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Over the past decade there have been profound societal changes in attitudes towards and institutional practices regarding sexualities and gender identity. The legalisation of same-sex marriage is just one example, but others include increasing public discussion about trans individuals. Within the field of ageing, the lives of lesbian, gay, bisexual and trans (LGBT) individuals, the analyses of sexualities and of trans ageing have been largely neglected. This insightful and timely edited collection successfully redresses this imbalance, while also offering new insights into the dynamic interrelationship of ageing, gender and sexualities.
A novel aspect of the book is that it critically examines not only the intersections of ageing and sexualities, but also the interconnections of gender and sexualities in later life. The chapters provide a nuanced illumination of the intersections of ageing, gender and sexuality, while also considering the importance of intersections with other sources of social division, including race, ethnicity, social class and disability. These are not only discussed as representing sources of social division, but also representing relations of power, privilege and oppression.
A particular feature of ageing is the impact of the cohort in which individuals were born, and the ways that institutional changes throughout their life courses have influenced their early lives and later life experiences. For LGBT elders, feelings of dislocation and ‘unbelonging’ may have accompanied them throughout their lives and continue to influence their later years. Key concerns are how normative expectations may have been disrupted and reformulated.
This edited collection clearly shows there can be no single understanding of ageing, but a need to understand the various contours shaping diversity among older people. It is equally important not to homogenise the ‘category’ of older people, but seek to understand their unique experiences that may be patterned by gender, sexuality, social class and ethnicity, as well as historical and societal contexts. The book highlights the ways that intersections of ageing, gender and sexualities are influenced by societal context, in particular through the international nature of the collection with chapters from a wide range of countries, including Australia, Iran, Italy, South Africa and Spain.
By taking a multi-disciplinary approach, Intersections of Ageing, Gender and Sexualities highlights how various disciplines provide depths of insights into a range of inequalities associated with gender and sexualities in later life.
Sleep is central to health and wellbeing, yet sleep is likely to deteriorate with advancing age. Health promotion over the last two decades has emphasised the importance for health and wellbeing of the ‘big four’ – a good diet, physical exercise, not smoking, and restricting alcohol consumption. A fifth health promotion message is also essential for good health and wellbeing, namely, sleep. Sleep of a sufficient duration and quality is important for older people's wellbeing and ability to engage fully in daytime activities, whether living in their own homes or in a care home.
While many sleep researchers view sleep purely as a physiological process, social scientists have increasingly shown how a range of societal factors associated with individuals’ roles, relationships, family circumstances, daytime activities and environmental factors have an impact on sleep quality and duration (Hislop and Arber, 2006; Williams et al, 2010; Arber et al, 2012). While not denying that sleep has some physiological basis, this chapter examines some of the social aspects of sleep that are critical in influencing the autonomy and independence of older adults. As Williams (2005) reminds us, how, when and where we sleep are all societally, historically and culturally contingent.
Prospective epidemiological studies show a link between short sleep duration (under 6 hours) and elevated mortality, especially from cardiovascular disease (Ferrie et al, 2010; Grandner et al, 2012). Sleep is also important for cognitive functioning and memory consolidation (Busto et al, 2001), and sleep problems have an impact on quality of life, on daytime functioning and on recovery from illness (Haimov and Vadas, 2009).
It is well known that depression is associated with sleep problems, although recent research has shown that sleep problems often predate depression, and may therefore be a causal factor in the development of depression (Ferrie et al, 2011). During sleep, various physiological mechanisms take place associated with repair of the immune and other biological systems. Thus, sleep problems have detrimental effects on health in later life, with those who suffer from poor sleep being more likely to be at risk of heart attacks, falls, stroke, obesity and depression (Ancoli-Israel, 2005; Harrington and Lee-Chiong, 2007).
This chapter concentrates on health and well-being, drawing on 11 New Dynamics of Ageing (NDA) projects covering the whole range, from basic biology to the arts and humanities. Our main purpose is to employ the findings from our projects to examine the barriers to healthy ageing and how to overcome them. By way of introduction to this discussion of healthy ageing we first consider some key concepts in this field: ageing and ill health, older age, quality of life and subjective well-being. We begin with an overview of the main demographic changes that underline the importance of research on healthy ageing.
Key concepts for healthy ageing
Major demographic shifts are currently under way in countries of the developed world such as the UK. In the 25-year period from 1985 to 2010 the number of adults aged over 65 in the UK increased by 1.7 million, and the number of those aged over 85 almost doubled to 1.4 million (ONS, 2011a). This is partly due to improvements in mortality leading to higher numbers in old age. Life expectancy is increasing at a rate of two years per decade in developed societies. However, there are sharply divergent views about how trends in life expectancy may develop during this century. For example, Christensen et al (2009, p 1196) pointed out, ‘if the pace of increase in life expectancy in developed countries over the past two centuries continues through the 21st century, most babies born since 2000 … [in] countries with long life expectancies will celebrate their 100th birthdays … research suggests that ageing processes are modifiable and that people are living longer without severe disability.’ On the other hand, Olshansky et al (2005, p 1142) stated, ‘as a result of the substantial rise in the prevalence of obesity and its life-shortening complications such as diabetes, life expectancy at birth and at older ages could level off or even decline within the first half of this century’.
The magnitude and implications of population ageing depend heavily on the magnitude of mortality improvement in decades to come. At present, overall age-standardised mortality rates (both sexes combined) are improving at about 2.5 per cent per annum in the UK (based on ONS, 2012a), but current trends are heavily influenced by patterns at ages where deaths are concentrated.
An ageing world contains growing numbers of grandparents, who share longer lifespans with, on average, smaller numbers of grandchildren. The scope for grandparenting is therefore widening, and grandparenting is taking on new forms as the social and economic contexts of family relationships evolve. Diversity in grandparenting also arises from grandparents’ own choices regarding engagement with grandchildren. Time is ripe for a new look at grandparenting.
This chapter provides an overview of the main themes, arguments and frameworks that research on grandparents has yielded, highlighting how this book addresses lacunae in the literature and engages with new or poorly understood aspects of grandparenthood. It introduces concepts and theoretical frameworks that will be advanced within Contemporary grandparenting, and provides an overview of how the chapters in this book link together to further our understanding of contemporary grandparenting in diverse welfare state and cultural contexts.
While grandparenthood is widely acknowledged as being of great and growing importance in contemporary societies, it has remained inadequately theorised. This is not surprising because the demographic, socioeconomic, family and social policy contexts that frame and shape grandparenthood have changed radically in recent decades, and continue to evolve. The sub-title of the book emphasises that grandparenting is embedded within ‘changing family relationships’. Contemporary grandparenting also seeks to provide new insights into how grandparents themselves exert an influence on the grandparent role, hence departing from earlier characterisations that have tended to pay little attention to grandparents’ agency. Changing family, economic and social contexts, and some grandparents’ ability to shape their role within these contexts, mean that grandparenting today is very different from grandparenting some decades ago.
Adopting a gendered perspective is fundamental when studying the practices of grandparents. The term ‘grandparenting’ often in reality reflects care and support provided by grandmothers. However, it is important to consider the ways in which women and men ‘perform’ grandparenting in different societal and family contexts, and how cultural and social changes shape the gendered nature of grandparenting. It is critical to consider the nature of triadic grandparent–adult child–grandchild relationships, and how these are manifest in ‘family practices’ (Morgan, 2011). A complex nexus of gendered interrelationships across three generations pertains: not only the gender of the grandparent, but also the gender of the grandchild, and the gendered roles of the middle generation, influence grandparenting practices.
This is the first book to take a sociological approach to grandparenting across diverse country contexts and combines new theorising with up-to-date empirical findings to document the changing nature of grandparenting across global contexts.
This paper examines the amount of time that care-home residents spend in bed at night, focusing on how residents' bedtimes and getting-up times are managed. Using a mixed-methods approach, diary data were collected over 14 days from 125 residents in ten care homes in South East England. The findings indicate that residents spent, on average, nearly 11 hours in bed at night, significantly more time than was spent sleeping. There was greater variance in the amount of time residents who needed assistance spent in bed than there was for independent residents. Detailed investigation of six care homes, each with 8 pm to 8 am night shifts, showed that bedtimes and getting-up times for dependent residents were influenced by the staff's shift patterns. Analysis of qualitative interviews with 38 residents highlighted a lack of resident choice about bedtimes and many compromises by the residents to fit in with the care-home shift and staffing patterns. The social norm of early bedtimes in care homes also influenced the independent residents. It is argued that the current system in care homes of approximately 12-hour night shifts, during which staff ratios are far lower than in the daytime, promotes an overly long ‘night-time’ and curbs residents' choices about the times at which they go to bed and get up, particularly for the most dependent residents.
The concept of ‘active ageing’ has received much attention through strategic policy frameworks such as that initiated by the World Health Organisation, and through government and non-governmental organisation initiatives. The primary goal of these initiatives is to encourage older people to be active and productive, and to enhance quality of life, health and wellbeing. It is well known that with increasing age, night-time sleep deteriorates, which has implications for how older people maintain activity levels, and leads to an increased propensity for day-time sleep. Using data from 62 interviews with people aged 65–95 years living in their own homes who reported poor sleep, this paper explores the meanings of day-time sleep, and how the attitudes and practices of ‘active ageing’ are intricately linked to the management of day-time sleep and bodily changes that arise from the ageing process. The desire to be active in later life led to primarily dichotomous attitudes to day-time sleep; older people either chose to accept sleeping in the day, or resisted it. Those who accepted day-time sleep did so because of recognition of decreasing energy in later life, and an acknowledgement that napping is beneficial in helping to maintain active lives. Those who resisted day-time sleep did so because time spent napping was regarded as being both unproductive and as a negative marker of the ageing process.
This paper examines UK and US primary care doctors' decision-making about older (aged 75 years) and midlife (aged 55 years) patients presenting with coronary heart disease (CHD). Using an analytic approach based on conceptualising clinical decision-making as a classification process, it explores the ways in which doctors' cognitive processes contribute to ageism in health-care at three key decision points during consultations. In each country, 56 randomly selected doctors were shown videotaped vignettes of actors portraying patients with CHD. The patients' ages (55 or 75 years), gender, ethnicity and social class were varied systematically. During the interviews, doctors gave free-recall accounts of their decision-making. The results do not establish that there was substantial ageism in the doctors' decisions, but rather suggest that diagnostic processes pay insufficient attention to the significance of older patients' age and its association with the likelihood of co-morbidity and atypical disease presentations. The doctors also demonstrated more limited use of ‘knowledge structures’ when diagnosing older than midlife patients. With respect to interventions, differences in the national health-care systems rather than patients' age accounted for the differences in doctors' decisions. US doctors were significantly more concerned about the potential for adverse outcomes if important diagnoses were untreated, while UK general practitioners cited greater difficulty in accessing diagnostic tests.
Little is known about how negotiation between older people and their carers varies according to gender. This paper reports a study of older men and women who have had multiple falls and the actions of their key family members to prevent multiple falls. In-depth interviews were conducted with 35 older people who had had recurrent falls, and separately with the identified key family member. The actions taken by the relatives to prevent future falls were classified as protective, coercive, negotiating, engaging and ‘reflective of mutual respect’. It was found that sons caring for older mothers took only ‘protective’ and ‘coercive’ actions, resulting in mothers having passive and submissive roles. In contrast, the daughters who were caring for their fathers undertook most often ‘engaging’ and some ‘negotiating’ actions, which empowered the fathers in their decision making. Daughters had a ‘peer-like’ relationship with the mothers that they supported and cared for, and undertook primarily ‘negotiating’ as well as ‘engaging’ actions. The two men who cared for older men took no specific actions but maintained mutual respect for each other. The findings demonstrate several ways in which the gender of the dyad members influences the nature of the negotiation between close relatives, and throws light on the factors that influence the autonomy and dependence of older people.