Enabling Social Inclusion and Urban Citizenship of Older Adults through eHealth: The iZi Project in the Hague

Abstract

While the elderly constitute a significant proportion of urban population, they are often not included in the decision-making processes concerning their health requirements. These exclusionary practices could be viewed as reflecting deficits in urban citizenship as well as a denial of what the French sociologist Henri Lefebvre defined in 1968 as the ‘right to the city’ (Lefebvre, 1968). This article is concerned with promoting the social inclusion of the elderly in urban spaces. It focuses on the potential of eHealth to facilitate their independent living in their own homes, an expressed priority of the elderly. It discusses a pilot project pioneered by the Municipality of The Hague where attention and space was given for the elderly to express their physical and emotional needs in different fora with relevant stakeholders, and reflect on ways in which eHealth could be of help to them. These ideas were important in creating the iZi Experience Home project, which also served as an important tool for creating awareness, enthusiasm and information about the possibilities of technology. The article examines the different processes involved in the development of eHealth applications, including the nature of the deliberations, the devices evolved and tried out in the homes of the elderly. Such methods also raised understanding regarding the challenges of using eHealth, such as the barriers faced by service providers, the costs associated with the gadgets and the resistance of caregivers to these techniques. The project demonstrated that traditional eHealth applications were indeed important in supporting the elderly through increased mobility, security and ability to remain in their homes. But these need to be complemented by community generation, spaces for sharing experiences and physical face-to-face interactions to bring about more comprehensive well-being and happiness. There is therefore the need to broaden the concept of eHealth to move beyond technical solutions only but to include the ideas of the patients, in this case the elderly, in policies, discussions with stakeholders, innovations and practices. In these ways, the elderly are supported to claim their rights to the city. The discussion contributes to understanding the challenges of exercising urban enacted citizenship amongst the elderly, and the need to include inclusion and democratic participation as rights and norms of ‘age-friendly’ cities.