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

Abstract

Approaches to ageing that are organised 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 organisational 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 marginalise persons who occupy the locations of dementia and disablement. This article 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 the concept of ‘precarity’, this article shifts debates on the ‘fourth age’ away from age or stage‐based thinking, into a recognition of the shared vulnerability and responsibilities for care. The argument of this article is that ‘precarity’ represents a ‘new form of ageing’, notably as regards its impact on the upper extremes of the life course. The article concludes with a call for a response that is grounded in an acknowledgement of the fragility and limitations which affect human lives, this requiring grounding in inclusive forms of citizenship.

The Effects and Meanings of Receiving a Diagnosis of Mild Cognitive Impairment or Alzheimer’s Disease When One Lives Alone

“…Multiple interviews with participants provided insights on participants’ experiences of grappling, often on their own, with the management of their health and with major decisions about where and how to live, despite having a diagnosis of MCI or AD in their medical records. On one side this finding corroborate the idea that people living with cognitive impairment are likely to sense precarity [9, 56], defined as “life worlds characterized by uncertainty and insecurity” [57]. On the other side, this fourth theme sets older adults living alone with cognitive impairment apart from their counterparts living with others who usually had a caregiver supporting them with major decisions.…”

Using longitudinal qualitative research to explore extra care housing

“…Additionally, we were able to explore how their experiences of living in ECH changed during this time, including the impact of changes in the organizational context. The findings of this study reflect the precarious position that older people are in when their need for care and support increases and how practices of care can either exacerbate a sense of precariousness or provide a sense of security (Grenier, Lloyd and Phillipson, 2017). The findings also demonstrate how changes in local ECH eligibility policy were impacting not just on the mix of residents but also on their experience of communal life.…”

Interdisciplinary and Collaborative Approaches Needed to Determine Impact of COVID-19 on Older Adults and Aging: CAG/ACG andCJA/RCVJoint Statement

“…At present, the research industry and media are emphasizing clinical trials and intervention-based research on COVID-19. However, even the most medically oriented area of work should also take into account social factors through the inclusion of social scientists and humanists, and through the use of relevant and critical theoretical tools such as intersectionality (Rice, Harrison, & Friedman, 2019), health equity (Marmot & Allen, 2014), and precarity (Grenier, Lloyd, & Phillipson, 2017). These are just some of many potential starting points for understanding the broader social structures that influence the COVID-19 contexts for diverse older people.…”