Towards age‐friendly municipalities: What are municipalities doing to support their ageing population with mental health problems?

• Published date: 01 March 2023
• Author: Mignon C. P. Schichel,Marja Y. Veenstra,Gertrudis I. J. M. Kempen,Marjolein E. Vugt,Frans R. J. Verhey
• Date: 01 March 2023
• DOI: http://doi.org/10.1002/wmh3.514

Received: 1 September 2021

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Revised: 23 December 2021

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Accepted: 22 February 2022

DOI: 10.1002/wmh3.514

ORIGINAL ARTICLE

Towards age‐friendly municipalities:

What are municipalities doing to support

their ageing population with mental health

problems?

Mignon C. P. Schichel

1

|Marja Y. Veenstra

2

|

Gertrudis I. J. M. Kempen

3

|Marjolein E. de Vugt

4

|

Frans R. J. Verhey

4

1

Department of Psychiatry &

Neuropsychology, Alzheimer Center Limburg,

School for Mental Health and Neuroscience

(MHeNs), Care and Public Health Research

Institute (CAPHRI), Maastricht University,

Maastricht, The Netherlands

2

Department of Psychiatry &

Neuropsychology, Alzheimer Center Limburg,

School for Mental Health and Neuroscience

(MHeNs), Maastricht University, Maastricht,

The Netherlands, Burgerkracht Limburg,

Sittard, The Netherlands

3

Department of Health Services Research,

Care and Public Health Research Institute

(CAPHRI), Maastricht University, Maastricht,

The Netherlands

4

Department of Psychiatry &

Neuropsychology, Alzheimer Center Limburg,

School for Mental Health and Neuroscience

(MHeNs), Maastricht University, Maastricht,

The Netherlands

Correspondence

Frans R. J. Verhey, Department of Psychiatry

& Neuropsychology, Alzheimer Center

Limburg, School for Mental Health and

Neuroscience (MHeNs), Maastricht

University, Maastricht, The Netherlands.

Email: f.verhey@maastrichtuniversity.nl

Funding information

Interreg, Grant/Award Number: EMR93

Abstract

Municipalities in Western Europe have increasingly

gained a responsibility to support their populations'

healthy ageing, but are they ready to do so? In this

case study, we are looking into the awareness, attitudes,

capacities and mandates of 33 neighboring Belgian,

Dutch, and German municipalities to support ageing

people, and especially people with dementia, people

with late‐life depression and informal caregivers. As part

of the Senior Friendly Communities Interreg project, we

conducted semi‐structured interviews with municipal

policymakers and relevant stakeholders from May

2017 to January 2018. The results show that dementia

was a more salient theme in municipality policies than

depression; that informal caregivers were considered

important but difficult for municipalities to identify; that

there was a difference between how embedded these

health themes were in policies versus in practice; and

lastly, that conducting this assessment turned out to act

as an intervention itself. We discuss the similarities and

differences between the regions, and the context that

needs to be taken into account for municipalities when

becoming more age‐friendly. These results do not only

provide an insight into the status quo of the participating

municipalities with regard to becoming more age‐friendly

but can provide a starting point for further development

of policies in this area.

World Medical & Health Policy. 2023;15:53–72. wileyonlinelibrary.com/journal/wmh3

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This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and

reproduction in any medium, provided the original work is properly cited.

© 2022 The Authors. World Medical & Health Policy published by Wiley Periodicals LLC on behalf of Policy Studies Organization.

KEYWORDS

age‐friendly policies, dementia, health policy, informal care, late‐life

depression

Key points

•The Senior Friendly Communities project stimulates

age‐friendly municipality policies for people with

dementia, people with late‐life depression, and

informal caregivers.

•This paper describes the results of interviews with

officials from municipalities in the Meuse‐Rhine Euro-

region who participated in the Senior Friendly Com-

munities project.

•The results indicate that dementia is a more salient

topic in municipality policies than depression.

•Informal caregivers are regarded as difficult to identify

for municipalities.

•The support of healthy ageing differs between policies

and practice.

•Conducting assessments of municipal health policies

acted as an intervention itself.

INTRODUCTION

In the near future, the proportion of older people (65 years and older) in Western European

countries will grow substantially, with predictions of growth from 20.3% in 2019 to over 30%

in 2070 (European Commission, 2020; Giannakouris, 2008). Whereas the responsibility for

care used to lie primarily on professionals and informal caregivers, a paradigm shift is

occurring in which a responsibility for the support of older individuals' ageing also lies at the

level of municipalities (Greenfield et al., 2012; Ward et al., 2021). In some cases, this is the

result of national policies that determine top‐down that municipalities need to take a more

active and responsible role in this regard (Jongen et al., 2015; Kroneman et al., 2012;

Maarse & Jeurissen, 2016). For this reason, many municipalities are trying to support ageing

in place and healthy ageing (Ward et al., 2021). Ageing in place means ageing in one's own

home for as long as possible without having to move elsewhere to receive long‐term care

(Pani‐Harreman et al., 2021). Promoting ageing in place can be done by strengthening

facilitators and diminishing barriers for citizens to remain living in their homes for as long as

they wish to, despite challenges such as health problems that may occur with ageing

(Greenfield et al., 2012). Healthy Ageing, as defined by the WHO's Policy Framework, does

not mean living without any medical disorders in older age, but rather implies that enabling

well‐being in older age consists of a process in which people develop and maintain their

functional ability as well as possible (WHO, 2015). It builds upon the earlier WHO Active

Ageing Framework, which focuses on three pillars: health,participation, and security, which,

if they are stimulated, enhance the quality of life of ageing populations (WHO, 2002). These

definitions treat health not as just the absence of disease, or what is not possible, but as

something that can be stimulated based on what is still possible, as has been suggested as

an updated definition of the original WHO definition of health (Card, 2017). Both Healthy

Ageing and Active Ageing emphasise the need for collaboration between multiple sectors to

support ageing populations to develop and maintain their functional ability and wellbeing.

The focus of this study is on how municipalities support healthy ageing.

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SCHICHEL ET AL.