Socio-economic disadvantage and poverty

Author(s):  
Alisoun Milne

Chapter 5 is the first of three chapters exploring the impact of age related risks affecting particular sub populations of older people. Socioeconomic disadvantage in later life tends to reflect a lifecourse status. It amplifies what is already present. In 2016/17 one million older people were living in poverty; an additional 1.2 million were living just above the poverty line. These numbers are rising. Those aged 85 years or over, frail older people, older women and single older people are particularly at risk. Poor older people are also more likely to live in poor housing and be exposed to fuel poverty. Being poor - and its concomitants - compromises mental health in a number of profound ways. It undermines an older person’s capacity to make choices, retain independence, save for a crisis, maintain social contacts and be digitally included. It is linked with worry, loss of control over life and shame. Poor older people are at heightened risk of isolation and loneliness, stress, anxiety and depression. The UK has a weak policy record, compared with other developed countries, of sustainably and coherently addressing poverty in later life. One of the cornerstones of doing so is a continued commitment to the basic state pension as a fundamental building block of a secure old age. Addressing poor housing is also pivotal.

Author(s):  
Lyn Barham

This article explores career development support offered to, and used by, older people since 2000. The context includes changes in age discrimination legislation and state pension entitlement, which intertwine in their effect on labour market participation. Career development services have changed, with a marked divergence between the fragmented delivery in England and the all-age services elsewhere in the UK. Initiatives have been piloted, judged successful, but not robustly pursued. The article argues that rhetoric outruns resources and delivery, and contemplates the additional complication of the impact of the Covid-19 pandemic on older people and the economy.


Author(s):  
Alisoun Milne

In broad terms there are two sets of age-related risks to mental health. The first set are those arising directly from experiences and losses common to later life, including physical ill health and/or disability, being a carer, retirement, and bereavement. These are associated with impaired psychological wellbeing and heightened risk of depression, particularly amongst older people with few economic or social resources. The second set of risks arise from ageism and age discrimination, and their intersection with other types of discrimination such as sexism for older women. Direct and indirect discrimination is widespread; it is located in all areas of society including health and social care services. It is profoundly damaging to older peoples’ psychological wellbeing and is associated with fear, helplessness, low self-esteem, anxiety and depression. It is also linked to exclusion, marginalisation and abuse. In recent years there have been efforts to ensure that older people are overtly included in policies intended to improve the population’s physical and mental health; this includes access to treatments e.g. for depression. There has also been a focus on addressing age discrimination in specific arenas e.g. in employment and mental health services. These initiatives have had mixed success.


2014 ◽  
Vol 15 (1) ◽  
pp. 21-33 ◽  
Author(s):  
Roiyah Saltus ◽  
Christalla Pithara

Purpose – Research evidence indicates the need for studies that explore the salience of dignity from the perspective of older people from a range of ethno-linguistic and cultural backgrounds. Drawing findings from a mixed-methods study on social-care expectations of community-dwelling older women from black and minority-ethnic backgrounds, the purpose of this paper is to explore the interrelationships between life-course events (such as migration) and the roles adopted by the women throughout their lives, which shaped their understanding of dignity. Design/methodology/approach – Face-to-face, semi-structured interviews with 32 older women in Wales were conducted in the participants’ first languages. The interview schedule was developed, piloted and peer-reviewed; it covered the themes of migration, perceptions of dignity, dignity in later life, perceptions of care and care with dignity. Transcripts were analysed using thematic analysis. This paper focuses on what dignity meant to older women and how a sense of dignity was fostered in later life. Findings – For the participants, a sense of dignity in later life was shaped by migration to the UK, and their shifting, transnational understanding of growing old in the UK and of the perceived worth and value of the roles they played. Although some women also saw other platforms (such as work and their status as professionals) as being of importance, a sense of purpose fostered in their roles as wives, mothers and grandmothers, and as mentors and guardians of cultural knowledge, underpinned their understanding of dignity, and reinforced their sense of acknowledgement and worth. Fostered from an early age through interactions with the family and close community (religious, cultural or ethnic), respect for older people was revealed to remain a key element of the participants’ personal and cultural value systems, as were the ways in which respect should be both earned and manifested. The sense of heightened vulnerability, because of advancing age, and the impact of cumulative negative encounters and racialised micro-aggressions, were real and pressing. Practical implications – Given the changing demographic of the older population throughout Europe and the world, there is a need to raise awareness among policy makers and practitioners of the importance of dignity from a range of perspectives – providing first-hand accounts that bring these to life, and data that can be used to help develop effective interventions. Originality/value – This paper adds to the understanding of dignity from a transnational, multi-ethnic perspective; the potential impact of multiple social positions (being old, being a woman, being a migrant and being from a minority-ethnic group) on the perception of being treated and regarded as important and valuable; and the need to raise awareness among policy makers and practitioners of the importance of dignity from a range of perspectives, providing first-hand accounts that bring these to life and that can be used to help develop effective social-care interventions.


Author(s):  
Judith A. Davey

The policies of many developed countries now aim to encourage older people to remain longer in the paid workforce. What are the pros and cons of this position? Longer lives and better health in later life provide opportunities for prolonging workforce participation. There is considerable evidence that having meaningful and appropriate work is beneficial to the physical, psychological and financial wellbeing of older people. Demographic trends suggest that labour and skills shortages will become more pressing in the future as younger people entering the workforce do not balance the numbers retiring. Firms which understand the implications of ageing will be better placed to address its challenges. Older workers represent a valuable and often untapped source of increased productivity. But how can we ensure that their working conditions are appropriate rather than precarious? There are social and economic benefits from having an economically active older population. It will contribute to economic growth and the maintenance of living standards and also, through taxation, help to meet the costs of an ageing population. But what about the impact on the employment prospects of young workers and on voluntary work?


BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e049829
Author(s):  
Elizabeth Tyler ◽  
Fiona Lobban ◽  
Rita Long ◽  
Steven H Jones

ObjectivesAs awareness of bipolar disorder (BD) increases and the world experiences a rapid ageing of the population, the number of people living with BD in later life is expected to rise substantially. There is no current evidence base for the effectiveness of psychological interventions for older adults with BD. This focus group study explored a number of topics to inform the development and delivery of a recovery-focused therapy (RfT) for older adults with BD.DesignA qualitative focus group study.SettingThree focus groups were conducted at a university in the North West of England.ParticipantsEight people took part in the focus groups; six older adults with BD, one carer and one friend.ResultsParticipant’s responses clustered into six themes: (1) health-related and age-related changes in later life, (2) the experience of BD in later life, (3) managing and coping with BD in later life, (4) recovery in later life, (5) seeking helping in the future and (6) adapting RfT for older people.ConclusionsParticipants reported a range of health-related and age-related changes and strategies to manage their BD. Participants held mixed views about using the term ‘recovery’ in later life. Participants were in agreement that certain adaptations were needed for delivering RfT for older adults, based on their experience of living with BD in later life. The data collected as part of the focus groups have led to a number of recommendations for delivering RfT for older adults with BD in a randomised controlled trial (Clinical Trial Registration: ISRCTN13875321).


Societies ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 12
Author(s):  
Paul Higgs ◽  
Chris Gilleard

This paper is concerned with the issue of ageism and its salience in current debates about the COVID-19 pandemic. In it, we address the question of how best to interpret the impact that the pandemic has had on the older population. While many feel angry at what they see as discriminatory lock-down practices confining older people to their homes, others are equally concerned by the failure of state responses to protect and preserve the health of older people, especially those receiving long-term care. This contrast in framing ageist responses to the pandemic, we suggest, arises from differing social representations of later life, reflecting the selective foregrounding of third versus fourth age imaginaries. Recognising the tension between social and biological parameters of ageing and its social categorisations, we suggest, may offer a more measured, as well as a less discriminatory, approach to addressing the selective use of chronological age as a line of demarcation within society.


Breathe ◽  
2016 ◽  
Vol 12 (1) ◽  
pp. 50-60 ◽  
Author(s):  
Alison McMillan ◽  
Mary J. Morrell

Key pointsSleep disordered breathing (SDB) is common and its prevalence increases with age. Despite this high prevalence, SDB is frequently unrecognised and undiagnosed in older people.There is accumulating evidence that SDB in older people is associated with worsening cardio- cerebrovascular, cognitive and functional outcomes.There is now good evidence to support the use of continuous positive airway pressure therapy in older patients with symptomatic SDB.Educational aimsTo highlight the prevalence and presentation of sleep disordered breathing (SDB) in older people.To inform readers about the risk factors for SDB in older people.To explore the impact of SDB in older people.To introduce current evidence based treatment options for SDB in older people.Sleep disordered breathing (SBD) increases in prevalence as we age, most likely due to physiological and physical changes that occur with ageing. Additionally, SDB is associated with comorbidity and its subsequent polypharmacy, which may increase with increasing age. Finally, the increased prevalence of SDB is intrinsically linked to the obesity epidemic. SDB is associated with serious outcomes in younger people and, likewise, older people. Thus, identification, diagnosis and treatment of SDB is important irrelevant of age. This article reviews the age-related changes contributing to SDB, the epidemiology and the risk factors for SDB in older people, the association of SDB with adverse outcomes, and diagnostic and treatment options for this population.


2017 ◽  
Vol 20 (15) ◽  
pp. 2685-2693 ◽  
Author(s):  
Ilse Bloom ◽  
Wendy Lawrence ◽  
Mary Barker ◽  
Janis Baird ◽  
Elaine Dennison ◽  
...  

AbstractObjectiveTo explore influences on diet in a group of community-dwelling older adults in the UK.DesignData were collected through focus group discussions with older people; discussions were audio-recorded, transcribed verbatim and transcripts analysed thematically.SettingHertfordshire, UK.SubjectsParticipants were sampled purposively from the Hertfordshire Cohort Study, focusing on those whose diets had been assessed at two time points: 1998–2001 and 2011.ResultsNinety-two adults participated (47 % women; 74–83 years) and eleven focus groups were held. A number of age-related factors were identified that were linked to food choices, including lifelong food experiences, retirement, bereavement and medical conditions, as well as environmental factors (such as transport). There appeared to be variability in how individuals responded to these influences, indicating that other underlying factors may mediate the effects of age-related factors on diet. Discussions about ‘keeping going’, being motivated to ‘not give up’, not wanting to be perceived as ‘old’, as well as examples of resilience and coping strategies, suggest the importance of mediating psychological factors. In addition, discussion about social activities and isolation, community spirit and loneliness, indicated the importance of social engagement as an influence on diet.ConclusionsInterventions to promote healthier diets in older age should take account of underlying psychological and social factors that influence diet, which may mediate the effects of age-related factors.


2009 ◽  
Vol 5 (2) ◽  
pp. 179-233 ◽  
Author(s):  
Harold Tan

The traditional tort system in medical malpractice is increasingly perceived as being incapable of addressing the mismatch between claims and negligent injuries. Tort reforms have been introduced in various developed countries in an attempt to bring about greater fairness and economic sustainability in the compensation of medical injuries and to reduce the overall rate of medical litigation. This paper reviews the key tort reforms that have been used in various countries, notably the US and the UK, and discusses the arguments that had been put forth by advocates and opponents of such reforms. The impact of these tort reforms, where studied and available, is also reviewed and discussed in the paper.


2019 ◽  
pp. 1-21 ◽  
Author(s):  
John Ratcliffe ◽  
Andrea Wigfield ◽  
Sarah Alden

Abstract Loneliness has become an issue of significant academic, public and policy focus. There has been much research on experiences of loneliness in later life and many accompanying interventions targeting lonely older people. However, there has been a dearth of research on the impact that loneliness can have on older men and the resulting implications for policy and practice. This paper aims to redress this by developing a theoretical framework to improve understanding of older men's constructions and experiences of loneliness. It draws on two qualitative empirical studies: the first explores older men's perceptions of masculinity and loneliness; and the second looks at the effectiveness of a service for older men which was designed to alleviate loneliness among older people more generally. The paper outlines the way in which older men often construct masculinity as an oppressive (hegemonic) requirement, but which can be reformed into ‘positive’ traits of ‘strength of mind’, ‘responsibility’, ‘caring’, ‘helping out’, ‘doing a favour’ and ‘giving something back’, with a consistent yet implicit assumption that enactment of these denotes a ‘proud’ masculine identity. Loneliness, on the other hand, is represented as a subordinate social role, both non-masculine and related to marginalising stereotypes of age. This results in the identification of two important implications for the way in which services can assist in the alleviation of loneliness in older men: that men are more likely to engage with a service that can facilitate the construction of a ‘proud’ masculine identity; and that services which deconstruct hegemonic masculinities, particularly by providing a space where men feel comfortable being emotionally tactile, are likely to be most effective at both alleviating loneliness and promoting overall wellbeing.


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