Working with changes in ageing

Working with changes in ageing

Article Type: Editorial From: Quality in Ageing and Older Adults, Volume 17, Issue 2.

Contemporary research on ageing emphasises how older lives cannot be assumed to be static nor immune to many types of change experienced more widely at all levels, societal, organisational, familial and individual. This suggests that flexible responses at every level are also being demanded of people, services and policymakers.

In societies such as India, where older people’s support has traditionally been embedded in extended family units, global demographic trends to nuclear households means that ageing in place is placing more and diverse demands on older people’s lives and relationships. In this issue, Agrawal, Dhillon and Ladusingh draw on three rounds of data from India’s National Family Health Survey to track this increasing trend in living arrangements. They argue that government and policymakers therefore must recognise and actively plan to manage the potential risks these pose to older peoples’ security, by reinforcing traditional support relationships and also to explore alternatives.

Other challenges to traditional forms of welfare accompanying social change, can be seen in the increasing recognition of diversity in the needs of older groups including those of LGBT elders. How these may be addressed through England’s recent care legislation through the 2014 Act is the focus of the timely policy discussion offered by Crossland, who highlights as a key role of social workers to positively take opportunities to apply the provisions of the Act, to promote the dignity and wellbeing of LGBT people. He illustrates this with an illuminating case study of how the needs of two older gay men who have a caring relationship may be sensitively and supportively assessed. Some of the disadvantages these groups may otherwise encounter are specified through Kneale’s analysis of 2012 data from the English Longitudinal Study of Ageing. Also in this issue, Kneale compares LGB and non-LGB respondents’ levels of social exclusion from services and amenities, adequate housing, public transport and neighbourhood communities, and suggests that their lesser likelihood of home ownership may reduce some the flexible access of some older LGB people to the kinds of services and spaces where their social networks can be maintained.

Imaginative ways of responding to both demographic and service changes are exemplified in the examination by Baillie, Sills and Thomas, of the use of ethnodrama to provide education about dementia for health services workers to encourage more person-centred engagement with the issues. Using film materials portraying “Barbara’s Story” could be seen to help staff integrate some of the resources available to support people such as “Barbara” with their own experience of practice, changing the care culture. However, this can also be seen to point up dilemmas created for staff if their work pressures force them to choose between such training, if not mandatory, and continuing to prioritise their time with patients.

As communities and families disperse, and as services may also become less locality-based as financial pressures increase, the importance of mobility to older people seeking to maintain their independence into retirement also increases. Berg reports a two-stage qualitative study of the everyday travel and transport experiences and expectations of men and women and their partners, if retired. These identified inter-relationships between attitudes to mobility, physical health, social participation and the dynamics of adjustment to life in retirement. In turn these have highlighted that mobility can help provide resources to create activities, including leisure, but for some older people may be less important than opportunities to enjoy life while staying at home.

There is increasing provision is now available to facilitate older people to make their own personalised choices, including through welfare mechanisms such as personal budgets in social care. This is the subject of O’Rourke’s exploration of how older peoples’ self-conceptions may have been affected as they exercised the care choices made available to them through their personal budgets. Their findings underline that it may not be enough to change the mechanism through which care resources may be accessed, if the financial pressures on resources and on the care workforce, mean constraints in practice, both in the range of choices made available to older “consumers” and the flexibility of care that they can be offered in practice.

Fiona Poland