The exclusion of older people in disability activism and policies — A case of inadvertent ageism?

Using Sweden as a case, the article discusses the tendency within disability activism and policies to overlook elderly people. From an analysis of a major Swedish government investigation on disability it is clear that disability policies in Sweden have come to rest upon stereotyped age norms that divide the life course into set stages, and there has been a tendency to define elderly disabled people as elderly rather than disabled. It is argued that this exclusion is partly the result of a successful endeavor to provide disabled people of younger ages with rights that are typical of non-disabled citizens. Justice and equality have been defined in comparison to citizens of similar ages: children, youth and adults of “active age”. Based on the analysis of the paper it is argued that activities of movements struggling to liberate oppressed populations may contribute to ageism, and that anti-ageist research must go beyond the idea that ageism is a simple matter of attitudes towards older people.     

“She was a little bit unrealistic”: Choice in healthcare decision making for older people

This paper examines autonomy, choice, options, and power in healthcare decision making for older people. Using discourse analysis and a case study from data gathered as part of an ethnographic field study we critique a common conceptualization of healthcare decision making as patients choosing from an array of options offered by healthcare providers. A discourse of “giving options and being realistic” used by healthcare providers is contrasted with the experience of a single patient's transitional care from hospital to home after hip fracture. This illustrates how a wide variety of actors, institutions, values, and resources take precedence in determining a discharge destination. While the accounts given by healthcare providers cast patient choice in respectful terms, an ethnographic approach illustrates that the “choices” are structured by a discourse which simplifies the complexity of what is offered and who gets to choose. In the case study the patient's choice was subjugated by expertise and institutional concerns; her options were largely illusory; and her autonomy was “at risk” due to her age, poor health, and limited resources. We use Foucault's ideas about discourse and governmentality to question the scope of agency in healthcare decision making. We argue that the conceptualization of informed patients making autonomous choices acts as “misdirection” which deflects problem solving and discussion away from a productive examination of the differences between healthcare system offerings and client needs. We conclude by posing questions to reorient the debate surrounding healthcare decision making for older adults and recommend a more participatory approach to designing social services.     

Financial worry among older people: Who worries and why?

This study sought to clarify what drives economic worries among older people. Based upon the data from a national sample of adults aged 65 and older in Israel (N = 550), we examined associations between financial worry and economic status, lifestyle, social network, concerns about functional health, long term care needs and cognition, and population group. The main financial worry was that pension funds will not suffice for one's entire life. Multivariate analysis revealed that financial worry was negatively related to perceived income adequacy and age, and positively related to concerns about care and to apprehensions regarding one's ability to make decisions. Immigrants from the former Soviet Union were found to worry less. Understanding the different sources of financial worries among older people is essential insofar as older people are increasingly expected to take personal responsibility for their financial futures. Dealing with negative outcomes that stem from financial worries are important programming and policy goals in an era of population aging.     

Relocation stress syndrome in older adults transitioning from home to a long-term care facility: myth or reality?

Relocation stress syndrome is a nursing diagnosis characterized by symptoms such as anxiety, confusion, hopelessness, and loneliness. It usually occurs in older adults shortly after moving from a private residence to a nursing home or assisted-living facility. The primary purpose of this study was to validate the symptoms of relocation stress syndrome. Eight nursing home residents and 8 assisted-living facility residents were interviewed 2 to 10 weeks after admission, when symptoms of relocation stress syndrome are most likely to appear. Results of this study indicate that the incidence of relocation stress syndrome may be overestimated. More accurate diagnosis and treatment of depression in older adults is needed.     

Taking a risk? The mortgage industry and perceptions of disabled people

This paper examines a relatively overlooked force within disability; the appraisal of risk, with a specific focus on disability and housing. In this context the paper explores how risk can operate against disabled people, using a case study of mortgage industry responses to disabled people in the mortgage application process. Given the recent downward shift in the buoyancy of the housing market this is a timely focus. The events in the USA, which led to the sub‐prime market ‘collapse’, and the consequent impact on the UK have meant that lenders have become even more risk averse, withdrawing numerous mortgage products and reducing loan amounts. This has left many people unable to access the owner‐occupier sector, but for disabled people this can be even more difficult. The role of risk in ‘the disabling process’ is therefore of great importance, and is illustrated here through the practice of risk assessment.     

Do disabled people need a stronger social model: a social model of human rights?

Abstract

We introduce the social model of disability by reflecting on its origins and legacy, with particular reference to the work of the Union of the Physically Impaired against Segregation. We argue that there has been a gradual rolling back of the rights and entitlements associated with the social model of disability. Yet no alternative for the social model has been proposed in response to such threats to disabled people’s human rights. Disabled people need a stronger social model that acts as a means to a society which enables and ensures their rights; the right to live a dignified life, as well as to live in an environment that enables people to flourish with disability.     

Motor-skill learning in older adults—a review of studies on age-related differences

This paper reviews research on motor-skill learning across the life span with particular emphasis on older age. For this purpose, studies that focus on age-related differences in fine and gross motor skills and studies that analyze the further refinement of known skills as well as learning of unknown motor skills are summarized. The reviewed studies suggest that although motor performance tends to decline in old age, learning capabilities remain intact, and older adults are able to achieve considerable performance gains. The extent to which the learning capability varies with age, however, has to be considered very carefully. While most studies revealed that performance gains in fine motor tasks are diminished in older adults, results for gross-motor-skill learning are more contradictory. Additionally, there is considerable agreement on the finding that age-related learning differences are statistically more robust in complex tasks, whereas in low-complexity tasks, the learning of younger and older adults is very similar. This applies to fine and gross motor skills. Relative age differences seem to become enlarged when effortful resources are required for motor performance. Thus, the decline in motor learning that accompanies aging is task specific and not absolute.

Designing ‘older’ rather than denying ageing: Problematizing anti-ageing discourse in relation to cosmetic surgery undertaken by older people

This paper problematizes anti-ageing discourse and interpretations that cosmetic surgery is an ageist practice and older people who undergo cosmetic surgery are denying ageing. It argues that conceptions of cosmetic surgery as anti-ageing are premised on an essentialist conception of the ‘naturally ageing body’. Interview data and media texts are used to demonstrate how, through the notion of “re” suggested by terms such as rejuvenation, reversal and renewal, anti-ageing discourses inscribe ‘ageing’ in the practice of cosmetic surgery by older people. The oppressive interpretation that older people who undergo cosmetic surgery are ‘denying ageing,’ and associated subjection to moral critique, are effects of this discourse. To counter interpretations of cosmetic surgery as ‘anti-ageing’, the paper takes up the idea that cosmetic surgery is undertaken to look better not younger. To advance this argument, the paper suggests that the forms of rationality associated with cosmetic surgery constitute a contemporary regimen of ‘care of the self’ which enable ethical agency and creative self-stylisation. Through this framework cosmetic surgery can be re-imagined as a practice for designing ‘older’ rather than denying ageing.     

Storytelling in Amy Tan’s The Bonesetter’s Daughter: belonging and the transnationality of home in older age

ABSTRACT

Amy Tan’s The Bonesetter’s Daughter is a fictional account of a Chinese American woman and her mother, a first-generation migrant, who is negotiating dementia in later life. Analysis of diasporic novels can provide insight into migrant belonging, especially the emotional geographies of home and emotional subjectivities of ageing that are not commonly or easily elucidated even by qualitative interviewing methods. This article examines Tan’s construction of ageing as an intergenerational, cultural and emotional process, and highlights the role of storytelling as an everyday home-making practice through which the transnationality of home in older age becomes evident.     

Young people’s everyday political talk: a social achievement of democratic engagement

Everyday political talk is an important democratic activity. Research on young people has focused on the role of talk in political socialization. The overall question in this study is: What encourages or impedes young people to participate in everyday political talk? Politics has been described as a potentially unsafe topic. The study investigates young people’s own experiences of conversations in families, peer groups, and social media. The study applies a social interactional approach and understands political talk as a social achievement, related to norms and the management of self-identities. It is based on a multimethod approach comprising individual interviews, group interviews, and diaries. The group consists of 23 high school students (aged 17–18). The results show that the engagement in political talk is sensitive to the social settings. Norms make political topics expected or best to avoid. The family and peer groups are potentially important context for friendly talk, argumentations, exploration of opinions, and identities. The participants are in general more reluctant to express opinions in social media. The fear of face-threatening responses is one important aspect. The study suggests that political talk is an activity in which young people express, reveal, and carefully manage political self-identities.     

Teaching pedagogies enhancing social work students’ perceptions and attitudes toward older age in an undergraduate course on working with older people

Approximately threefold increases in older age population groups (+65 years) are projected in the next 15 years. Demographic changes in society will mean greater numbers of older adults in proportion to the younger generation. In the current policy on older age groups, emphasis is placed on healthy aging warranting a multidisciplinary workforce to work with older people. Despite this need and increased demand in the aged care sector, a fewer social work students are willing to undertake aged care placements or to choose it as a career option.

An innovative teaching and learning pedagogy was used in designing the course curriculum titled ‘Social Work with Older People’, including the input of invited specialist guest speakers, an on-campus interactive workshop with older guests, and an assessment designed to evaluate the learning related to the workshop content. The paper reports changes in the attitudes of students studying gerontological social work after the course delivery, evaluated through an online survey with the purpose of improving the learning outcomes in the course and to gauge students’ interest, experiences, attitudes and motivation to work in the aged care sector. The paper contributes to building knowledge in addressing the needs of the changing social demographic.     

Tracing a cartography of struggle: reflections on twenty years of transnational solidarity with the U’wa people of Colombia

ABSTRACT

The author reflects upon two decades of research and activism by mapping a cartography of struggle that emphasizes the importance of relationality and Indigenous theory and practice.     

Effectiveness of water-based exercise in people living with Parkinson’s disease: a systematic review

This systematic review summarizes the relatively scant literature concerning the effectiveness of water-based exercise (WBE) interventions in people with Parkinson’s disease (PD). Databases MEDLINE, EMBASE, PEDro, Scopus, and SportDiscus were searched from the earliest available date to December 2011. Studies had to meet the following selection criteria: (1) the target population was patients with PD; (2) the effects of a WBE intervention (as the primary intervention) were tested; (3) the abstract of the research was available in English. Selected studies were subject to unmasked quality assessment by applying a methodological scoring with a possible maximum score of 15 points. Twelve studies met the inclusion criteria, although only three of them achieved a methodological quality score above 10 points. Collectively, the data showed that WBE has some beneficial short-term effects on the impact that PD has on the patients (mainly on their motor symptoms and on their functional mobility), as well as on their quality of life. This review provides evidence that WBE is safe for patients with PD, but there is a lack of hard evidence regarding its beneficial effects. Further randomized and controlled trials with larger sample sizes are required.     

Young people’s perceptions of power and influence as a basis for understanding contemporary citizenship

Persistent simplistic binary discourses of young people’s citizenship portray them either as civically deficit and disengaged citizens or the creators of new democratic modes and approaches. This paper draws on field research with two groups of young people in Australia to better recognise the nuance of young people’s experiences of citizenship, power and influence. The study investigated the extent to which different groups of young people believe that they have the power to influence society; the ways in which they seek this influence; the current barriers to their influence; and what would enable them to have greater influence. Our analysis in this paper draws on Lukes’ concepts of power [2005. Power: A Radical View. 2nd ed. London: Palgrave Macmillan] and Arvanitakis’ framework of citizenship engagement and empowerment [in Arvanitakis, J., and E. Sidoti. 2011. “The Politics of Change: Where to for Young People and Politics.” In Their Own Hands: Can Young People Change Australia?, edited by L. Walsh and R. Black, 11–20. Melbourne: ACER Press], but also builds on an emerging scholarship concerned with the geographic dimensions of young people’s citizenship engagement and action, as well as with the affective, relational and temporal dimensions of this engagement and action. Our findings suggest that power works in different ways to both constrain and liberate young people as citizens – sometimes at the same time. The paper concludes with an argument for the continuing need to understand young people’s lived and located experiences of engagement, power and influence in more nuanced and sophisticated ways. This includes reframing the discussion about young people’s experiences in terms of the nature of their democratic engagement and action rather than simply their citizenship.     

Does your older adult client have a gambling problem?

Pathological gambling is becoming an increasing problem in today's culture, particularly because opportunities and inducements to gamble abound. This article describes symptoms, consequences, and comorbidities experienced by pathological gamblers. Gambling pathology is often invisible because pathological gamblers seldom disclose gambling problems to their primary care provider. Thus, nurses will benefit from knowledge of the physical and emotional signs of the disorder. A two-question assessment tool, the Lie/Bet Questionnaire, is useful in helping nurses identify pathological gamblers. Interventions and treatment options, including group therapy and environmental modification, are also discussed. As always, education concerning problems and consequences of pathological gambling is a first step. Because research has indicated that visits to casinos by older adults have doubled since 1975, the authors use an example of an older adult to clarify the issues. Although the article's content is applicable to clients across the life span, it has particular significance for older adults.     

The role of public relations in a counterhegemony: A case study of the 1968 poor people’s campaign

This study examined the role of public relations in Antonio Gramsci’s concept of cultural hegemony, specifically in a counterhegemony. Dr. Martin Luther King, Jr.’s preparation for the 1968 Poor People’s Campaign serves as a test case on how public relations can help subordinate groups confront a hegemony. This paper suggests that Gramsci’s philosophy provides an analytical heuristic for researching instances of contestation. Examining counterhegemonic campaigns offer public relations practitioners a means both to think about and to intervene in the world more effectively.     

Can we create a therapeutic relationship with nursing home residents in the later stages of Alzheimer's disease?

1. Despite their entrance into advanced illness, the majority (83%) of participants in the study displayed evidence of having begun a therapeutic relationship with their assigned advanced practice nurse. 2. With one exception, those participants who did not evidence development of the relationship had severely limited speech, perseverative speech, or did not speak at all. 3. It is time to challenge the assumption that individuals in the middle and later stages of Alzheimer's disease are not good candidates for developing a therapeutic relationship.     

‘He was a secret’: family narratives and the institutionalization of people with intellectual disabilities

This article examines family narratives concerning the existence of an institutionalized family member with an intellectual disability. A research study investigating the experiences of institutional survivors and members of their families in post-World War II Ontario, Canada reveals ambiguous family narratives in which the story of an institutionalized family member with an intellectual disability was absent or uncertain. Secretive family narratives and their impact on family life are discussed from the perspectives of siblings of institutional survivors. Drawing from narrative enquiry literature, the potential repercussions of false or ambiguous narratives on the lives of people with intellectual disabilities are also examined.     

Long-term care preferences among older adults: a moving target?

This study investigates long-term care preferences across three hypothetical scenarios and over one year of time among a sample of disabled older women receiving informal care (n = 420). Unpaid or paid help in one's home was preferred, given scenarios of instrumental activities of daily living (IADL) and activities of daily living (ADL) needs; nursing home care was most preferred for dementia care. While aggregate preferences for long-term care were relatively stable, there was considerable fluctuation in individuals' preferences over time, with just 52.5%, 44.4%, and 44.6% of participants retaining their initial first choice across IADL, ADL, and dementia scenarios, respectively. Implications of study findings are discussed.