Redefining “Old Age” and “Dependency” in East Asia: Is “Prospective Aging” A More Helpful Concept?

East Asian societies are currently some of the most rapidly aging in the world. Projections of the traditional old‐age dependency ratios (OADR) present a daunting future of the size of the aged population both in absolute terms and, in the context of low fertility, relative to the future workforce. Recently scholars, especially Sanderson and Scherbov, have argued that OADR is inadequate as a guide to future levels of dependency based, as it is, on past scenarios of “old age” and “dependency” rather than current and future notions. Indeed, in the context of rapidly aging settings in East Asia with developmental welfare states, the OADR has probably never been truly relevant, is profoundly unhelpful and could lead to policy paralysis. As such, Sanderson and Scherbov suggested a new method to measure aging prospectively to take into account both improved life expectancy and health across the life‐course. We introduce these new measurements as a possible new, more radical and optimistic way to think about aging in East Asia. These measurements more accurately demonstrate the “boundaries” to “dependency” and, hence, demonstrate the potential room for social policy interventions to maximize “active aging” for the population currently, perhaps incorrectly, defined as “old” and “dependent”.     

“Risk Society”: The Cult of Theory and the Millennium?

The relation between theory and empirical data in sociology and social policy is explored through a critique of Ulrich Beck's influential book, Risk Society . Consideration is given to the extent to which a book that purports to describe contemporary societies in general is actually rooted in the unique circumstances of postwar Germany. The various arguments of Risk Society are reviewed and tested against relevant empirical reports from England. Many of the historical and contemporary generalizations made by Beck are shown to be questionable. The conclusion reflects on the popularity of the genre in which Beck is working and questions the consistent glumness of its attitude to contemporary societies—whether those of the 1890s or the 1990s. The new millennium might be a time for a new spirit and the rejection of the nostalgia and conservatism of humanities-oriented scholarship.     

Inequality in the welfare state? Local variation in care of the elderly – the case of Sweden

This article uses Sweden as an example to describe and analyse municipal variation in services and care for elderly people. Responsibility for these services lies with the municipalities. National statistical data on municipalities are analysed to map out the variations in old-age care; to study compensating factors in the care system; and to explore the connection with municipal structural and political conditions. The overall finding of the bivariate analyses was that most relations with structure and policy were weak or non-existent. The final multivariate model explained only 15% of the variance. The large differences between municipalities makes it more appropriate to talk about a multitude of 'welfare municipalities' rather than one single welfare state. The article concludes that this municipal disparity constitutes a greater threat to the principle of equality in care of the elderly than gender and socio-economic differences.     

“A game of two halves?” Understanding the process and outcomes of English care home closures: Qualitative and quantitative perspectives

With care services increasingly delivered via a market there is always a risk that care homes could fail financially or struggle in terms of quality, ultimately having to close. When this happens, the received wisdom is that subsequent relocation can be detrimental to the health and well‐being of older residents (possibly even culminating in increased mortality). However, there is very little formal evidence in the United Kingdom (UK) or beyond to guide policymakers and local leaders when undertaking such sensitive work. Against this background, this article reports findings from an independent evaluation of what is believed to be the largest care home closure program in the UK (and possibly beyond). This consisted of qualitative interviews with older people, families, care staff, and social work assessors during the closure process in one case study care home and one linked day center, as well as self‐reported health and quality of life data for older people from 13 homes/linked day centers at initial assessment, 28 days after moving and at 12‐month follow up. The study is significant in presenting public data about such a contested topic from such a large‐scale closure process, in its focus on both process and outcomes, in its mixed‐methods approach, and in its engagement with older people, families, and care staff alongside the use of more formal outcome measures. Despite significant distress part‐way through the process, the article suggests that outcomes either stayed the same or improved for most of our sample up to a year after moving to new services. Care homes closures may thus be a “tale of two halves”, with inevitable distress during the closure but, if done well, with scope for improved outcomes for some people in the longer term. These findings are crucial for current policy and practice given that the risk of major closures seems to be growing and given that there is virtually no prior research on which to base local or national closure processes. While some of this research is specific to England, the underlying issue of care home closures and lessons learned around good practice will also apply to other countries.