Picture of the team participating in the innovation program at the Helsinki Cityhall. Image: City of Helsinki.

Tackling the root causes of problems by meeting people face to face – the City of Helsinki took a nine-month field trip into mobility with the elderly

The City of Helsinki’s cooperation with Harvard University and Bloomberg Philanthropies emphasised the importance of meeting people in person and promoting more agile operating cultures. A multi-disciplinary group tackled the root causes of the lack of mobility among the elderly.

How can we find tangible solutions to modern, complex issues, such as increasing inequality, climate change and immobility? How should we face a challenge that cannot be solved by just an individual or their actions? How could we examine the root causes of the problems instead of only treating the symptoms? How can we solve one of the key well-being challenges of our time, immobility?

The innovation programme by Bloomberg Philanthropies and Harvard University offers tangible tools for solving complex challenges and testing promising new ideas. Helsinki was the only European city to participate in the programme, which was implemented for the first time this year.

The City of Helsinki chose the promotion of everyday mobility in the lives of the elderly as the theme for the programme. The reasoning is solid: increasing mobility is one of the City’s main objectives for this strategy season. Of the European countries, Finland’s population is aging most rapidly, and Helsinki is no exception to the rest of the country. According to estimates, the number of people over the age of 65 in Helsinki will increase from 108,000 to 170,000 by 2050. Mobility is important to people of all ages, but with age, its significance as a source of functional day-to-day life and independent living increases. Currently, only a few percent of people exercise sufficiently to maintain their health.

A multidisciplinary team to solve the mobility challenge

A team of eleven employees from different City divisions was appointed to the innovation programme. The team consisted of employees who meet and exercise with the elderly, who perform strategic development tasks and who are responsible for digital services, land use planning and home care for the elderly, or who are responsible for the daily accessibility of culture and leisure time services.

The team was led by service designer Ruben Ocampo, commissioned by Bloomberg Philanthropies, who specialises in steering urban planning work in the direction of user orientation.

“I thoroughly enjoyed working with the Helsinki team. Something that really stuck with me was how vested all the team members are in the problem, which was manifested in how engaged they were in learning the methodology that we introduced, the high degree of care they showed in all their interactions with senior citizens, and their commitment to create real, sustainable solutions.

The Helsinki team also made me feel incredibly at home! With each interaction we got to know each other more and more, and my last visit to the city had the taste of a bittersweet goodbye. I have continued to follow their progress on this project after the program wrapped up, and I look forward to not only seeing their solutions come to life, but also to staying in touch with the team members,” Ruben Ocampo says.

Social Advisor Tuula Sillanpää from Kustaankartano Comprehensive Service Centre also enjoyed working with the multidisciplinary team.

“In hindsight, I can say that a discussion as rich as this on increasing the mobility of the elderly could not have been possible without such a multidisciplinary team. What I found excellent about this programme was that the different divisions worked together,” she says.

The know-how of the multidisciplinary team helped outline the root causes of the problem

The programme was not created out of thin air. Each team member had relevant professional skills or experience from personal life. Helsinki already boasts many services, circumstances and projects that promote mobility among the elderly. Only the amount of research data and number of reports and reviews tops the former.

The precise definition of the problem and gaining an understanding of the root causes took time. It is one thing to talk about increasing the number of times someone exercises and quite another to promote everyday mobility.

“For the elderly, exercise is like medicine, this is something everyone who works with the elderly already knows. During this innovation programme I learned that mobility is not only about exercise or sports. For some, merely leaving the house can be considered a small victory. The elderly residents of Helsinki have a wealth of wisdom and resources that can be utilised in renewing and developing services,” says Head of Home Care Suvi Kan from the Social Services and Health Care Division.

Averages are a poor indicator for the elderly

The training programme also strove to strengthen competence in terms of service development principles and methods within the City organisation. The objective was to utilise the lessons learned from the training programme in development across organisational boundaries as widely as possible.

“Genuine human-oriented development to create new service concept ideas together with City operators and external operators requires time and effort. The process calls for empathy, curiosity, tenacity and the ability to live with incompleteness. These skills, and foremost the right attitude, can only be learned by doing and experiencing,” says Development Consultant Meri Virta from the City Executive Office.

The team learned by completing exercises. In the span of nine months, the team members met with more than one hundred elderly people in the course of interviews and testing sessions in shopping centres, health stations, service centres, libraries and adult education centres. The purpose of these exercises was to ensure that any issues were understood thoroughly and that the experiences of elderly people are heard before making any proposals.

The observations of the team show that the life situations, resources, wishes and needs of the elderly are pointedly individual. Aging is related to many changes that can have comprehensive effects – this goes for mobility, too. These changes include retirement or the death of a spouse, falling ill, diminishing physical ability to function and reduced income. 

The interviews showed that identifying these changes is important and providing the right kind of support in these trying times requires sensitivity. Activity in men, for example, is more related to their physical condition, and when the physical condition deteriorates, social interaction is also reduced dramatically. The relationship to digital services depends on the skills of the individual, but more importantly, on the support network that enables access to the digital world. You should always be careful when making assumptions: an 80-year-old may be more active on social media than a 40-year-old.

The interviews highlighted the power of internal motivation and experiences of relevance. The will to engage in activities that are significant to the person themselves may help people overcome obstacles, such as challenges posed by diminishing physical functional capacity and condition. Local services support leading an independent life, which is why the significance of local services and the communal spirit in the neighbourhood is emphasised. As the innovation programme progressed, the concept of activity expanded to mean all social activity, of which actual exercise services only play one part.

“Older people, seniors, the elderly, oldsters, pensioners. There are many words to describe older people, and there must be at least as many experiences of being something other than what can be summed up in one word. Each elderly person is an individual with their own background and hopes for the future. Supporting lifelong functional ability as well as physical and psychological well-being is the most important thing we can do for each of our fellow human beings,” says Education Manager Satu Luomajoki from the adult education centre.

Two prototypes proceeded to practical tests

The research problem took the following shape in the course of the work: How can we ensure that each old person finds it easy and pleasant to leave the house every day? How could the friends and family of an old person and the professionals working with the elderly support mobility through their speech and actions, while also considering each individual’s functional ability, motivation and interests?

The team collected ideas to resolve identified issues for the elderly and the professionals that work with them. More than 800 ideas were generated. Two prototypes were tested based on the ideas.

The first idea to be tested was the ‘mobility bonus card,’ which was created to map individual motivational factors. Feedback from the users indicated that services, such as free concert tickets and spending time with friends, were valued more than monetary rewards.

The second idea to be tested was the ‘mobility service centre.’ The idea was born out of the realisation that information on exercise opportunities should be distributed among the people and be presented in an easily understood and attractive form. The team also discussed a service that would make is easier to leave the house in practice and overcome physical and other obstacles. The team decided to try hiring young people as mobility advisors, who could walk with the elderly and keep them company on the way to various activities. This activity is based on an existing Job´d operating model funded by the We Foundation. In the model, young people with an immigrant background help older people in their everyday chores.

“It is important to hear what the elderly are saying, truly listen and understand what they want, instead of shrugging their opinions off. Many interviewees were very pleased to be asked. Even though the attitude of the old person is often a deciding factor, encouragement from those who work with the elderly is not without merit, because not everyone has their own support network. I also learned that it is easier for some to be out and about when they have a clear destination, such as visiting a shopping centre. It would be wonderful if every old person could have their ‘own’ Job’d support person whom they could be active with,” says Nursing Manager Pirjo Tyllillä from Kustaankartano Comprehensive Service Centre.

The service centre inspired the elderly to be more active and received positive feedback on its engaging attitude

The mobility service centre was tested in a genuine environment in July, in shopping centre Kaari in Kannelmäki. Shopping centres are everyday meeting places visited by both senior citizens and their loved ones. They provide a natural environment to reach people and meet each person with their individual needs. The service centre was designed by Harvard University postgraduate student Taylor Greenberg Goldy, who spent the summer taking a deep dive into the content of the innovation project in Helsinki.

In Kaari, the service centre experiment gathered information on City services under one roof in the shopping centre. Visitors could find out more about the likes of City sports services, adult education centre classes, home care, social and health care services, and the offering of service centres.

Visitors to the centre could measure their grip strength and discuss their mobility, experiences and hopes with City of Helsinki employees. Two mobility service providers from the shopping centre also participated. The purpose was to think of a neighbourhood as an area where all the services that promote and inspire mobility were packaged into a user-friendly package.

The two-day test run of the mobility service centre was very educational. Nearly 50 older people and their loved ones visited the centre. Each visitor had their own unique story. These discussions led to the idea that elderly people could act as mobility advisors for each other, sort of ambassadors and contact people between the City and those older people with a high risk of becoming isolated.

The idea that the service centre could also have some light activities in addition to serving up information on current services in the area was also floated. The team concluded that the service centre could be used as a place where you could sign up for events and review event attendance afterwards.

What happens going forward?

The understanding of the principles that should be recognised in designing services accumulated during the programme was enriched as a result of the trial.

“Customer-oriented development opens up the diversity of human life and the countless different challenges and opportunities that serving people presents. People are not a homogenous mass. Understanding individual needs and serving people with a personal touch creates an experience of a functional city,” says Chief Digital Officer Mikko Rusama from the City of Helsinki.

The innovation programme may be very significant in terms of planning strategic programmes or measures.

“The innovation programme showed us that before we start thinking about tangible measures, we must take the time to define our goals and understand the root causes. Without a shared understanding of the problem at hand, we risk implementing measures that treat the symptom instead of healing the patient. It was also delightful to understand that measures do not always have to be planned and prepared for years in advance at the office before having the courage to test and subject them to feedback from the people that the measures are for,” says Project Manager Minna Paajanen from Helsinki’s physical activity programme.

Meeting people yielded the most important takeaways

The lessons learned from the innovation programme for the promotion of mobility amongst the elderly became part of the physical activity programme of the City of Helsinki. The programme contains nearly 60 measures. The conclusions and observations from the innovation programme have been advanced to processing within the City organisation.

“Genuinely meeting and listening to people takes time, but also highlight many different viewpoints and individual needs, even quite small things, that could solve mobility challenges for individuals,” says Minna Ekman, sports planning officer at the City of Helsinki.

Going forward, the most important measures are the ones that clarify marketing and communications directed at the elderly; increase local cooperation between the public, private and third sector; offer support for older people whose functional ability has diminished; and create opportunities for volunteer work.

“In the innovation programme, we learned that change is only affected by meeting people face to face. Starting from next year, we will focus our marketing efforts on areas that people would visit anyway – places like shopping centres, health stations and libraries. We also learned that many people would like to be of use, but need a little push. We will be making it easier to become a volunteer mobility advisor and increasing cooperation with companies and organisations. All reasons to be physically active are valuable. It is always a triumph when the front door opens, regardless of whether the senior is going to the grocery store, Nordic walking, a hockey game, a concert or the library,” says Executive Director of the Culture and Leisure Division Tommi Laitio.

Further information:
The physical activity programme of the City of Helsinki (in Finnish)

The Harvard University and Bloomberg Philanthropies innovation programme team: Executive Director of the Culture and Leisure Division Tommi Laitio, Project Manager of Helsinki’s physical activity programme Minna Paajanen, Head of the Development Unit Reetta Sariola, Sports Planning Officer Minna Ekman, Social Advisor Tuula Sillanpää, Nursing Manager Pirjo Tyllilä, Head of Home Care Suvi Kan, Education Manager Satu Luomajoki, Head of Urban Planning Division Richard Manninen, Chief Digital Officer Mikko Rusama and Development Consultant Meri Virta.
City Innovation Track is part of the leadership and management training for mayors provided by Bloomberg Philanthropies and Harvard University. Mayor of Helsinki Jan Vapaavuori has participated in the programme.