The biological perspective of ageing believes that the process of aging is a biological fact which is universal and affects all people. It takes the view that aging is a fundamental, progressive process which continuous throughout life (Lymbery, M 2005). The biological approach believes that as a person ages there is a decline in function as cells degenerate. Therefore, this approach views age as connected to a state of dependency and weakness with no possibility for improvement (Crawford, K and J, Walker 2004). However, in contrast there are other perspectives which take into account other elements such as the social construction of old age. For example, the introduction of retirement meant that clear boundaries were created which defined the point at which a person enters older age. Also, other developments in the welfare system such as the provision of pensions, have further defined the concept of old age. Therefore, the end of employment and the start of retirement can be seen as a major influence in the way older age has been socially constructed (Lymbery M 2005).
Crawford and Walker (2004) believe that the way in which older age has been historically constructed impacts upon the current view and treatment of older people in today’s society. They note that during the Middle Ages, older people were cared for by either charities or religious institutions. The Poor Law Act, introduced in 1601, transferred the responsibility of the care of older people within the family, to care within the community. This meant that older people were now cared for by their local parish, as families were unable to support them due to the financial risks of agricultural based society.
Workhouses were then introduced for individuals who were seen as needy and unproductive members of society. This included groups such as older people, the sick and those who were disabled. As there were no welfare system in existence, this meant that older people had to reside in workhouses as they had no other means of support. As the demand for care rose, the Poor Lawn Amendment Act in 1834 was introduced in attempt to cut costs by eliminating outdoor relief, this meant that older people were no longer able to receive support in their own homes and those in need of welfare were institutionalised in workhouse. This resulted in older people being viewed as a burden on society as they no longer had power, choice or control over they way they lived their lives (Crawford, K and J, Walker 2004).
According to Phillipson (1998), the concept of old age being a separate group within society only surfaced during the end of the nineteenth century. As highlighted by Slater (1930 cited Phillipson, C. 1998) up until this period both the welfare provision for the sick, and the welfare provision for the elderly, were classified in the same way with no distinction between the two groups. Slater believes that it was at this point that societies found it necessary to end sickness benefit when an individual reaches 65, and to replace this with old age pension.
The Old Age Pension Act was introduced in 1908 and provided all citizens who were over the age of seventy with up to five shillings a week if their income was under ten shillings a year. However, although this provided support for older people, the view held by society was to remain in work until they were unable to do so due to physical difficulties. Therefore, this resulted in older people who did not work being viewed in a negative way, as they were looked upon as ‘useless’ due to the belief that they were either too stupid or too weak to work (Crawford, K and J, Walker 2004).
It was during the twentieth century when older people began to be seen as different in they way they experienced and held an inferior status within society. It was found that through this period in time, one in five people who had reached the age of seventy were very poor and were a recipient of state welfare, and the likelihood rose significantly for those who were seventy-five, to a chance of one in three. This meant that circumstances such as being in poverty and experiencing marginalisation were seen as inevitable as an individual entered later adulthood, which provided the basis for which the concept of older age was constructed.
What are the consequences for people in terms of social disadvantage?
Older people face social disadvantage in many ways, such as infantilisation. This refers to a process in which adults are treated as though they were a child. This is a form of oppression as it demeans older people by assuming that they are fundamentally different from other adults and are therefore less worthy of respect (Thompson, S 2005). For example, the desexualisation of older age plays a key role in infantilisation. This is because old age is seen as a second stage of childhood, with an inappropriate link with sexuality, which further reaffirms the idea that older people are not adults. However, as sex is seen as an action of the healthy, this also reinforces the idea that older people are unwell, dependent and frail and further excludes them from sexuality. This illustrates they way in which older people are seen to be in need of support and reliant on others, similar to the conventions of childhood (Gott, M 2005). Also, by referring to older people by names such as ‘dearie’, it can be degrading as the person using the term automatically assumes that the individual does not mind being referred to in this way, which can be seen as disrespectful and inconsiderate of their feelings. (Thompson, S 2005)
Marginalisation is also another way through which older people face social disadvantage. Marginalisation is a form of social exclusion, and is used to describe the way in which people are pushed to the margins of society, which then prevents them from taking part in activities (Thompson, S 2005). When referring to older people, this is the process where older people are excluded from society due to preconceived ideas that they have no use, and are therefore a burden to society (Thompson, N 2006). There are many ways in which older people can experience marginalisation within society. For example, Thompson (2005) highlights the lack of suitable transport for many elderly people. This can mean that they are isolated from the rest of the community as the public transport is either inaccessible or unsuitable. This shows how older people can be marginalised due to factors they are unable to control, such structural problems within society.
Dehumanisation is also another factor of social disadvantage in older people. This is because it gives older people a label of being ‘elderly’, to which the individual is then viewed in terms of this label and not as a person with unique thoughts, emotions and needs. Dehumanisation can have adverse consequences as it fails to identify that each person is different, which can cause discrimination and oppression due to its impersonal and stereotypical viewpoint
Abuse of older people is a further way in which people of an older age may face disadvantages in society. Abuse in elderly people can be physical, psychological, sexual, emotional or financial. The underlying factor in this type of abuse is the exploitation of a comparatively vulnerable group within society. The people who carry out this abuse believe that older people within society are inferior with no requirement for respect (Thompson, S 2005). The ‘No Secrets’ document (DoH 2000 cited in Crawford, K and J, Walker 2004) was created as guidance on how to implement and adhere to procedures to help protect vulnerable adults from abuse, and also clarify definitions, which would enable authorities to carry out good practice. According to Hothersall and Mass-Lowit (2010), older people who are isolated, reliant on others, have poor health, or who are considered disabled are more likely to be abused. They believe this abuse can take place in any environment, such as hospitals, residential homes or even the individuals own home.
What multiple disadvantages can impact on people’s lives?
Ethnicity within older age can be seen as a significant influence on the life a person leads. This is because there is a belief that older people, who are of an ethnic minority background, face a ‘double jeopardy’ in society, as they are oppressed by both age and their ethnicity (Thompson, S 2005). Ray, Bernard and Phillips (2009) argue that services are institutionally racist. This is because they tend to be directed towards the majority population, which can mean that people are doubly disadvantaged. This can occur as they are not recognised within the service, and instead they are they are overlooked and treated as though they are invisible. Thompson (2005) states that the common feature of racism and ageism is that they are often susceptible to dehumanisation. This is because it is easy to categorise people as ‘elderly’ or ‘Asian’, however, in reality, these terms incorporate a vast amount of people into one group who experience different religion, culture and way of life. This leaves little manoeuvre for individuality and therefore these categories should be avoided, as the person is then seen in terms of this labels and not as a unique individual. Consequently, social work should seek to recognise the barriers which face ethnic minorities who are of an older age, and attempt to work with them to overcome their disadvantage (Phillips, J, M, Ray and M, Marshall. 2006).
Gender can also be seen as a key issue which can further disadvantage older people within society. Phillips, Ray and Marshall (2006) support the idea of a ‘feminisation of aging’, as older age is now seen as a predominantly female world due to the fact that women live longer than men. This can mean that women are widowed for a greater time than men, which can lead to women having to enter residential care due to being unable to support their own needs without the help of their partner (Arber and Ginn, 1991, cited in Phillips, J, M, Ray and M, Marshall 2006). Women are also seen as less likely to have private pensions compared to men, which means that they are forced to depend upon state pension (Hunt, S 2005). This can be increasingly difficult for women living alone as it becomes the only source of household income which can leave them deprived and subjected to poverty (Phillips, J.M, Ray and M, Marshall 2006). Gender stereotypes within older age can also cause detrimental effects. Women can be seen to be oppressed due to pressure to conform to gender roles, such as to be caring and supportive, which can mean that they are undervalued as it is seen as ‘normal’ and not something which needs to be commended. However, the caring role when displayed in men receives a higher status, as it is not seen to be a typical responsibility of mans stereotypical gender role, therefore they receive greater praise and support in fulfilling the role (Rose , H and E, Bruce, cited in Thompson 2005). It is important to note that not all gender related disadvantages in older age are associated with women, as men also experience undesirable situations. For example, the male gender role is surrounded by the belief that they are the dominant, providing and protective sex. However, this expectation may come under threat in older age as work is replaced by retirement and their health declines. This can then lead to lower self-esteem as they experience a loss of role within society (Thompson, S 2005).
Multiple oppression can also be experienced in regard to ageism and economic disadvantage. Social class can be an important factor within old age, as those who belong to a lower class are significantly more likely to have a lower income and to live in poverty. Being in poverty affects a vast amount of older people, and can have negative consequences as a sufficient income is a required to be able to meet a persons fundamental needs (Crawford K, and J, Walker 2001). According to Thompson (2005) if an older person has a low socio-economic status within society then they are more likely to suffer from a state of poor health. Crawford and Walker (2001) point out that this may be due to being unable to afford to heat their home or to buy nutritional food, which increases the risk of contracting an illness as well as being able to properly recover. Also, they believe that other socio-economic factors act in a way in which reinforces multiple oppression. For example, older people may be afraid to seek medical help when it is needed due to a fear of disapproval from people of a higher and professional status, such as doctors. This can mean that an older person tolerates their condition for a longer period of time, during which it could cause their health to deteriorate. Phillips, Ray and Marshall (2006) believe that it is becoming increasingly important in modern day society to contribute to an occupational pension. This is because there is a growing inequality between older people who rely on a public pension and those with the benefit of private pension schemes. Consequently, as state pensions are low, they have to be supplemented by means-tested top up benefits in an attempt to enable older people to remain above the poverty line.
What do social workers need to think about when working with these service users with particular reference to anti-discriminatory practice
One crucial factor in which social workers need to think about when working with older people is to avoid ageist assumptions. For example, Thompson (2006) proposes that older people are often subjects of sympathy as they stereotyped as being lonely. However, it is important to realise that people of all ages can be lonely, it is not something reserved for the elderly. Also, many older people have good social relations, and although they live alone, this does not mean they are lonely. Therefore, within social work practice, each case needs to be assessed individually to avoid stereotypical assumptions about older age.
Another aspect which social workers need to think about when working with service users is to challenge the concept of ageism. This is because there are many negative stereotypes surrounding old age, which can be seen by the disproportionate media coverage when an older person is abused and dies, and when the same happens to a child. This means, that to actively challenge the concept of aging a social worker needs to perform roles such as assessing the strengths of an older person and what they are able to do, rather than focusing on their problems and inabilities. As well as other positive functions such as advocating on the behalf of the service user, to enable them to gain access to services to improve their standard of living. This will allow the service user to overcome the discrimination and oppression which they may face (Phillips, J. M, Ray and M, Marshall 2006)
To conduct good social work practice when working with older people there should be support for the service user, individual personal care tailored to their needs, and also physical assistance, especially when offering help to those who have long term illness or disabilities. There are also other factors which constitute good social work practice such as values, skills and knowledge which enable social workers to carry out anti-discriminatory practice. A value base is needed to recognise the common issues amongst older people when trying to protect their independence. Skills are needed such as being able to empower people to remain in control of their lives, to advocate on behalf of the service user, to manage risk, and to be able to communicate effectively with both the service user and their carer. And also a knowledge base, that is derived from evidence based practice, policies and similar past experiences (Ray, M. M, Bernard and J, Phillips 2009)
An important factor that social workers need to consider when working with older people is the language that is used. This is because terms such as ‘the elderly’ can be seen as demeaning as they have negative connotations which can be seen as disrespectful. Also referring to service users as ‘old dears’ or similar names, although it is not meant to be intentionally offensive it can be seen as patronising. This can then mean that the person feels inferior due to the lack of respect shown through the language used towards them and make them feel as though they are