Precarity in late life: rethinking dementia as a ‘frailed’ old age

Abstract

"This is the pre-peer reviewed version of the following article: Grenier, A., Lloyd, L., and Phillipson, C. (2017 AbstractUnderstandings and approaches to ageing that are organized around productivity, success, and active late life have contributed to views of dementia as an unsuccessful, failed or 'frailed' old age. Operating through dominant frameworks, socio-cultural constructs and organizational practices, the 'frailties' of the body and mind are often used to mark the boundaries of health and illness in late life, and shape responses accordingly. Our concern is that both the taken for granted and the 'imagined' can further marginalize persons who occupy the locations of dementia and disablement. This paper analyses the extent to which frailty and dementia are better understood in the context of new forms of insecurity affecting the life course. Drawing on understandings of 'precarity', we shift debates on the 'fourth age' away from age-or stage-based thinking, into a recognition of shared vulnerability and a responsibility for care. We argue that 'precarity' represents 'new ageing'-in particular as one progresses to the upper extremes of the life course. Pairing our analysis with a consideration of inclusive forms of citizenship, we 2 conclude with a call for a response that is grounded in an acknowledgement of fragility and limitation, and not the denial or distinction from it. Abstract Word count: 198Article Word count: 7503

New horizons in frailty: the contingent, the existential and the clinical

“…The fourth age as a social imaginary [10] undermines any concept that old age may contain value and meaning. It stresses separation rather than continuity both from other (more 'successfully' ageing) older people and from experiences of vulnerability common through the life course including those precipitated by structural conditions configuring socio-economic insecurity and increased social inequality that undermine well-being and increase poor health as summed up in the term 'precarity' [11]. For all these reasons, older people themselves fear and resist the label, thus potentially alienating them from practitioners and 'frailty' services.…”

“Old age” as a social location: Theorizing institutional processes, cultural expectations, and interactional practices

“…Where individuals are held personally responsible for health, the dependencies of the fourth age are regarded as individual failures. That said, socioeconomic and bodily conditions intersect (Grenier, Lloyd, & Phillipson, ) in ways that can allow wealthier older persons with disabilities and chronic health problems to appear more “independent” by virtue of their capacity to pay for care (Rozanova, Miller, & Wetle, ).…”

Towards Critical Intersections of Ageing, Housing and Well-Being

“…While the oldest old are currently living well into their eighties, nineties and, increasingly, hundreds, many may do so in ill health, leading to a loss of personal agency and increasing vulnerability at the end of life ( Lloyd 2015;Victor 2010; see also Visser, this issue ). Indeed, this sense of loss of agency and increasing vulnerability among the older old is not merely a problem for those of the fourth age and the environments of care in which the frail elderly often live (See Higgs in this Issue; Gilleard and Higgs 2010;Grenier et al 2017;Higgs and Gilleard 2015 ). It is itself a 'dreaded social imaginary' (Gilleard and Higgs 2010;Gilleard 2015, 2016) which casts its shadow over the cultural field of the third age 'baby boomers' Higgs 2000, 2013 ), even as they remain active, possibly still working, and fully enmeshed in consumer society.…”

“…It is itself a 'dreaded social imaginary' (Gilleard and Higgs 2010;Gilleard 2015, 2016) which casts its shadow over the cultural field of the third age 'baby boomers' Higgs 2000, 2013 ), even as they remain active, possibly still working, and fully enmeshed in consumer society. A key element of this social imaginary of the fourth age is the fear of dementia (impacting one in six people over the age of eighty years [Alzheimer's Society 2019]), which also has objective implications for the arrangement and configuration of homes for those who face cognitive impairment (Grenier et al 2017).…”