Seniors as 21st Century Urbanites

According to the 2016 census, 4 million Canadian seniors (66 percent) live in metropolitan areas, a number that has risen 21 percent from just five years earlier. This is only expected to intensify as the seniors’ population doubles in size over the next two decades.

The trend towards urbanization has given rise to the phenomenon of vertical aging: seniors living in apartment, co-op, and condo buildings that were not originally built for seniors, but have become home to a high density of older adults nonetheless. Nowhere is this phenomenon more apparent than in Toronto where there are 489 high-rise buildings where at least 30 percent of the residents are over 65 years old (approximately 70,000 seniors).  

Zooming out, we know that more than 36 percent of Toronto’s seniors’ population are now living in high-rise buildings. Similar trends towards high-density living are happening in big cities like Vancouver, Montreal, and Ottawa, where one in five seniors live in high-rises.

These buildings, which are sometimes referred to as naturally occurring retirement communities (NORCs), are regular residential buildings that are home to older adults for a variety of reasons. Some are full of seniors who have been residents for many years and have watched as their building slowly becomes more ‘grey’. Others are home to seniors who have ‘downsized’ due to difficulty maintaining a single-family home, higher than anticipated costs of living, or the desire for a greater ease of mobility.

What residents in NORCs have in common is the desire to age in place, and a concern for how they will do so in buildings that are not set up to meet their needs.

We are witnessing a pivotal shift in the way seniors live in cities. Suburban cul-de-sacs are giving way to ad-hoc retirement communities in the sky. This is reshaping the social and physical environments within which aging takes place and poses some important questions about what livable communities for seniors could look like over the coming decades.

Redefining Place in ‘Aging in Place’

Canadians want to age in place and stay living independently in their homes for as long as possible. 

The vast majority of seniors dread the prospect of living in institutional settings, such as long-term care homes, which threaten their most basic human rights: autonomy, self-determination, and choice. 

Unfortunately, for those who do wish to consider supported living, there is not sufficient capacity within our current system to accommodate the wave of incoming seniors. It is estimated that the existing seniors’ residential care system would need to double in capacity to meet the needs of the ever-growing aging population. And yet, data suggests that one out of five seniors placed in long-term care would be able to remain in their homes if they had access to appropriate supports.

While most Canadians are able to access publicly-funded home care, these services do not typically include help with many of the things seniors need to maintain independence, such as exercise, mobility support, nutrition, cognitive stimulation, and system navigation.

What’s more, for many seniors the experience of aging is typified by a sense of loneliness and isolation. For others, it is a loss of meaning and connection to community. Not only do these things have a profound effect on quality of life and overall health, but they also cut away at the ability to maintain a sense of vitality needed to remain living independently. 

While these issues are not new, the landscape in which they are going to be taking place in the near future is changing and the sheer scale of their implications will be more profound than at any time in our past. This new landscape, we believe, will be shaped by a number of important shifts. These are:

Three Innovations to Unlock the Potential of NORCs

When seniors live right next to each other in a building, separated by just a wall or a ceiling, it opens up the possibility of bringing in supports that take advantage of these natural densities to deliver a more expansive notion of care. It also gives rise to new opportunities to achieve economies of scale by allowing us to break free from the paradigm of one-to-one service provision to one where hundreds of people with similar needs can be served in entirely new ways, under the same roof.  

The goal of this exploratory project was to come up with 2 to 3 high-potential innovations that can unlock the potential of NORCs and help shape the future of aging in place in urban Canada. 

In a sense, the project asked us to consider how we might reimagine cities for the future—where the building you live in becomes a determinant of health in and of itself. It asked us to consider the role that health care can play in shaping a more livable future for seniors, and how technology might be integrated.

Through research, co-design, and inter-professional collaboration, we arrived at three specific ideas we believe possess great potential for reshaping vertical aging and what healthy living could look like in the near future.