolation and loneliness amongst an increasingly
large component of the city’s population. Loneliness*

When people leave the workforce and enter the retirement

stage of their lives, they often begin to experience social
Social isolation can Less active lifestyles Lack of investment
isolation and increased rates of loneliness. The incidence of
worsen or hasten create a decline in tackling loneliness
loneliness typically increases with age, as life events result onset of poor mental in physical health can reduce savings
in a higher number of individuals living alone or without health outcomes elsewhere
access to the same friendship circles which sustained them
emotionally throughout much of their lives. No less than
one-third of older individuals already experience either
Diabetes Less preventative
loneliness or severe loneliness.74 COTA Australia predicts Depression health
that the number of socially isolated people will more than Stroke
Dementia
double by 2040,75 while international research has found that Less ageing in place
Coronary heart
people who are socially isolated or lonely are also more likely disease
to report risky health behaviours such as poor diet, lack of
physical activity, and smoking.76 Increased disability

Loneliness can also result in unexpected costs in other

areas for government. People who classify as ‘lonely’
are 60% more likely to access emergency services than More GP visits
Short-term healthcare costs of
those who consider themselves ‘non-lonely’.77 That older treatment
More hospital
individuals are visiting emergency departments not so much admissions visits
Medium-term health and social
for serious medical problems but rather for the added social cost of treatment
Increased likelihood
interactions provides a sad yet powerful demonstration as to
of entering into more
why substantially more needs to be done to promote better Loss of quality adjusted life years
costly care options
mental health outcomes in the community.
Source: IoTUK, Social Isolation and Loneliness in the UK
Separate research from the UK has found that that a failure
to tackle social isolation is now creating additional costs for
government in other areas of the health budget.78

74 Minister for Aged Care, Ken Wyatt AM, Speech to the Tackling Aged Care
Mental Health & Social Isolation Conference
75 COTA, Social Isolation: Its impact on the mental health and wellbeing of
older Victorians
76 Age and Ageing, Social isolation and loneliness as risk factors for the
progression of frailty
77 Aged & Community Services Australia, Social Isolation and Loneliness
Among Older Australians
78 IoTUK, Social Isolation and Loneliness in the UK

30 COMMITTEE FOR SYDNEY

To address the challenge of social isolation, Aged & advocating for the creation of an "intergenerational start-
Community Services Australia (ACSA) has recommended the up culture"81 that will connect experienced older people
development of programs which encourage older people with younger entrepreneurs. Similar efforts should also be
to contribute meaningfully to others through volunteering made locally to connect the wisdom and experience of
activities. Other beneficial policies suggested by the research older generations with the entrepreneurial enthusiasm of
include offering classes in a local community centre where younger generations.
older residents can engage socially with others.79
In West Australia, SGS Economics & Planning has taken on an
The Committee for Sydney encourages all levels of advisory role in the delivery of multi-age precincts, drawing
government to consider how they can support the growth of from successful programs used in both the Netherlands
volunteerism across Sydney’s ageing demographic, while and Japan.82 Such precincts can be delivered by better
Universities should be supported to embrace innovative connecting senior citizens with other, younger adults, but
ways to involve older residents in both learning and teaching they can also come from connecting senior citizens to much
in areas that sit outside the standard curriculum. In Lisbon, younger demographics. Research has identified substantial
one University has expanded opportunities to people over social and economic benefits to projects which combine
the age of 50 to volunteer by offering free lectures on the aged care and childcare programs, along with substantial
arts or computer sciences. Lendlease has also announced improvements in participant wellbeing.83 In a similar vein,
a partnership with the University of Wollongong to build BeyondBlue recommends programs which connect older
retirement living units on campus as part of a $500 million adults and school children for mutual benefits, with senior
state-of-the-art health and wellbeing precinct.80 Similar Australians volunteering to help students with activities such
opportunities should be considered by other universities. as reading, literacy and numeracy.84

Opportunities should also be examined for intergenerational This delivery of a broad range of social activities for seniors
learning beyond the university sphere. The mayor's design will be dependent on the availability of infrastructure to
advisory group in London recently released a report house those activities. For local councils seeking to promote

81 Mayor’s Design Advisory Group, Ageing London

79 Aged & Community Services Australia, Social Isolation and Loneliness 82 SGS Economics & Planning, ‘MAPs in the City’ series
Among Older Australians 83 AJSI, Intergenerational care as a viable intervention strategy for children at
80 Australian Financial Review, Lendlease signs up to build on-campus risk of delinquency
retirement living, March 27, 2019. 84 BeyondBlue, Connections Matter: Helping older people stay socially active

31
more ageing-inclusive social engagement, it is especially Not all individuals are extroverted or enjoy larger social
important that they retain their community infrastructure gatherings. For these individuals, the risk of social isolation
assets. Sociologist Ray Oldenburg once highlighted the becomes more acute if they are living alone, for example,
social importance of "third places"; those places where after the passing of a lifetime partner. For individuals in
people spend time between their home ('first' place) and their these circumstances and who are recipients of a Home Care
work ('second' place), including libraries, parks, churches, package to age in place, the connection with their local carer
recreation and health centres. These third places will become is likely to be of significant importance. As such, it is important
increasingly important as our population continues to age.85 to ensure that Australia's carer workforce remains adequately
trained to deal with the challenges of social isolation, and that
For social isolation to be tackled across the wealth spectrum churn of staff in the sector is minimised in order to facilitate
and on an all-inclusive basis, it will also be important that the development of more long-term, positive social bonds
social events in these spaces are not commercialised and between the carer and the care recipient.
made unaffordable or selectively available. While such facilities
and programs are welcome when provided by local or state Finally, it needs to be acknowledged that when funding social
government, in other areas, charities are stepping up to the programs for the community, governments should remain
task. Across NSW, BaptistCare offers a series of centres that cognisant of the reality that an investment in preventing
are supporting people living with disadvantage so they can social isolation is an investment in preventing worse and
address key issues including social and financial exclusion, more costly health outcomes further down the line. Effort
mental health challenges, drug and alcohol dependence, will also need to be made to ensure that social events are
and housing needs.86 These centres also provide a valuable delivered in a way that is accessible by public transport,
opportunity to connect with others in the local community. in line with the other recommendations contained within
this report.
However, meeting the challenge of tackling social isolation
should not be the exclusive domain of charities. Local
Recommendations
councils should also play a role in providing social events that
are affordable and accessible to those who are financially
disadvantaged. Effort should also be made to ensure that NSW Local Councils
activities on offer are also accessible to culturally and
linguistically diverse (CALD) communities. • Promote more ageing-inclusive social events which are
both accessible to culturally and linguistically diverse
Many of these events could be delivered in conjunction with demographics and affordable for disadvantaged residents.
the not-for-profit sector. One such example is the Riverwood
Community Centre, which services 17 different cultures groups Federal Department of Education and Training
in the Canterbury Bankstown and Georges River areas. The
non-profit centre partners with local councils as well as both the • Fund universities to trial innovative pilots that involve older
NSW and Australian Government to provide extensive services, residents in both learning and the teaching of areas that sit
activities, and facilities for children, young people, families, older outside the standard curriculum.
people, people with a disability and community groups.87

85 Ray Oldenburg, Celebrating the Third Place

86 BaptistCare, Centres
87 Riverwood Community Centre, About us

32 COMMITTEE FOR SYDNEY

Tackling the
dementia challenge

While the challenges associated with dementia differ in many Friendly Policy. The area surrounding Hornsby has a
respects from those that are associated with other aspects dementia rate of 2.4%, higher than the NSW average of 1.59%,
of ageing, the need to plan for a growing number of Sydney prompting the council to develop a plan to become Sydney's
residents who will be living with the condition creates a first dementia-friendly community.91
logical imperative to utilise this opportunity to also gauge
the city's preparedness and inclusivity for people living with The University of Wollongong is meanwhile working with
dementia. Figures compiled by Deloitte Access Economics Kiama Council to showcase a dementia-friendly community,
for Dementia Australia calculate that the number of NSW drawing on the collaborative research it has undertaken with
residents living with the condition will increase from around Alzheimer's Australia.92 The Dementia-Friendly Kiama Project:
120,000 today to roughly 300,000 in 2050.88 No area will be
• Tracks the progress of businesses and organisations
exempt from having to service a substantial increase in the
looking to make changes to design and staff training to
number of residents with dementia. As such, local councils
work towards becoming more dementia-friendly.
should begin working on strategies to help manage this
demographic shift, while ensuring that their approach is • Increases community awareness of dementia
appropriately tailored to their localised urban environment. through education.

Academics have already outlined a number of planning • Suggests improvements to town-scape and amenities to
principles which are already helping to make our public improve access for people living with dementia.
spaces dementia friendly. The University of Warwick's
Wellbeing in Sustainable Environments research unit The initiative has been so successful that work is now
has published Streets for Life: inclusive Urban Design.89 underway to create more Dementia-Friendly Communities
Alzheimer's Australia has released Creating Dementia- in other parts of Australia, with the Kiama project recognised
Friendly Communities: A toolkit for Local Government.90 with an Excellence in Community Partnerships Award at the
Hornsby Shire Council in 2018 announced a Dementia 2016 National Disability Awards.93

Forecast number of people living with dementia in Australia

2011 2012 2015 2020 2030 2040 2050

NSW 91,038 95,028 107,037 128,238 182,331 248,139 303,673
VIC 68,397 71,544 81,117 98,123 141,161 195,459 245,813
QLD 48,674 51,005 58,509 73,470 114,800 166,032 215,272
SA 23,710 24,627 27,353 32,062 44,236 59,053 69,620
WA 23,931 25,177 29,041 36,500 46,332 57,781 68,708
TAS 6,732 7,003 7,818 9,362 13,544 18,043 20,653
NT* 838 878 1,049 1,473 2,700 3,992 4,916
ACT 3,254 3,445 4,040 5,167 8,181 11,632 13,970
AUST 266,574 278,707 315,963 384,396 553,285 760,131 942,624
Source: Deloitte Access Economics prepared for Dementia Australia

88 Deloitte Access Economics, Dementia across Australia, 2011-2050 91 Hornsby Council, Dementia Friendly Policy
89 Streets for Life: inclusive Urban Design 92 Dementia Australia, Dementia Friendly Communities, Kiama
90 Creating Dementia-Friendly Communities: A toolkit for Local Government 93 Dementia Australia, Dementia-friendly Kiama wins National Disability Award

33
Other local councils across NSW should examine both the forecast growth in demand, state governments must ensure
Kiama and Hornsby initiatives and develop their own tailored that their housing stock is appropriate in scale and design to
strategies to deal with the growing number of residents within meet the needs of this rapidly growing demographic.
their own community which are living with dementia. Such
strategies should be developed in partnership and through The Australian Government should also use the upcoming
collaboration with individuals who are living with dementia Aged Care Royal Commission to review whether the Home
themselves. Much of the success of Kiama's strategy is directly Support Programmes and Home Care Packages available
attributable to the fact that it was developed in collaboration today are being appropriately tailored to provide the right level
with both the Dementia Friendly Alliance and a Dementia of support, and that employees in this sector are appropriately
Advisory Group, both of which involved a large number of trained to provide for the needs of people with dementia.
residents who were living with dementia. At present, home care recipients with moderate to severe
levels of cognitive impairment associated with dementia
Beyond street design, local planning and social services, may be eligible for a Dementia and Cognition Supplement.96
there is also a need to ensure that adequate housing The supplement rate is currently set at 10% of the package
and care is available for people living with dementia. It is funds the care recipient already receives under their Home
overwhelmingly beneficial for people living with dementia to Care package, though an evaluation should be undertaken to
be able to remain within the family home with a family carer determine whether the supplement is set an appropriate level.
available, with quality of life significantly higher and coping
with memory loss significantly easier for those who are able Not all people living with dementia will reside in traditional
to do so.94 The Australian Government will need to ensure that housing. For retirement village operators, Alzheimer's
a sufficient number of Home Care Packages are available to Australia, the Property Council of Australia, Retirement Living
support the needs of a growing number of Australians living and the IRT Foundation in 2016 have produced a discussion
with dementia. The number of people living with dementia paper on Dementia in Retirement Villages.97 While each of the
who are in public housing is also forecast to grow from 12,916 recommendations in that report are worthy of consideration, there
in 2020 to 31,672 by 2050 across Australia.95 To meet this are several that should be introduced as a matter of priority.

96 Department of Health, The Dementia and Cognition supplement

94 AHURI: Future housing and support needs of people with dementia in home care
95 Ibid. 97 Dementia in Retirement Villages

34 COMMITTEE FOR SYDNEY

For the Australian Government, these include: International research has identified a full 35% of people with
dementia had self-reported experiences of loneliness in the
• Allocating funds from the Department of Social Services' recent past.99 To tackle this, the UK Government has introduce
Dementia and Aged Services Grant to promote dementia a Side by Side volunteer initiative to encourage people to
awareness, risk reduction messages and healthy ageing in buddy up with people with dementia, helping to improve
retirement villages. health outcomes in the process.100 Similar initiatives should
be trialled in Australia. In that vein, the Art Gallery of NSW
• Fund dementia education programs specifically for deserves special commendation for its Art and Dementia
retirement village operators and staff. Program, which has been hugely beneficial for people living
• Instructing the Department of Social Services to prioritise with dementia across Sydney.101 Both councils and the private
allocations of home care packages which provide service- sector should consider expanding their offerings of programs
integrated housing in retirement villages for people to deliver more opportunities for people with dementia to
with dementia. engage with the wider community.

Tackling social isolation will also require accessibility

For the NSW Government, this would include: to appropriate transport services. Thankfully, the NSW
Department of Family & Community Services in conjunction
• Incorporating reduced developer contributions in State/ with Alzheimer's Australia has already developed a report on
Territory planning policies for retirement villages that Meeting the Transport Needs of People with Dementia.102 This
support people with dementia and/or developments document will remain useful in the near term but will need to
that co-locate retirement villages and residential aged be updated soon to take into account new forms of mobility.
care facilities that incorporate dementia-friendly design
and environments. Finally, this paper commends the NSW Government's work
to date on the Dementia Care Competency Framework,
Combatting social isolation remains important, if not more- developed by NSW Health, The University of Wollongong and
so, for people living with dementia. People with dementia Dementia Collaborative Research Centres.103 This initiative
are almost twice as likely to have high rates of loneliness has already delivered high-quality dementia care training to
compared to the general public.98 over 5000 clinicians. This program will need to be continued
to ensure that the state is able to provide an adequately
trained network of professionals sufficient in scale to meet
the forecast surge in dementia incidence.

99 Turning Up the Volume: Unheard voices of people with dementia.

100 Alzheimer’s Society, Side by Side
101 Art Gallery NSW, Looking at paintings brings pleasure for people living
with dementia
98 https://www.dementia.org.au/files/NATIONAL/documents/Dementia- 102 Meeting the Transport Needs of People with Dementia
and-Loneliness.pdf 103 Health Dementia Care, Competency & Training Network

35
RECOMMENDATIONS • Provide support for the development of dementia
education programs specifically targeted at
Federal Department of Social Services retirement village

• operators and staff.

• Prioritise allocations of home care packages which provide
service-integrated housing in retirement villages for
NSW Local Councils
people with dementia.

• Introduce an Australian version of the UK Government’s • Develop local strategies to manage the forecast growth
Side by Side volunteer initiative, which encourages in local residents living with dementia, drawing from
younger people to buddy up with people with dementia. Alzheimer Australia’s Creating Dementia-Friendly
Communities: A toolkit for Local Government.
Federal Department of Education and Training • Ensure that social events are delivered in a way that
makes them accessible and welcoming for people living
• Develop a larger tertiary curriculum to ensure that
with dementia.
Australia’s carer workforce is being adequately trained to
deal with the challenges of social isolation and dementia.

Self-reporting of loneliness for people with dementia and their carers is significantly higher than the general population

30%

25% Person with dementia

20% Carer

General public
15%

10%

5%

0%
No relatives No relatives No relatives No friends No friends No friends
seen at to talk to call for seen at to talk to call on
least once to about help least once to about for help
a month private a month private
matters matters
Source: Alzheimer's Australia, Dementia and Loneliness

36 COMMITTEE FOR SYDNEY

Conclusion

The Committee for Sydney acknowledges that the ageing Contributors

population is not a phenomenon that is unique to Sydney,
nor are the policy challenges associated with that change. The Committee for Sydney would like to thank Research
This report seeks to provide a series of immediate, practical Principal Sam Stewart for his work as lead-author on
recommendations that federal, state and local governments this report, and Andrew Silk for his role as contributing
can take to begin to prepare for the ageing of the population. researcher. The Committee also undertook a series of
workshops and interviews with members to produce this
It is the Committee for Sydney’s strong belief that in preparing report, and is grateful to the following organisations for
for this shift, policymakers will need to place dignity and their contributions:
choice at the centre of their ambition to create a city that is
both inclusive and liveable for its senior residents. Many of Airbnb
the workers who are today contributing to the renewal of Arup
Sydney and its establishment as a globally leading city are BaptistCare
the same individuals who will one day seek to retire here, BlueCHP
and on the principle of fairness, policymakers owe it to those
City of Sydney
individuals to design a city that is considerate of their needs
City West Housing
and not just the needs of the next generation of workers.
Community Housing Ltd
Many of the reforms recommended in this report will be Elton Consulting
beneficial to all Sydneysiders. Better public spaces, more HASSELL
flexible public transport and a stronger social offering are all Heart Foundation
outcomes that would benefit Sydneysiders both young and
Link Housing
old alike. However, a failure to design a city around these
Liverpool City Council
placemaking principles is likely to be felt more acutely by
older residents as they continue to age. While policymakers Local Government NSW
at all levels have demonstrated a genuine desire to facilitate Mecone
the ability of retirees to age in place, there is a need to ensure PAYCE
that policies consider not just at where older generations Place Design Group
might choose to live, but also at the ways in which they are PwC
connected to their local communities. A well connected, SGS Economics and Planning
socially active and happy ageing population adds vibrancy South Western Sydney Local Health District
to a city. Ensuring that such an outcome is available to
Stockland
individuals of all cultural and financial backgrounds should
Sydney Local Health District
also be a key goal of policy makers as they build the
infrastructure and public spaces which will define the city The Australian Centre for Social Innovation
over coming decades. The Star Entertainment Group
Transdev Australasia
The Committee for Sydney hopes that this report provides Transport for NSW
practical recommendations to assist with achieving that
University of Technology Sydney
vision, and that these recommendations are embraced in
University of Wollongong
their totality through a collaborative framework engaging all
layers of government. UNSW
Western Sydney University

37
Keep in touch

The Committee for Sydney

Level 27
680 George Street
Sydney
NSW 2000

sydney.org.au

@Committee4Syd
[email protected]
+61 2 99275611