Through a set of integrated programmes including New Active Outlook (Mirada Activa Berria), Opportunity Space (Aukeragune) and the Home Help Service (SAD), Bilbao promotes healthy ageing in place by combining preventive, community-based interventions with personalised care. These initiatives reduce unwanted loneliness, strengthen social connections and enable older residents to remain in their homes and communities for as long as possible, reflecting a broader commitment to building an inclusive, participatory and cohesive city where no one is left behind. By prioritising early intervention, cross-sector collaboration and user-centred design, Bilbao contributes to reducing inequalities and improving quality of life for its ageing population.
Healthy ageing in place in Bilbao
Abstract
Bilbao’s policy framework for the inclusion of older people aims to address the challenges of population ageing, social isolation and inequality by promoting autonomy, wellbeing and social cohesion. Grounded in the city’s broader vision to build development “from and for people”, the policy seeks to ensure that older residents can live independently in their own homes and communities for as long as possible. In doing so it contributes to inclusive growth by maintaining older people’s participation in social and economic life, reducing inequalities in access to services and support and preventing the higher long-term costs associated with exclusion, poor health and institutional care.
A central objective is to prevent situations of vulnerability linked to unwanted loneliness, while supporting those already experiencing isolation to reconnect with their social environment. The policy also aims to strengthen personal autonomy and build caring, community-based neighbourhoods that support ageing in place. These objectives are embedded within the Bilbao Charter of Values, which commits the city to fostering an inclusive, participatory and equitable society where diversity, human rights and social cohesion are promoted.
Inclusion for the elderly (New Active Outlook, Opportunity Space, and Home Help Service) in Bilbao Summary
Country: Spain
City: Bilbao
EU member state: Yes
Geographic scale: City
City size: Midsize (1 044 000 residents)
Date launched: 2013
Current status: Ongoing
Policy pillar(s): Education, Public services and infrastructure, Fair climate action
Target group(s): Older people, Low-income households, Families
Funding and budget:
Total budget: EUR 17 620 000
Funding sources: Local government
EU funds/programmes: Not applicable
Bilbao’s approach is grounded in the recognition that population ageing, increasing life expectancy and declining birth rates are reshaping social needs. Evidence from the city’s Social Observatory and a network of “social antennas” – including associations, social services and health professionals – helps identify individuals at risk of loneliness, dependency or social exclusion. This diagnostic system enables early detection of vulnerability and informs targeted yet flexible interventions, ensuring that policies respond to real and evolving needs within neighbourhoods.
The city has prioritised active ageing, prevention of loneliness and support for autonomy as core pillars of its social policy. Rather than relying solely on reactive care, Bilbao emphasises preventive, community-based approaches that allow people to remain independent for longer. The focus on ageing in place reflects both individual preferences and broader policy goals to reduce inequalities and strengthen social cohesion. Priority is given to vulnerable older populations, while recognising that loneliness can affect a wider range of age groups.
Policy design is led by Bilbao City Council in close coordination with the Provincial Council of Bizkaia, the Basque Government, and actors from the third and private sectors. Structured working groups ensure alignment between municipal and provincial competences, particularly in managing transitions between primary (local) and secondary (provincial) care services. Delivery is supported through partnerships with experienced social sector organisations and underpinned by appropriate legal, financial and organisational frameworks. Resources are mobilised to ensure adequate infrastructure, trained personnel and high-quality service provision. Communication and outreach strategies, supported by inter-institutional collaboration, help ensure that programmes reach those most in need.
Implementation takes place through a set of complementary, person-centred programmes. The New Active Outlook (Mirada Activa Berria) programme provides tailored support to older people experiencing social fragility through community activities, reaching 245 participants in 2024 through initiatives such as the Senior Coffee Space (Nagusi KafeGunea) and the Opportunity Space (Aukeragune) provide daytime care for older people at risk of dependency, combining individualised support with opportunities for social engagement and community participation, serving 101 users (including 93 women) despite a capacity of 80, highlighting strong demand. The Home Help Service (Servicio de Ayuda a Domicilio) delivers personalised in-home assistance, enabling individuals to maintain autonomy while remaining in familiar surroundings. Across all programmes, interventions are highly personalised, integrating prevention, care and community participation.
Monitoring and evaluation are embedded through KPIs, surveys and programme-specific indicators tracking participation, service use and outcomes. Evidence shows that programmes have expanded users’ social networks, reduced feelings of loneliness, and helped maintain cognitive and functional autonomy. The policy framework is designed as a “living system”, continuously adapting to new needs identified through monitoring. This has led to increased personalisation of services, adjustments in intervention intensity and evolving collaboration between institutions and community actors. For example, the target population of New Active Outlook has been expanded to include residents below 65 years old, reflecting a broader understanding of loneliness.
Continuous learning is supported by strong user involvement and bottom-up feedback, fostering innovation and ensuring that services remain responsive. The use of shared frameworks, such as the Bilbao Charter of Values, helps maintain coherence across programmes while enabling flexibility and ongoing improvement.
Prioritise active ageing through preventive, personalised and community-based approaches. Shifting from reactive care to early intervention can help older people remain independent for longer and reduce future care needs, while tailored support plans and local social activities can reduce loneliness and delay dependency.
Build strong multi-level and cross-sector coordination. Aligning municipal services with regional care systems, while partnering with community organisations and the third sector, improves service continuity and reach.
New Active Outlook (Mirada Activa Berria) – Experience overview: https://www.berrituz.eus/es/experiencias/mirada-activa-berria/ex-55/
New Active Outlook (Mirada Activa Berria) – Project description (Grupo SSI): https://grupossi.es/proyectos-sociosanitarios/mirada-activa-berria/
Aukeragune – Day care and community participation centre (Basque Government): https://www.euskadi.eus/gobierno-vasco/-/documentacion/2024/aukeragune-centro-de-atencion-diurna-y-promocion-de-la-participacion-comunitaria-para-combatir-la-soledad-entre-las-personas-mayores/
Home Help Service (SAD) – Service description (PDF): https://www.bilbao.eus/catalogoservicios/es/01312_sad.pdf
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Photo credits: Colegio Territorial de Administradores de Fincas de Bizkaia
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