Routledge Handbook of Cultural Gerontology 9780415631143, 9780203097090

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Routledge Handbook of Cultural Gerontology

Later years are changing under the impact of demographic, social and cultural shifts. No longer confined to the sphere of social welfare, they are now studied within a wider cultural framework that encompasses new experiences and new modes of being. Drawing on influences from the arts and humanities, and deploying diverse methodologies—visual, literary, spatial—and theoretical perspectives, Cultural Gerontology has brought new aspects of later life into view. This major new publication draws together these currents, including sections on Theory and Methods; Embodiment; Identities and Social Relationships; Consumption and Leisure; and Time and Space. Based on specially commissioned chapters by leading international authors, the Routledge Handbook of Cultural Gerontology will provide concise authoritative reviews of the key debates and themes shaping this exciting new field. Julia Twigg is Professor of Social Policy and Sociology at the University of Kent, UK. She has written widely on age and embodiment, recently focusing on the role of dress in the cultural constitution of age. She published Fashion and Age: Dress, the Body and Later Life and The Body in Health and Social Care. She is co-convenor of the British Sociological Association Ageing, Body and Society study group. Wendy Martin is a Lecturer in the College of Health and Life Sciences, Brunel ­University London, UK. Her research focuses on ageing, embodiment and daily life and the use of visual methods in ageing research. She was Principal Investigator for the Economic and Social Research Council research project ‘Photographing Everyday Life: Ageing, Lived Experiences, Time and Space’. She is co-convenor of the British Sociological Association Ageing, Body and Society study group. She was previously Secretary of the British Society of Gerontology.

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Routledge Handbook of Cultural Gerontology

Edited by Julia Twigg and Wendy Martin

First published 2015 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 711 Third Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2015 Julia Twigg and Wendy Martin The right of the editors to be identified as the authors of the editorial material, and of the authors for their individual chapters, has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data A catalog record for this book has been requested ISBN: 978-0-415-63114-3 (hbk) ISBN: 978-0-203-09709-0 (ebk) Typeset in Bembo by Apex CoVantage, LLC

Contents

Acknowledgements x List of illustrations xi xiii Author biographies 1 The field of cultural gerontology: an introduction Julia Twigg and Wendy Martin

1

SECTION I

Theory and methods

17

2 Theory and methods: introduction Julia Twigg and Wendy Martin

19

3 Aged by culture Margaret Morganroth Gullette

21

4 The cultural turn in gerontology Chris Gilleard and Paul Higgs

29

5 Beyond the view of the West: ageing and anthropology Sarah Lamb

37

6 Historians of ageing and the ‘cultural turn’ Antje Kampf

45

7 Literature and ageing Sarah Falcus

53

8 Theatre and ageing Miriam Bernard and Lucy Munro

61

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Contents

9 Ageing in film Aagje Swinnen

69

10 Popular music and ageing Ros Jennings

77

11 Art, ageing and the body Michelle Meagher

85

12 Visual methods in ageing research Wendy Martin

93

13 Ethnographies of ageing Cathrine Degnen

105

14 Ageing, narrative and biographical methods Joanna Bornat

113

SECTION II

Embodiment 121 15 Embodiment: introduction Julia Twigg and Wendy Martin

123

16 Theorising embodiment and ageing Emmanuelle Tulle

125

17 Gender, ageing and appearance Laura Hurd Clarke and Erica V. Bennett

133

18 Hair and age Richard Ward

141

19 Dress and age Julia Twigg

149

20 Science, technology and ageing Kelly Joyce, Meika Loe and Lauren Diamond-Brown

157

21 Ageing, risk and the falling body Stephen Katz

165

vi

Contents

22 Dementia and embodiment Pia Kontos

173

23 Suffering and pain in old age Kate de Medeiros and Helen Black

181

SECTION III

Identities and social relationships

189

24 Identities and social relationships: introduction Julia Twigg and Wendy Martin

191

25 Intersectionality and age Toni Calasanti and Neal King

193

26 Gender: implications of a contested area Jeff Hearn and Sharon Wray

201

27 Anti-ageing and identities Barbara L. Marshall

210

28 Sex, sexuality and later life Linn Sandberg

218

29 Lesbian, gay, bisexual and transgender ageing Yiu-tung Suen

226

30 Grandparenting Sara Arber and Virpi Timonen

234

31 Widowhood and its cultural representations Anne Martin-Matthews

243

32 Loneliness and isolation Christina Victor and Mary Pat Sullivan

252

33 The fourth age Liz Lloyd

261

34 Cultures of care Michael Fine

269

vii

Contents

35 Ethnicity, culture and migration Sandra Torres

277

36 Ageing well across cultures Matthew Carroll and Helen Bartlett

285

SECTION IV

Consumption and leisure

293

37 Consumption and leisure: introduction Julia Twigg and Wendy Martin

295

38 Retirement. Evolution, revolution or retrenchment Sarah Vickerstaff

297

39 Money and later life Debora Price and Lynne Livsey

305

40 Possessions as a material convoy David J. Ekerdt

313

41 Gardens and gardening in later life Christine Milligan and Amanda Bingley

321

42 Sport, physical activity and ageing Cassandra Phoenix and Meridith Griffin

329

43 Travel and tourism in later life Martin Hyde

337

44 Volunteering in later life Jeni Warburton

345

45 Youth culture, ageing and identity Andy Bennett

353

46 Celebrity culture and ageing Kirsty Fairclough-Isaacs

361

47 Representations of ageing in the media Virpi Ylänne

369

viii

Contents

48 ‘Late style’ and late-life creativity David Amigoni and Gordon McMullan

377

SECTION V

Time and space

385

49 Time and space: introduction Julia Twigg and Wendy Martin

387

50 Global and local ties and the reconstruction of later life Chris Phillipson

389

51 Time in late modern ageing Jan Baars

397

52 Transitions, time and later life Amanda Grenier

404

53 Rural and urban ageing Ricca Edmondson and Thomas Scharf

412

54 Lifestyle migration Karen O’Reilly and Michaela Benson

420

55 Ageing trends in the Asia-Pacific region Alfred C. M. Chan and Carol H. K. Ma

428

56 Connectivity, digital technologies and later life Ian Rees Jones

438

57 Meanings of home and age Sheila Peace

447

58 Public places and age Caroline Holland

455

59 Cemeteries and age Allison Kirkman

463

Index 471

ix

Acknowledgements

We would like to thank Rachel Hazelwood, our Editorial Administrator for the Routledge Handbook of Cultural Gerontology who showed organisation, patience and kindness throughout this complex international project, ensuring it moved forward in an efficient manner. We also thank all the authors who contributed to the Handbook, helping thereby to advance the wider cause of cultural gerontology. Colleagues and friends within the British Society of Gerontology remain a source of inspiration and encouragement in the shared commitment to understanding and enhancing the lives of people in mid to later life. We would also like to thank colleagues from Routledge, especially Gerhard Boomgaarden, Emily Briggs and Alyson Claffey. Julia Twigg and Wendy Martin

x

List of illustrations

Figures 11.1 Melanie Manchot, Mrs Manchot Hands on Hip (from the Look at You Loving Me series), 1996 88 97 12.1 Hermi’s creative representation of ageing 12.2 Rosy Martin, photographer 98 98 12.3 Daily Routine 12.4 Work Routine 99 100 12.5 Photographing Everyday Life Exhibition; Brunel University London 12.6 Photographing Everyday Life Exhibition; Brunel University London 101 323 41.1 Adaptive Gardening 55.1 Percentage of population aged 60 years or older in various Asia-Pacific sub-regions429 55.2 The speed of population ageing. Time required or expected for population 430 aged 65 or older to increase from 7 per cent to 14 per cent

Tables 32.1 Prevalence (%) of loneliness among those aged 65+ by country 32.2 Prevalence of loneliness: United Kingdom and Russian Federation 55.1 Number of years lived beyond life expectancy at 60 years of age for male and female, by WHO Region

256 257 431

xi

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Author biographies

David Amigoni is Professor of Victorian Literature at Keele University. He has been a member of Miriam Bernard’s interdisciplinary team working on the NDA-funded ‘Ages and Stages’ project since 2009 and co-author of a paper in Ageing and Society (2014) about that project. He was Principal Investigator of the AHRC-funded ‘Late-Life Creativity’ research network. Sara Arber is Professor of Sociology and Co-Director of the Centre for Research on Ageing

and Gender (CRAG) at the University of Surrey, UK. She was President of the British Sociological Association (1999–2001) and is a Fellow of the British Academy. She received the British Society of Gerontology Award for Outstanding Achievement in 2011. She has written over 300 journal articles on gender and ageing, inequalities in health, and sociology of sleep. Jan Baars is Professor of Interpretive Gerontology at the University for Humanistic Studies in Utrecht, The Netherlands. He focuses on basic concepts that are implicit in theoretical and practical approaches to ageing. He has written extensively on critical gerontology and concepts of time and temporality in ageing. His publications include Aging and the Art of Living (2012) and co-edited volumes such as Aging, Meaning and Social Structure (2013); Aging and Time (2007); and Aging, Globalization and Inequality:The New Critical Gerontology (2006). Helen Bartlett is Pro Vice-Chancellor and President at Monash University Malaysia. She has an international research record in gerontology, focusing on ageing policy, healthy ageing, and aged and community care. She has established and directed three research centres, including the Australasian Centre on Ageing at the University of Queensland, and in 2002 established the Australian Emerging Researchers in Ageing initiative. Key government consultancies include a review of the National Strategy for an Ageing Australia. Andy Bennett is Professor of Cultural Sociology and Director of the Griffith Centre for Cultural Research at Griffith University in Queensland, Australia. He has authored and edited numerous books including Music, Style and Aging; Popular Music and Youth Culture; Cultures of Popular Music; Remembering Woodstock; and Music Scenes (with Richard A. Peterson). He is also a Faculty Fellow of the Center for Cultural Sociology at Yale University. Erica V. Bennett is a PhD student in the School of Kinesiology at the University of Brit-

ish Columbia, Vancouver, Canada. She holds a Bachelor of Arts (Psychology) and Master of Arts (Kinesiology) from the University of British Columbia. Her research uses qualitative methods to better understand older women’s perceptions and experiences of body image and self-compassion in physical activity settings. Michaela Benson is a sociologist. Her research expertise is focused on the relationship between

class and space. On the basis of ethnographic fieldwork in France and Panama, she has written xiii

Author biographies

extensively on lifestyle migration, including her monograph The British in Rural France: Lifestyle Migration and the Ongoing Quest for a Better Way of Life (2011), shortlisted for the British Sociological Association’s Philip Abrams Memorial Prize (2012), and the co-edited volume Lifestyle Migration (2009). Miriam Bernard is Professor of Social Gerontology at Keele University, UK. She has led

the interdisciplinary ‘Ages and Stages’ project since 2009: funded initially under the national multi-research council New Dynamics of Ageing Programme; subsequently from the Arts and Humanities Research Council’s ‘Follow-on Funding’ Scheme; and currently, by their ‘Cultural Value Project’. She was President (2010–12), and is now Past-President (2012–14), of the British Society of Gerontology. Amanda Bingley is a Lecturer in Health Research in the Faculty of Health and Medicine,

Lancaster University. Her work focuses on the relationship between mental health, well-being and place, including research with older people and the benefits of gardening, the effects of woodland spaces on mental health in young people, woodland workers and current research with older conservation volunteers. Her work also includes a number of projects in palliative care. She has published in a range of journals and edited collections. Helen K. Black has built a body of research related to older adults’ lived experiences. Through narrative inquiry, she has investigated the meaning and significance, to elders, of phenomena such as poverty, suffering, childlessness, and control.Within funded projects she has also explored the experiences of formal and informal caregivers, and conducted research on African-American elders and depression, suffering, and experiences in war. In-depth qualitative interviewing is central to her research goals. Through this methodology elders are the authors and experts of the ‘truth’ of their lives. Joanna Bornat is Emeritus Professor of Oral History at the Open University. She has a long-standing interest in remembering in late life and has researched and published on a number of topics including ageing and family change, reminiscence and older people, the re-use of archived interviews, oral histories of South Asian geriatricians and the NHS, inter-generational family relationships and memories of religious and secular ceremonies in three European countries. She is joint editor of the journal Oral History. Toni Calasanti is Professor of Sociology at Virginia Tech, where she is also a faculty affiliate of both the Center for Gerontology and Women’s and Gender Studies. Her research on the intersections of age and inequalities has appeared in several journals as well as in the books Gender, Social Inequalities, and Aging (2001); Age Matters: Re-Aligning Feminist Thinking (2006); and Nobody’s Burden: Lessons from the Great Depression on the Struggle for Old-Age Security (2011). Matthew Carroll is a Senior Research Fellow in the School of Rural Health at Monash Univer-

sity. With Helen Bartlett he has worked to build a program of ageing research in the Gippsland region of Victoria, Australia. This includes research on lifelong learning, evidence-based policy development, social inclusion, and older people and climate change. Alfred Chan is Chair Professor of Social Gerontology, Department of Sociology and Social

Policy, Member of the Council, and Director of the Asia-Pacific Institute of Ageing Studies (APIAS) and Director of Office of Service-Learning (OSL) at Lingnan University in Hong Kong (HK), China. He is the Chairman of the Elderly Commission in Hong Kong and a ­consultant on ageing and social development issues for the United Nations Economic and Social Commission for Asia and the Pacific (UN ESCAP). xiv

Author biographies

Cathrine Degnen is Senior Lecturer in Social Anthropology in the School of Geography, Pol-

itics and Sociology at Newcastle University, UK. Her research on ageing focuses on people’s experiences of older age, the relations people forge with each other and with place, and how social memory is put to work. She is co-convenor of the ASA Anthropology of Britain Network and has recently published Ageing Selves and Everyday Life in the North of England:Years in the Making. Kate de Medeiros is the Robert H. and Nancy J. Blayney Professor of Gerontology at Miami

University, Oxford, Ohio. Her work has focused on narrative approaches to understanding old age to include self and identity, the meaning of friendships, suffering, and the experience of dementia. In addition to journal articles on these topics, her book Narrative Gerontology in Research and Practice was recently published. Lauren Diamond-Brown is a doctoral student in Sociology at Boston College, USA. Her areas

of interest are medical sociology, gender and feminist theory, sociology of knowledge and qualitative methodology. Ricca Edmondson is Professor in the School of Political Science and Sociology, NUI, Galway,

Ireland. Her research in cultural gerontology concentrates on wisdom, meaning and ageing; rural ageing; gerontological theory and methods, and the implications of interdisciplinarity. Publications include Valuing Older People: A Humanist Approach to Ageing (2009, co-edited with Hans-Joachim von Kondratowitz and published by The Policy Press), and Ageing, Insight and the Life Course: Social Practices and Intergenerational Wisdom (Policy Press, 2015). David Ekerdt is Professor of Sociology at the University of Kansas, USA. He conducts research

on the third-age and fourth-age transitions of later life—the ways that people form and act on expectations for the future in such settings as retirement and residential moves. He has worked in medical and academic settings and was previously editor of The Journal of Gerontology: Social Sciences and the four-volume Macmillan Encyclopedia of Aging. Kirsty Fairclough-Isaacs is Lecturer in Media and Performance in the School of Arts and Media

at the University of Salford, UK, where she teaches courses on feminism, celebrity, comedy, and film studies. Journals in which her work on celebrity and ageing have appeared include Celebrity Studies and Genders. She is the co-editor of The Music Documentary (Routledge) and co-editor of The Arena Concert: Music, Mediation and Mass Entertainment (Bloomsbury). Sarah Falcus is a Senior Lecturer in English Literature at the University of Huddersfield. Her research focuses on contemporary women’s writing, in particular the intersection of ageing and gender in this. She is currently working on a project investigating literary and filmic representations of dementia. Michael Fine is Adjunct Professor in the Department of Sociology at Macquarie University, Sydney, Australia. He has researched, published and taught in the fields of aged care, ageing, human services and social policy. His publications include the recent book, A Caring Society? Care and the Dilemmas of Human Service in the Twenty-First Century. He is a former president of the Australian Association of Gerontology (NSW) and is currently a member of the NSW Ministerial Advisory Committee on Ageing. Chris Gilleard is an Honorary Research Fellow at University College London. He was previously Director of Psychology and Psychotherapies for South West London. He has published widely about the nature of ageing across a number of areas. He is particularly interested in exploring the nature of the third and fourth ages. xv

Author biographies

Amanda Grenier is Associate Professor in the Department of Health, Aging and Society at McMaster University, Canada. Her funded research has focused on homecare, frailty, transitions, and older homelessness (SSHRC). In 2012, she published Transitions and the Lifecourse: Challenging the Constructions of ‘Growing Old’ (Policy Press). She currently holds the Gilbrea Chair in Aging and Mental Health and is Director of the Gilbrea Centre for Studies in Aging at McMaster University. Meridith Griffin’s primary research interests are ageing, health and wellbeing, disability, gender

and embodiment. Not solely, but more often than not, she is interested in these empirical topic areas as they interact in the social and cultural realms of leisure and physical activity. A critical qualitative researcher, Meridith’s empirical and theoretical interests are framed by a methodological interest in interpretive forms of understanding including life history, ethnography, visual and narrative approaches. Margaret Morganroth Gullette is Resident Scholar, Women’s Studies Research Center, Brandeis. She is the author of Agewise, a 2012 winner of the Eric Hoffer Award; Aged by Culture, a Noteworthy Book of the Year; and Declining to Decline, winner of the Emily Toth Award as the ‘best feminist book on American popular culture’. Her essays are often cited as notable in Best American Essays; her articles appear in the mainstream, left, and feminist press, and the blogosphere. Jeff Hearn is Guest Faculty Research Professor, based in Gender Studies, Örebro University, Sweden; Professor, Hanken School of Economics, Finland; and Professor of Sociology, University of Huddersfield, UK. His research interests include age and generation, gender, sexuality, violence, men and masculinities, work and organisations, and transnational issues. His most recent book is Rethinking Transnational Men, co-edited with Marina Blagojevic´ and Katherine Harrison (Routledge 2013), in the Routledge Advances in Feminist Studies and Intersectionality series for which he is co-managing editor. Paul Higgs is Professor of the Sociology of Ageing at University College London. He is co-author with Chris Gilleard of Cultures of Ageing: Self, Citizen and the Body (2000), and Ageing, Corporeality and Embodiment (2013). Professor Higgs is an editor of the journal Social Theory and Health and has published widely in both social gerontology and medical sociology. He is a co-investigator on two ESRC/NIHR-funded projects investigating the social dimensions of dementia. He is a Fellow of the Gerontological Society of America. Caroline Holland is Senior Research Fellow at the The Open University, UK. She researches the environments of ageing, including aspects of how the physical, social, technological, emotional, and political environments affect people and are affected by them across the life course. Past studies have included ‘everyday’ age discrimination, the uses of technologies, and the aspirations of older people, from younger-old people nearing retirement to older-old people with high support needs. Her participative work with community researchers included a study of social interactions in urban public places. Laura Hurd Clarke is a Professor of Sociology of Aging and Health in the School of Kinesiology at the University of British Columbia, Vancouver, Canada. Her research interests are in the embodied experience of ageing with a particular focus on gender, health, illness, disability, body image, and qualitative methods. Her research is funded by the Social Sciences and Humanities Research Council of Canada, as well as the Canadian Institutes of Health Research. xvi

Author biographies

Martin Hyde is a Sociologist whose main area of research is on ageing and later life. He has

published on a range of issues around ageing, from the impact of retirement on health to the engagement of older people in consumer society. He has also worked on a number of large scale studies including the English Longitudinal Study of Ageing (ELSA) and the Swedish Longitudinal Occupational Study of Health (SLOSH). Ros Jennings is Director of the Centre for Women, Ageing and Media (WAM) at the University

of Gloucestershire, UK and Deputy Executive Director of the European Network in Aging Studies (ENAS) Association. Her interests include developing research training for doctoral education in Ageing Studies and feminist approaches to the intersections of popular music, television and ageing. She is editor (with Abigail Gardner) of the collection: Rock On: Women, Ageing and Popular Music (Ashgate 2012). Ian Rees Jones is Professor of Sociological Research at Cardiff University and Director of the

Wales Institute of Social & Economic Research, Data & Methods (WISERD) and its ESRC Research centre (WISERD/Civil Society). He is a Fellow of the Learned Society of Wales and an Academician of the UK Academy of Social Sciences. He is a member of the editorial team and monograph series editor for the journal Sociology of Health and Illness. Kelly Joyce is a Professor in the History and Politics Department and Director of the Center for

Science, Technology and Society at Drexel University, USA. Her research investigates the social dimensions of medical knowledge and medical technology. She is the author of Magnetic Appeal: MRI and the Myth of Transparency and is co-editor (with Meika Loe) of Technogenarians: Studying Health and Illness through an Ageing,Technology, and Science Lens. Antje Kampf is a Teaching Associate in the History Department at Humboldt-Universität zu

Berlin. Her current research includes a larger historical study on the translation of breast and cervical cancer as a risk concept to the public in GDR and FRG, 1947–1990s. She is co-editor of Aging Men, Masculinities and Modern Medicine (Routledge 2012), and has published widely on the history of public health, aging, and gender in international peer-reviewed journals. Stephen Katz is Professor of Sociology, Trent University, Canada. He is author of Disciplining Old Age and Cultural Aging, and numerous book chapters and journal articles on the sociology of the aging body. His current research is on the cultural aspects of memory, part of a new book on Age, Mind and Body in Later Life. In 2009 he received the prestigious Trent University Distinguished Research Award for his work in critical gerontology. Neal King is Associate Professor of Sociology at Virginia Tech, where he is also a faculty affiliate of the Center for Gerontology and a member of the teaching faculty of the Program in Women’s and Gender Studies. His research on intersecting inequalities and popular culture, focusing mainly on old manhood, has appeared in several journals and edited collections, such as Millennial Masculinity (Wayne State University Press 2012) and Representing Ageing: Images and Identities (Palgrave 2012). Allison Kirkman is Senior Lecturer in Sociology in the School of Social and Cultural Studies, Victoria University of Wellington, New Zealand. Her research focuses on gender, sexuality, ageing, dying and death. Her recent publications are concerned with ageing and people with dementia. Pia Kontos is a Senior Scientist at Toronto Rehab–University Health Network, and Associate Professor in the Dalla Lana School of Public Health at the University of Toronto. Central to her program of research is ‘embodied selfhood,’ a philosophy and approach to care that emphasizes xvii

Author biographies

the importance of the body for self-expression. She utilizes arts-based methodologies to bring this approach to clinical practice, and to engage persons with dementia in creative and meaningful ways. She has published across multiple disciplines on selfhood, dementia, embodiment, and arts-based innovations to improve dementia care. Sarah Lamb is Professor of Anthropology at Brandeis University, USA. Her research focuses on ageing, gender, families and understandings of personhood in daily life in West Bengal, India, and the United States. She published White Saris and Sweet Mangoes: Aging, Gender and Body in North India and Aging and the Indian Diaspora: Cosmopolitan Families in India and Abroad, and is co-editor (with Diane Mines) of Everyday Life in South Asia. Her current research critically examines US notions of ‘successful’ aging. Lynne Livsey is a social gerontologist and freelance researcher specialising in social policy and ageing, with particular interest in social care, health and housing and the financing of later life. She completed her PhD at the Institute of Gerontology at King’s College London and worked as a Research Associate on the Economic and Social Research Council project, ‘Behind Closed Doors—Older Couples and the Management of Household Money’ with Dr. Debora Price. Liz Lloyd is Reader in Social Gerontology in the School for Policy Studies at the University of

Bristol. Her specialist focus is ageing and care, including end-of-life care, and she has published widely on this subject. She has led several research projects on older people’s experiences of care in both community and residential settings. Currently she is the Principal Investigator in the UK of an international research project, Re-imagining Long-Term Residential Care. Meika Loe is Associate Professor of Sociology and Women’s Studies at Colgate University in New York, USA, where she teaches courses on aging, gender, culture and medicine. She is the author of Aging Our Way: Lessons for Living from 85 and Beyond and The Rise of Viagra: How the Little Blue Pill Changed Sex in America, as well as co-editor (with Kelly Joyce) of Technogenarians: Studying Health and Illness through an Ageing, Science, and Technology Lens. Carol Ma is Adjunct Assistant Professor of the Department of Sociology and Social Policy and

the Assistant Director of the Office of Service-Learning (OSL) at Lingnan University in Hong Kong (HK), China. She has been appointed to various government committees, including the Independent Police Complaints Council (IPCC), Active Ageing committee under the Elderly Commission, and Promotion Civic Education, HKSAR. She has also been a manager of the Lingnan Dr. Chung Wing Kwong Memorial Secondary School. Barbara L. Marshall is Professor of Sociology at Trent University in Peterborough, Canada. She has written widely on feminist theory, gender, sexuality and the body, and with her colleague Stephen Katz has co-authored a series of articles exploring ageing, embodiment and sexuality. Her most recent book is a co-edited collection (with A. Kampf and A. Peterson), Ageing Men, Masculinities and Modern Medicine (Routledge 2013). Wendy Martin is a Lecturer in the College of Health and Life Sciences, Brunel University

­London. Her research focuses on ageing, embodiment and daily life and the use of visual methods in ageing research. She was Principal Investigator for the Economic and Social Research Council research project ‘Photographing Everyday Life: Ageing, Lived Experiences, Time and Space’. She is co-convenor of the British Sociological Association Ageing, Body and Society study group. She was previously Secretary of the British Society of Gerontology. Anne Martin-Matthews is a Professor of Sociology at the University of British Columbia, Can-

ada. She has published two books, three edited volumes, and numerous papers in the sociology xviii

Author biographies

of aging, on issues of health and social care, work-family balance, widowhood, and rural aging. Her current research examines the intersection of paid and unpaid care in home care settings. Gordon McMullan is Professor of English and Director of the London Shakespeare Centre at King’s College London. His publications include Shakespeare and the Idea of Late Writing (2007) and a collection of essays, co-edited with Sam Smiles, entitled Late Style and Its Discontents: Essays in Art, Literature and Music (forthcoming). He was co-investigator, with David Amigoni, for the AHRC-funded ‘Late-Life Creativity’ research network. Michelle Meagher is Associate Professor of Women’s and Gender Studies at the University of

Alberta, Canada. Her research centres on feminist art history and women’s self-representation in contemporary art. Most recently, she is the author of ‘Against the Invisibility of Old Age: Cindy Sherman, Martha Wilson, Suzy Lake,’ an art essay in a 2014 issue of the journal Feminist Studies. Christine Milligan is Professor of Health and Social Geography in the Faculty of Health and Medicine and Director of the Centre for Ageing at Lancaster University, UK. Her research interests focus around the interactions between older people and place, particularly in relation to active ageing, the home, care, technology and social isolation. Christine has published over 100 journal articles and books on these topics. Her current work involves older male carers and interventions to alleviate social isolation in older men. Lucy Munro is a Lecturer in Shakespeare and Early Modern Drama Studies at King’s College London. Her current research focuses on theatre and the performance of ageing. She is the author of Children of the Queen’s Revels: A Jacobean Theatre Repertory (2005) and Archaic Style in English Literature, 1590–1674. She was a co-investigator in ‘Ages and Stages: The Place of Theatre in Representations and Recollections of Ageing’, a collaboration between Keele University and the New Vic Theatre, Newcastle-under-Lyme, Staffordshire. Karen O’Reilly is Professor of Sociology at Loughborough University. Her research interests

include migration, social class and ethnographic methods. In particular, she has pioneered the use of practice stories for conducting research on migration. She has conducted extensive fieldwork among the British in Spain and is currently researching the British in Thailand and Malaysia. She is the author of several books including The British on the Costa del Sol (2000), International Migration and Social Theory (2012) and Ethnographic Methods (2011), and numerous journal articles. Sheila Peace is Professor of Social Gerontology at Faculty of Health and Social Care of The Open University. She has written widely in the field of Environmental Gerontology, encompassing both macro and micro research environments from care homes to mainstream housing, from public spaces to kitchen living. She was Principal Investigator for the research project ‘Transitions in Kitchen Living’ part of the New Dynamics of Ageing programme supported by the Economic and Social Research Council. She is President of the British Society of Gerontology. Chris Phillipson is Director of the Manchester Interdisciplinary Collaboration for Research on Ageing (MICRA), based at the University of Manchester (UK), where he is Professor of Sociology and Social Gerontology. He is the co-author of the Handbook of Social Gerontology (Sage Books 2010); Ageing, Meaning and Social Structure (co-edited, Policy Press 2012); and Ageing (Polity Press 2013). His present research involves work around the theme of ‘age-friendly cities’ and a study examining changes in the transition from work to retirement. Cassandra Phoenix is Senior Lecturer at the University of Exeter. Her work draws on the sociology of ageing, the body and physical culture. Her research explores the embodiment of xix

Author biographies

ageing and physical activity across the life course; the impact of ageing on self, identity, health and well-being; intergenerational relationships; disability; nature(s); exercise and the body. Her work is often framed by narrative approaches, visual methods, and ethnography. Recent work includes the ESRC funded project ‘Moving Stories: Understanding the Role of Physical Activity on Experiences and Perceptions of (Self-)Ageing.’ Debora Price is a Senior Lecturer at the Institute of Gerontology, King’s College London. Her research centres on finance over the life course, especially pensions and poverty in late life, financial services for an ageing society, household money, and the financial consequences of cohabitation and separation. She has acted as Principal or Co-Investigator on a number of related research projects and has served on the Executive Committee of the British Society of Gerontology in various capacities for 7 years. Linn Sandberg is a researcher at the Department of Gender Studies, Stockholm University,

Sweden. Her research focuses on gender, ageing, sexuality and embodiment and she has published several articles on masculinity, sexuality and ageing in journals such as Sexualities, International Journal of Ageing and Later Life and Men and Masculinities. She is currently the Principal Investigator for a research project on Alzheimer’s disease, sexuality and intimacy among older couples, funded by the Swedish Research Council for Health, Working Life and Welfare. Thomas Scharf is Professor of Social Gerontology at and Director of the Irish Centre for

Social Gerontology, NUI Galway, Ireland. His research addresses broad issues connected to social policy and later life. Key themes have been ageing in urban and rural environments, and the conceptualization and measurement of social exclusion. His most recent book is From Exclusion to Inclusion in Old Age: A Global Challenge (2012, co-edited with Norah Keating and published by The Policy Press). Yiu-tung Suen is Assistant Professor of Sociology at the Chinese University of Hong Kong. His

research focuses on sexualities and ageing, and the use of qualitative research methods. He is Co-Investigator for the Economic and Social Research Council seminar series ‘Older Lesbian, Gay, Bisexual and Trans People: Minding the Knowledge Gaps’. He has also worked with Age UK Oxfordshire on the Mental Health Foundation–funded project ‘Rainbow Care Homes’ examining LGBT friendliness in care homes. Mary Pat Sullivan is a registered social worker and Senior Lecturer in Social Work at Brunel

University London. Her principal research interests are focussed around gerontological social work practice including geriatric mental health, dementia care, social isolation and loneliness, elder abuse and ageing without children. She is a member of the Executive Committee of the British Society of Gerontology and the Editorial Board for the journal Ageing & Society. Aagje Swinnen is Assistant Professor at the Department of Literature and Art of Maastricht

University, The Netherlands. She published on the representation of age, gender and sexuality in literature, film and photography. Swinnen is co-founder and current chair of the European Network in Aging Studies as well as co-editor of the journal Age, Culture, Humanities. Virpi Timonen is Professor in the School of Social Work and Social Policy at Trinity College Dublin. Her research focuses on intergenerational relations across the life course. Recent projects include research on grandparenthood; never-married older adults; coping with terminal illness; and on how parents socialise their children in matters pertaining to sexuality and relationships. She has authored Ageing Societies (Open University Press 2008) and co-edited (with Sara Arber) Contemporary Grandparenting (Policy Press 2012). xx

Author biographies

Sandra Torres is Professor of Sociology at Uppsala University. Her research focuses primar-

ily on the implications of ethnicity, culture and migration for the manner in which ageing and old age are experienced and understood. In 2008 she was awarded one of the prestigious FLARE-fellowships (Future Leader of Aging Research in Europe) by the European Research Area on Aging for her research on globalization’s implications for elderly care and the cross-cultural interaction that takes place within this sector. Emmanuelle Tulle is Reader in Sociology at Glasgow Caledonian University. She has written

widely on age, embodiment and anti-ageing science, focusing more specifically on masters sport, physical activity and sedentary behaviour. She has edited Old Age and Agency and authored Ageing, the Body and Social Change: Running in Later Life. Julia Twigg is Professor of Social Policy and Sociology at the University of Kent, UK. She has

written widely on age and embodiment, recently focusing on the role of dress in the cultural constitution of age. She published Fashion and Age: Dress, the Body and Later Life and The Body in Health and Social Care. She is co-convenor of the BSA Study Group Ageing, Body and Society. Sarah Vickerstaff is Professor of Work and Employment and Head of the School of Social Policy, Sociology and Social Research at the University of Kent, UK. She is interested in the transitions into and out of work at the beginning and end of ‘working lives’, and she has written widely on extending working life and retirement. She co-edited Work, Health and Wellbeing. Christina R. Victor is a Professor of Gerontology and Public Health at Brunel University Lon-

don and Editor-in-Chief of the journal Ageing & Society. Her principal research interests are focussed around understanding the social context of ageing and later life and the public health aspects of old age and population ageing. She has a specific interest in loneliness and social isolation, care and caring, ethnogerontology, dementia, and physical activity, exercise and later life. Jeni Warburton is Chair of the John Richards Initiative at La Trobe University,Wodonga,Victoria, Australia, a research centre focused on rural ageing. She has more than 20 years’ experience in ageing research, with her main areas of interest comprising healthy and productive ageing, as well as volunteering and community. She has published extensively on these topics, and her research has played a key role in the development of practice and policy around volunteering and social inclusion, particularly relating to older people. Richard Ward is a Lecturer in Dementia Studies in the School of Applied Social Science at

the University of Stirling. He was Principal Investigator on the Economic and Social Research Council project ‘Hairdressing, Image and Body Work in Care Services to Older People’. He is also a co-applicant on a 5-year study of neighbourhoods and dementia jointly funded by the ESRC and the National Institute for Health Research. Sharon Wray is a Reader in Sociology and Associate Director of the Centre for Applied Child-

hood Studies and Chair of the Huddersfield Intergenerational Research Group, at the University of Huddersfield. Her research interests include ageing and the life course, gender, intergenerational relationships, and diversity. She is editor of International Journal of Aging and Society and a member of the Runnymede Trust Academic Advisory Forum. Virpi Ylänne is Senior Lecturer in Language and Communication at Cardiff University, Wales,

UK. Her research has focused on discursive construction of age identities in talk and text, and she has co-directed an Economic and Social Research Council–funded project on representations of older people in UK advertising. She is the editor of the collection Representing Ageing: Images and Identities (Palgrave Macmillan 2012). xxi

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1 The field of cultural gerontology An introduction Julia Twigg and Wendy Martin

Cultural gerontology has emerged in the last decade as one of the most lively and insightful areas of academic analysis. Drawing together work across the humanities and social sciences, it has changed the ways in which we study later years, challenging old stereotypes and bringing new theories, new methodologies, and new forms of political and intellectual engagement to bear. In this Handbook we draw together work in this field, displaying the range and potentiality of the area, revealing its current vibrancy and future promise, with the aim of providing a position statement for the field. Cultural gerontology has its roots in the wider phenomenon of the cultural turn, and in the opening section of this chapter we review the nature of the cultural turn in gerontology, where it came from and what are its principle themes, reflecting on the relationship between cultural gerontology and other key strands, such as critical gerontology. We then discuss some of the critiques that have been advanced in relation to the approach, both within gerontology and more widely. We then review the processes, practical and intellectual, underlying the formation of the Routledge Handbook of Cultural Gerontology. Finally we ask what is currently missing from the approach, reviewing possible future directions and ways forward.

The cultural turn The cultural turn came relatively late to gerontology, and it is only in the last decade or so that its influence has begun to be fully felt. Since then however it has provided the motive force behind some of the most stimulating work in the field. By common account, the cultural turn within the social sciences encompasses two interconnected elements: the theoretical-epistemological and the socio-historical (Nash 2001, Friedland and Mohr 2004). The first relates to the upsurge of new theorising broadly termed postmodern or poststructuralist that has disturbed assumptions made earlier about the social world and how it could be known and analysed. Drawing on a range of theorising, and involving both ontological and epistemological elements, it has presented a complex and at times discordant set of ideas; and indeed some have questioned its overall coherence (Roseneil 2012). Broadly uniting the area, however, is the sense of the centrality of meaning, in both the constitution and analysis of the social world. With this has gone a shift from a focus on structure—and with it the earlier grand narratives of social science 1

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epitomised by Marxism—towards agency, with renewed interest in subjectivity, reflexivity and individuation (Giddens 1991). In the context of ageing, an example of such approaches is research, drawing on feminist and queer theory, that has acted to destabilise and deconstruct definitions of age, challenging earlier modernist accounts based on medical or chronological definitions of age, and the explicit normativities contained within them, suggesting the ways in which the categories of age—like those of gender and sexuality—are subject to fluidity and cultural constitution. The second element in the cultural turn—the historico-social—relates to the sense that under the condition of postmodernity—or late or second modernity; the terminology and exact definitions differ with different authors—the character of the social world has itself undergone a significant shift. An example of this in relation to ageing is what is termed the reconstitution of ageing thesis, a set of arguments that suggest that in late modern society, the experience of age has itself changed, becoming more diverse and less embedded in social structures, more influenced by cultural phenomena such as consumption (Blaikie 1999, Gilleard and Higgs 2000). Cultural gerontology has also been shaped by factors distinctive to the field of ageing. Much of the impetus behind cultural gerontology has come from a desire to get away from the dominant account of ageing in academic studies that has focussed on problematic old age, emphasising frailty and its consequent social burdens. Cultural gerontology by contrast aims to produce a fuller and richer account of later years—as it is often termed in this literature—one that places the subjectivity of older people, the width and depth of their lives, at the forefront of analysis. Cultural gerontology also represents an attempt to redress the neglect of age specifically within sociological analysis, which traditionally avoided the topic, handing it over to the discursive constructions of medicine, social work and public policy. The cultural turn in gerontology can thus be interpreted as an attempt to provide what has long been missing, in the form of an adequate sociology of old age. We can ask at this point what is implied by culture here. Despite the currency of the term, it is noticeable that few writers in the area attempt a definition, and where they do it is often not as helpful as might be expected. This is because the driving force behind cultural gerontology is not debates about the meaning of culture, so much as concerns centred on the field and how it can be analysed. ‘Cultural’ is used in this context in varying and sometimes conflicting ways, so that its meaning, application and significance are contested. In the context of cultural gerontology, it is, therefore, perhaps best to see it as a tendency, a broad movement of ideas and theories focussed around meaning, that have together created a new field, encompassing work across the social science/humanities divide.

The arrival of the humanities Until recently the arts and humanities were not greatly interested in the subject of age. Old age was seen at best as marginal and uninteresting, and at worst dull and depressing. In this the humanities reflected the wider ageism of the academy and society generally. More recently, however, in response to demographic shifts and the growing cultural visibility of older people, there has been a flowering of work that has explored the experience of old age in films, novels, poetry, biography, and art. As a result the humanities have increasingly turned their academic gaze towards the area, bringing new approaches, influenced by psychoanalytic, linguistic, poststructuralist, and other literary theories. Some of the most influential writers in cultural gerontology, such as Margaret Gullette, Tom Cole and Kathy Woodward, indeed come from this humanities background (Gullette 2015).These shifts have produced a wealth of new subject areas, including 2

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literature (Gullette 1988, Zeilig 2011, Worsfold 2011, Falcus 2015), autobiography (Thompson 2000, Ray 2000, Bornat 2011, 2015), theatre (Basting 2009, Mangan 2013, Bernard and Munro 2015), film (Chivers 2003, 2011,Wearing 2007, 2013, Robinson et al. 2007, Cohen-Shalev 2012, Swinnen 2013, 2015), painting (Meagher 2014, 2015), music (Jennings and Gardner 2012, Bennett 2013, Jennings 2015), as well as the concept of late style in relation to creativity (Amigoni and McMullen 2015). This has gone with a revived historiography of age that draws on wider cultural sources (Cole 1992, Katz 1996, Thane 2000, 2005, Botelho and Thane 2001, Kampf et al. 2012, Kampf 2015), and new philosophical explorations (Small 2007, Baars 2012).

Central themes In the Handbook we have grouped the chapters into five broad sections: theory and methods; embodiment; identities and social relationships; consumption and leisure; and time and space. These, however, are not mutually excluding; indeed it is one of the features of the field that its central themes overlap and interpenetrate, crossing boundaries, both disciplinary and theoretical. In this brief overview we will reflect on some of the central features of the field. The first feature to note is the active engagement with theory. Mainstream social gerontology has often been criticised for being atheoretical (Birren and Bengston 1988). Cultural gerontology by contrast is marked by active engagement with social theory, as is illustrated in the work of influential writers in the field, such as Stephen Katz, Barbara Marshall, Toni Calasanti, Chris Phillipson, Chris Gilleard and Paul Higgs (Katz 2015, Marshall 2015, Calasanti and King 2015, Phillipson 2015, Gilleard and Higgs 2015).Writers from the arts and humanities have been similarly influenced by the turn to theory that took place in their fields in the late twentieth century. The body and embodiment have been central to cultural gerontology, reflecting wider intellectual influences (Turner 1991, Shilling 2012). Social gerontology, however, was initially reluctant to engage with this territory, regarding it as potentially retrogressive, threatening to reduce old age to physiological and medical processes, sidelining the significance of social and cultural forces in the constitution of age. More recently, however, with the cultural turn there has been a flowering of work exploring the complex nature of embodiment in old age (Öberg 1996, Gilleard and Higgs 2013, Tulle 2015). The body in later years is increasingly treated as a site of governance, whether in the form of bio-power exercised by professionals such as doctors and social workers, or in the form of Foucauldian technologies of the self (Foucault 1988), through which the bodies of older people are disciplined, made subject to regimes of fitness and health. Responsibility for ageing well has become a new moral imperative, with, as Katz (2001) argues, ageing well increasingly understood as ageing without appearing to do so, producing a proliferation of anti-ageing techniques in the form of the commercialised culture of cosmetics, hair dyes, and slimming and exercise regimes (Furman 1997, Coupland 2003, Calasanti 2007, Hurd Clarke 2011,Ward and Holland 2011, Ellison 2014, Hurd Clarke and Bennett 2015, Carroll and Bartlett 2015). The field is also marked by the focus on subjectivity and identity, which in turn reflects the shift in analysis from structural aggregate forms of sociality towards a more fluid conception of ‘being in society’ (Rojek and Turner 2000). With this has gone a new emphasis on the views, experiences and subjectivities of older people, previously obscured by the dominance of more ‘scientific’ approaches and by the objectifying practices of policy makers, opening up work exploring the subjectivities of older people through film, literature, autobiography, and art.Work in cultural gerontology attempts to recover the individuality of older lives, through autobiography or narrative (Thompson 2000, Ray 2000, Bornat 2015), through ethnographic techniques (Degnen 2015) or other methodologies that place the voices and visions of older people centre 3

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stage (Richards et al. 2012, Martin 2015). Work within psychology has similarly explored the social construction of identity in age (Biggs 1997, Gergen 2002). Such work emphasises the range and variety of older people’s experiences and views, reiterating the point that people in later years—contrary to the stereotype—are more, rather than less, diverse than the young. The emphasis on agency has also reinforced an understanding of society as malleable, constituted in and through cultural practices and discourses capable of being made and remade through changing lifestyles. The emphasis on discourse, rooted in the linguistic turn, which was the precursor and major contributor to the cultural one, has encouraged analysts to see ageing as a discursive construction created in and through culture, though as we shall note one that for most in the field retains its concrete physiological base. The cultural turn has also brought new interest in diversity, exemplified in work around gender, ‘race’, sexuality, ethnicity and disability. In relation to age this has produced a range of work unpacking the gendered nature of old age and its cultural diversity (Arber and Ginn 1991, Thompson 1994, 2006, Calasanti and Slevin 2001, Krekula 2007, Torres 2015, Hearn and Wray 2015, Calasanti and King 2015, Chan and Ma 2015).Work around sexualities is also increasingly prominent, once again challenging the implicit normativities of earlier work (Hearn 1995, Gott 2005, Sandberg 2011, 2015, Suen 2015). Diversity has also been explored through work on sub-groups such as older punks (Bennett and Hodkinson 2012, Bennett 2013, 2015) or alternative women (Holland 2004). With the shift from production to consumption within late modernity has gone a new emphasis on lifestyle as the locus of identity, including in later years. Work has explored the role of consumption goods (Jones et al. 2008, 2009, Moody and Sood 2010), of dress and fashion (Fairhirst 1998, Twigg 2013, 2015, Twigg and Majima 2014), of hair and appearance (Furman 1997, Ward and Holland 2011, Ward 2015, Hurd Clarke and Bennett 2015) and of music (Bennett 2013, Jennings 2015). Activities such as gardening (Bhatti 2006, Milligan and Bingley 2015), volunteering (Warburton 2015), sport (Tulle 2008, Phoenix and Griffin 2015) and caring for grandchildren (Arber and Timonen 2015) become increasingly important in older people’s lives, which are also shaped by cultures of widowhood (Martin-Matthews 2015), retirement (Vickerstaff 2015), and money (Price 2015). The expansion of consumption culture has created a new arena within which subjectivities are being forged. This is explored in work on the grey market (Moody and Sood 2010), travel (Hyde 2015) and material goods generally (Ekerdt 2009, 2015). This links to debates about the baby boomers and claims that they represent a distinctive consumption generation—or at least those with the purchasing power—that are rewriting the scripts of old age (Gilleard and Higgs 2000). It has been suggested that older people are now increasingly integrated with the mainstream through shared lifestyle, so that later years now form part of an extended arc of middle life that endures until the interruption of serious ill health (Öberg and Tornstam 1999, 2001). Much of the new cultural work explores the nature of late middle and early old age. Indeed part of the impetus behind the development of the field has come from a realisation that the nature of later years is changing, with the extension of the life course and the opening out of the Third Age as a new cultural space. The focus on the Third Age has, however, been criticised for privileging the experiences of a select group of older people, those with income and health; for presenting an aspirational account of their lives, influenced by the commercialised worlds of the media and consumption; and for implicitly endorsing the neo-liberal restructuring of the welfare state by its emphasis on choice and autonomy. Jönson (2012) raises the question of the degree to which this account of the ‘new old’ in fact represents the ageism of the middle

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aged, keen to mark themselves off from the truly old, asserting a different present and future for themselves. It is sometimes assumed that cultural approaches are confined to these earlier stages of age; and they have certainly been the main focus of analysis. However one of the challenges of the cultural approach is to show how it applies also to the oldest old and older people receiving care and support. Work in this mode in relation to dementia has begun on narrative (Kontos 2015), hair and appearance (Ward and Holland 2011, Ward and Campbell 2013), and dress (Twigg and Buse 2013, Buse and Twigg 2014). Chapters in the Handbook address the fourth age (Lloyd 2015), falls (Katz 2015), care (Fine 2015), loneliness (Victor and Sullivan 2015), suffering (de Medeiros and Black 2015) and death (Kirkman 2015). One of the most significant features of late or postmodernity has been the rise of the visual and the virtual. Through technological innovation, visual imagery is now omnipresent in our lives, to some extent replacing the dominance of the word that marked the earlier stages of modernity. This shift has exposed the ways in which age is itself a visual phenomenon, a process whereby older people are caught in and defined by their appearance. This is particularly marked for women. As Woodward (1999) has commented, older women are both invisible—in that they are not seen—and hypervisible—in that they are all that is seen. Cultural gerontology has increasingly explored the visual constitution of age through work on fine art, film, photographic representation, advertising and cartoons, and through the use of visual methodologies (Martin 2015). Sources of imagery have been explored in relation, for example, to soap opera stars and celebrities (Harrington and Brothers 2010, Fairclough-Isaacs 2015), advertisements (Williams et al. 2007, Lee et al. 2007, Ylänne 2012, 2015) and magazines (Lewis et al. 2011). The new emphasis on the visual has also refreshed and extended the methods used in gerontology (Black 2009, Reynolds 2010, Martin 2012, Richards et al. 2012, Phoenix 2012). Finally, changes consequent on the digital revolution have also altered our understandings of time and space, which have become disembedded (Baars 2015, Grenier 2015). Globalisation, at both the economic and cultural levels, has presented new possibilities in terms of travel, family reconstitution, sources of care (Phillipson 2013, 2015), of late and lifestyle migrations (O’Reilly 2000, Katz 2005, Ramji 2006, O’Reilly and Benson 2015) and the use of social media and digital technologies (Buse 2010, Joyce et al. 2015, Jones 2015). With this have come new forms of uncertainty and risk (Giddens 1991, Kaldor and Stiglitz 2013). Global events at a distance now rapidly impact on the localities of older people, drawing them into global financial and welfare structures (Phillipson, 2015). The division between rural and urban has become more complex (Edmondson and Scharf 2015). Within cultural gerontology there is renewed interest in the analysis of space and place, especially through work on the cultural meaning of home (Peace 2015), and of significant spaces within the home, such as kitchens and bathrooms (Twigg 2000, Angus et al. 2005). The changing significances of public space for older people have also been explored (Rowles and Bernard 2013, Holland 2015).

Cultural gerontology as an academic field Though cultural gerontology has become an increasingly popular term, it overlaps with others, such as humanistic gerontology and critical gerontology. Humanistic gerontology—the term used by Cole and Ray (2010)—shares many of the same concerns with meaning and subjectivity as cultural gerontology, though with a particularly strong emphasis on the role of the arts and humanities.

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Critical gerontology has a longer history of use. It shares with cultural gerontology a concern with deconstructing the definitions and understandings of age, critiquing theoretical self understandings of gerontology dominated by idealised concepts of natural science as representative of ‘objective’ knowledge (Lynott and Lynott 2002, Ray 2008, Baars 2012). But drawing on the Frankfurt School, it emphasises political economy—in the UK indeed the approach is often termed the Political Economy School—exposing and critiquing the political and economic structures that shape the experience of age, largely in disadvantageous ways (Townsend 1986, Phillipson and Walker 1986, Estes and Binney 1989, Arber and Ginn 1991).There is thus significant overlap with cultural gerontology, particularly at the level of theorising, though less in subject matter, for the political economy of ageing that underpins critical gerontology remains rooted in economic and political structures, whereas cultural gerontology extends into areas of culture not addressed by this.Work in critical gerontology is also marked by its political commitment.We shall return below to the question of whether cultural gerontology implies any erosion of this. At a more concrete level the academic field has also been shaped by a series of international conferences that took place under the title of cultural gerontology in the 1990s and 2000s and that continue today. It is evidence of the vibrancy of the field that these conferences maintained themselves without any formal organisation, simply relying on the willingness of a new group of academics to take the next one on. The early conferences, held in Copenhagen, Berlin,Visby, Tampere and Milton Keynes (UK) had a Nordic and northern European character, reflecting the strength of social science in relation to age in those countries (Andersson 2002). Later conferences in Lleida and Maastricht brought stronger literary and performative emphases. The 2014 conference in Galway, which was the largest so far, adopted a broad approach that encompassed the arts and humanities, as well as the social sciences. It saw the conference become a constituent part of the European Network of Aging Studies. As yet there has not been a cultural gerontology conference in North America, though the conferences have always attracted strong representation from there.

Critiques Are there problems or limitations associated with the approach? First we should note a general set of intellectual problems associated with the wider cultural turn.These focus primarily on the radical epistemology that underlies poststructuralist theorising, though they extend also to the sense that the cultural turn threatens to dissolve everything into discourse, with a consequent loss of a sense of the social and its underlying reality (Rojek and Turner 2000). David Harvey (1990) was early in his critique of these tendencies from a Marxist perspective. Critics from this tradition attack what they see as the postmodern world of smoke and mirrors that hides the real bases of exploitation. It is also worth noting that the cultural turn has only occurred in some of the social sciences: disciplines such as economics, or to lesser degree psychology, have remained relatively indifferent. There are also, however, criticisms distinctive to the field of gerontology.We have noted how cultural gerontology is in part constituted around a specific set of assertions about the nature of society under conditions of late or postmodernity, in which cultural fields such as consumption and the media are accorded central significance. There are parallels here with the way in which academic fields such as cultural criminology have been constituted around the impact of media and consumption, in conjunction with the desire to decentre policy related analysis (Ferrell et al. 2015). But this focus on consumption and the media in the lives of older people can be questioned. It is one thing to point to the impact of such areas of life, another to establish their predominance in the lives of older people. Cultural gerontology can be criticised for exaggerating 6

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the impact of these, leading the field into an overly modish analysis that reflects aspects of wider popular culture but that neglects the major structural forces that continue to shape the lives of older people. In practice, as we shall see through the chapters of the book, structural issues remain prominent. Much work around consumption has suffered from theoretical weakness with regard to its theory of action, with its emphasis on voluntarism, and on an active, expressive, choosing subject motivated by concern with personal identity expressed through lifestyle (Warde 2005). As a result, cultural analyses of consumption have often been marked by a celebrationist tone in which consumption is uncritically identified with freedom and empowerment. In general cultural gerontology has avoided this trap; and work on consumption among older people has not adopted a celebrationist tone. Rather it has persistently emphasised the ambiguity of cultural formations, pointing to ways in which consumption both enlarges the expressive capabilities of older people’s lives and locks them into new disciplinary discourses. Older people, like everyone else, are caught in webs of cultural meanings, so that while they are able to express agency and resist dominant cultural norms, they are at the same time formed by them. Critics have accused the cultural turn of being theoretically incoherent, marked by intellectual eclecticism in which ideas are adopted uncritically. It is true that cultural gerontology has in general been characterised by an inclusive spirit, with a wish to encompass and embrace all approaches; and this can indeed hide what are real tensions and differences, particularly between the interpretive traditions of the humanities and the more empirically focussed social sciences. Not everyone agrees on what counts as evidence and analysis in this field. This leads to a third area of critique. This concerns the character of cultural gerontology as a Western-dominated and arguably post-imperialist form of analysis. It is certainly the case that most of the work that has been done under this label focusses on the West (Lamb 2015); and in the section that follows we will note the difficulties we encountered in locating relevant work in non-Western contexts. The focus on consumption reinforces this bias. To this degree cultural gerontology does reflect the particular social and cultural experiences of the affluent West.There is, of course, nothing wrong with exploring such preoccupations. Such a focus fits well with culturally based arguments exploring the culturally located and situated. But their character, as local, distinctive and partial, needs to be acknowledged if we are to avoid the distortions associated with the old sociology of modernity, with its homogenising account in which the current circumstances of the developed West were presented as a universal situation. Lastly, the turn to culture, with its emphasis on subjects such as appearance, consumption, and identity, can seem to present a de-politicised account that threatens to take us away from the nitty-gritty world of gerontology with its proper concerns with frailty, poverty and social exclusion. As we have noted, Marxist critics argue that an emphasis on discourse obscures the economic and social factors that materially shape the experiences and situations of old people. One of the gains of the Political Economy School in the UK and critical gerontology in the US has precisely been to expose the operation of such structural factors (Townsend 1986, Estes and Binney 1989, Arber and Ginn 1991). The lives of many older people contain suffering and constraint that is to a significant degree social and economic in origin, and this needs to be analysed and exposed. But the perception of a depoliticised account is, we suggest, a mistake. In reality, the cultural turn allows us to deepen our engagement with the politics of age. Increasingly we understand the nature of political struggle as extending beyond the familiar territory of access to economic goods or structural positions, expressed in the conventional field of party politics, towards a wider focus on the politics of everyday life. The wider shift towards identity politics in the late twentieth century showed how politics are potentially present in every context, involving the 7

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contestation of normalised identities and social relations in which one individual or group is subordinated to another, wherever these occur in the social field (Nash 2001). Such understandings that developed particularly in relation to new social movements apply also to age. The turn to culture allows us to understand and contextualise how such norms implicitly marginalise and render less visible the experience of age (Laws 1995, Laz 1998, 2003). Many of the most deeply felt assaults of ageism operate at the level of culture, as Gullette (1997, 2011), Woodward (1991, 1999), Bytheway (1995) and others have shown, through the pervasive culture of birthday cards, jokes, adverts, and fictional or media representations that teach people to fear ageing, to lose ­confidence and to retreat from cultural visibility. Here the body becomes a key site for the politics of age. As disability theorists have shown, some of the most profound forms of exclusion and assaults on self-worth are expressed at the level of the body (Morris 1992, Hughes 2000), and this is true also of age. To exclude these aspects is to miss a central part of the operation of ageism. This is not, of course, to deny the significance of more material or structural factors, or the need to engage politically with these.The turn to culture need not by its nature undermine structural understandings of power, inequality or oppression. Rather it adds new tools for their analysis.

Constructing the handbook In constructing this volume we have adopted three broad approaches. The first has been to identify key writers and studies in the field. This is reflected in chapters either written by such authors or reviewing their work. Those familiar with the field will recognise that we have indeed secured contributions from many such. As we have pursued our research, we have come into contact with new authors whose work is clearly central to how this territory is developing; and we would have been delighted to have included contributions from them. But a Handbook, in the nature of things, aims at a moving target. Future—and other—versions will be able to encompass even more work in this field. The second approach has been to identify key topics or dimensions of life that are of central importance in that broadening of understanding that has been consequent on the cultural turn. As we have noted, later years are now understood in fuller, richer and more plural ways: chapters on gardening, hair, travel, music, and sexuality illustrate this. Indeed, once you begin to look at the lives of older people through this lens, a myriad of potential subjects come into view. Even in the fifty-nine chapters that constitute this Handbook we could not hope to cover all these, nor in many cases would we be able to identify appropriate authors. This is a protean area, and much of the research remains to be done. Thirdly, we have attempted to reflect the range of new methods and analytic approaches that have entered the field as a consequence of the cultural turn. Many of these result from the different disciplines that now engage with the area. The arts and humanities in particular have brought new theorising, new analytic techniques—visual, linguistic, historical, literary—as well as wholly new topic areas, such as theatre, art, music, and film. In social sciences there has been a rediscovery of, or at least reemphasis on, qualitative approaches, such as ethnography, narrative, and visual methods. As a result ageing is now analysed in more plural and variable ways; and we have aimed to reflect this in the Handbook.

Future challenges and directions As we have seen, cultural gerontology is a vibrant and growing field that is presenting new challenges for academic analysis.The potential range of subjects that can be explored within this

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paradigm is broad, and new developments are emerging all the time. However, there are areas that need further elaboration. For example, cultural gerontology, with its focus on mediatisation, consumption and individuation, has its roots in the experience of younger old age. Indeed making this stage of life academically visible has been one of its principal contributions. However, cultural approaches can also be deployed in relation to frailer and more disabled groups, as the chapters in the Handbook on subjects such as the fourth age, care and suffering show (Lloyd 2015, Fine 2015, de Mederios 2015). These are fruitful developments, and their theories and methods could be translated further into exploring care homes and the oldest old as well as wider structural dimensions and organisations associated with paid work. Examples could include the everyday and cultural lifestyles of residents in care, the oldest old as well as elders who are far from affluent, many of whom live in poverty. As we noted earlier, one of the limitations of current work in the field has been its focus on the developed West, and within that on the experiences of relatively affluent and often ‘white’ elders. Among social divisions, gender has received relatively extensive analysis; indeed, work on gender has in many ways led the field. This has, however, left ‘race’ and ethnicity relatively poorly addressed. Future work needs to explore the interconnections of ageing, race and ethnicity, understood as within, between and of Western, non-Western and transnational countries. One potential barrier to the development of the field, however, is the pattern of funded research, which is heavily biased towards policy related subjects. This makes it harder to pursue work that aims to foreground the everyday lives of older people. Even where such lives are studied, they are often conceptualised through the prism of health and wellbeing, with cultural aspects of life, such as gardening, theatre and the arts, evaluated in relation to the extent that health and wellbeing are promoted. Lastly, the move towards public engagement opens up new possibilities for social scientists and arts and humanities scholars collaborating in interdisciplinary research, engaging public audiences through the media of digital technologies, theatre, the arts, and visual and sensory exhibitions.

Conclusion In this short introduction we have aimed to outline the main features of cultural gerontology, exploring where it has come from—what intellectual influences it has drawn on, what social and historical shifts it reflects. One of the great benefits of the approach has been the ways that it has linked age studies to wider academic concerns, particularly through its active engagement with theory, helping to reduce its intellectual isolation. The focus on the life course has also had the effect of integrating work on old age with earlier stages of life, helping to reduce the ways in which age is seen as different and isolated, undermining the processes whereby older people are homogenised, reduced to the single identity of ‘old’. We believe that cultural gerontology has much to contribute to the field of age studies: widening the social gerontological imaginary, bringing new and creative methodologies to bear on the understanding of all dimensions of the lives of people in mid to later life. We hope that this Handbook will act as a catalyst for further work in the field.

Acknowledgment This introduction draws in part on an earlier article in The Gerontologist (Twigg and Martin 2014).

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Section I

Theory and methods

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2 Theory and methods Introduction Julia Twigg and Wendy Martin

The handbook opens with two chapters from classic authors who have shaped our understandings of the field. Margaret Gullette, one of our foremost writers on age, pioneered work on later life within the humanities. A brave and persistent critic of ageism, in this chapter she has lost none of the passion that marked her earlier engagement with the ways we are ‘aged by culture’. Chris Gilleard and Paul Higgs are two key theorists of the field, whose Cultures of Ageing in 2000 was a landmark text. Here they explore the roots of the cultural turn in the wider developments of social theory. Their analysis foregrounds the themes of risk, contingency, individualisation and reflexivity in such theorising, as well as social and cultural changes related to the destandardisation of the life course, the rise of consumption and the emergence of life or identity politics. Most work within cultural gerontology—and indeed in the earlier tradition of social gerontology—is focussed on the developed West. However Sarah Lamb’s reflections on the contribution of anthropology remind us that this is not the whole story and that we need to think about the very different ways ageing is understood and experienced in other cultures. She uses perspectives from non-Western cultures to critique, or ‘queer’, the assumptions of the West around, for example, living independently, later years sexuality and its medicalisation through Viagra or interventions around the menopause, dementia and the meaning of personhood and different valuations of the transience of life. She notes how anthropologists are beginning to turn their theoretical and methodological lenses towards the West, a point developed more fully by Catherine Degnen in her chapter on ethnography, in which she explores a range of ethnographically informed work that has explored the lives of older people in the West. In line with the ethnographic tradition, these two authors emphasise the contexuality of meanings, a point reiterated by others in this volume. Cultural gerontology indeed seeks to identify and understand the specificities of cultural contexts, whether revealed in literature, historical analysis, art or ethnography. Antje Kampf brings a historical dimension to the analysis, exploring the ways in which historians, influenced by feminism and other theoretical developments in the social sciences, have brought into view the lives of groups previously hidden from history, such as older people. She engages with the complexity of sources and their interpretation, expanding on the distinctive problems and contributions that historians can make to the analysis of age. We then turn to a series of chapters—on literature, film, art and theatre—that focus on modes of representation, exploring how these both reflect the world and are active in shaping it. Sarah 19

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Falcus’s chapter on literature explores the way in which age has emerged both as a subject in current writing, and a critical perspective from which to view literature. She notes the way in which narrative analysis has formed a bridge between gerontological and literary studies, a point also taken up by Joanna Bornat in her account of biographical methods. Aagie Swinnen continues these themes in her account of film studies, noting the recent growth of work that engages with the experience of later years. In doing this, however, she flags up the importance of mastering the specific conceptual and technical vocabulary of film analysis. Her chapter also discusses the—gendered—dynamics created by the ageing of film actors. This is taken up more strongly in Ros Jenning’s chapter on popular music, where she looks at, among other things, late performance styles. She notes how popular music is being shaped by the ageing of a specific cohort, who gave birth to pop and rock, but who are now themselves ageing. This sense of a significant cohort is something that has also been explored in the work of Gilleard and Higgs. Michelle Meagher notes the relative absence of diverse representations of age within the classic canon of Western fine art, linking this to society’s deep resistance to dealing with this stage of life, but she points to the emergence recently of work that has begun to present the older figure as an aesthetic object worthy of representation in its own right. Most artists working in this area are women, reiterating the role of feminism and of women in the new cultural exploration of age. Some of these artists use their practice to show up and explore the impossible cultural demands imposed on older women by a youth-focussed visual culture, a point returned to in subsequent chapters in the section on embodiment. Miriam Bernard and Lucy Munro’s chapter addresses both the representation of older people in the theatre and their active involvement in performance; and indeed the idea of ageing as performative resonates through a number of chapters in the book. Bernard and Munro note the historical dominance of stereotypical images of old people in theatre, but they examine some of the ways in which older people are challenging this through active involvement in performance. Such interventions increasingly extend to people otherwise excluded from theatre, such as those with dementia; and the chapter discusses pioneering work in the use of theatre to enrich their lives. With Catherine Degnen’s chapter we turn more directly to questions of methodology, reminding ourselves of the importance of the specificity of context that ethnography so skilfully illuminates. Ethnographic methods are by their nature interactive, and Degnan notes the growing involvement of older people as co-researchers. In passing, however, she notes how age segregated Western society is, a point contrary to the assumption that is often made that age ordering in the West has declined.Wendy Martin explores the developments in visual methods in ageing research, with an increasing amount of visual research now focussing on embodiment, social identities and everyday life. Joanna Bornat’s chapter on biographical methods emphasises the importance of focussing on the individual older person and their life. Earlier work in age studies that did look at individuals tended to approach them through a generalised psychology of ageing, rather than reflexive and individual accounts of the self. Cultural gerontology, by contrast, with its emphasis on subjectivity and identity, foregrounds the perspectives of older people themselves, decentring dominant, often objectifying accounts. Oral history has a particularly significant role to play here, and Bornat notes the links between this approach and other forms of history that have also aimed to understand the lives of marginalised and oppressed groups.

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3 Aged by culture Margaret Morganroth Gullette

The most significant development in age studies during the last decade has been the emergence of the cultural dimension in the analysis of age and ageing. This is a promising portent of increasing resistance to ageism. At the same time—painful facts—the age beat is still barely visible in the positivist mainstream media or the youth-oriented universities, and the general public thinks that how one feels about ageing has nothing to do with ageism. Even the Dalai Lama, 77, from a tradition that venerates ageing, articulates the casual ageism of our fallen world. Gesturing to two American priests, he said, ‘These days, I have felt I am quite old. But with them, I am young’ (Powers 2012: B1). He used ‘young’ as everyone does—to mean a desirable state of being in opposition to the unwanted state of feeling ‘old’. Is there no escape? Biomedicine constructs us all as bodies-that-will-fail. Ecstatic announcements of ‘anti-ageing’ remedies are effective in increasing ageism, if not in producing cures. The ‘treatments’ proposed operate, if we can’t resist, because of their parasitic intimacy with the vast commerce in ageing: industries that thrive on our supposed sexual dysfunction (Big PhaRMA) and growing uglification (plastic surgeons, ‘beauty’ magazines). People who are vulnerable to the messages may become invested in options for useless somatic intervention. Age profiteering is buoyed by trends other than the cult of youth. Age is subject to history like any other body-based attributes. The forces that promote narratives of either decline or progress in later life are not in the same equilibrium, or rather imbalance, in 2000 as they were in 1900 or 1950. Now fantasies of the longevity bonanza proliferate alongside growing terrors of living too long and becoming a ‘burden’. This savage contradiction characterizes ‘the New Longevity’. Other distinctive elements of living in a heightened-risk society also distort intergenerational relations and later life: partisan laments at the ‘greying’ of nation-states, just as capitalism is failing to produce adequate numbers of jobs even for mature workers; the alarm over midlife memory loss in the Age of Alzheimer’s; and insidious proposals to defund old age, which circulate widely atop the grey data. Positive ageing, not to mention cultural gerontology and progressivism, pant in the rear behind the juggernaut. Just as sexism survives good news about women’s advances, ageism survives sunshiny news about ‘bonus years’ and liberal defences of old-age entitlements as due to elders who have paid into the safety nets and deserve them. Radically changing contexts give 21

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urgency to critics’ attempt to keep up with the powers playing the age cards. The task of age critics is often to show how age ‘knowledge’—publicly shared decline culture and the framing of policy debates–is constructed, in tandem, by all of the above. Understanding age means going interdisciplinary in unexpected ways, and steeling oneself for unearthing more bad news. In the United States (where the author of this chapter lives), ageism has been growing worse, becoming in some contexts (as we shall see) lethal. Ageism is most vicious toward the most vulnerable, those who grow past the long midlife into frail old age. But ageism inevitably has effects on younger people as well—on how they anticipate their own life course and judge the value of older people. Evidence has been mounting for decades that ageist attitudes and emotions are acquired in childhood, like sexism and racism, and harden in youth.

Our children learn ageism, like everyone else A baby learning to walk toddles on tippy-toe across the floor and falls; anyone present applauds. An ‘old man’ falls to the floor and onlookers hold their breath. Both participate in central cultural narratives of age and expectation. The next step for the baby is known: speaking, growing, learning. Progress. The baby stands up; her laughter when falling may become part of her legend. The old man collapses into another narrative. The next step, even if he rises making a rueful joke, appears to be a walker or a hospital. Decline. In both cases, onlookers ‘know’ the next step. It clicks into place mechanically. To put the cultural point briefly, life-course beliefs, behaviours and narratives depend on the age of the human object in question. The fall of the baby embodies progress, while the fall of the old man embodies expectations about his failing body. As I have explored in earlier books, Declining to Decline and Agewise, even a man who comes from a highly protected subculture knows the master narrative of decline (Gullette 1997, 2011). Sometimes people ageing-past-youth know this in excruciating detail. In Doris Lessing’s novel, Love, Again, a theatre director, age 65, sitting one night surrounded by younger actors suddenly ‘feels her age’ sexually and says to herself, harshly, that she, Sarah Dunham, is ‘in exactly the same situation as the innumerable people of the world who are ugly, deformed, or crippled. . . . [N]o matter how unfeeling or callous one is when young, everyone, but everyone, will learn what it is to be in a desert of deprivation’ (Lessing 1996: 141). Ageing is a lengthy process involving gains as well, but ‘ageing-as-decline’ may flare up suddenly—especially in fiction, which adores epiphanies—as a sudden loss of privilege. Decline, also an ableist and looksist discourse, invokes all the disabilities and losses linked to being no longer young. But does the ‘old man’ who fell—how old? how strong?—apply similar ideas to himself? As he falls, he may believe that osteoporosis is only a story about old women. Race, class, access to medical care, religion, also help decide what our man thinks, lying on the floor. He may not concur, but has no control over the banal narrative onlookers impose. In nothing do people differ more than in their ageing; in nothing are they more homogenized than by ageism. In all cultures, children are exposed early to accepted life-story formulations. Learning them is an important activity. These stories tell the meaning of time passing. My grand-daughter Vivi, at age six, has been told she can’t pierce her ears until she is ‘thirteen’. A miniature progress narrative, giving her another reason to look forward in the life course. At the same time, scholars report that by age eight, American children have ‘well defined negative notions’ about old age (Quadagno 2011: 13). In a Michigan study (Aday et al. 1996: 44), pupils with the most negative views answered, ‘Growing old makes me scared of being sick’ and, ‘When I grow old, I don’t want to be in an old folks’ home. I want to be independent’. Schoolchildren lard their sentence completions with images that include ‘scary’, ‘weird’, ‘lonely’, 22

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‘stingy’, ‘vulnerable’.Young children sit further from older adults than from younger ones (Isaacs and Bearison 1986). Might Vivi soon sit further from me? Learning is constructed through overlaps among ‘information’, behaviour, semantic events, and intergenerational patterns. New public-health advice to avoid obesity is effected by warning children about ageing-as-disease: heart disease, stroke, diabetes. Parents who act to ‘minimize their own risk of ever needing health care that would be available only at market prices’ (Kunow 2010: 303) might also reinforce their children’s fears of ‘ageing’. So might adults joking about ‘old-timer’s disease’ and comic TV skits about ‘cougars’ hunting younger men. Humour is the last refuge of hate speech. Is it a surprise that increased ‘knowledge’ of the ageing process doesn’t necessarily improve participants’ attitudes toward older adults, even, disappointingly, after the gerontologists intervene? The researchers add, wearily, ‘this finding is not new’ (Cottle and Glover 2007: 511). Many children placidly expect to be old and nice when they become grandparents. But some turn into young adults who write ugly stuff on the Internet. Speaking as if for his youth cohort, one student writes on Hatebook.com, ‘God forbid these miserable once-were-people not [sic] survive as long as possible to burden the rest of us’ (Stripling 2011). Ageism can be more vicious than racism or sexism because it has no righteously belligerent community vocally resenting it. When the economy crashed in 2008, and American media and the Republican party scandalously described old people as ‘burdens’, a teacher—not coincidentally—set a debate topic for students: ‘Why are old people a burden not only to the family but also society?’ (Yahoo Answers 2008. Many people on the Yahoo Website, however, defended old people). Leni Marshall (2008–9: 56), an English professor and feminist gerontologist, observes, ‘Most students arrive at college with a set of stereotypes about ageing firmly but unconsciously embedded’. Many students reject ageist hate speech but are unable to formulate good arguments against it. Since students may learn ageism from their syllabi, discussing ageism in all classes—including in classics and vampire fiction—is another useful exercise. Starting in childhood, as age narratives accumulate in our minds (those miscellaneous repositories), we are being aged by culture. Age curricula, mediated and interpreted through everyone’s unique bodily experience, change over any lifetime. National crises force changes, absorbed in bits as we feel interpellated by them, lifelong. How narratives, language, images, institutions, and systems function to ‘re-place’ us in the life course as we think we merely ‘age’—these issues drive the age beat. In the next sections, I follow the money, critical currency, into middle and later life.

Middle-ageism in the workforce The crisis in employment can now start at 40. I invented the term ‘middle-ageism’ to focus on it, but ‘older worker’—which is misleading—is used by economists. The years from 45 to 54 are supposed to be the highest earning, at least for the middle class. The family life course is most expensive then—particularly with young-adult children staying home or boomeranging and older parents suffering longer with chronic illnesses. Women ageing-into-midlife in recent decades began to benefit from this rising age-wave curve. But the arc of the American Dream is being eroded, with enormous consequences for individuals and for our vision of the life course. Up in the Air, the 2009 movie about a midlife man whose job is to fire others, starts by interviewing real people who had just been canned. The response of one middle-aged African-American woman ‘to her horrifically impersonal firing’, a critic writes, ‘is to quietly claim, with her eyes trained directly on the [camera], that she will jump off a bridge’ if she can’t find work. She followed through (Koresky 2009). Suicide goes up, as do heart attacks, among the unemployed. At midlife, they may rightly despair, because the consequences are dire. 23

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Workers in prime age fall out of work—3.5 million of them in the US between the ages of 45 and 64 in 2012 (Casselman 2012). The jobless rates for men and women older than 55 are the highest they have been since the Great Depression (Cauchon 2009). In an ageist society, if you lose a job at midlife, you will be unemployed for far longer than a younger person—months longer than your own adult child. The average job search for a young woman aged 25 to 34 was 9 months in 2011, while that of a woman 45 to 54 was two and a half months longer (BLS 2011). The situation for people 45 to 54 has worsened since 2000, when only 16 per cent were unemployed for over 6 months. In 2011 it was half (EPI 2012). If you are under 40, you have a 40 per cent higher likelihood of being interviewed than if over 40, Sara Rix of the American Association of Retired People reported at the Gerontological Society of America meeting in 2011. The average duration of unemployment rises every decade over the working life course.

Not old, but too old Midlife unemployment destroys because there are fewer ways back up. Those lucky enough to find jobs again typically lose status, pay and benefits. Their jobs may be temporary; they may be underwater with debt. A Rutgers study estimates that of the millions of American workers who have lost jobs since 2008, 28 per cent are between the ages of 45 and 59. Almost half of these prime age workers had not recovered fully by 2011—that is, had not found new, well-paying jobs and regained their standard of living. A large proportion of this age group have been ‘devastated’—selling possessions, eating less, borrowing from family or friends, feeling humiliated (Zukin et al. 2011). Of men aged 55–61, only 7 per cent are underemployed; for same-age women the percentage is almost three times higher (OWL 2012: 6). People being cut out of employability are in their prime in terms of skills and experience. At the lower quintiles, they lose their chance to save. ‘Whites experience more rapid rates of wealth accumulation than their minority counterparts during middle and later life, resulting in accelerating wealth disparities with age’, especially for women of colour (Brown and Warner 2008, iii–iv). As of 2010, more than half of households will not have enough retirement income to maintain their pre-retirement standard of living (Kleyman 2012). Midlife discrimination, although too often accepted as rational (employers save money), is illegal. Over 40, Americans are supposed to be protected by the Equal Employment Opportunity Commission. In one typical suit that went to the EEOC, an employer said to his underlings, ‘We need young blood’.The assumption is that midlifers are not tech-savvy or as quick to learn. If we misplace our car keys, employers may expect us to declare with a grin, ‘old-timer’s disease’. If employers don’t dump midlifers, they often pay us less. The percentage of complaints based on age has been increasing steadily, from less than 20 per cent in 1997 to 25 per cent in 2008—one in four (EEOC 2011). Women sue 10 years younger than men, in their mid-40s. Plaintiffs rarely win. OWL says only 1 per cent do. The loss of jobs is not just an effect of the Endless Recession. It is a long-term fact of an economy failing to overcome middle-ageism. Eliminating midlife workers has become a tacit business practice and a disastrous capitalist trend. As the people long called ‘the ageing Boomers’ matured, they increasingly slammed into offshoring, weakened unions, loss of jobs in manufacturing and later in white-collar work, layoffs, ‘early retirement’ and pension defaults instituted by globalizing and privatizing capitalism. The jobs are gone. Andrew Sum, professor of economics at Northeastern University, estimates that in 2012 there were six people seeking full-time work for every one opening (personal communication). Experienced people willing to work hard become another excess labour pool. 24

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Some elites, to borrow from Emerson, ‘would not so much as part from their ice cream’ to save others from poverty and humiliation (Emerson 1929). But even those who profit from the race to the bottom should regret this waste of the nation’s human resources, the lost purchasing power and the tax revenues lost to poverty. Societies underestimate the historic implications of degrading the midlife. As ‘boomers’ lose work, the midlife age class as a whole loses status, dismissed as future unproductive and expensive seniors. The gravest effect on our vision of the life course comes from destroying the underlying principle of seniority: that people deserve more respect and rising wages—not automatic deflations—as they grow older. Without seniority as a set of practices and values taken for granted, ageing-beyond-youth becomes a hopeless decline. ‘Progress’ becomes a hollow phrase. Middle-ageism is indeed changing what it means to be human. This tragic side of the greying of America should appal the young, because if not stopped it is their future too. And as middle-ageism becomes harder to stymie, lethal ageism becomes harder to resist.

Ageism in the duty-to-die discourse Mainstream discussions about America’s economic woes often get twisted into polemics against the old. Both ‘ageing Boomers’ and senior citizens who vote are represented as powerful and therefore responsible—even for downward mobility and the deficit. Ignoble motives are ascribed to them: they selfishly burden ‘our’ children. The consequent point-of-view of the ageist deficit hawks is that old people, costing too much while staying alive on Social Security, will soon cost too much trying to postpone death on Medicare. They should go cheaply by refusing medical treatment. A bioethicist, Daniel [hope I would off myself when my time comes] Callahan gained notoriety for this argument in a book sternly titled Setting Limits, although he later accepted a life-saving operation at age 80. This duty-to-die campaign has moved out of bioethics where it was contested (by philosophers such as Christine Overall in Ageing, Death and Human Longevity, 2005), and into major outlets where it can influence multitudes and be supported as the least bad final solution for Medicare’s costs. In Time, for example, Joe Klein (2012) begrudges his mother her heart surgery at 80: she lived another 10 years, but the surgery cost—he tells us—$100,000. The Atlantic Monthly gave Sandra Tsing Loh (2012) space to explain ‘Why Caring for My Ageing Father Has Me Wishing He Would Die’. Writers pity the young, in articles such as ‘Are Millennials the Screwed Generation?’, or attack Boomers as ‘The Entitled Generation’. Some exacerbate generational warfare, arguing that older people in need of life-saving measures should be permitted to die in favour of younger people. Peter Singer (2009), a well known philosopher, argues grotesquely on the basis of chronological age that the death of a teenager is ‘a greater tragedy than the death of an 85-year-old [. . .] If a teenager can be expected to live another 70 years, saving her life counts as a gain of 70 life-years, whereas [. . .] saving the 85-year-old will count as a gain of only 5 life-years’. His 1:14 ratio of value is deadly. Expensive care is often called ‘heroic’ ‘over-treatment’ when old people are the recipients, by those who forget that ‘under-treatment’ means medical neglect or disregard of patients’ wishes. Seventy per cent of patients and their families would undergo radical operations requiring Intensive Care Unit treatment again, to achieve as little as 1 month’s survival (Gillick 2001: 247 n1). Yet rationing care by age—and gender—appears common. Of 400 oncologists surveyed, 93 per cent were likely to recommend intensive therapy for a woman with stage IIA breast cancer if she were only 63, but only 66 per cent would do so if the patient was identical but 75 (Foster 2010). Another study (Woodard 2003) found the odds of not receiving chemotherapy 25

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were seven times greater for women over 65 than for women under 50. One meta-review (Dale 2003: 11) noted ‘decreasing diagnostic zeal’ toward older cancer patients and concluded that bias may be ‘a primary reason for their having poorer outcomes’ than younger patients. Articles complaining about over-treatment usually fail to consider under-treatment a genuine problem. An article supporting doctors who ratchet back ‘avoidable’ care ends, one critic joked, ‘by a quick hand-wave at healthcare rationing, just in case you were getting concerned. “This is not, I repeat not, rationing”, said Dr Steven Weinberger of the American College of Physicians. This affords us Preview of the Future #2: Rationing will occur, but few if any will admit it’ (Brownlie 2010). You might think that dying is tough enough without putting pressure on people to do it cheaply, prematurely, and against their wishes. Cost is in many ways a red herring (Garson and Engelhard 2009). Of the 4,600 Medicare beneficiaries who die every day, most incur low costs. Only a small percentage incur high costs, and most are in fact men between 65 and 74, with cancer. Doctors apparently believe in ‘heroic’ measures to save them. As age at death increased, cancer deaths and Medicare per capita outlays fell. Most over 85 were women (Hogan 2001). Women’s ‘survival advantage’ means many are poorer, more likely to be alone, and living longer with chronic conditions. If people refuse life-sustaining interventions at any age, they may require care of a different kind. Funding Hospice adequately may not be cheaper. Will Congress decide those younger men shouldn’t get the ‘aggressive’ care they want, or that older women should not receive whatever care they need? It makes ethical sense for everyone concerned to give people more options, respect their choice if they want treatment, manage their pain and avoid posthumous regrets, paying whatever it takes. Perhaps if you have not helped care for someone who is living with dying, you should stay quiet on this subject. ‘Age ideology’ now includes the duty-to-die. A Nobel Prize-winning economist, Paul Krugman (2012), summarized the 2012 Republican presidential campaign goals: ‘a literal description of [the Romney-Ryan] plan is that they want to expose many Americans to financial insecurity, and let some of them die, so that a handful of already wealthy people can have a higher after-tax income. It’s not a pretty picture’. Heidi Hartmann and Martha Burk (2012: 24) explain, ‘The right wing is enjoying the fruits of 30-plus years of work to change the dominant ideology from one of shared responsibility and sacrifice to a “winner take all” society, where social supports are minimal to nonexistent’. The campaigns waged by this ideology are well-funded; their will relentless. The excess suffering that results from indifference, malice, ignorance, or disregard for social justice is the tragic part of the age crises. Each of my foci (ageism in children, middle-ageism in work-life, scapegoating Boomers and old people, and accelerating our deaths) compels our mission.

Conclusion The great demographic irony is that the sheer numbers of the adversely-affected grow, but without enabling us to organize a countervailing collective. Many people understand that sexism and racism are constructs, but age lags. Journalists are puzzlingly wedded to a fantasy in which passive ‘Boomers’ bring about enormous changes at the last minute, a ‘tsunami’ rolling richly into old age. Such phony ascriptions endorse helplessness. A young friend writes that she fears ageing. When I say, ‘Fear ageism, not ageing’, she retorts, ‘Ageism! Yes. That’s why I fear ageing!’ A new impasse is foretold, in which we become agewise but remain impotent. In the world that most people inhabit (dominated by capitalism, positivism, and ‘anti-ageing’), realizing that we are aged by our culture is still the mental step that is hardest to take.

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But suppose more people take it. Ageism-consciousness has immediate goals as well as a long-term vision of deep educational reform and public resistance to decline. The jobs crisis may force government into creative ways to provide more jobs and economic security to midlife as well as younger people. As political anger grows at those who poison age culture, more parents and teachers will refuse to let children grow up ageist. The life course, insofar as it is socially constructed, should be something that the youngest can look forward to with anticipation, that all can relish through the long midlife and frail age, and that we can look back on with some satisfaction when dying.

Acknowledgement Some of the research for this essay was provided by my Brandeis intern, Katey Duchin.

References Aday, R. H. et al. (1996) ‘Changing Children’s Perceptions of the Elderly’, Gerontology and Geriatric Education, 16(3), pp. 37–51. BLS (United States Department of Labor, Bureau of Labor Statistics) (2011) ‘Labor Force Statistics 31, 2011.’ Available online at www.bls.gov/cps/cpsaat31.htm. Brown, T. H. and D. F. Warner (2008) ‘Divergent Pathways?’ Journal of Gerontology: Social Sciences, 63(3), pp. S122–34. Brownlie, T. (2010) ‘The Overtreatment-Undertreatment Debate Rises Again’, Med_Policy, June 7. Callahan, D. (2008) ‘How Old Is Too Old for Lifesaving Surgery?’ New York Times, November 13. Casselman, B. (2012) ‘For Middle-Aged Job Seekers, a Long Road Back’, Wall Street Journal, June 22. Cauchon, D. (2009) ‘Older White Males Hurt More by This Recession’, USA Today, July 30. Cottle, N. R. and R. J. Glover (2007) ‘Combating Ageism: Change in Student Knowledge and Attitudes Regarding Ageing’, Educational Gerontology, 33, pp. 501–12. DOI: 10.1080/03601270701328318 Dale, D.C. (2003) ‘Poor Prognosis in Elderly Patients with Cancer’, Journal of Supportive Oncology, 1, Supplement 2 (November/December), pp. 11–17. EEOC (United States Equal Employment Opportunity Commission) (2011) ‘Charge Statistics, 1997–2011’. Washington, DC.Available online at http://eeoc.gov/eeoc/statistics/enforcement/charges.cfm (accessed December 2012). EPI (Economic Policy Institute) (2012) ‘Long-term Unemployment’, The State of Working America, May 15. Available online at http://stateofworkingamerica.org/chart/swa-jobs-table-5–7-long-termunemployment/. Emerson, R. W. (1929) ‘Address’, Representative Men and Miscellanies (pp. 99–147), Boston: Houghton Mifflin. Foster, J. A. et al. (2010) ‘How Does Older Age Influence Oncologists’ Cancer Management?’ Oncologist 15(6) (May 23), pp. 584–92. Garson, A., Jr. and C. L. Engelhard (2009) ‘The Economics of Dying: Myth’, Governing, March 31. Available online at www.governing.com/topics/health-human-services/The-Economics-of-Dying.html (accessed September 10, 2012). Gillick, M. (2001) Lifelines. New York: W. W. Norton. Gullette, M. M. (1997) Declining to Decline: Cultural Combat and the Politics of the Midlife, Charlottesville: University of V   irginia Press. Gullette, M. M. (2011, 2013) Agewise: Fighting the New Ageism in America, Chicago: University of Chicago Press. Hartmann, H. and M. Burk (2012) ‘The Shape of Equality’. New York: Rosa Luxemburg Foundation, October. Available online at http://files.meetup.com/1580690/Hartmann%20%26%20Burk-women’s%20 movement.pdf. Hogan, C. et al. (2001) ‘Medicare Beneficiaries’ Costs of Care in the Last Year of Life’, Health Affairs, 20(4) ( July), pp. 188–95. Accessed September 10, 2012 Isaacs, L. W. and D. J. Bearison (1986) ‘The Development of Children’s Prejudice against the Aged’, The International Journal of Ageing and Human Development, 23(3), pp. 175–94.

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Klein, Joe (2012) ‘How To Die’, Time, May 31. Kleyman, P. (2012) ‘Elders’ Advocates Worry Politics May Push Vital Programs off “Fiscal Cliff ” ’, New America Media, November 12. Koresky, Michael (2009) ‘Down with the People’, Reverse Shot. Available online at www.reverseshot.com/ article/air. Krugman, P. (2012) ‘Death by Ideology’, New York Times, October 14. Kunow, R. (2010) ‘Old Age and Globalization’ in T. R. Cole et al., A Guide to Humanistic Studies in Ageing: What Does it Mean to Grow Old? (pp. 293–318). Baltimore: Johns Hopkins University Press. Lessing, D. (1996) Love, Again: A Novel. New York: HarperCollins. Loh, S. T. (2012) ‘Daddy Issues’, Atlantic Monthly, March. Marshall, L. (2008–9) ‘Teaching Ripening’, Transformations: The Journal of Inclusive Scholarship and Pedagogy, 19(2) (Fall/Winter): pp. 55–80. Overall, C. (2005) Ageing, Death and Human Longevity (new edn). University of California Press. OWL (2012) Mother’s Day Report. Available online at www.owl-national.org. Powers, M. (2012) ‘Spiritual Bonding’, Boston Globe, October 15, p. B1. Quadagno, Jill (2011) Ageing and the Life Course: An Introduction to Social Gerontology (fifth edn). New York: McGraw Hill. Singer, P. (2009) ‘Why We Must Ration Health Care’, New York Times, July 15. Stripling, A. et al. (2011) ‘College Students’ Perceptions of and Responses to Internet Ageism’, poster presented at Gerontological Society of America meeting, November 19. Woodard S. et al. (2003) ‘Older Women with Breast Carcinoma . . . Evidence of Possible Age Bias?’ Cancer 98(6) (September 15). pp. 1141–9. Yahoo! Answers (2008) http://answers.yahoo.com/question/index?qid=20080419195953AAmHhvM (accessed October 23, 2012). Zukin, Cliff et al. (2011) ‘Categorizing the Unemployed’,The John J. Hendrich Center, Rutgers University (December).

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4 The cultural turn in gerontology Chris Gilleard and Paul Higgs

The aim of this chapter is to set cultural gerontology within the context of the broader ‘cultural turn’ in the social sciences. Although there were earlier precursors who wrote about the importance of cultural processes for the study of social signification and distinction, such as Clifford Geertz, Michel Foucault and Pierre Bourdieu, the cultural turn became more evident during the 1990s with the growing interest in the ideas of post-structuralism and post-modernism as sociological rather than aesthetic or literary phenomena.The work of Zygmunt Bauman, Ulrich Beck and Anthony Giddens became leading theoretical reference points for European sociology during this period (Outhwaite 2009). Their writings exemplified a new approach focusing on themes of contingency, individualization and reflexivity in social analysis. Despite areas of difference, these writers agreed that a fundamental change was taking place in the organization of modern society, a change that undermined the certainties of the modern nation-state. The outcomes generated by this change were to be found in increasing fluidity, indeterminacy and reflexivity in the formation and exercise of social identities and individual lifestyles. Identity became an important issue, but significantly it could no longer be seen to map unproblematically onto the distinct socio-economic categories established in the previous phase of modernity. All that once had seemed solid about the institutions of modernity was now in flux. Although each of the above sociologists emphasized different aspects and different vectors of what could be described as ‘post-modern’ change, they broadly agreed on presaging it on: (a) the transformation of national economies from a basis on industrial capital and mass production to a basis on mass consumption; (b) cultural and economic globalization; (c) the disembedding influences of the market and the media; and (d) new social movements. The latter, particularly, stimulated new academic disciplines subsumed under the rubric of ‘cultural studies’. In contrast to the emphasis on social class, deviance and status in the mainstream social sciences, cultural studies drew attention to the ‘covert’ positionalities and subjectivities of variously gendered, racialized, sexualized and disabled bodies. Socially, culturally and academically, greater attention was paid to the body as a source of identity and expression of lifestyle. These embodied identities were viewed through the critical prisms of power and performativity. Rather than accepting as ‘natural’ the corporeal binaries of gender, race, sexuality and able-bodiedness, the contingency and fluidity of ‘embodied’ signification was explored through gender and women’s studies, studies of race and ethnicity, of sex and sexuality and through disability studies. While 29

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initially focusing on youthful bodies, these new fields of academic inquiry began to impact on the study of age and ageing (Gilleard and Higgs 2013). Such ‘thinking through the body’ has caused similar questions to be raised about age and ageing as were asked about sex and gender, ethnicity and race, impairment and disability. The hegemony of the ‘youth versus age’ paradigm that previously dominated gerontological thinking in the twentieth century is beginning to be challenged as the social identity of old age fragments. Perhaps the first impetus for re-examining ageing ‘through the body’ was provided by women’s studies. A number of feminist gerontologists began to argue that it was no longer satisfactory to speak about ageing as if it were a reified phenomenon unrelated to particular individual bodies embodying particular identities. Such questioning first began in articles published in the 1970s and 1980s (Sontag 1972, Olson 1988), but turning a thoroughly gendered lens on ageing was primarily a phenomenon of the 1990s (Venn, Davidson and Arber 2011: 72–3). This was most strongly highlighted when, in 1993, a special issue of the Journal of Aging Studies was published devoted to the new ‘feminist’ gerontology. In reviewing what was being realized in this issue, Beth Hess made clear that the papers assembled enabled gender at last to be treated as a phenomenon of ‘the social relations of age’ and not simply the product of individual differences in ageing (Hess 1993: 196). Coming from outside the sphere of ageing studies, cultural sociologists such as Mike Featherstone and Mike Hepworth were also beginning to extend their interest in the body and consumer society to the concerns of those with ageing bodies (Featherstone and Hepworth 1991). Remarkably, this chapter appeared in one of the first edited collections on the sociology of the body (Featherstone, Hepworth and Turner 1991), something that many subsequent collections in this growing subfield have failed to pursue. Both perspectives have helped re-direct the study of age and ageing toward the adoption of a more explicitly cultural approach, while at the same time drawing attention to age’s embodied nature. The cultural sociology of consumerism and the sociology of gender have independently helped to open the door to other ways of examining age and ageing beyond the chronological traditions of gerontology. Subsequently, not only gender but race, ethnicity, sexuality and disability have been used to re-examine previously unquestioned assumptions about ageing and later life. Age is now being seen through the lens of ‘inter-sectionality’, the cross-disciplinary arena that sees social phenomena through the lenses of the multiple identities and positions that destabilize and render contingent dominant interpretations of later life. In a similar fashion, cultural sociology has encouraged the positioning of older people not as happy or unhappy, healthy or unhealthy, fit or frail individuals but as agentic, contradictory and potentially desiring subjects who are both implicated in and contributors to contemporary culture and the individualized, consumerist ‘project of the self ’ (Giddens 1991). These perspectives have encouraged social science researchers to go out and explore changing patterns of consumption, time use and leisure activities as well as investigate ‘body work’, ‘self-care’ and other lifestyle practices in later life.

Consumption, culture and the politics of post-modernity Instead of the word ‘post-modernity’, sociologists such as Bauman, Beck and Giddens chose other terms, such as ‘post-traditional or reflexive modernity’ (Giddens 1991), ‘liquid modernity’ (Bauman 2000: 2005), ‘second’ modernity or even ‘after’ modernity (Beck 1999, Beck and Grande 2010), to describe the social, economic and cultural arrangements of present-day society. Despite the differing nomenclature, they have each contributed to the creation of a language in which the changed nature of society could be discussed. Beck wrote about a first (classical, industrial) modernity and a second (reflexive, post-industrial) modernity. The latter he delineated through the five inter-linked processes of globalization, individualization, gender 30

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revolution, underemployment and global risk (Beck 1999: 2). The simultaneous operation of these five processes has undermined the solid structures of the modern world of the nation-state. While much of Beck’s work around the idea of ‘risk society’ was concerned with institutionalization of ‘individualization’ within specific societies (Beck and Beck-Gernsheim 2001), he also paid attention to the effects of globalization and the limitations of the nation-state. ‘Globality’, as he termed it, represents the expansion and ever greater density of international trade, the revolution in information and communications technology, universal demands for human rights, and a post-national polycentric world politics ‘where transcultural conflicts are enacted in one and the same place’ (Beck 2000: 11–12). The nation-state and the institutions through which it operates no longer have the dominating influence they had during the late nineteenth and early twentieth centuries (Beck and Lau 2005). For Bauman, much as Beck’s second modernity had replaced first modernity, a new ‘liquid’ modernity had replaced the older ‘solid’ modernity. Like Beck, he viewed this new liquid form as an ‘individualized, privatized version of modernity’ where ‘the burden of pattern weaving and the responsibility for failure fall[s] primarily on the individual’s shoulders’ (Bauman 2000: 8). The transformation of solid into liquid modernity is also seen by Bauman as a consequence of the impact of individualization, as well as resulting from changes in the ordering of time and space, along with the replacement of stable with fluid communities, changes to the nature of work and the shift from building future structures to the playing of games (Bauman 2000: 138). Equally, an emphasis on ‘emancipation’, which he describes as ‘the need for self-determination’, has played a role in transforming social reality. In a later work, he summarized this transformation as a shift from a society of producers to a society of consumers. In liquid modernity, he argues, the ‘consumerist syndrome’ determines ‘virtually all the parts of the social setting and of the actions they evoke’ (Bauman 2005: 83). For Giddens, who was writing before either Beck or Bauman had fully formulated their approaches, the transition is less about consumerism and more about a shift toward a new ‘life politics’ at the centre of which lies ‘the reflexive project of the self ’ (Giddens 1991: 237). In life politics, social conflicts are as much over meanings as they are over resources—particularly the struggle to free oneself from the oppressiveness of ascribed identities and assigned communities. But, as Giddens noted, such struggles are fraught with conflicts. They risk diverting attention, and concern, away from those without the material resources to realize their ‘self-project’ to those with the means to do so, while increasing opportunities for the market to commodify individuals’ life choices and lifestyles (Giddens 1991: 196–200). Giddens particularly addressed the shift in the ‘referentiality’ of the lifespan, which he viewed as an important consequence of the ‘disembedding’ of tradition. He concluded that as a consequence ‘the lifespan becomes more and more freed from externalities associated with pre-established ties to other individuals and groups’ and that, ‘lacking the external referents supplied by others, the lifespan again emerges as a trajectory which relates above all to the individual’s projects and plans’ (Giddens 1991: 147). Specifically discussing later life, Giddens sees that ‘old age at 65 is a creation, pure and simple, of the welfare state’, whereby ‘ageing is treated as “external,” as something that happens to one not as a phenomenon actively constructed and negotiated’ (Giddens 1994: 170). Instead, he suggests, there is a need for ‘a politics of second chances’ that offers opportunities for rethinking and repositioning later life (Giddens 1994: 172). Three themes unite these three theorists. Each saw the transition or change in the nature of modernity less as a purely structural one and more as one over-determined by culture, and with this went the superseding of production-based collective approaches by individualized consumer ‘mentalities’. Previous habits and collective traditions framed by the institutions of the workplace and the state were transformed by the profusion of choice provided by the market operating 31

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alongside an increasing reflexivity that celebrated individual choice and the exercise of personal agency. All three implicated the power of globalization in facilitating this change, through both the expansion of the global market for goods and services and the limiting of the discretionary powers of the nation-state. For these canonical theorists there has been an acceptance that the nation-state could no longer serve as the principal determining influence organizing individual life courses. In various ways their work combines to argue for the institutionalization of individualization, the necessity for continual reflexivity and the ever present valorization of choice, with all the intended and unintended consequences that such ‘emancipation’ might bring throughout the life course.

Liquid ageing: the destandardization of the life course If, as Giddens has suggested, new opportunities—second chances—are being realized to age differently in second modernity, what might the main influences on this ‘destandardization’ of later life be? Drawing on the theoretical writings of Bauman, Beck and Giddens, we have previously postulated that these ‘opportunities’ have arisen through several inter-related ‘vectors’ of change that have characterized post-war Western society. Foremost among these has been the expansion of mass consumerism, alongside the rise of new social movements associated with the cultural ferment of the 1960s, the changing social geography of life and the changing nature of work and retirement (Gilleard and Higgs 2005, 2011a). A mass consumer society emerged in a number of Western countries during the decades after the Second World War.Those initially most affected by and most involved in the expanding markets for consumerist goods and services were younger adults, but as these young adults grew older they remained major consumers (Higgs et al. 2009). Not only did the numbers and ages of consumers grow, but so too did the arenas in which consumerism was realizable. Fashion for all ages jostled with cosmetics and cosmetic surgery for all ages (Twigg 2013). The disposable income of people over 60 has grown at a rate either matching or, more often, exceeding that of people of ‘working age’ since the 1980s (Wolf, Zacharias and Masterson 2012). Despite the financial crisis of the early twenty-first century, the proportions of pensioners in the UK in each of the five income quintiles is now broadly similar to that of the general population (Department of Work and Pensions 2013). Similar changes can be found across most Western societies, evincing the novelty that ‘older persons constitute an increasing consumer group with [. . .] sig nificant aggregate purchasing power’ (UNECE 2009: 1). Young adults were imbricated in the cultural transformation of the post-war era as much through the new social movements that emerged in or shortly after the 1960s as through their rising discretionary income. United under the slogan that the ‘personal was political’, the women’s liberation, the black civil rights and the gay liberation movements asserted the voices of groups of people who previously had suffered varying degrees of cultural, economic and social marginalization within ‘modern’ societies that had traditionally valorized the position of the white, male, middle aged, heterosexual breadwinner. Equality of access to the main institutions of society—of the state, the workplace and the market—was legislated to enable increasing degrees of inclusion for people embodied by ‘difference’. In a similar fashion to participation in consumer culture, although these ‘life politics’ affected younger adults first, the subsequent ageing of these youth sub-cultures saw issues of identity and lifestyle extend across the life course into mid- and later life (Gilleard and Higgs 2011b, Hodkinson 2013). Changing social geographies have also contributed to changing the place of age in society. The communities of place built up during the course of what Beck has termed ‘first modernity’ have given way to the new communities of identity and interest (Gilleard and Higgs 32

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2005). Social communication relies less on ‘the propinquity of neighbourhoods’ and more on access to information and communication technology (ICT). The ‘network’ society described so extensively by Castells (1996) has removed the dependency of social interaction on physical proximity. It has established new patterns of inter-relatedness that obfuscate time and place and in so doing break down some of the ‘rhythmicity’ of life and the life course. As Castells (1996: 446) noted, ‘[w]hile old age was once considered a homogenous last stage of life [. . .] dominated by “social death” it is now a highly diverse universe’ fostered by the development of the new network society. Several developments illustrate this trend. First is the growth in ‘senior citizen’ tourism, in retiree seasonal migration and in transnational home ownership and home rentals, particularly by late life couples. Second is the growth in older people’s use of mobile (cell) phones, of the Internet and of Internet-enabled telecommunications (such as Skype) and social media. Third is the growth among the older population in participation in various interest-based ‘outdoor’ pursuits ranging from sporting activities (such as the rise of master athletes) to cultural events (such as the growth of ‘retro-concerts’ and ‘book clubs’ or ‘reading groups’) to educational activities (such as universities of the Third Age). There are no doubt many more examples—facilitated by greater disposable incomes, by developments in domestic ICT and by active state policies directed toward improving access (such as subsidizing the costs of travel for senior citizens). While it is true that those at both ends of the life cycle remain more dependent on the resources of their neighbourhood than those in the middle, network society’s potential for freeing individuals from the limits of ‘communities of propinquity’ increasingly impacts on all stages and ages in the ‘post-modern’ life course. Finally there is work. If the life course of first modernity was based on the standardized working life of a white heterosexually partnered male employed in industrial labour, in second modernity no such singular model can prevail. The middle class white collar worker may be an aspirational figure but his pervasiveness is as much under threat as was the fate of the previously ubiquitous blue collar post-holder. Gender divisions have been reduced while sexual identities have become diversified. Working lives have shrunk (at both ends) and overt racialized segregation has diminished as the nature of the place of work has been transformed. The result is a mixture of individual emancipatory gains and collective social losses. In the United States, the corporate (or work-based) welfare system is fast becoming a memory, alongside some selective forgetting of its exclusionary practices. Work-based collective pension schemes are declining, particularly in the ‘Anglo-Saxon’ economies. Even within the welfare states of continental Europe a guaranteed job and a guaranteed retirement age and income are under considerable threat. The ‘three pillar’ pension model espoused by the World Bank, comprising a poverty-prevention state pension, an income-stabilizing occupational pension and an additional flexible income return from a private pension, seems increasingly unachievable for the majority of workers, with ‘[p]ension reforms in many countries [. . .] result[ing] in more choice and risk to individuals’ (Gough and Niza 2011: 97). The future of retirement is less certain as the outcome of pension reforms grows steadily more opaque (Grech 2013). Despite the growing uncertainties surrounding the source and amount of income in later life, the risk of becoming impoverished in later life has been attenuated. Declining rates of poverty in later life, evident since the 1980s, show no sign of being reversed in the twenty-first century (Figari, Matsaganis and Sutherland 2011, Grech 2013, Zaidi 2009, 2010). As the division between working and non-working life again begins to blur and as individuals are increasingly expected to shoulder the responsibility for ensuring an adequate income throughout their entire adult lives, the reading off of retirement from previous occupation becomes ever more contingent and open to alternative meanings. In short, class framed in terms of labour market position 33

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seems to matter less in understanding contemporary later lifestyles—even as later life inequalities increase. Lifecycles are not what they once were, and later lifestyles even less so.

The cultural turn in ageing studies: opportunities and risks The rise of consumer society has witnessed position and status transformed into lifestyle. Cultural and consumer practices have moved to centre stage.This is the case at most if not all points in the life course, including later life.The cultural turn both reflects and reinforces the fracturing of a ‘modern’ discipline (gerontology) and of a ‘modern’ social group (the old). In place of the traditional dualism of chronology and corporeality, later life is now being examined through alternative lenses, through consumption and lifestyle, technologies of the self and the life politics of identity. While these themes have stimulated much interesting and innovative research, both empirical and theoretical, the cultural turn has not been short of its critics. Within mainstream sociology, Will Atkinson has castigated Bauman, Beck and Giddens for preferring ‘the shifting sands of rhetoric [to][. . .]the firm foundations of observed reality’ (Atkinson 2010: 32). ‘Whatever the age and no matter the occupational position’, he argues, ‘the firm grip of class[. . .]has been shown to remain unbroken’ (Atkinson 2010: 32). Whatever the class, one might equally add, the firm grip of age has likewise remained unbroken.The anti-culturalist argument persists: that society remains structured by age, sex and class, and that understanding age without reference to the biology of ageing and the class structure of society is misguided, perverse or simply superficial. International social survey research does not support such a structuralist analysis. Neither age nor class feature as salient sources of identity for over two-thirds of the population of Western societies (Hyde and Jones 2013: 83). For people no longer part of the labour force, no longer directly engaged with the social relations of production, it might be thought that property ownership could stand as a proxy for ‘class’. But the division between a property-owning and a property-less class changed remarkably over the course of the last century. At the beginning of the twentieth century, the aged working poor were unable to own anything beyond the clothes on their back; by its end, home ownership was the ‘norm’ for people of retirement age, in France, in the United Kingdom and in the United States. While there are continuing debates about the usefulness of the term ‘class’ in contemporary sociology, the structures of class characterizing ‘first’ modernity no longer seem so stable nor so determining (Higgs and Formosa 2013). Instead we have inequality and diversity in later life, equally unjust but in different guises to the inequalities structured by twentieth century colonialism and industrial capitalism.

Conclusion Foucault’s ‘late work’ can serve as an important point of reference in charting these changing times. Although his earlier work was preoccupied by the nature of knowledge and power, he became more interested in ideas of ‘governmentality’ and ‘self-care’ later in his life.These themes are of particular relevance to cultural gerontology. In his later writing, he began to examine what he called ‘practices of freedom’, reframing power as ‘strategic games between liberties’, with technologies of governance mediating between these games and the particular states of domination that apply at any point in time or place (Foucault 1994: 19). Age and ageing can be seen as sites for these kinds of ‘strategic games’, whether played out between corporeality and embodiment, or between states and markets, or between communities and individuals. Cultural gerontology we would argue should place these kinds of strategic games at the centre of its concerns—exploring the various struggles such as that between asserting and ignoring 34

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chronological age; between privileging and de-emphasizing ageing over able-bodiedness, sexual identity, gender or race; between an ageing that is shaped by the market and one that is shaped by the state. At the same time it is important that cultural gerontology recognizes the contingencies and temporalities that determine the individual outcomes of these struggles.There is no more a final resolution for the place of age in society than there is any final resolution of the power age exercises over individuals’ lives. But by exploring these struggles, cultural gerontology can only enrich our understanding of the present and possible cultures of ageing. Such struggles involve continually transforming and re-organizing issues of selfhood, citizenship and embodiment, struggles that extend over what Deleuze and Guattari (2004) called a thousand plateaus of inscription and re-inscription. The present handbook offers a glimpse of these plateaus, and will hopefully encourage others to explore and challenge them as they emerge.

References Atkinson, W. (2010). Class, Individualization and Late Modernity. Palgrave Macmillan, London. Bauman, Z. (2000) Liquid Modernity. Polity Press, Cambridge. Bauman, Z. (2005) Liquid Life. Polity Press, Cambridge. Beck, U. (1999) World Risk Society. Polity Press, Cambridge. Beck, U. (2000) What Is Globalization? Polity Press, Cambridge. Beck, U. and Beck-Gernsheim, E. (2001) Individualization: Institutionalised Individualism and its Social and Political Consequences. Sage Publications, London. Beck, U. and Grande, E. (2010) Varieties of Second Modernity:The Cosmopolitan Turn in Social and Political Theory and Research, British Journal of Sociology 61(3): 409–43. Beck, U. and Lau, C. (2005) Second Modernity as a Research Agenda: Theoretical and Empirical Explorations in the ‘Meta-change’ of Modern Society, British Journal of Sociology 56(4): 525–54. Castells, M. (1996) The Rise of the Network Society. Blackwell Publishers, Oxford. Deleuze, G. and Guattari, F. (1980/2004) A Thousand Plateaus. Continuum Books, London. Department of Work and Pensions (2013). The Pensioners’ Income Series, United Kingdom, 2011–2012. Department of Work and Pensions, UK. Available online at https//www.gov.uk-government-uploads-system -uploads-attachment_data-file-211685-pi-series-1112.pdf (accessed 29/3/2014). Featherstone, M. and Hepworth, M. (1991) The Mask of Ageing and the Postmodern Lifecourse, in Mike Featherstone, Mike Hepworth and Bryan S. Turner (eds), The Body, Social Process and Cultural Theory. Sage Publications, London, 371–89. Featherstone, M., Hepworth, M. and Turner, B. (eds) (1991) The Body, Social Process and Cultural Theory. Sage Publications, London. Figari, F., Matsaganis, M. and Sutherland, H. (2011) The Financial Well-being of Older People in Europe and the Redistributive Effects of Minimum Pension Schemes, EUROMOD Working Paper, No. EM7/11. Institute for Social and Economic Research (ISER), University of Essex. Foucault, M. (1994) The Ethic of Care for the Self as a Practice of Freedom: An Interview Translated by J.D. Gauthier, in James Bernauer and David Rasmussen (eds), The Final Foucault. MIT Press, Cambridge, MA, 1–20. Giddens, A. (1991) Modernity and Self-Identity. Polity Press, Cambridge. Giddens, A. (1994) Beyond Left and Right. Polity Press, Cambridge. Gilleard, C. and Higgs, P. (2005) Contexts of Ageing: Class, Cohort and Community. Polity Press, Cambridge. Gilleard, C. and Higgs, P. (2011a) The Third Age as a Cultural Field, in Dawn Carr and Kathrin Komp (eds), Gerontology in the Era of the Third Age. Springer, New York, 33–50. Gilleard, C. and Higgs, P. (2011b) Consumption and Aging, in Richard Setterson and Jacqueline L. Angel (eds), Handbook of Sociology of Aging. Springer, New York, 361–75. Gilleard, C. and Higgs, P. (2013) Ageing, Corporeality and Embodiment. Anthem Press, London. Gough, O. and Niza, C. (2011) Retirement Saving Choices: Review of the Literature and Policy Implications, Population Ageing, 4: 97–117. Grech, A. G. (2013) How Best to Measure Pension Adequacy. MPRA Paper No. 46126. Munich Personal RePEc Archive, University of Munich. Available online at http://mpra.ub.uni-muenchen.de/46126 /(accessed 16/04/2013). 35

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Hess, B. B. (1993) Afterword: A Personal Reflection, Journal of Aging Studies, 7(2): 195–96. Higgs, P. and Formosa, M. (2013) The Changing Significance of Social Class in Later Life, in Marvin Formosa and Paul Higgs (eds), Social Class in Later Life: Power, Identity and Lifestyle. Policy Press, Bristol, 169–81. Higgs, P. F., Hyde, M., Gilleard, C. J., Victor, C. R., Wiggins, R. D., & Jones, I. R. (2009). From Passive to Active Consumers? Later Life Consumption in the UK from 1968–2005. The Sociological Review, 57(1): 102–24. Hodkinson, P. (2013) Spectacular Youth Cultures and Ageing: Beyond Refusing to Grow Up. Sociology Compass, 7(1): 13–22. Hyde, M. and Jones, I. R. (2013) Social Class, Age and Identity in Later Life, Marvin Formosa and Paul Higgs (eds), Social Class in Later Life: Power, Identity and Lifestyle. Policy Press, Bristol, 73–94. Olson, L. K. (1988) Aging is a Woman’s Problem: Issues Faced by the Female Elderly Population. Journal of Aging Studies, 2(2): 97–108. Outhwaite, W. (2009) Canon Formation in Late Twentieth-Century British Sociology. Sociology, 43(6): 1029–45. Sontag, S. (1972) The Double Standard of Aging. Saturday Review, 23 September, 29–38. Twigg, J. (2013) Fashion and Age: Dress, the Body and Later Life. Bloomsbury Publishing, London. United Nations Economic Commission for Europe (2009) Older Persons as Consumers. UNECE Policy Brief on Ageing No. 3. Geneva, UNECE. Venn, S., Davidson, K. and Arber, S. (2011) Gender and Aging, in Richard Setterson and Jacqueline L. Angel (eds), Handbook of Sociology of Aging. Springer, New York, 71–82. Wolff, E. N., Zacharias, A. and Masterson, T. (2012) Trends in American Living Standards and Inequality, 1959–2007, Review of Income and Wealth, 58(2): 197–232. Zaidi, A. (2009) Poverty and Income of Older People in OECD Countries. Available online at http://ssrn.com/ abstract=1992492 or http://dx.doi.org/10.2139/ssrn.1992492. Zaidi, A. (2010) Fiscal and Pension Sustainability: Present and Future Issues in EU Countries. Policy Brief Series. European Centre,Vienna.

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5 Beyond the view of the West Ageing and anthropology Sarah Lamb

Beliefs and practices surrounding ageing speak to fundamental conceptions of who we are as human beings and how best to live. Anthropologists work closely with people in diverse social-cultural settings to gain access to their complex perspectives, expose unexamined assumptions, and highlight striking cultural differences. Looking beyond the view from the West, anthropologists use studies of ageing in diverse settings not only to understand others, but also to critically examine their own societies, unsettling familiar ways of thinking and revealing underlying values. The aim of this chapter is to highlight a range of responses to some of the fundamental questions ageing poses: Where are the best sites of elder living and elder care: the self-reliant individual, the family, the market or the state? How do we deal with the transience of the human condition? Must situations of frailty and decline entail the loss of social personhood? What does it mean to age well? Two prevailing themes in Euro-American answers to these questions stand out: One is that living independently in late life is ideal (the value placed on independence and the importance of avoiding dependence); and another is that decline in old age is bad (the value of agelessness and self-maintenance). These themes merit further scrutiny by juxtaposing to alternatives. Although Western theories of ageing form just one among many global models, they are often uncritically presumed to be culture-free and universally valid, as evident in the biomedical, public health, and media discourses on ‘active,’ ‘healthy,’ and ‘successful’ ageing now circulating around the globe after having originated in the West. A central aim of the anthropology of ageing is to make interventions into presumably universal, Eurocentric models: to show how what is often taken for granted as ‘natural’ or ‘fact’ is instead, to an important degree, cultural, emerging out of particular cultural-historical and political-economic circumstances.

Where is the best site of elder care: the individual, the family, the market, or the state? In contemporary Western societies, the self-reliant individual is often idealized as the best source of elder care. Although state and market support systems exist, in the form of social security and elder housing, and are considered important security options should independent living fail, and while families also offer help, the ideal is to live independently. A central theme in 37

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American discourse on ‘successful ageing’ is independence, a goal tied to individualist notions of ­personhood. US gerontologists John Rowe and Robert Kahn present dependence as one of the worst fears connected to ageing, reporting: ‘Older people, like younger ones, want to be independent. This is the principal goal of many elders, and few issues strike greater fear than the prospect of depending on others’ (1998: 42). Eighty-five percent of US persons aged 65 and older do, in fact, live either singly (30.1 percent) or with only their spouse (54.8 percent) (US Dept. of Health and Human Services 2010).The figures are similar in Europe (Klinenberg 2012: 157). In reality, frail elders in Western contexts receive much help from family members, but they tend to shun receiving full financial support, co-residence, or intimate bodily care (such as toileting and bathing) from kin. Anthropological studies find that many Americans consider being fully dependent on younger relatives in such ways destructive to their sense of dignity and value as a responsible person (Clark 1972). Independent living and ideals of health and well-being in old age are often linked in gerontological discourse, yet it is important to consider that throughout Asia and in most of the developing world, living intimately with others in a condition of appropriate inter/dependence is generally regarded as much more normal and valued than is living independently (Brijnath 2012, Cliggett 2005: 13–15, Ikels 2004: 9, Lamb 2013, Sokolovsky 2009: 110–11). In India, people tend to describe living alone, at any age, as ‘not part of human nature,’ ‘impossible,’ and ‘unthinkable.’ ‘We had no concept at all even that a person could live alone!’ one retired widowed math professor exclaimed after suddenly finding herself alone, with both her children settled abroad (Lamb 2009: 175). Most Indians do not wish for full dependence, preferring to die while their ‘hands and feet are working’ (Vatuk 1990), and many feel anxiety that their children may not come through to offer adequate care (Cohen 1998, Lamb 2009, 2013).Yet most elders find it entirely appropriate to reside with, depend on, and receive respectful care (seva) from junior kin, just as those in Europe and America find it entirely appropriate and valued for minor children to be dependent on their parents. In societies emphasizing the family as the appropriate site of elder living and elder care, the cultural norms justifying why family members should care for their aged (and why the aged should wish to live with their families) are complex and varied. One widespread cultural model of family-based elder care is that of intergenerational reciprocity: adult children are morally obligated to care for their elder parents in exchange for the tremendous support and sacrifice the parents earlier extended to their children in producing and raising them.This is a model very familiar in Asia, Africa, and Latin America (e.g., Brown 2013, Cliggett 2005, Ikels 2004, Lamb 2000). In India, elders and their juniors often state that it is precisely what parents once gave to their young children—including co-residence, food, material support, love, time together, assistance with daily routines, and toileting—that adult children will later reciprocate to their parents when the parents become old (Lamb 2000). From such a perspective, not only children but also elders can be very appropriately dependent on kin for material, emotional, and bodily support. Such models of intergenerational reciprocity intersect varyingly with local gender norms. Cliggett (2005) finds that in rural Zambia, cultural ideals of motherhood emphasize the sacrifices and energy that mothers in particular invest in raising their children. Men do not share the same bargaining power in relation to their children, while old women can make the claim that ‘I did everything for you, I carried you on my back, I fed you from my breast, so now you can sacrifice for me’ (p. 21). Diana De G. Brown relates a fieldwork conversation in Brazil with Dona Luiza, a widow of 78 and pillar of the local Nativo community: ‘When I asked her who would assume the main burden of care for her, she replied, “Ah, my daughters.” And when I asked her why her daughters but not her sons, she gave me a look indicating that I was being particularly dense—“Because I took care of them when they were children. Now it is their turn to take 38

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care of me” ’ (2013: 130). Daughters are the most appropriate caregivers, Dona Luiza explains, as they have taken care of their own children and know how to do household caregiving tasks, but Dona Luiza adds: ‘My sons, ah, they will also help out’ (p. 130). In most parts of Asia, it is sons and daughters-in-law—and sometimes the eldest son and his wife in particular—who bear the primary responsibility of caring for parents, while daughters marry out to join their husbands’ families, assuming care obligations for in-laws. Other principles of kin-based elder care emphasize less an ethic of lifelong reciprocity and more a sense that elder parents are simply inherently deserving of respectful care.The East Asian notion of filial piety is a prime example of such an ideology. With its roots in Confucian writings, the notion of filial piety is found in China, Japan, and Korea. According to the Classic of Filial Piety, Confucius (551–479 BC) said, ‘In serving his parents, a filial son reveres them in daily life; he makes them happy while he nourishes them; he takes anxious care of them in sickness; he shows great sorrow over their death; and he sacrifices to them with solemnity’ (cited in Ikels 2004: 3). Ikel’s volume Filial Piety: Practice and Discourse in Contemporary East Asia (2004) offers the rich ethnographic data of eleven fieldworkers examining how old patterns of filial piety are under pressure and changing in China, Japan, Korea, and Taiwan, as people contend with population ageing, China’s one-child policy, industrial development, and emerging ideologies of gendered and aged egalitarianism. Cultural-moral models of individual versus family-based elder care exist in relation to political and economic contexts.The model of individual self-reliance and healthy, active, productive ageing prevailing in many Western nations complements well, for instance, current neoliberal ideals about personal responsibility, self-governance, and minimizing of public support. Stephen Katz observes how activity and self-reliance have become a ‘panacea for the political woes of the declining welfare state and its management of so-called risky populations,’ including the growing numbers of aged (2000: 147). Most developing nations lack sufficient resources to provide the kinds of social security offered elders (to varying degrees) in developed nations, making family support particularly important. Some states have harnessed conventional family moral systems to national elder care policies, enacting laws mandating family support of the aged. Brazil’s ‘Laws for the Elders’ (Leis dos Idosos) mandate families to take responsibility for the care of their own elders, a step that Brown finds ‘reinforces and legitimizes traditional practices as modern answers to an inadequate health service for the popular classes’ (2013: 134–35). In India, the Maintenance and Welfare of Parents and Senior Citizens Bill of 2007 (enacted into law in 2009) stipulates that adult children must care for their aged kin, or risk being fined or imprisoned (Lamb 2013: 74–6). In China, the government has recently taken to promoting Western-style individual-centered active ageing practices, including daily exercise, as a means to ‘translate into fewer health costs’ and to create ‘a more stable social order’ (Zhang 2009: 212). At the same time, Chinese law-makers have passed an ‘Elder Rights Law’ similar to India’s, requiring grown children to visit their parents, and ensure that their parents’ financial and spiritual needs are met, or potentially face fines or jail (Hatton 2013). Even in societies emphasizing family care as a cultural and national policy, there is a widespread perception that multigenerational family living is on the decline, often interpreted as a feature of westernization and modernity (e.g., Cohen 1998, Lamb 2009). Some development discourse interprets such a move beyond the family as ‘progress,’ yet in places such as India the trend of moving beyond the family as the nation witnesses the emergence of old age homes is regarded much more ambivalently (Brijnath 2012, Lamb 2009). Demographer Kevin Kinsella reports: ‘Although the tendency has been for multigenerational households to become relatively fewer in the more developed world, two- and three-generation households are still the norm in most developing countries’ (2009: 27). 39

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Medicalization, anti-ageing, sexuality, and the body Along with independence, another theme in contemporary Western approaches to ageing is the medicalization of the ageing body and sexuality. Although some in the US and UK are uncomfortable with the notion of dying hooked up to elaborate machines and are promoting ‘right to die’ initiatives, it is still common for elders to be swept up into medical institutions over the final days, months, and even years of life. Anthropologist Luisa Margolies writes movingly about her own mother’s final five months of life in seven different medical institutions, where, without really pausing to question or to heed her mother’s clearly expressed wish to be allowed to die, US medical practitioners engaged in an ‘all-out assault to defeat death’ (2004: 230). Such practices accompany a deep discomfort with ageing and dying, as medicine becomes a way to control and even forestall bodily decline and death (Kaufman 2005). Byron Good reflects on the key salvational role that biomedicine plays in American culture, where death, finitude, and sickness are found in the human body, and ‘salvation, or at least some partial representation of it, is present in the technical efficacy of medicine’ (1994: 86). The American Academy of Anti-Aging Medicine (A4M) celebrates its active agenda of anti-ageing biomedical research that has, reportedly, brought millions to the realization that ‘Aging Is Not Inevitable’ (Lamb 2009: 140, cf. Mykytyn 2006). The medicalization of sexuality in North America is part of this broader anti-ageing trend. For men, the unprecedented success of Viagra offers a cure for a bodily condition previously considered normal in older age. One of the top American news stories of 1998,Viagra ‘naturalizes lifelong performance of phallocentric sex as a marker of healthy aging’ (Wentzell 2013: 3). For women, the situation is more complicated and ambivalent: women’s sexuality and sexual performance have been much less medicalized (Loe 2004: 125–66); yet until the recent discovery that hormone replacement therapy (HRT) can be medically dangerous, HRT was near ubiquitous in North America among menopausal women (Lock 1993). The medicalization of the ageing body and of sexuality is much less prevalent in most non-Western contexts, even within industrialized nations with highly advanced medical technologies, such as Japan. Emily Wentzell finds that, ‘despite the traditional association of penetrative sex with successful masculinity, many older, working-class Mexican men faced with erectile difficulty reject “youthful” sexuality and drugs that facilitate it in order to embody a “mature” masculinity focused on home and family’ (2013: 3). Linn Sandberg (2013) encounters similar perspectives in Sweden, finding that older men view intimacy as more or other than sexual intercourse—involving touch, softness, and feelings of love in a committed relationship—suggesting that the story may be more nuanced in the West, too. In India, common views are that asexuality is normal and desirable in older age for both men and women, as bodies naturally become ‘cooler’ and ‘drier’ with age, and as elders appropriately move on to more spiritually-focused, post-reproductive life phases (Lamb 2000: 197–204). Anthropological research reveals similarly that even something so widely regarded as biological and universal as menopause varies profoundly (Beyene 1989, Lock 1993, Sievert 2006). In many non-Western cultures, there is a rarity or complete absence of menopausal symptoms; hot flushes, for instance, are not universal, and menopause is not ‘naturally’ experienced as negative. Yewoubdar Beyene (1989) finds that Mayan peasant women in Mexico have very positive attitudes toward the stopping of menses, which can signify a youthful return to a carefree sexuality without the worry of pregnancy, and do not associate menopause with any physical or emotional symptomatology. A term easily translated as ‘menopause’ is not even found in all languages. The closest Japanese equivalent, konenki, means more ‘the change of life’ and may or may not be associated in women’s minds with the cessation of menstruation (Lock 1993: 3–45). The most 40

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common ‘symptom’ of konenki is shoulder stiffness. Anthropologists suggest that intersecting cultural, environmental, dietary, reproductive, and genetic factors all probably play a role in explaining such diverse experiences (Beyene 1989, Lock 1993: xxi, 38–9, Sievert 2006). Aspects of cultural, environmental, and biological context impact ideas and experiences of sexuality and the body over the life course, encouraging people to embrace or medicalize sexual and bodily changes as they grapple with how best to age.

Personhood and dementia Cultural meanings of dementia are also profoundly varied, and illuminate local understandings of age, care, personhood, and what constitutes ‘normal’ and ‘natural’ decline. Writing from North America, Lawrence Cohen reflects on how Alzheimer’s narratives have served as a ‘form of dependency anxiety’ in an ‘aging public whose members are organized around their independence’ as critical to ‘available forms and narratives of successful aging’ (2006: 7). Despite a ‘personhood movement’ within some clinical, lay, and academic spaces to rediscover the person ‘lost’ within the logic of dementia diagnosis and care (Cohen 2006: 3, Kitwood 1997, Leibing 2006), a person diagnosed with Alzheimer’s is widely regarded in biomedical and Western social contexts as facing a ‘loss of self ’ and ‘social death.’ Janelle Taylor indicts US society’s discomfort with situations of bodily and cognitive impairment. She asks, ‘Why is it apparently so difficult for people to “recognize”—as a friend, as a person, as even being alive—someone who, because of dementia, can no longer keep names straight?’ (2008: 324). Taylor portrays the ‘processes of “social death,” social exclusion and abandonment’ experienced in the US by persons with dementia (p. 325), who are regarded as ‘the not quite (or no longer) fully human’ (p. 332). Cross-culturally, cognition and memory are not always crucial to the designation of social personhood, and the experience of senility within interrelational family dynamics can be more important than the ability (or failure) of an individual to maintain self-reliance. Lawrence Cohen (1998) finds that those in India readily identify senility with the spread of ‘bad families’ rather than isolatable disease processes. A dominant narrative in Indian gerontology has been that ‘it is only meaningful to speak of senile old bodies in the context of fragmented or nonexistent—and thus “Western”—families’ (p. 17). Within traditional multigenerational ‘Indian’ families, senility and even ageing itself would not emerge as problems. Bianca Brijnath’s later (2011) research shows increasing recognition of ‘Alzheimer’s’ as a ‘disease’ in India, while nonetheless revealing how Indian families still very much treat dementia within the context of family caregiving and intimacy, seva (service), and love. John Traphagan explores both biomedical framings of senility in Japan and the more familiar Japanese concept of boke, translatable as something close to ‘being out of it’ (2000, 2006). Boke is understood to be a state over which one has some control. Engagement in activities intended to delay or prevent boke is not simply a matter of individual activity; it also carries moral weight as a social responsibility. The moral component of boke is related to Japanese notions of reciprocity and interdependence; it is appropriate for elders to receive care within the family but not to over-burden others in ways that preclude engagement in ongoing reciprocal relations. Boke elders experiencing relatively mild symptoms are not represented as a serious problem, but rather as ‘cute’ family members in a way similar to that of a dependent child. One television drama portrayed a boke grandfather as one generally enjoyable to live with, with a pleasant smile on his face. ‘Even when he wandered off, it was an opportunity for joviality when he was ultimately found’ (Traphagan 2006: 273). Yet as a person enters into more severe states of boke, one becomes dependent without the apparent possibility of reciprocation, thereby removing the boke elder from the social interdependencies that make one a good person in the Japanese 41

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context (p. 275). Boke presents, then, a problem not precisely of the failure of independence but rather of the failure of appropriate interdependence. We see that understandings of senility in any cultural context speak to conceptualizations of what makes a good person. Some personhood models allow for a broader range of cognitive and physical capacity than those currently prevailing in Western medico-cultural settings, and highlight social-familial interrelations more than individual functioning.

How to deal with human transience: permanent personhood and meaningful decline Each of the themes explored thus far—of independence and dependence, of medicalization of the ageing body and its alternatives, of dementia and personhood—speaks to a broader theme, that of how persons within societies approach the fundamental transience of the human condition. In the West, there is a profound tendency to prevent or deny the changes and declines of age. Contemporary American attitudes about ageing and personhood feature ‘permanent personhood’ or ‘anti-ageing’ models (Lamb 2009: 137–9), evident in the gerontological Successful Ageing and Active Ageing theories as well as lay discourses. In such cultural models, persons strive to maintain an agelessness as they move through later life, in fact denying changes of (old) age. Prevalent assumptions are that if change does occur in late life, such change is predominantly negative in character—entailing loss, decay, meaninglessness, and ageism (Gullette 1997), and it is hence no wonder that people would fight against the changes of age. Pursuing lifelong vitality and youthfulness can certainly be appealing and inspiring as well, although critics argue that anti-ageing and successful ageing models insufficiently recognize socio-economic and health disparities, set people up for inevitable ‘failure,’ and hinder the possibility of learning from the full spectrum of the human experience (e.g., Holstein and Minkler 2003). An alternative Indian Hindu perspective is that life fundamentally entails decline and transience—not only in old age, but as an essential feature of the human, material condition. Coming to realize this transience can be a positive and enlightening move, potentially making both ageing and dying meaningful. According to the classical Hindu model of life stages, two of four stages constitute older age: the ‘forest-dweller’ (vanaprastha) and ‘renouncer’ (sannyasi) stages, life phases intended to be devoted to spirituality and loosening worldly ties. Few Hindus actually move to the forest or become wandering renouncers, but many do speak of late life as an appropriate and valuable time for focusing increasingly on God and spiritual awareness, as part of preparing for the transitions of dying and grappling with the reality of human transience (Lamb 2000).Talk of readiness for death and acceptance of decline, in fact, seems to be expected cultural discourse among older Indians, and highlights the widely held Hindu view of the impermanence of the human condition—the temporariness of any individual’s stay within any one human body amidst the natural cycle of births and deaths of worldly existence or samsara. Related Buddhist perspectives popular in many Asian contexts are that change is entirely normal: everything that arises also ceases.

Conclusion We have seen the specificity of cultural ways of ageing. No one way can be considered essentially correct or incorrect, advanced or backward, natural or unnatural, humane or inhumane. However, to the extent that Western models are becoming globally hegemonic—at times recognized not as cultural but rather as ‘fact,’ especially when grounded in biomedicine and science—it is useful to explore alternative perspectives, to unsettle the certainties of Eurocentric models, and 42

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to bring the fields of anthropology and gerontology more fully into conversation. One lesson for those in the West, perhaps, is that they might do well to come to better terms with conditions of human transience and decline, so that not all situations of (inter)dependence, debility, and even mortality in late life will be viewed and experienced as entailing a loss of social personhood and a failure to age well.

References Beyene, Y. (1989) From Menarche to Menopause: Reproductive Lives of Peasant Women in Two Cultures. Albany: State University of New York Press. Brijnath, B. (2011) ‘Alzheimer’s and the Indian appetite,’ Medical Anthropology 30(6): 610–28. ——— (2012) ‘Why does institutionalized care not appeal to Indian families? Legislative and social answers from urban India,’ Ageing and Society 32(4): 697–717. Brown, D.D.G. (2013) ‘ “I have to stay healthy”: elder caregiving and the third age in a Brazilian community,’ in C. Lynch and J. Danely (eds), Transitions and Transformations: Cultural Perspectives on Aging and the Life Course, 123–36. New York: Berghahn. Clark, M. (1972) ‘Cultural values and dependency in later life,’ in D.O. Cowgill and L.D. Holmes (eds), Aging and Modernization, 263–74. New York: Appleton Century Crofts. Cliggett, L. (2005) Grains from Grass: Aging, Gender, and Famine in Rural Africa. Ithaca, NY: Cornell University Press. Cohen, L. (1998) No Aging in India: Alzheimer’s, Bad Families, and Other Modern Things. Berkeley: University of California Press. ——— (2006) ‘Introduction: thinking about dementia,’ in A. Leibing and L. Cohen (eds), Thinking about Dementia: Culture, Loss, and the Anthropology of Senility, 1–19. Brunswick, NJ: Rutgers University Press. Good, B. (1994) Medicine, Rationality, and Experience: An Anthropological Perspective. Cambridge: Cambridge University Press. Gullette, M.M. (1997) Declining to Decline: Cultural Combat and the Politics of Midlife. Charlottesville: University of Virginia Press. Hatton, C. (2013) ‘New China law says children “must visit parents,” ’ BBC, 1 July 2013. Available online at www.bbc.co.uk/news/world-asia-china-23124345. Holstein, M.B. and Minkler, M. (2003) ‘Self, society, and the “new gerontology,” ’ The Gerontologist, 43(6): 787–96. Ikels, C. (ed.) (2004) Filial Piety: Practice and Discourse in Contemporary East Asia. Stanford, CA: Stanford University Press. Katz, S. (2000) ‘Busy bodies: activity, aging, and the management of everyday life,’ Journal of Aging Studies, 14: 135–52. Kaufman, S.R. (2005) . . . And a Time to Die: How American Hospitals Shape the End of Life. Chicago: The University of Chicago Press. Kinsella, K. (2009) ‘Global perspectives on the demography of aging,’ in J. Sokolovsky (ed.), The Cultural Context of Aging, third edn, 13–29. Westport, CT: Praeger. Kitwood, T. (1997) Dementia Reconsidered:The Person Comes First. Philadelphia, PA: Open University Press. Klinenberg, E. (2012) Going Solo: The Extraordinary Rise and Surprising Appeal of Living Alone. New York: Penguin. Lamb, S. (2000) White Saris and Sweet Mangoes: Aging, Gender, and Body in North India. Berkeley: University of California Press. ——— (2009 Aging and the Indian Diaspora: Cosmopolitan Families in India and Abroad. Bloomington: Indiana University Press. ——— (2013a) ‘In/dependence, intergenerational uncertainty and the ambivalent state: perceptions of old age security in India,’ South Asia: Journal of South Asian Studies, 36(1): 65–78. Leibing, A. (2006) ‘Divided gazes: Alzheimer’s disease, the person within, and death in life,’ in A. Leibing and L. Cohen (eds), Thinking about Dementia: Culture, Loss, and the Anthropology of Senility, 240–68. New Brunswick, NJ: Rutgers University Press. Lock, M. (1993) Encounters with Aging: Mythologies of Menopause in Japan and North America. Berkeley: University of California Press. Loe, M. (2004) The Rise of Viagra: How the Little Blue Pill Changed Sex in America. New York: New York University Press. 43

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Margolies, Luisa. (2004) My Mother’s Hip: Lessons from the World of Eldercare. Philadelphia: Temple University Press. Mykytyn, C.E. (2006) ‘Anti-aging medicine: predictions, moral obligations, and biomedical intervention,’ Anthropological Quarterly, 79(1): 5–31. Rowe, J.W. and Kahn, R.L. (1998) Successful aging. New York: Pantheon Books. Sandberg, L. (2013) ‘Just feeling a naked body close to you: men, sexuality and intimacy in later life,’ Sexualities, 16(3/4): 261–82. Sievert, L.L. (2006) Menopause: A Biocultural Perspective. New Brunswick, NJ: Rutgers University Press. Sokolovsky, J. (2009) ‘The life course and intergenerational ties in cultural and global context,’ in J. Sokolovsky (ed.), The Cultural Context of Aging:Worldwide Perspectives, third edn,Westport, CT: Praeger. Taylor, J. (2008) ‘On recognition, caring and dementia,’ Medical Anthropology Quarterly, 22(4): 313–35. Traphagan, J.W. (2000) Taming Oblivion: Aging Bodies and the Fear of Senility in Japan. Albany: State University of New York Press. ——— (2006) ‘Being a good rojin: senility, power, and self-actualization in Japan,’ in A. Leibing and L. Cohen (eds), Thinking about Dementia: Culture, Loss, and the Anthropology of Senility, 269–87. New Brunswick, NJ: Rutgers University Press. US Department of Health and Human Services. (2010) ‘A profile of older Americans, 2010: living arrangements.’ Available online at www.aoa.gov/aoaroot/aging_statistics/profile/2010/docs/2010profile.pdf. Vatuk, S. (1990) ‘ “To be a burden on others”: dependency anxiety among the elderly in India,’ in O. Lynch (ed.), Divine Passions:The Social Construction of Emotion in India, 64–88. Berkeley: University of California Press. Wentzell, E. (2013) ‘Aging respectably by rejecting medicalization: Mexican men’s reasons for not using erectile dysfunction drugs,’ Medical Anthropology Quarterly 27(1): 3–22. Zhang, H. (2009) ‘The new realities of aging in contemporary China: coping with the decline in family care,’ in J. Sokolovsky (ed.), The Cultural Context of Aging: Worldwide Perspectives, third edn, 196–215. Westport, CT: Praeger.

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6 Historians of ageing and the ‘cultural turn’ Antje Kampf

Historical scholarship can offer a contextual grounding for the recurrent sociological, anthropological, political and economic questions arising from the contingent and ambivalent meanings of ageing.Yet, while ageing studies have been providing a timely evaluation of contemporary trends in ageing, the history of ageing has, until recently, still been grappling with Simone de Beauvoir’s contention in her seminal 1972 book Coming of Age that there is more to the meaning and conceptualizations of old age than is found in mere statistical facts. Old age needs to be seen as a process, a last stage of life and a change of one’s own life (Beauvoir 1972). In the twenty-first century, historical studies have come broadly to embrace cultural approaches to the history of old age, evidenced in a growing range of articles and surveys on old age in Western history (for example, Johnson and Thane 1998, Troyansky 1996, Laslett 1984, Ehmer 2008, Blessing 2010). The vexed relation between the historian’s tool-kit (in the form of source material) and the way in which we interpret and weigh the meaning of old age, however, still dominates historical approaches to ageing: ‘But if there is no language, no discourse, no text, and no possibility of direct anthropological observation, then there can be no historical construction’ (Johnson 1998: 17), writes historian Paul Johnson on the intricacy of approaching the history of age(ing) from a post-modern perspective. As this chapter illustrates, however, historians have found ways of historical construction. The chapter discusses the benefits and limitations of the ‘cultural turn’ within historical approaches to ageing. In order to make sense of the vastness of historical scholarship on age, the chapter makes an eclectic choice of the literature, discussing modern Western historiography with an emphasis mainly on Anglo-American and Continental literature. The chapter is organized in three, interrelated parts. The first outlines the predominant demographic strands in the historiography of ageing.The second discusses the shift in emphasis due to the arrival of cultural history. The third offers a short excursus into the way in which medical history has recently taken a further material turn. Lastly, the chapter concludes with some suggestions concerning the future shape of scholarship.

Demographic strands Early social gerontologists turned to history in an effort to help their cause of studying older people in their own right. Social gerontology, emerging as a sub-field in the 1950s, used 45

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demographic and population studies, life expectancy ratios and mortality and fertility rates to launch a decisive condemnation of the negative impact of modernization on older people. A rich and still dominant strand of socio-demographic historical scholarship on ageing has similarly focussed on the issue of generations, families, work life, insurance patterns, socio-politics and mortality changes of old age (for example, Achenbaum 1995, Bourdelais 1998). This prioritized a focus on employment, household authority and ownership. At the centre of these studies has been the interpretation of the outcome of modernization for older people. Modernization, which was interpreted as the process of change from traditional and local social structures to a state-driven, centralized apparatus that took over care of social groups, was identified as coming with a mixed bag of private/public visibility and benefits, and being beneficial or deleterious for older people’s lives: Post-industrial societies were characterized by a substantial rise in the presence and public visibility of the aged in the community due to changing demographic features, such as low fertility rates and increased life expectancy. At the same time, social dilemmas concomitant with this rise increased the need to provide adequate health care, securing social, economic status and governmental responsibility for the well-being of the older people. The early studies have argued the case for a golden age for old people in the past, now lost in modern society that brought a weakening of family bonds and carried in its wake medicalization and isolation of older people in the nineteenth and twentieth centuries (for example, Stearns 1980, Laslett 1984). Modernization thus became the culprit for increasing decrepitude of the old by destabilizing support structures and diminishing the higher social status that older people once had (Burgess 1960). George Minois’s History of Old Age, hailed as one of the first major studies of the ways in which old age has been perceived in Western culture throughout history, and a grand narrative of literature and representations, can be read as falling into the tradition of a lost golden past (Minois 1989). This interpretation has been criticized (as will be discussed below) but continues to influence historical research (and a large body of gerontological and sociological literature).

Cultural history Cultural history I: mentalities Wishing to focus on the lives of ordinary people, social historians have approached the history of old age through attitudes, sentiments, everyday life, family structures and life course perspectives.Within an increasingly critical attitude to older interpretations and broad stereotypes based mainly on demographic data (for example, Hendricks 1982), historians such as Margaret Pelling and Richard Smith have pointed out that while ageing was highly visible, it was also hidden, in that it remained a very private experience (Pelling and Smith 1991). Thus the historical focus shifted from structural approaches to ones that detailed the diversity of daily life.These revisionist approaches have questioned the ‘golden age’ theory. They replaced it with what they argued was a fuller or more complex history of old age, which considered the provision of policy and care, and focussed on change within family structures and private networks (for example, see Ottaway 2004, Thane 2003). Categorization based on solely chronological age was seen to limit understanding of the varying experience of ageing. Jaber Gubrium (2005) highlighted the importance of detailed research into the lives of older people at the micro level. Decisive also has been Thompson, Itzin and Abendstern’s (1990) study that argued against social gerontology’s tendency to focus on the problems of old age. Instead, they insisted, we should look at the enriching, positive and non-devaluated experiences of old age in the past, basing their accounts on autobiographies and life stories recorded in the 1970s. 46

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The shift in the historiography of age(ing) has thus come with the introduction of cultural history approaches that have opened up the social constructionist view, with enquiries into the impact of mentalities, images, narratives and metaphors. Moving from the detailed description of the metaphors and pre-eminent representation of, for example, ageing pyramids and/or other classic arts and literary subjects (for example, Hazan 1994), a whole range of sub-fields, such as gender studies, social science and technology studies, media and literary studies, have called for rethinking norms and difference within the ageing discourse itself and within historiography (for example, Gullette 2004, Soland 2001, Moreira and Palladino 2011, Kampf, Marshall and Petersen 2012). Thomas Cole’s by now classic cultural approach to historical gerontology, The Journey of Life: A Cultural History of Ageing in America (1992), used literature and art to detail the transition from fundamental questions about ageing to scientific theories. There is now a boom in literary studies in gerontology and historical examination re-considering cultural values, definitions of old age and the limitations and ambiguities of old age, thereby offering gerontology a humanist interpretation (Achenbaum 1995). Studies examining the popular impact of representation of ageing have identified the role of the media in making visible such shifts in societal mood (Streubel 2011).

Cultural history II: minorities Much of what drove historians to ask different questions was influenced by the minority studies of the 1970s, which highlighted the complexities of human life. Treating older people as a homogeneous group, the argument went, disregarded important factors of inequality in society, notably the impact of race, class and gender. Class and race, however, important factors in the social history of minorities and a growing issue within social gerontologist writings of old age, remain understudied in historical scholarship (for an exception on class, see, for example, Susannah Ottaway’s work on the eighteenth century, 2004). Gender has been given greater prominence as a theme in social history. In the history of ageing, however, though it has featured as a sub-theme, it has not been in the forefront of analysis. Much scholarship has focussed on men, though without specifically identifying them as subjects of inquiry, and often to the exclusion of women. ‘Where Are the Women in the History of Ageing?’ asked Marjorie Chary Feinson back in 1985, berating most women’s historians’ ignorance of older women (Feinson 1985: 1). At first sight this absence might come as a surprise. Was it not the aim of women’s studies to unravel social and cultural differences, and the vexed relation between nature and culture, with its conceptions of normality and pathology (of female bodies)? These themes are equally vital for the history of old age. Some scholars have explained this apparent scholarly blindness towards ageing women as the result of continuing ageism that underlay historians’ neglect of older women. Feminist historians have argued that the absence of women within the historiography of ageing has been due not only to the fact that much of the then visible public power was granted to men while denied to women: they have also highlighted that historians’ views were narrowed by such prevalent power structures—their theories of ageing were based on models of ageing that did not account for the experiences of older women (for example, Haber 1985). Lastly, the absence of gender in historical research on ageing has also been identified as resulting from a problem of scant sources on ageing women. Researchers have had to embrace alternative approaches to sources, and ask new questions. Such studies have been influential in expanding quantities approaches that treat old age as an obvious category defined by chronological age by highlighting the specificity of individual ageing. The concept of identity, which has been a vital part of the mentalities approach in history, has only recently received attention in the scholarship investigating minority elder groups. 47

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Important works by social scientists and literary critics (for example, Calasanti and Slevin 2006, Woodward 1999) have only slowly filtered into historical research.These recent studies illustrate the positive side of female ageing, looking for example at the social networks of older women that gain them status. One of the first collections specifically on ageing and women in history was Lynn Botelho and Pat Thane’s Women and Ageing in British Society since 1500 (2001), in which individual social and life course perspectives were presented. There now exists a growing body of historical studies of ageing women; literature addressing the subject of male ageing identity as historical process is just emerging (Hofer 2007, Watkins 2008, Kampf 2009). Why, then, is there such continuous predominance of quantities approaches to the history of ageing and such a slow introduction of differential markers such as gender, race and class? David Troyansky has argued that this problem has emerged due to the division of socio(political) and cultural approaches in history (1996: 21). Paul Johnson has similarly criticized the lack of connection between social and cultural historians that has limited the interpretation of the history of old age (Johnson 1998): on the one hand, social historians’ interests focussed on social experience studied under the categories of family and related status viewed as part of a macro view on social, economic and political structures; on the other hand, cultural historians’ interests focussed on the epistemology of the term ‘age’ and the social construction of ageing. To bridge both approaches, gender, race and class could work as possible categorical links between social and cultural histories of ageing since they are important characteristics of personal identity, of social construction and of societal and political making (see also Rogers 1999: 55).

Cultural history III: materiality Reflecting the influence of work on gendered bodies, recent historical scholarship has turned to the field of materiality and to issues of embodiment.The lateness of this interest by historians of old age in ‘bodies’—which has been an established field within general history—is unsurprising. Social gerontologists had evaded debates about materiality since the introduction in the late 1960s of the concept of ageism, which saw a focus on biology as retrogressive and potentially degrading. Similar arguments were made in women’s history with regard to a focus on the female body. Literary critic Margaret Gullette has, however, argued for the need to research difference, and she blamed researchers who themselves suffered from gerontophobia, and from the fear of confronting their own ageing (Gullette 2004).This argument could also be applied to the failure to recognize the material aspects of age, thereby ignoring important issues such as ageing identity and the socio-cultural dimensions of the ageing body. However, there is an increasing trend to (re)evaluate ‘materiality’ in the historical experience of old age. Social sciences have already started to do this, and the approach has spread to studies in medical history investigating medicine as cultural practices in relation to older people. Most promising for future research has been the current interest in the ways in which embodiment and the materiality of bodies intersect culturally with biological and chronological changes. This can be seen in work that has explored the role of science and technology in the constitution of age (Katz 1996, Ballenger 2006, Moreira and Palladino 2011). Studies have also looked at the interface of gender, ageing bodies, modern medicine and the reshaping of medical expertise (Katz 1997, Watkins 2008, Kampf, Marshall and Petersen 2012). Some scholars have revisited the medicalization theory, arguing for a more nuanced picture, for example, pointing to the ways the disciplines of geriatrics and gerontology themselves represent minorities within the larger medical field (Haber 2004: 516). Despite this new work, the older person in history remains a somewhat shadowy presence. Most of the work in medical history focusses on expert knowledge and constitution of 48

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expertise. These studies also explore the way gerontology has developed as a field of knowledge and its relation to mainstream medicine (Achenbaum 1995). This focus, however, alerts us to the fact that we know very little historically of the experience of ageing from the perspective of the older people themselves. Medical history is only now beginning to turn its attention to everyday life (for example, Moses 2007). This development offers a potential bridge between social structural and cultural approaches to the field.

The historian’s tool-kit and the history of old age There are two major interrelated issues impacting on the benefits and limits of the cultural turn of historical approaches to ageing: these are sources and their interpretations. Sources are the Achilles’ heel of any historical contextualization of ageing. Of course, this problem is not confined to historical work in relation to age: there are other groups that historians have had to work hard to recover (for example, children as seen from their own perspectives). But this does not make the issue of sources for historians of old age any easier. There is only limited information from the past on the views of older people themselves. There is also controversy over what kind of sources are reliable indicators of how older people lived and experienced their lives. From a social historical perspective, evaluating the standing accorded to older people by measuring indicators of status (rather than sentiments or identity issues) is considered a more appropriate approach in the context of a world grappling with the political, social and economic effects of a growing older population.These problems are not confined to age. Other sub-disciplines of history, such as gender, have already dealt with questions of who is to say what the reliable source is. The field has drawn successfully on the tools of autobiography and oral history (specifically for modern history). Pat Thane, for example, has used petitions against unwanted application of the New Poor Law to demonstrate that the aged were able to manipulate the system, and have not (always) internalized negative prejudices, emphasising thereby the importance of different layers and levels of understanding ageing historically (Thane 2003). Why not make more use of artefacts? Using material sources within historical investigation is an established method of analysis in cultural history that can be employed to the benefit of the history of ageing. Using an array of sources remains important; and promising work is currently being produced by young scholars, for example in an oral history of nurses working at geriatric wards (Brooks 2009). What has become clear is that historians of ageing grapple with interpretations that appear to be particularly challenging on a number of levels that can be addressed here only briefly: the lack of linearity and questions of age threshold; questions of ambiguous readings of interpretations and representations of ageing; and the role of the individual in shaping of meanings of old age within society (for example, old people living in hospices). In addition to questions of the social, cultural and political status of older people, the element of time is fundamental for ageing scholars. Time comes in different layers: it adds another dimension to the question about the differentiation of old age into distinguishable phases, such as the third and fourth age; it marks the importance of the onset of health care provision; it is vital to a (re)consideration of retirement age; and it works as a problematic parameter for gender studies and how bodies have shaped identities. Scholars have grappled with who counts as old. This is also significant in, for example, definitions of pathological or normal status of the health of older people, or in cultural practices in relation to the representation and medical treatment of menopause. Here the reliance of historians on sources is specifically treacherous, as ‘it is particularly difficult to evaluate whether one form of discourse is especially dominant at any one time’ (Johnson 1998: 5).

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Conclusion Where do we go from here? There are clearly both benefits and limitations of the ‘cultural turn’ for historical scholarship on ageing. The cultural turn in history has allowed the telling of a wider range of stories than those presented in conventional analysis. As a result a more diverse and nuanced picture has emerged that promises to provide a ‘fuller’ account of ageing, linking the individual experiences of older people with their public representations. Reconceptualizations of the interpretation of older people, social and critical gerontology as well as literary and gender studies have all added to the richness of the historical narrative. In its wake are also reconsiderations—highlighted by medical history approaches—that have returned to the vexed relationship between ageing and materiality. They illustrate how it is time to move beyond aspects of medicalization in an effort to understand the day-to-day lives of old people. This needs to encompass what gerontology has termed the fourth age (Gilleard and Higgs 2011), which remains the most challenging aspect for historical investigation, as it often goes beyond institutional history (and more easily accessible sources). It needs also to include the still under-researched field of kinship support, since intricate family structures and processes remain under-researched areas of the modern history of ageing (new work on the early modern period has begun to explore the impact of family structure on old age; see Ottaway 2004). Conversely, current social and critical gerontology would benefit enormously from considering the historical contextualization of its subject, allowing not only for unravelling of the contingencies of age in society but also for questioning the universality of ageing bodies and the failure to implement a fully embodied analysis. Despite the cultural turn, defining ‘old’ seems especially complicated when the subject is women, or (even more so) class or race, requiring a search for non-traditional evidence and re-framing of questions. Scholars have already called for more tightly focussed questions, be they in relation to regional, gender or class aspects (Botelho and Thane 2001, Johnson 1998). There is a gap in knowledge about other markers of difference, foremost class and ethnicity (for a recent exception: Hunter’s 2008 observations of changes in the experience of old age that affected all classes). Also missing are investigations into time periods that have been influential in shaping the socio-cultural and political dimensions of old age, for example the fascist era (for an exception see Schlegel-Voß 2005). Overarching cultural histories on ageing from a transnational perspective are also absent. The variation and ambiguities of ageing thus continue to present challenges to historians of old age (Thane 2003, Ehmer 2008, Rogers 1999). But it is worth remembering that sub-disciplines such as gender history have taken more than a generation to develop their position within historical scholarship, in part because their approaches cross disciplinary boundaries. A similar argument could be made about the development of ageing history. There is so much more left to explore. The involvement of historians in teasing out the continuities but also the changes in old age history is vital if we are to avoid narrow conceptions of old age in our future.

References Achenbaum, W. A. (1995) Crossing frontiers: Gerontology emerges as a science, Cambridge: Cambridge University Press. Ballenger, J. F. (2006) Self, senility, and Alzheimer’s disease in modern America: A history, Baltimore, Maryland: The Johns Hopkins University Press. Blessing, B. (2010) ‘Die Geschichte des Alters in der Moderne: Stand der deutschen Forschung‘, Medizin, Gesellschaft, Geschichte, vol. 29, pp. 123–50. Botelho, L. and P. Thane (eds) (2001) Women and ageing in British society since 1500, Harlow: Longman.

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Bourdelais, P. (1998) ‘The ageing of the population’, in Johnson, P. and P. Thane (eds), Old age from antiquity to post-modernity, London: Routledge. Brooks, J. (2009) ‘ “The geriatric hospital felt like a backwater”: aspects of older people’s nursing in Britain, 1955–1980’, Journal of Clinical Nursing, vol. 18, pp. 2764–72. Burgess, E. W. (1960) Aging in western societies, Chicago, Illinois: University of Chicago Press. Calasanti, T. and K. F. Slevin (eds) (2006) Age matters: Realigning feminist thinking, New York: Routledge. Cole, T. (1992) The journey of life: A cultural history of aging in America, Cambridge: Cambridge University Press. de Beauvoir, S. (1972) [1970] The coming of age, New York: G. P. Putnam. Ehmer, J. (2008) ‘Das Alter in Geschichte und Geschichtswissenschaft‘, in Staudinger, U. and H. Häfner (eds), Was ist Alter(n)? Heidelberg: Springer. Feinson, M. C. (1985) ‘Where are the women in the history of aging?’ Social Science History, vol. 9, pp. 429–52. Gilleard, C. and Higgs, P. F. (2011) ‘Ageing abjection and embodiment in the fourth age’, Journal of Ageing Studies, vol. 25, no. 2, pp. 135–42. Gubrium, J. F. (2005) ‘The social worlds of old age’, in M. L. Johnson, in association with V. L. Bengtson, P. G. Coleman and T. B. L. Kirkwood (eds), Cambridge handbook of age and ageing, Cambridge: Cambridge University Press. Gullette, M. M. (2004) Aged by culture, Chicago: Chicago University Press. Haber, C. (1985) Beyond sixty-five:The dilemma of old age in America’s past, Cambridge: Cambridge University Press. Haber, C. (2004) ‘Life extension and history: The continual search for the fountain of youth’, Journal of Gerontology: Biological Sciences, vol. 59, no. 6, pp. 515–22. Hazan, H. (1994) Old age: Constructions and deconstructions, Cambridge: Cambridge University Press. Hendricks, J. (1982) ‘The elderly in society: Beyond modernization’, Social Science History, vol. 6, no. 3, pp. 321–45. Hofer, H.-G. (2007) ‘Medizin, Altern, Männlichkeit: zur Kulturgeschichte des männlichen Klimakteriums‘, Medizinhistorisches Journal, vol. 42, no. 2, pp. 210–45. Hunter, C. (2008) ‘The concept of successful ageing: A contribution to a history of old age in modern Australia’, History Australia vol. 5, no. 2, pp. 42.1–42.15. Johnson, P. (1998) ‘Historical readings of old age and ageing’, in P. Johnson and P. Thane (eds), Old age from antiquity to post-modernity, London: Routledge. Johnson, P. and P. Thane (1998) Old age from antiquity to post-modernity, London: Routledge. Kampf, A. (2009) ‘The absence of Adam: Prostate cancer and male identity’, in J. Powell and T. Gilbert (eds), Aging and identity: A postmodern dialogue, New York: Nova Science Publishers. Kampf, A., Marshall, B. and Petersen, A. (eds) (2012) Aging men, masculinities and modern medicine, New York, London: Routledge. Katz, S. (1996) Disciplining old age: The formation of gerontological knowledge, Charlottesville, London: University Press of Virginia. Katz, S. (1997) ‘Charcot’s women: Bodies of knowledge at the interface of aging studies and women’s studies’, Journal of Women & Aging, vol. 9, no. 4, pp. 73–87. Laslett, P. (1984) ‘The significance of the past in the study of ageing: Introduction to the special issue on history and ageing’, Ageing and Society, vol. 4, no. 4, pp. 380–1. Minois, G. (1989) History of old age: From antiquity to the renaissance, Chicago: Chicago University Press. Moreira, T. and Palladino, P. (2011) ‘ “Population Laboratories” or “Laboratory Populations”? Making sense of the Baltimore Longitudinal Study of Aging, 1965–1987’, Stud. Hist. Phil. Biol. Biomed. Sci, vol. 42, pp. 317–27. Moses, S. (2007) ‘Alt und krank. Ältere Patienten in der Medizinischen Klinik der Universität Tübingen zur Zeit der Entstehung der Geriatrie 1880 bis 1914‘, Medizin, Gesellschaft und Geschichte, vol. 24, pp. 201–11. Ottaway, S. (2004) The decline of life: Old age in eighteenth-century England, Cambridge: Cambridge University Press. Pelling, M. and Smith, R. (eds) (1991) Life, death and the elderly: Historical perspectives, London: Routledge. Rogers, P. (1999) ‘Introductory note’ to ‘Aging and identity: An eighteenth-century perspective’, Journal of Aging and Identity vol. 4, no. 2, p. 55. Schlegel-Voß, L.-C. (2005) Alter in der “Volksgemeinschaft”: Zur Lebenslage der älteren Generation im Nationalsozialismus, Berlin: Duncker & Humboldt.

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Soland, B. (2001) ‘Editor’s note. Ages of women: Age as a category of analysis in women’s history, special issue’, Journal of Women’s History, vol. 12, no. 4, pp. 6–10. Stearns, P. (1980) ‘Old women: Some historical observations’, Journal of Family History, vol. 5, pp. 44–57. Streubel, C. (2011) ‘Strange old worlds: Socio-critical reports about old-age experiences in West-German print media (1970s–1990s)’, Women’s History Review, vol. 20, no. 2, pp. 319–37. Thane, P. (2003) ‘Old age’, in Cooter, R. and J. Pickstone (eds), Companion to medicine in the twentieth century, London, New York: Routledge. Thompson, P., Itzin, C. and M. Abendstern (1990) I don’t feel old: The experience of later life. Oxford: Oxford University Press. Troyansky, D. (1996) ‘Progress report: The history of old age in the western world’, Ageing and Society, vol. 16, no. 2, pp. 233–43. Watkins, E., (2008) ‘Medicine, masculinity, and the disappearance of male menopause in the 1950s’, Social History of Medicine, vol. 21, no. 2, pp. 329–44. Woodward, K. (ed.) (1999) Figuring age:Women, bodies, generations, Bloomington: Indiana University Press.

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7 Literature and ageing Sarah Falcus

Stories of age do not provide answers to questions about ageing. They do not illustrate gerontological concepts. They can offer comfort, inspiration and possibility. They may not offer any of those things. Telling and reading stories of age does open up debate and embrace complexity, and may challenge our ways of thinking. From the trauma of Shakespeare’s bereft King Lear to the eccentricity of Charles Dickens’ Miss Havisham (Great Expectations 1860) and the ribald effrontery of Angela Carter’s Nora and Dora (Wise Children 1991), ageing—across the life course—is part of our literary heritage and, according to some, becoming more prominent in texts from current writers (Oró-Piqueras 2013). Others argue that demographic change is, in part, responsible for a ‘new coming of age of literature’ (Ramos 2010: 14). There is not space in this short piece to map fully the way that literature deals with ageing. Instead, the chapter concentrates on a specific aspect of the literary treatment of age: how critics have addressed ageing and literature, or, to put it another way, how age has emerged as a critical perspective from which to view literature. Despite the wealth of literary texts that explore and present ageing across the life course, as Helen Small argues, literary critics very rarely take ageing as a focus for their work: ‘Old age in literature is rarely if ever only about itself—but as far as criticism has been concerned, it has oddly rarely been much about itself at all’ (2007: 6). In literary studies, ageing has been the unacknowledged shadow that intersects with more prominent approaches such as gender or postcolonialism. A similar lack of interdisciplinary connections has also been the case in gerontology, meaning that the humanities, including literature, found themselves marginalized in this area. However, this is changing and a genuinely dialogic relationship between literature and gerontology is becoming established, a field appropriately coined by the term ‘literary gerontology’. As a result, the importance of literature and the literary to gerontological study is increasingly recognized and, though this is expressed in multiple ways by critics, few would disagree with Sally Chivers’s argument that ‘a humanities-based approach to aging can consistently maintain the crucial complexity of growing old because works of art, such as literature, can comfortably encompass contradictions and even gain their aesthetic strength from doing so’ (2003: x). It is the ability to accommodate and even thrive on contradiction, incompleteness and possibility that makes literature such a valuable area of study for gerontology. Literature does not—as most

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literary critics working on ageing are at pains to stress—simply mirror or reflect a social world, but, instead, is part of and complicit in shaping that social world. This of course raises the related question: what does gerontological research have to bring to the literary studies table? As Aagje Swinnen and Cynthia Port argue in relation to the humanities as a whole, there are numerous benefits to be derived from the engagement with social science, including the possibility of links with ‘living people’, producing research that has clearer relevance to society in general, and learning how to exert a greater impact on public policy (2012: 10–11). More generally, as Swinnen and Port explain, being aware of research in the social sciences prevents duplication and promotes collaboration and innovation (2012: 10). Developments in literary studies, the influence of literary theory and cultural studies, particularly since the late 1960s, have fostered interdisciplinarity and widened the field of study, making it easier for gerontology and literary studies to meet. Much of the work in literary gerontology shares a positive approach to literature and ageing, aiming, in the words of Barbara Frey Waxman, to ‘foster social change regarding old age’ (1990: 2). And this political edge chimes with the ‘cultural studies’ aspect of literary criticism.There are, of course, potential dangers in such an openly political drive, something Oliver Davis argues is the case in some gerontological work, which unites around ageism to such an extent that it risks falling foul of the simplistic promotion of positive ageing (2006: 17–18). However, it is clear that most critics working in literary gerontology are cognisant of the complexities of gerontological debate in their keen engagement with the ethical and political questions around ageing and culture.

Literature and gerontology: a brief history Though there was some interest in literature and ageing prior to the 1980s, it was in that decade that literary gerontology really began to develop, allowing Anne M.Wyatt-Brown to herald ‘The Coming of Age of Literary Gerontology’ in 1990. Wyatt-Brown argued that, though there were relatively few existing literary gerontological studies, the number was increasing and this looked set to continue. As she noted, one of the most significant early and continuing contributors to the field is Kathleen Woodward. Moving from Memory and Desire (1986) to Ageing and Its Discontents: Freud and Other Fictions (1991), Woodward pairs psychoanalytic texts and concepts with literary works, proposing, for example, the mirror stage of old age, addressing what she sees as the neglect of ageing in Freudian models (1991: 68). Similarly significant, both in the early days of the field and subsequently, is Margaret Morganroth Gullette. Gullette’s ‘progress narrative of the middle years’ (1988: xi) is an early example of the identification of what we might call ‘ageing genres’, those that accommodate new discourses of ageing. Gullette suggests that this progress narrative emerged in the 1970s and 1980s in Anglo-American culture and is identified by stories of change and development (1988: xii), which are at odds with the dominance of what she terms the decline narrative. Gullette’s work, like Woodward’s, continues, and in Declining to Decline (1997) and Aged by Culture (2004) a much less optimistic view of the progress narrative emerges, a trend continued into her latest book, Agewise: Fighting the New Ageism in America (2011). An indefatigable campaigner for ‘age studies’ (2004: 101–19), Gullette produces work that is often literary, but she combines this with economics, history, media studies and social sciences to create a multidisciplinary, cultural studies of ageing. Barbara Frey Waxman’s From the Hearth to the Open Road (1990) similarly identifies generic developments in literature since the publication of Simone de Beauvoir’s The Coming of Age (1970/2) (a keystone text for many in literary gerontology), positing the existence of the reifungsroman, a term she coins to describe the novel of ripening, as opposed to the youth of the bildungsroman. Constance Rooke also looks to the bildungsroman to explain her term vollendungsroman, 54

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defining the latter ‘as a complementary term, to refer to the novel of completion or winding up’ (1992: 245). Like Gullette (1988) and Waxman, she argues that there has been a ‘recent proliferation of novels about old age’ (Rooke 1992: 244), making the 1970s onwards crucial decades for literature about age, and the 1980s and 1990s important in the literary gerontology that followed from this. Following on from the work of these pioneers, perhaps the most significant sociological figure engaged in literary gerontology in the 1990s and into the twenty-first century was Mike Hepworth, whose Stories of Ageing (2000; see also 2002) brought literature into sociology with his use of symbolic interactionism in readings of selected literary texts. Hepworth sets out his aim in the book thus: ‘to encourage you as readers to explore fiction as an imaginative resource for understanding variations in the meaning of the experience of ageing in society’ (2000: 1). Hepworth recognizes the complexities of the debates about the relationships between reader, author, text and world that bedevil literary studies, but he largely sidesteps these in favour of his own ‘interest [. . .] in the potential of fictional representations of ageing to engage our interest and concern’ (2000: 6). Hepworth’s work is not therefore particularly informed by literary theory or practice, but it is important for the way it highlights the value of fiction and the significance of cultural representation in gerontology, bringing to the fore authors who are interesting to literary gerontologists. Like many studies in the 1980s and 1990s, Anne M. Wyatt-Brown and Janice Rossen’s Aging and Gender in Literature: Studies in Creativity (1993) tried to put right the lack of literary interest in ageing, but this book was also significant as an example of a strand of literary gerontology that focusses on later-life creativity.There are potential pitfalls in this approach, since it can too easily conflate ageing and creativity, and read authorship in a way that seems naive in the light of the radical questioning of the role of the author since Barthes and Foucault. This is not, however, to suggest that the concept of late style or the biographical focus is not important, and this aspect of literary gerontology continues to develop in interesting ways, including in recent work by Wyatt-Brown (2010). Gordon McMullan’s work (2007) is a further example of this approach, as he considers late style as a construction that denies old age. Another theoretically more complex approach is found in Mary Eagleton’s (2011) recent essay on British editor and writer Diana Athill, which explores age identity as an older writer, drawing on both Bourdieu and the notion of the literary life. She examines Athill as one of a group of older writers who are marketed as ‘new’ and analyzes both her high media profile and the effects of her work on readers. Rather than linking these things simply to late style, Eagleton (2011) argues that a combination of factors accounts for Athill’s popularity, including the ageing population, class nostalgia, the popularity of the memoir and Athill’s own influence within a publishing world. Critical work from gerontology may have added to the conceptualization of ageing and the older writer here, but this is nevertheless an example of both a more nuanced reading of the relationship between age and creativity and the way that age has entered the literary critical mainstream. Similarly contentious within literary gerontology is the prominent content-based study of representations of ageing within fiction. Often aligned to the early feminist literary ‘images of women’ approach, this has been criticized for not paying enough attention to extra-textual factors and to matters of style (Davis 2006: 23). Some critics argue that a more multi-dimensional and contextual approach is needed (this can be seen as analogous to the way that feminist literary studies have developed, with a move to more contextual and intersectional works). As Hannah Zeilig comments: Fictional stories can be invaluable for considering the various manifestations of age and ageing. However, these stories are most insightful when they are thoroughly contextualized, 55

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when the frame of reference is accounted for and when fiction as one in a range of cultural discourses is appreciated. (2011: 31) This helps to develop literary gerontology and protect it from accusations—sometimes levelled by critics from the social sciences—that it is methodologically flimsy. It is important, however, not to deny the value of analyses of representations of ageing in literature. Such representations do need to be addressed. As Josephine Dolan and Estella Tincknell note in their summary of Canadian scholar Sally Chivers’s approach to this in Silvering Screen (2011, a study of film rather than literature), she examines representation in its ‘richest, fullest iteration’ and is therefore considering ‘representation as power’ (2012: xi). This link between representation and power is crucial to understanding the importance of film and literature as part of the discourses of ageing. If we appreciate the power of literary narratives of ageing to influence our cultural understanding of what ageing means, then it becomes clear that content-based studies, as well as spirited defences of the need to consider representations of ageing in literature, are still very valuable to the field (see Oró-Piqueras 2013). Nevertheless, also emerging are examples of more contextual criticism. Jeannette King’s recent study of ageing and literature, for instance, looks at nineteenth- and twentieth-century literary representations of older women alongside medical, psychological and social discourses of ageing at the time of writing: Such a reading of nineteenth- and twentieth-century fiction by women suggests the dynamics and tensions at work between text and context. Since novelists can imaginatively explore the subjective experience of ageing, their representations of ageing may contest those embodied in these powerful discursive contexts, offering alternative ways of understanding ageing in women. (2013: xv) King’s book is also an example of a prominent critical intersection in literary gerontology: age and gender. Wyatt-Brown could argue in 1990 that literary gerontology had not explored the relationship between ageing and feminism, but this is certainly not the case now. Susan Sontag’s (1972) assertion of the ‘double standard of aging’ provided a clarion call that has been developed and critiqued not only by those working in gerontology and the social sciences, but also by literary scholars. What this yoking of age and gender has had to battle with is, as Woodward argued in Figuring Age in 1999, the ‘ageism [. . .] entrenched within feminism itself ’ (xi). But as gerontology began to develop a feminist strain in the 1990s (see Calasanti 2004 and 2006), literary gerontology could do the same, having the advantage of a strong tradition of feminist literary studies behind it. From Woodward (1999) to Chivers (2003), Brennan (2005), Paloge (2007) and King (2013), the intersection of ageing and feminism has proved fruitful in literary gerontological work and more widely in cultural gerontology.

Literary studies: the difference age makes In this way, and particularly in the last 10 years or so, age has come to be seen as another way to approach literature, akin to, say, feminist, postcolonial or queer approaches. Age may therefore be read, as Victoria Bazin and Rosie White do here, as ‘the last difference, the unspoken but inevitable site of a difference not only between subjects but also a difference within subjects as they are exiled from their younger selves’ (2006: ii). Literary gerontology is energized by this intersectional

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approach. This dialogue between age and other, more traditional literary approaches (such as gender, class, race and ethnicity) offers a rich vein of scholarship that can encompass the complexities inherent in the different experiences of ageing. However, it is important to recognize, as Chivers acknowledges, that we may all have a more mobile relationship to age than to other perspectives or subject positions (2003: xiii). Age is not a ‘category’ quite like gender or ‘race’, though, like these terms, it is contested, because we are all ageing at any one moment and will most likely find ourselves moving across stages and definitions of age as we develop through the life course. This makes the focus of our study when we turn to age remarkably unclear. Indeed, as Gullette argues, awareness of ageing is moving down the life course and we must attend to ageing across this rather than simply focussing on ‘old’ age (2004: 3–20). This awareness does not invalidate intersections between age and other critical categories such as ‘race’ and gender, but the best literary gerontology is that which acknowledges the complexity of its parameters. Also becoming more established as a bridge between gerontology and literary studies is the concept of narrative (see Bornat in this volume). Traditionally the preserve of the literary, narrative has now entered gerontology and become established within both theoretical and therapeutic environments (Kenyon, Bohlmeijer and Randall 2011). With its insistence on the temporal, narrative is of obvious interest to those exploring age, often based on the idea that we live storied lives. It is fair to say that narrative gerontology is not a clear-cut field, but an area that draws on many methodological and disciplinary knowledges, including literary studies. And perhaps it is this flexibility that enables it to provide a conceptual bridge for the literary and the gerontological. Bringing together narrative, critical and literary gerontology, Zeilig explains their concerns thus: ‘Narrative, literary and critical gerontology all share an ability to confront (rather than shirk) the ambiguities and complexities of age, ageing and later life and an interest in quizzing the cultural norms of ageing via non-scientific forms of knowing’ (2011: 8–9). This acceptance of complexity and ambiguity is, of course, where the chapter started with the value of the literary to gerontology. There are potential downfalls in the co-option of a literary concept into gerontology, as Zeilig (2011: 17–19) outlines, but the possibilities of the meeting-place for the literary and the gerontological provided by narrative are clear and are only just starting to be explored, as evidenced by Rishi Goyal and Rita Charon’s essay on Woolf ’s The Waves in Kenyon, Bohlmeijer and Randall’s Storying Later Life (2011). Making clear the way that literary gerontology is finding its feet within an interdisciplinary environment, other recent work on ageing and literature takes a more practice- and people-based approach. For example, the Fiction and the Cultural Mediation of Ageing Project based at Brunel University, UK, takes literature beyond theory and analysis with its emphasis on readership. As stated earlier, Swinnen and Port argue that two of the main advantages to humanities scholars of the dialogue with social science research are ‘engagement with living people’ and learning how ‘to exert influence over policy making’ (Swinnen and Port 2012: 10–11). This project demonstrates the viability of both of these aims, using diary responses by volunteers from the UK University of the Third Age to a series of literary texts chosen for their representations of ageing. The project aimed ‘not to examine the event of reading for its own significance, but to explore fiction’s capacity to catalyze individual and collective reflection on the changing dynamics of contemporary age culture’ (Morrison 2011: 6). The voices of older people are prominent within this study, but it also draws on literary techniques and the currently less popular approach of reader-response. The project was unusual in that it resulted in a report, ‘Ageing is Not a Policy Problem to Be Solved: Coming of Age’ (Bazalgette et al. 2011), produced by the UK think tank Demos, demonstrating the synergy between literary gerontology and work in public policy.

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Conclusion Since Wyatt-Brown’s 1990 essay, it can be said that literary gerontology has indeed come of age. Books and articles on ageing and literature proliferated throughout the 1990s and into the twenty-first century, and there is no sign of a slowing of pace. Literary gerontology has spread its net widely, taking in drama and performance, fiction, auto/biography and poetry. It includes attention to non-Western writers—though it is true that at the moment the balance is still tipped in favour of US, Canadian, European and (to a lesser extent) Australian writers—and pays some attention to both the popular and the literary. Content-based studies draw close attention to representations of ageing within literature; others look at ageing and creativity, genre or readership. More and more, intersectionality is invigorating literary studies of ageing, with a notable flood of work addressing age and gender (see above) and a more limited amount of research into ‘race’ and age (for example, Gual 2004). And exciting, truly interdisciplinary work that yokes literary and social science methodologies is developing. This does not, however, mean that the field has nowhere to go.The conceptual and practical aspects of the use of narrative in gerontology and literature have yet to be fully explored. Intersectionality may be flourishing, particularly around age and gender (though the issue of masculinity is not given significant attention, despite the growing interest in masculinity in gerontology and the strength of masculinity studies within literature), but other connections are less well explored, such as age and ‘race’, and age and sexuality. For example, little work has been done on the intersection between queer theory and age studies, and Brian Worsfold points out the need for cultural gerontology as a whole, including literature, to attend to the experience of the ageing immigrant and emigrant (2011: xxxi). Perhaps the greatest hurdle facing literary gerontology comes from the literary field. Despite the enthusiasm for literature within cultural gerontology, and the burgeoning of the field of literary gerontology detailed in this chapter, literary gerontology still struggles to find its feet within literary studies. There is some evidence of increasing acceptance of gerontological work within the discipline, such as the publication of literary gerontology by mainstream literary journals (for example, Studies in the Literary Imagination and Contemporary Women’s Writing), the prominence of literary studies within cultural gerontology research groups (for example, the European Network in Aging Studies) and conferences on ageing emerging from literature departments within universities. But the relationship between ageing and literature is very rarely a focus for syllabi within higher education institutions and is not strongly represented within literary doctoral studies. Gerontological research is still not given the attention it deserves by some literary critics. For example, Thomas Cole (2009), in his review of Helen Small’s The Long Life (a text that brings together philosophical and literary texts, but is primarily interested in old age and philosophy), argues that she pays little attention to gerontological work, and Roberta Maierhofer is ‘less convinced that the work done in cultural gerontology has found recognition in the field of cultural studies, and has entered research and teaching as part of the overall field’ (2011: xv). Nevertheless, the possibilities for literary study within gerontology, and the value of literature and literary study for interrogating and even changing discourses of age, are now firmly established. Kathleen Woodward sees the potential for literature (and other imaginative works) to be ‘epistemological tools’, offering vital knowledges about ageing (2012: 6). Literary gerontologists are in the privileged position of unearthing and bringing to light these knowledges.

References Bazalgette, L., Holden, J., Tew, P., Hubble, N. and Morrison, J. (2011) ‘Ageing Is Not a Policy Problem to be Solved’: Coming of Age, London: Demos.

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Bazin,V. and White, R. (2006) ‘Generations: Women, Age and Difference’, Studies in the Literary Imagination, 39(2): i–x. Brennan, Z. (2005) The Older Woman in Recent Fiction, Jefferson, NC: McFarland. Calasanti,T. M. (2004) ‘New Directions in Feminist Gerontology: An Introduction’, Journal of Ageing Studies, 18(1): 1–8. Calasanti, T. M. and Slevin, K. F. (eds) (2006) Age Matters: Re-aligning Feminist Thinking, New York and London: Routledge. Carter, A. (2006) Wise Children, London:Vintage. Chivers, S. (2003) From Old Woman to Older Women: Contemporary Culture and Women’s Narratives, Columbus: Ohio University Press. ——— (2011) The Silvering Screen: Old Age and Disability in Cinema, Toronto: University of Toronto Press. Cole, T. (2009) ‘Helen Small’s The Long Life’, Ageing and Society, 29(2): 328–30. Davis, O. (2006) Age Rage and Going Gently: Stories of the Senescent Subject in Twentieth-Century French Writing, Amsterdam: Rodopi. de Beauvoir, S. (1972) The Coming of Age, trans. P. O’Brian, New York: Norton. Dickens, C. (2003) Great Expectations, ed. C. Mitchell, London: Penguin. Dolan, J. and Tincknell, E. (2012) Aging Femininities: Troubling Representations, Newcastle: Cambridge Scholars. Eagleton, M. (2011) ‘When Old Is New: Diana Athill and Literary Value’, Contemporary Women’s Writing, 5(3): 172–87. Goyal, R. and Charon, R. (2011) ‘In Waves of Time, Space, and Self: The Dwelling-Place of Age in Virginia Woolf ’s The Waves’, in G. Kenyon, E. Bohlmeijer and W. L. Randall (eds), Storying Later Life: Issues, Investigations, and Interventions in Narrative Gerontology, Oxford: Oxford University Press. Gual, N.C. (2004) ‘Black Skins, Old masks: Ageing through Racism in Edgar Nkosi White’s Drama’, in M. V. Grau and N. C. Gual (eds), The Polemics of Ageing as Reflected in Literatures in English, Lleida: University of Lleida Press. Gullette, M. M. (1988) Safe at Last: The Invention of the Midlife Progress Novel, Berkley: University of California Press. ——— (1997) Declining to Decline: Cultural Combat and the Politics of Midlife, Charlottesville: University Press of Virginia. ——— (2004) Aged by Culture, Chicago: University of Chicago Press. ——— (2011) Agewise: Fighting the New Ageism in America, Chicago: University of Chicago Press. Hepworth, M. (2000) Stories of Ageing, Buckingham: Open University Press. ——— (2002) ‘Generational Consciousness and Age Identity: Three Fictional Examples’, in J. Edmunds and B. S. Turner (eds), Generational Consciousness, Narrative, Politics, Lanham, MD: Rowman & Littlefield. Kenyon, G., Bohlmeijer, E. and Randall,W. L. (2011), Storying Later Life: Issues, Investigations, and Interventions in Narrative Gerontology, Oxford: Oxford University Press. King, J. (2013) Discourses of Aging in Fiction and Feminism, Basingstoke: Palgrave Macmillan. Maierhofer, R. (2011) ‘Preface’, in B. J. Worsfold (ed.), Acculturating Age: Approaches to Cultural Gerontology, Lleida: University of Lleida Press. McMullan, G. (2007) Shakespeare and the Idea of Late Writing: Authorship in the Proximity of Death, Cambridge: Cambridge University Press. Morrison, J. (2011) ‘Aging Reimagined: Exploring Older Women’s Attitudes to Aging through Reader Response’, Contemporary Women’s Writing Advance Access. Available online at http://cww.oxfordjournals .org/content/early/2011/10/18/cww.vpr008.short> (accessed 20 October 2011). Oró-Piqueras, M. (2013) ‘Narrating Ageing: Deconstructing Negative Conceptions of Old Age in Four Contemporary English Novels’, Journal of Aging Studies, 27: 47–51. Paloge, H. (2007) The Silent Echo: The Middle-Aged Female Body in Contemporary Women’s Fiction, Lanham, MD: Lexington Books. Ramos, N. B. (ed.) (2010) Flaming Embers: Literary Testimonies on Ageing and Desire, Bern: Peter Lang. Rooke, C. (1992) ‘Old Age in Contemporary Fiction’, in T. R. Cole, D. D. Van Tassel and R. Kastenbaum (eds), Handbook of the Humanities and Aging, New York: Springer. Small, H. (2007) The Long Life, Oxford: Oxford University Press. Sontag, S. (1972) ‘The Double Standard of Aging’, Saturday Review, 23 September. Swinnen, A. and Port, C. (2012) ‘Aging, Narrative and Performance: Essays from the Humanities’, International Journal of Ageing and Later Life, 7(2): 9–15.

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Waxman, B. F. (1990) From the Hearth to the Open Road: A Feminist Study of Aging in Contemporary Literature, Westport, CT: Greenwood. Woodward, K. (1991) Aging and Its Discontents: Freud and Other Fictions. Bloomington: Indiana University Press. ——— (ed.) (1999) Figuring Age:Women, Bodies, Generations, Bloomington: Indiana University Press. ——— (2012) ‘Assisted Living: Aging, Old Age, Memory, Aesthetics’, Occasion: Interdisciplinary Studies in the Humanities, 4 (31 May). Available online at http://occasion.stanford.edu/node/104. Woodward, K. and Schwartz, M. M. (eds) (1986) Memory and Desire: Aging, Literature, Psychoanalysis, Bloomington: Indiana University Press. Worsfold, B. J. (2011) Acculturating Age: Approaches to Cultural Gerontology, Lleida: University of Lleida Press. Wyatt-Brown, A.M. (1990) ‘The Coming of Age of Literary Gerontology’, Journal of Aging Studies, 4(3): 229–315. ——— (2010) ‘Resilience and Creativity in Aging: The Realms of Silver’, in T. R. Cole, R. E. Ray and R. Kastenbaum (eds), A Guide to Humanistic Studies in Aging, Baltimore: Johns Hopkins University Press. Wyatt-Brown, A.M. and Rossen, J. (eds) (1993) Aging and Gender in Literature: Studies in Creativity, Charlottesville: University Press of Virginia. Zeilig, H. (2011) ‘The Critical Use of Narrative and Literature in Gerontology’, International Journal of Ageing and Later Life, 6(2): 7–37.

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8 Theatre and ageing Miriam Bernard and Lucy Munro

Social and critical gerontologists, as well as literary and cultural scholars, have become increasingly interested in the artistic engagement of older people, and in how the arts may construct, perpetuate or challenge stereotypical views and existing models of the ageing process (Basting 1998, 2009, Small 2007, Lipscomb and Marshall 2010, Mangan 2013). Theatre is a particularly fruitful context for such explorations, not least because it is a cultural arena in which both ageing and older people are highly visible as audience members and as volunteers (DCMS 2013). In addition, older people feature strongly in the theatrical cultures of many countries and eras, both as performers and characters.Yet, although some plays present complex meditations on ageing, it is also true, as Mangan (2013: 23) argues, that ‘theatre and performance has always made extensive use of stereotypes and stock characters’, and these include caricatured old men and old women. Similarly, many cultural institutions, not just individuals, tend to hold stereotypical and deficit views of what older people are or are not capable of and will tend to write off, or ignore, their contributions to their communities and localities in cultural as in other arenas (Cutler 2009). Despite many valuable critiques, the role that older people play in making theatre—in both professional and non-professional contexts—is poorly understood or researched, as is theatre’s potential to develop individuals and communities, and its role—or potential role—in fostering intergenerational relationships.Thus, the purpose of this chapter is threefold: first, to look at how ageing and older people have been—and are currently—represented on the professional stage; second, to describe the evolution of older people’s theatre groups in various contexts; and, third, to examine what the existing research evidence tells us about older people’s experiences of theatre-making. It concludes with suggestions for a number of areas that cultural and critical gerontologists might like to explore further.

Representing age on stage Although theatre is in some respects inherently intergenerational, its representations of older people and the ageing process have often been partial, incomplete or based on stereotype.While some of the oldest surviving plays of the Western tradition, such as Aeschylus’s The Persians (472 BCE), feature older men and women in prominent roles, the New Comedy of Menander developed performative stereotypes and polarized its treatment of age into the young and the 61

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old whereby ‘one generation would be represented with white hair and beards, and the other with dark hair and no beards’ (Marshall 2006: 129). Similarly, later European theatre’s tendency towards non-realist performance styles meant that casting rarely depended on the age of the individual actor. The protagonist of Shakespeare’s King Lear (c. 1605–6), still a central text in theatrical culture’s meditations on ageing, was originally played by Richard Burbage (b. 1568), then in his late thirties, while a century later, in 1709,Thomas Betterton (b. 1635) played Hamlet when he was in his sixties. As Mangan (2013: 45) notes, ‘ “How to act old” is less common as a feature of actor training today than it once was’. However, greater naturalism has not always created more roles for older actors or more nuanced treatments of ageing and old age. Until comparatively recently, the position of older men and, especially, older women within the theatre industry was often uncertain, with roles drying up or becoming less interesting as actors hit middle (for women) or old (for women and men) age. Notwithstanding these problems, some plays have engaged directly with the process of ageing and have questioned realist approaches to theatrical age: examples include On Ageing (Young Vic, London, 2010), a devised piece based on interviews with older people but performed by a group of children (Johnson 2011), and a radical revision of Shakespeare, Juliet and Her Romeo (Bristol Old Vic, 2010), starring the 76-year-old Siân Phillips and the 66-year-old Michael Byrne. Nonetheless, scholarship has hesitated to deal critically with the precise details of the ways in which age is represented in dramatic works. As Small (2007: 5) writes, ‘Remarkably little of the vast literature on King Lear . . . says much or anything about old age’ (see also Martin 2012), and many studies—Small’s included—have had little to say about dramatists other than Shakespeare and/or Beckett. In addition, where representations of ageing and old age in drama have been discussed, many analyses have uncritically adopted deficit models of old age. Taunton (2007: 82), for instance, argues that in late sixteenth- and early seventeenth-century literature ‘the only way one can grow old in a seemly fashion is to adopt attitudes embodied in an amalgam of biblical precept and stoicism. An old person’s only recourse is to accept old age as a misfortune that cannot be avoided’. Similarly, White’s (2009) monograph, Beckett and Decay, begins with an epigraph from Beckett’s ‘Tailpiece’, ‘who may tell the tale of the old man?’, and successive chapters treat ‘The Body Infirm’ and ‘Old Age: The Dictatorship of Time’. More recent work is beginning, however, to demonstrate a turn to gerontological frameworks and what Gullette (2004, 2008, 2011) terms ‘age studies’. There are also signs that scholarship is starting to address, in greater depth, the specific techniques through which age is staged and the impact that representations of age might have on actors as well as spectators (Fries-Dieckmann 2009). Lipscomb and Marshall (2010: 2), for example, self-consciously position their collection as an intervention in age studies, drawing on the work of Butler (1990) to contend that ‘age as well as gender can be viewed as performative, in that each of us performs the actions associated with chronological age minute by minute, and that the repetition of these performances creates a so-called reality of age both for the subject and for those who interact with the subject’. Martin’s (2012) concerns are shaped by Gullette’s (2004) critique of gerontophobia, while Mangan (2013), in the most sustained study of this kind to date, devotes his first chapter to an overview of gerontology’s potential for the study of theatrical age. This developing area of research thus has the potential to become richly self-reflexive.

Senior theatre and theatre with seniors A key development of the twentieth century has been the emergence of forms of theatre that focus on older people’s experience of ageing, involving them in their conception and writing as well as performance. The roots of these contemporary interests can be traced back through 62

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history and to the evolution of different forms of theatre including community, applied and participatory theatre; documentary and verbatim theatre; playback and forum theatre; and reminiscence theatre. Reminiscence theatre is perhaps the genre of theatre most obviously allied with considerations of ageing and old age. It emerged as part of the growing recognition during the 1970s and 1980s of the importance of reminiscence and life review to the mental health and wellbeing of older people (Butler 1963, Bornat 2001, Webster and Haight 2002). A dawning recognition of the changing socio-demographic make-up of our populations and a gradual, but increasing, visibility of older people all provided a backdrop and impetus to the establishment of theatre groups such as ‘Fair Old Times’ in Devon, England, in 1978 (Langley and Kershaw 1981–2) and the internationally renowned ‘Age Exchange’ Theatre Trust in London in 1983 (Schweitzer 2007). Since then, reminiscence theatre has also become an increasingly accepted form with which to work therapeutically and creatively with people with dementia (Schweitzer and Bruce 2008). While there is overlap and a shared basis in much theatre work with, and about, ageing and older people, Schweitzer (2007: 207) notes an important distinction between the UK, on the one hand, and North America and Europe on the other in that many groups in the UK initially brought older people together ‘as volunteers, greeting and sharing their stories’ rather than ‘with a view to performing’. By contrast, a desire to perform and a love of theatre were the motivating factors behind the remarkable growth of what is now termed the ‘senior theatre’ movement in North America. In her path-breaking book The Stages of Age (1998), Anne Basting charts the growth of this movement from its beginnings in the 1970s through to the first national Senior Theatre Festival in 1993 and beyond. A year after Basting’s book was published, Bonnie Vorenberg (1999), one of the pioneers of the movement, compiled the first directory of information, which included guidance on a range of things, from acting to funding; from academic programmes to playwriting and scripts. At this time, there were some 79 senior theatre groups in the USA but, by 2011, the ‘Senior Theatre Resource Centre’ had over 800 senior theatre groups on its database. Many of these groups are amateur, with just a few professional companies, and tend to be small in size, with participants usually staying between 1 and 3 years and leaving as a result of illness or other commitments (Vorenberg 2011). This means that refreshing and replenishing such groups is an ongoing challenge, although some of the key companies established in the early days are still very active indeed, such as StAGEbridge in California. Over this same time period, Basting’s own TimeSlips project (founded in 1998), which she still directs, has become synonymous with innovative drama work with people with dementia. In contrast with reminiscence-based techniques, she seeks to stimulate the imagination rather than the memory and uses improvisation to develop plays, performance pieces and creative activities in various community and institutional settings (Basting 2009). Her most recent work has been on the Penelope Project, a professionally produced play staged inside a Wisconsin nursing home in March 2011, and inspired by residents’ discussions on the myth of Penelope from Homer’s Odyssey (see Mello and Voigts 2012). In Europe, by contrast, where many countries have a strong tradition of community-based theatre, older people’s theatre groups and projects are often grafted onto existing organizations. The Grey Matters project is a case in point: over a 2-year period (2013–15), Bristol-based ‘Acta Community Theatre’ brought together five other European companies in Poland, Holland, Belgium, Germany and Slovakia to make theatre with older people. The intention is to share the work by touring each show to perform in another country and, at the conclusion, to bring together all six companies to share learning from the process. The growth of senior theatre companies and drama-based projects demonstrates the extent of interest there now is in theatre 63

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work with older people.Yet, despite this growth, theatre practitioners, researchers and academics still lament the lack of attention paid to what participation in theatre-making means to older people and what benefits may be derived from it.

Older people’s experiences of theatre-making Lipscomb (2012: 131) argues that more than a decade after the appearance of Basting’s (1998) The Stages of Age, ‘this branch of the arts remains woefully under-researched and under-theorized’. Such lack of scholarly attention means that cultural gerontology has to build its knowledge-base by drawing on a combination of practitioner-knowledge and experience; on existing small-scale evaluations and research projects; and from the writings of academic colleagues who may not necessarily identify themselves first and foremost as (cultural) gerontologists. In the UK, for example, experiential evidence from the work and writings of important practitioners such as Schweitzer (2007, 2010) suggests that theatre and drama work can have multiple and far-reaching benefits for all involved. In her description of the work of The Good Companions—the first group in which older people enacted their own memories—she observes how ‘the more they performed, the more confident the older people became’ (Schweitzer 2007: 209); how ‘it was noticeable that people’s communication and memory skills improved’ (209); how they were enabled to see ‘connections between very different parts of their lives’ (212); and how exciting it was ‘watching the older people in this group, most of whom had never acted before, develop into a team of people who were first class communicators’ (255). Theatre and drama work, she argues, has social, physical and emotional benefits for the individuals involved; it also has positive effects on intergenerational relations and on the wider community. These themes recur in the practitioner literature about the senior theatre movement in the United States (Basting 1998,Vorenberg 2011) and in evaluations of the work of arts organizations such as ‘Magic Me’ in the East End of London (Magic Me 2009). However, other than such commissioned evaluations, research-based studies of older people’s experiences of theatre-making are few and far between. A recent UK review of the impact of participatory arts on older people, conducted by the Mental Health Foundation (2011), cites just three UK studies (Pyman and Rugg 2006, Hafford-Letchfield et al. 2010, Johnson 2011). Like the Magic Me evaluations, the Hafford-Letchfield et al. (2010) study demonstrates that working with older people through drama activities enhances intergenerational learning, enabling (young) participants—in this case social work students—to think outside their established views of older people. Similarly, Johnson’s (2011) evaluation of On Ageing highlights how the devising process helped create positive impressions among children of older people as active and fun. Meanwhile, for older participants, there is evidence from Pyman and Rugg’s (2006) qualitative study of community theatre members—the only one to include interviews with both performers and production crew—that theatre and drama engagement results in enhanced skills and learning ability; improved confidence and self-esteem; new social connections and friendships; and a sense of individual and collective enrichment, achievement and ‘community spirit’. They also note that, for recently bereaved people, having ‘a reason to go out and a welcome when you arrived’ was particularly valued, while performing a role on stage could provide a temporary distraction from grief (2006: 568). Other existing research, notably from North America, derives from the remedial use of the arts and tends to be couched within therapeutic and/or health and wellbeing frameworks. In this context, the oft-cited studies by the late Gene Cohen (2006, 2009) and his colleagues (2006, 2007) were instrumental in establishing the physiological and psychological benefits of arts participation for older people and confirming that creativity is essential for a healthy and 64

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meaningful old age (Kastenbaum 2000). Similarly, the systematic review of creative and performing arts programmes conducted by Castora-Binkley et al. (2010), which includes music, singing, visual arts and dance alongside drama, highlights positive impacts for community-dwelling older adults in terms of both physical and mental health. More recently still, the review of Noice et al. (2013: 10) of ‘wellness studies’ shows how seven studies exploring theatre and drama with older people produce ‘converging evidence of cognitive/affective benefits’. The Noices’ own research over 25 years also demonstrates that theatrical-based interventions improve older people’s cognitive skills because drama requires participants to be active rather than passive, to engage mentally, physically and emotionally at a high level, and to take part in problem solving (Noice and Noice 2008, 2013, Noice et al. 1999, Noice, Noice and Staines 2004). They also observed significant increases on a personal growth scale and on tasks of daily living. As Mangan (2013: 169) concludes, their work ‘gives good experimental and empirical reason to think what many have long suspected: that acting is good for you’.

Theatre, ageing and later life: potential avenues Theatre is, by its very nature, both inter- and multi-disciplinary. It thus holds out the promise of fruitful explorations and convergences in a number of areas, both between disciplinary perspectives and in practical terms. Some scholars with backgrounds in theatre and performance studies, such as Basting (2000) and Mangan (2013), are highlighting the connections with age studies; likewise, some gerontologists are engaging with the narrative and performative turn evident in the social sciences and adopting tools more commonly associated with the arts and humanities to co-create outputs with older people, to disseminate research findings, and to provide a bridge between different disciplinary traditions. In terms of theatre and ageing, Lipscomb (2012) suggests three potential avenues for researchers interested in combining critical, narrative and performative approaches: first, analyses of plays featuring older characters, and their production and staging; second, analyses of play scripts specifically about ageing and issues encountered in later life: works intended to effect social change; and, third, closer examinations of the older people who act and are involved with theatre groups. A striking example of the second of these suggestions can be seen in the transformation of Feldman’s doctoral study on widowhood into a script—Wicked Widows—by well-known Australian playwright Alan Hopgood (Feldman et al. 2011). Performed by three professional actors, it has been seen by over 6,000 people across the state of Victoria. Responses to the performances affirm that, among other things, the years that follow a spouse’s death are ‘much more than just a time of depression, negativity, and prolonged sadness’ (Feldman et al. 2011: 896), and lead the researchers to conclude that theatre of this kind is an important medium for engaging older people in meaningful discussions about their lives. To Lipscomb’s three possibilities for research, three others can be added. First, there is substantial scope for comparative work. It would be instructive, for example, to see theatre and drama work with older people compared and contrasted with other (community-based and collective) art forms, such as music-making, dance and singing, exploring the ways in which different artistic practices and traditions facilitate and support people to age in ways that they choose and which give meaning to their lives. Second, theatre and drama can deal directly with pressing practice and policy issues, such as age-related discrimination in different arenas, the absence of services or the plight of carers. Allied to this, cultural gerontologists have the potential to contribute a much-needed critical perspective to the existing disjuncture between ageing policies and arts policy. In the UK at least, these two policy arenas are yet to be brought into one field of engagement. 65

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Third, and finally, Lipscomb’s (2012: 136) call for interdisciplinary collaborations involving ‘a broad spectrum of academics and professionals’ is to be endorsed. She cites Basting’s Penelope Project as ‘a bold move in this direction’ (Lipscomb 2012: 136). In similar vein, the Ages and Stages project in the UK has also attempted to take up this challenge (Bernard et al. 2014). Begun in 2009, it is a continuing collaboration between a research team comprising a social gerontologist, humanities scholars, a psychologist and an anthropologist, working together with theatre practitioners from the New Vic Theatre in Newcastle-under-Lyme and with older people who now constitute the Ages & Stages Company. To date, the project has examined historical representations of ageing within the Vic’s ground-breaking documentaries and docudramas; explored contemporary recollections and experiences of older people who are, or have been, associated with the theatre in different ways; devised and toured three research-based and contrasting performance pieces; and developed, delivered and evaluated a pilot inter-professional training course. At the time of writing, company members are being supported to co-explore and co-research their experiences of the last four years and to articulate, through live performance, the cultural value of what they have been engaged in.

Conclusion Readers familiar with the wider literature and research around creativity and ageing will have been aware of many parallels and resonances with the material and developments reviewed above. Indeed, the work on creativity undertaken by the late Gene Cohen and his colleagues was fundamental to scholars’ attempts to articulate more precisely what the engagement of older people in the arts adds to their lives.Theatre and drama is not exceptional in this respect, though it differs from some other artistic forms in its inherently collective and communal qualities. This dimension makes it particularly important, in that engagement in senior, intergenerational or community-based theatre groups has the potential to address pressing social concerns such as isolation and loneliness, as well as contributing to physical and mental health and wellbeing. However, although theatre and drama is a (presently under-utilized) medium for conveying positive messages about growing older (Feldman et al. 2011), it is much more than this: it can also add meaning to people’s lives through its ability, when sensitively handled, to open up and address a range of other issues in a safe and supportive environment. Theatre’s potential lies, therefore, in its ability to help us move away from a narrow focus on health and wellbeing, and on deficits and problems, and articulate what else might be achieved by bringing theatre and drama to bear more directly on the concerns of (cultural and critical) gerontologists and others interested in our ageing population. This challenge is a demanding, but exciting, one.

Acknowledgments This chapter has been developed from our work on the Ages and Stages project, funded originally under the UK’s New Dynamics of Ageing programme (project number RES-356–25–0005). We also wish to acknowledge the contributions and support of our colleagues, David Amigoni, Ruth Basten, Tracey Harrison, Michael Murray, Jill Rezzano and Michelle Rickett.

References Basting, A. (1998) The Stages of Age, Ann Arbor: University of Michigan Press. Basting, A. (2000) ‘Performance Studies and Age’, pp. 258–71 in T. R. Cole, R. Kastenbaum and R. E. Ray (eds), Handbook of the Humanities and Aging, New York: Springer. 66

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Basting, A. (2009) Forget Memory: Creating Better Lives for People with Dementia, Baltimore: Johns Hopkins University Press. Bernard, M., Rickett, M., Amigoni, D., Munro, L., Murray, M. and Rezzano, J. (2014) ‘Ages and Stages: The Place of Theatre in the Lives of Older People’, Ageing and Society. Available in First View at http://jour nals.cambridge.org/abstract_S0144686X14000038. Bornat, J. (2001) ‘Reminiscence and Oral History: Parallel Universes or Shared Endeavour?’ Ageing and Society, 21(2): 219–41. Butler, J. (1990) Gender Trouble: Feminism and the Subversion of Identity, New York: Routledge. Butler, R. N. (1963) ‘The Life Review: An Interpretation of Reminiscence in the Aged’, Psychiatry, 26: 65–76. Castora-Binkley, M., Noelker, L., Prohaska, T. and Satariano, W. (2010) ‘Impact of Arts Participation on Health Outcomes for Older Adults’, Journal of Aging, Humanities, and the Arts, 4: 352–67. Cohen, G. (2006) ‘Research on Creativity and Aging:The Positive Impact of the Arts on Health and Illness’, Generations, 3(1): 7–15. Cohen, G. (2009) ‘New Theories and Research Findings on the Positive Influence of Music and Art on Health with Ageing’, Arts and Health, 1(1): 48–63. Cohen, G. D., Perlstein, S., Chapline, J., Kelly, J., Firth, K. M. and Simmens, S. (2006) ‘The Impact of Professionally Conducted Cultural Programs on the Physical Health, Mental Health, and Social Functioning of Older Adults’, The Gerontologist, 46(6): 726–34. Cohen, G. D., Perlstein, S, Chapline, J., Kelly, J., Firth, K. M., and Simmens, S. (2007) ‘Impact of Professionally Conducted Cultural Programs on the Physical Health, Mental Health, and Social Functioning of Older Adults—2-year Results’, Journal of Aging, Humanities and the Arts, 1(1–2): 5–22. Cutler, D. (2009) Ageing Artfully: Older People and Professional Participatory Arts in the UK, London: The Baring Foundation. DCMS (2013) Taking Part 2013/14, Quarter 2, London: Department for Culture, Media and Sport. Feldman, S., Radermacher, H., Lorains, F. and Haines, T. (2011) ‘A Research-Based Community Theater Performance to Promote Ageing: Is it More Than Just a Show?’ Educational Gerontology, 37(10): 885–98. Fries-Dieckmann, M. (2009) ‘Performing Old Age on Stage: Selected Plays by Beckett, Pinter and Stoppard’, pp. 183–95 in H. Hartung and R. Maierhofer (eds), Narratives of Life: Mediating Age, Vienna: Lit Verlag. Gullette, M. M. (2004) Aged by Culture, Chicago: University of Chicago Press. Gullette, M. M. (2008) ‘What’s Age Got to Do with It? My Life in Age Studies’, Journal of Aging Studies, 22(2): 189–95. Gullette, M. M. (2011) Agewise: Fighting the New Ageism in America, Chicago: University of Chicago Press. Hafford-Letchfield, T., Couchman, W., Webster, M. and Avery P. (2010) ‘A Drama Project about Older People’s Intimacy and Sexuality’, Educational Gerontology, 36(7): 604–21. Johnson, R. (2011) ‘On Ageing’ Case Study: Evaluation Report, London: Fevered Sleep. Kastenbaum, R. (2000) ‘Creativity and the Arts’, pp 381–401 in T. R. Cole, R. Kastenbaum and R. E. Ray (eds), Handbook of the Humanities and Aging, second edn, New York: Springer. Langley, G. and Kershaw, B. (eds) (1981–2) Reminiscence Theatre, Dartington: Dartington Theatre Papers. Lipscomb, V. B. (2012) ‘ “The play’s the thing”: Theatre as a Scholarly Meeting Ground in Age Studies’, International Journal of Ageing and Later Life, 7(2): 117–41. Lipscomb, V. B. and Marshall, L. (eds) (2010) Staging Age: The Performance of Age in Theatre, Dance, and Film, New York: Palgrave. Magic Me (2009) Our Generations: Report on a 3-year Programme of Intergenerational Arts Projects in Tower Hamlets, East London April 2006–June 2009, London: Magic Me. Mangan, M. (2013) Staging Ageing:Theatre, Performance and the Narrative of Decline, Bristol: Intellect. Marshall, C. W. (2006) The Stagecraft and Performance of Roman Comedy, Cambridge: Cambridge University Press. Martin, C. (2012) Constituting Old Age in Early Modern English Literature, From Queen Elizabeth to King Lear, Amherst: University of Massachusetts Press. Mello, R. and Voigts, J. (2012) The Penelope Project: Using The Power Of Myth To Transform Long Term Care, Program Evaluation Report. Available online at www.thepenelopeproject.com/links/materials. Mental Health Foundation (2011) An Evidence Review of the Impact of Participatory Arts on Older People, Edinburgh: Mental Health Foundation. Noice, H. and Noice, T. (2008) ‘An Arts Intervention for Older Adults Living in Subsidized Retirement Homes’, Aging, Neuropsychology, and Cognition, 16(1): 56–79. 67

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Noice, H. and Noice, T. (2013) ‘Extending the Reach of an Evidence-based Theatrical Intervention’, Experimental Aging Research, 39: 398–418. Noice, H., Noice, T., Perrig-Chiello, P. and Perrig, W. (1999) ‘Improving Memory in Older Adults by Instructing Them in Professional Actors’ Learning Strategies’, Applied Cognitive Psychology, 13: 315–28. Noice, H., Noice,T. and Staines, G. (2004) ‘A Short-term Intervention to Enhance Cognitive and Affective Functioning in Older Adults’, Journal of Aging and Health, 16: 1–24. Noice,T., Noice, H. and Kramer, A.F. (2013) ‘Participatory Arts for Older Adults: A Review of Benefits and Challenges’, The Gerontologist, Advance Access published December 11, doi: 10.1093/geront/gnt138. Pyman, T. and Rugg, S. (2006) ‘Participating in a Community Theatre Production: A Dramatherapeutic Perspective’, International Journal of Therapy and Rehabilitation, 13(12): 562–71. Schweitzer, P. (2007) Reminiscence Theatre: Making Theatre from Memories, London: Jessica Kingsley Publishers. Schweitzer, P. (2010) ‘Experience Shared and Valued: Creative Development of Personal and Community Memory’, pp. 57–77 in J. Bornat and J. Tetley (eds), Oral History and Ageing, London: Centre for Policy on Ageing/Open University. Schweitzer, P. and Bruce, E. (2008) Remembering Yesterday, Caring Today: Reminiscence in Dementia Care—A Guide to Good Practice, London: Jessica Kingsley. Small, H. (2007) The Long Life, Oxford: Oxford University Press. Taunton, N. (2007) Fictions of Old Age in Early Modern Literature and Culture, New York: Routledge. Vorenberg, B. L. (1999) Senior Theatre Connections: The First Directory of Senior Theatre Performing Groups, Professionals and Resources, Portland, OR: ArtAge Publications. Vorenberg, B. L. (2011) ‘The New Senior Theatre Survey: A Reflection of What’s Happening in Community Theatres’, AACT Spotlight, Nov/Dec. Available online at www.seniortheatre.com/A_New_ Senior_Theatre_Survey_article.pdf. Webster, J. D. and Haight, B. K. (eds) (2002) Critical Advances in Reminiscence Work: From Theory to Application, New York: Springer Publishing Company. White, K. (2009) Beckett and Decay, London: Continuum.

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9 Ageing in film Aagje Swinnen

Film represents a ‘possible world’ that cannot be assumed to reflect the reality outside the story-world without mediation. The integration of film into gerontological research therefore requires scholars who master a vocabulary with which to analyze cinematic form and style (mise-en-scène, cinematography, montage, etc.), have knowledge of film history and recognize the ideological dimensions of film so as to engage in critical readings of case studies. So far, the most extensive studies of ageing in film are Visions of Aging (Cohen-Shalev 2012), The Silvering Screen (Chivers 2011) and The Becoming of Age (Gravagne 2013). Anthologies such as Staging Age (Lipscomb and Marshall 2010) and Aging, Performance, and Stardom (Swinnen and Stotesbury 2012) include several essays on the topic. Overviews such as Yahnke (2010), though they do not offer critical analyses of ageing in film, indicate possible case studies.

Representations of ageing The current proliferation of films about later life points to an adjustment of the underrepresentation of people over 60 in film compared to their proportion in the population. A purely quantitative approach however does not reflect the ways in which age ideologies are articulated through moving pictures. Films are products of industries situated in a given culture that both replicate and generate the values and norms of that culture. Hence, visual literacy is required to assess the extent to which imagery of older people moves beyond ageism towards more diverse representations. ‘Senior-friendly’ representations are not exclusive to independent cinema. Mainstream cinema can also offer a counterbalance to negative cultural assumptions about ageing. Many contemporary films about ageing feature love stories.These seem to confirm the intertwining of the discourse of ‘successful’ ageing with (heterosexual) coupling and intercourse (cf. Katz and Marshall 2003). In their respective analyses of the British drama The Mother (2003) and the Hollywood-produced romantic comedy Something’s Gotta Give (2003), Kaplan (2010) and Wearing (2007) examine to what extent such pictures move beyond stereotypical plot-lines (e.g. May–December love stories), hyperbolical characters (e.g. the dirty old man and the withered menopausal woman) and other features characteristic of master narratives that reflect and shape age ideology within a given society. In The Mother, the widowed May (Anne Reid) starts an 69

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affair with the much younger Darren (Daniel Craig), the lover of her daughter. In Something’s Gotta Give, the writer Erica (Diane Keaton) falls in love with the cliché of the perennial playboy (Jack Nicholson), who previously dated her daughter. Although both films are careful not to reproduce negative assumptions about old age, such as the idea of later life as an asexual stage, they do revert to ageist logic, more specifically to a form of generational politics that limits the narrative possibilities of the leading characters. This results in conflicting messages and not entirely convincing endings. In The Mother, the intimacy between May and Darren ensues from shared feelings of outsidership in the first three-quarters of the film. When May’s children discover the sexual nature of the relation between May and Darren, the plot takes a turn that contradicts earlier images of their heartfelt bond. Darren is revealed to be a drug addict who takes advantage of May, and the stereotype of an abusive relationship between an older woman and a much younger man is thus ultimately confirmed. The film ends with May leaving her children and family home to engage in a quest of her own. What drives the plot in Something’s Gotta Give is the idea that the rogue has to come to terms with his age by settling down with an age-appropriate woman. As such, the character of Erica mainly serves as a narrative device to help Harry overcome his fear of older women and convert into a respectable older man. Yet, in order to bring the story to the predictable happy ending and to convey the message of generationally proper sexuality, the potentially much more fulfilling and balanced relationship between Erica and Julian (Keanu Reeves), whose only ‘fault’ is that he is some decades younger than Erica, has to be nipped in the bud. Kaplan’s (2010) and Wearing’s (2007) readings further exemplify how the form and style of film convey ideology. Key elements of the plot are put across by aesthetic choices.The agency of the women characters, for instance, is suggested by different means to present them as speaking, acting and gazing subjects. Kaplan describes how already in the garden scene at the beginning of The Mother (when May’s husband is still alive and the couple has just arrived in London to visit their children), May’s awakening is implied through subjective shots and camera movement. From the garden, May watches her husband discuss cricket with Darren in the conservatory. This foretells the scenes in which May as amateur artist appropriates the male gaze by making revealing drawings of Darren’s desirable body. By contrast, the credit sequence of Something’s Gotta Give features a succession of shots of young supermodel-like women with ‘display’ bodies. The rap song ‘Butterfly’ accompanies the shots, until the music is replaced by Harry’s misogynist voice, as if this sequence pictures his imagination.Yet, the credit sequence differs greatly from the subsequent narrative in terms of aesthetics. Harry will turn out to be an unreliable narrator who needs to adjust his objectifying gaze. Erica, conversely, is portrayed as a playwright who turns their love story into a play, thereby ultimately taking charge of the narrative. The sexual reawakening of both May and Erica is suggested by changes in their clothing style—a narrative element of the mise-en-scène. May gradually exchanges her plain look for a more flattering and colourful one. Close-ups suggest that her wrinkles have almost disappeared. In a similar vein, Harry literally snips away Erica’s turtleneck right before having intercourse, which symbolizes her transformation from a sex-deprived divorcee into a lustful older woman. From this moment onwards, V-necks and pastels replace her beige, high-fitting shirts. Simultaneously, Erica’s daughter Erin takes on her mother’s maternal look, emphasizing the continuity between them. Erica and Erin swap men, but it is emphasized that a heart attack prevents Harry from having intercourse with the daughter. In the most notorious scene of the film, Harry inadvertently catches sight of a nude Erica, thereby mirroring the opening scene in which Erin strips before him. On seeing Erica’s body, Harry reacts with distress only to realize later that her body is not so different from the younger women’s bodies he is so familiar with. Wearing interprets 70

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this scene as evidence of the more progressive ideological work of the film, namely rehabilitating the older woman’s body into visibility and sexual activity.

Films about dementia If we have late-life romances at one end of the film spectrum, on the other we find plots propelled by the impact of dementia on individual lives. The proliferation of films about dementia shows how the disease now epitomizes fear of old age. In so-called ‘hyper-cognitive’ cultures (Post 1995), dementia is seen as a particularly frightful illness because it violates the disposition of autonomy, productivity and development that defines what it means to be human. The Cartesian model, designating the mind as the locus of personhood, has led to the stigmatization of people with dementia as ‘non-people’. For this reason, it is particularly relevant to examine how film not only mirrors and reinforces the fear of ageing into cognitive decline, but also offers alternatives to the predominant negative discourses, for instance by drawing attention to elements sustaining the personhood of people with dementia. Scholars have argued that films about dementia tend to revert to tropes (e.g. Wulff 2008). A first trope is the focus on the caregiver. Film viewers are rarely invited to see through the eyes of the person with dementia, for instance by means of internal focalization, in order to get a glimpse of their inner self. This implies that the process of identification is primarily directed towards the caregiver and his or her burden. Gullette (2014) claims that the praise for Amour (2012) results from the viewers’ identification with the husband who, in almost total isolation, takes care of his wife through her final days. Sympathy for the devoted partner seems to make the audience uncritically accept the ending of the narrative in which social death is paired with murder (the husband smothers his wife with a pillow). A second trope is to opt for a person diagnosed with dementia who is known to the public as someone exceptional, making the impact of the illness seem especially cruel. The latest example is the portrayal of Margaret Thatcher in The Iron Lady (2011), one of the few films that highlight the perspective of the person with dementia (Wearing 2013). In the opening sequence, the viewer sees Mrs Thatcher having breakfast with her husband, only to realize that his presence is a figment of her imagination. At the end, however, the film denies its own evocation of dementia as an embodied state of disorientation by making the protagonist banish her husband from her life and, in doing so, take charge of her own mind again. This ambiguous ending signifies simultaneously the questionable idea that one can discipline one’s body into being healthy and that Mrs Thatcher has entered a new phase of the illness in which she no longer remembers her husband. A third popular trope is the flashback that contrasts the younger with the older self, played by different actors and actresses. This results in the preference for the past self over the present one, and makes it difficult to imagine meaningful exchanges in the here and now. The Notebook (2004), in which a husband patiently reads from his wife’s diary, hoping to activate her memory of their exceptional love story, is a popular rendering of this nostalgia for an idealized past. Beyond these and other tropes, there is great genre variety in dementia representations; and the cultural contexts in which films about dementia are produced differ significantly. Even films about dementia that seem rather formulaic in structure and scope can be read against the grain. Critical scrutiny of the complex cinematographic ways by which spectators are positioned and of the tension between their aesthetical and ethical involvement in the picture can illuminate the impact of film on popular views of dementia. In this respect, Swinnen (2013) calls attention to dementia documentaries. Because documentaries show real people with dementia rather than actors performing cognitive decline, their informative value is often taken for granted. 71

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Nonetheless, documentaries are also subject to directorial choices during filming and montage. As such, they do not necessarily come closer to the ‘truth’ of dementia experiences than does fiction film.

Film and the performativity of age Age is performative in that everyone ‘performs the actions associated with a chronological age minute by minute, and that the repetition of these performances creates a so-called reality of age both for the subject and those who interact with the subject’ (Lipscomb and Marshall 2010: 2). This implies that ageing does not ‘happen to us’ but is something we actively engage in or ‘do’. Age performances are potential sites of transformation and subversion because, both on and off stage, one can escape normative behavioural scripts by ‘failing’ to act ones’ age. For older people this involves disrupting expectations dictated by the master narrative of decline. Film is a medium particularly suited to facilitate study of the performativity of age because it potentially creates a field of tension between the age of the character performed and the ‘default body’ of the actor, which is the visible manifestation of their selfhood at a given moment or the embodied identity in culture over time (Gullette 2004: 161). Professional actors can be cast to act younger or older. An interesting example is The Curious Case of Benjamin Button (2008) in which the main character is born with the physical characteristics of an old man (Port 2012). In the course of the narrative, he moves through the different stages of development while bodily ageing in reverse—becoming physically younger rather than older. This raises the question of what it might be like to simultaneously grow up and grow young. A first challenge of the film adaptation is to portray Benjamin’s unconventional development in a plausible way. Instead of selecting different actors to play sequential selves, the director decided to suggest continuity by stretching the age credibility of Benjamin (Brad Pitt) through visual effects (Seymour 2009). In the first 52 minutes of the film, digitally manipulated head shots of Pitt are paired with various body actors.Viewers may not ‘buy’ this solution because the star persona of Pitt, a quintessentially good-looking man, works against the animations of him as prematurely aged. When the ‘real’ Pitt comes into view, he is aged visibly by means of cosmetic and makeup tricks until he develops into the Pitt whose vigour viewers are familiar with. In the last stages of Benjamin’s life (the last film scenes), various child actors finally replace the star. A second challenge is radically to think through what it means when behaviour corresponds with one’s chronological age but not with one’s physique. It becomes especially clear that Benjamin’s fate complicates his life course when it is contrasted with the ‘normal’ development of his love interest Daisy (Cate Blanchett). Intimate scenes are poignant in this respect. For instance, when both characters are in their teens, they meet in a homemade tent in the living room at night. The innocence of the scene is disrupted by a co-resident who finds it outrageous that an old man (in fact, a boy who looks like an old man) spends the night with a girl. Accordingly, when they are both presumably in their fifties, Daisy feels uncomfortable having sex with Benjamin because she is middle aged and he looks like a young adolescent. It follows that the film can help viewers better understand how, in a naturalized life course, stages of life are connected to certain age performances that are inherently corporeal. We can compare this with the generational politics of 50-plus romances discussed earlier. The idea of personhood as the conglomerate of performances over time facilitates the analysis of how different identity categories such as age and gender intersect. King (2010) has demonstrated that the figure of the cop in action films released from 1967 onwards personifies the irreconcilability of masculinity and ageing scripts. Hegemonic masculinity scripts are connected to physical strength, sexual prowess and power. Contrarily, later life is delineated as 72

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the period wherein all these traits are in decline. This puts older men at risk of being ‘othered’, prompting them to resort to strategies to keep ageing at a distance. In cop action films, normative masculinity scripts are enacted by the protagonist who works on the street to enforce law and restore social order. Policing requires physical aggression ranging from firing weapons to racing cars, and is portrayed as particularly masculine. Consequently, to the action cop figure, retirement only becomes a serious option when masculinity can be reaffirmed in ways other than violent conflict, ideally (and predictably) by a love story with a much younger woman. King is convinced that the figure of the ageing cop corresponds with the figure of the ageing male star whose career needs to be maintained in an industry that is primarily concerned with selling pictures.

Ageing stars in visual culture Researchers (e.g. Addison 2006) have described the youth-oriented disposition of the Hollywood industry in terms of writing and casting, which makes professional longevity for film stars difficult to achieve. This is especially true for female stars whose careers rely on genres that emphasize beauty and sexuality. The classic example is Gloria Swanson who was about 50 years old and considered a ‘has-been’ star when she featured in Sunset Boulevard (1951) (Chivers 2011). The film focuses on the main character Norma Desmond’s hopes of making a comeback, which fails because her physique and acting style have aged visibly. Little distance was perceived between Swanson’s on- and off-screen personae, which forced her to re-enact the Norma Desmond role for the rest of her career. Despite the tendencies of the Hollywood industry to prevent female stars from extending their careers into the later stages of their lives, some actresses manage to work well into their 60s and beyond.This professional longevity seems connected to these women’s lasting ability to look and act young. Consequently (and ironically), their visibility on the silver screen promotes disciplinary practices such as Botox, plastic surgery, heavy exercise and dieting among older women in an attempt to mitigate the cultural forces that render their bodies invisible (Woodward 2006, Dolan 2013). A film that illustrates the tension between the desire to stay young and the punishment for resorting to drastic smoothing and lifting procedures is Death Becomes Her (1992) (Sobchack 1999, Tincknell 2012). It brings the story of Madeline Ashton (Meryl Streep) and Helen Sharp (Goldie Hawn) who go to extreme lengths to turn themselves into younger, more attractive versions of themselves to compete for the love of their ex-husband. A magical potion grants them rejuvenation as well as eternal life. This implies that Madeline and Helen, who inflict violent assaults on each other, causing significant injuries, are forced forever to obsess over their disintegrating bodies. Comic effects in this film build entirely on the exposure of the two ‘monstrous’ women who refuse to act their age. Tincknell (2012) argues that the extensive use of special effects in Death Becomes Her prevents Hawn’s image of attractive, youthful star from being jeopardized by her incarnation of a woman beyond desirability. Hawn will never be read as the character Helen because she manages to successfully negotiate her association with the youth- and counter-culture of the 1960s as well as with the role of dumb blond bombshell who disrupts but never really challenges power structures. European cinema is almost as reluctant as Hollywood to grant significant roles to older characters (Beugnet 2006). Stars such as Catherine Deneuve (now 70 years old) only retain their status of beauty icon by appearing quasi ageless. An exception is Simone Signoret, icon of French womanhood, who continued to take up roles once her stunning beauty had been lost. Leahy (2006) explains how the actress was able to turn the changes of her physique to her professional advantage. Signoret’s body was never the focus of her films but functioned as a vehicle to convey 73

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strong women characters. In her early femme fatale roles, she already played women who appropriated the male gaze rather than embodied the enigmatic sexuality characteristic of the film noir genre. By the 1970s, when her signature image of woman who asserts her subjectivity had become fully accepted, Signoret continued to accept roles that provide women characters with agency, resisting stereotypes of passive older women, such as grandmother or lonely spinster. Turning back to the genre of late-life romances, the question arises whether the increased visibility of older characters also implies older sexual bodies, and how aesthetic limits of their acceptability are demarcated. An interesting case in this respect is the German film Wolke 9 in which the housewife Inge (Ursula Werner) leaves her marriage because she falls in love with another man (Marshall and Swinnen 2014). On the one hand, the film unveils time’s inscription on sexual bodies. Medium shots and close-ups of Inge disclose her breasts, bottom and even pubic hair. The actress has a mature body type that departs significantly from the seemingly ageless body of Diane Keaton revealed in Something’s Gotta Give. Inge’s older lover Karl (Horst Westphal) is also shown in full frontal nudity; extreme close-ups bring his body even more explicitly into view during sex scenes than hers. On the other hand, viewers’ perceptions are blurred through backlighting, overexposure and filters, and the clever positioning of curtains and bedding. The focus moves from the visual to the auditory by emphasizing the heavy breathing and sighs of especially the woman character. The European public highly appreciated the more realist style of Wolke 9’s portrayal of late-life sexuality.This decrease in fear of ageing bodies may foretell more changes in their filmic visibility.

Conclusion This overview shows how film does ‘cultural work’, how it negotiates the often contradictory meanings of ageing and later life that shape our specific historical moment. For this reason, the analysis of ageing in film cannot convincingly be limited to an account of characters and events to merely illustrate theories of ageing. State-of-the-art research into ageing in film has given us a better understanding of the way age ideologies operate in film and their relation to particular genres, the relevance of conceptualizations of age as a performative for the study of performance in film, the growing acceptance of older bodies in visual aesthetics, and the relation between star personae and the (dis)continuation of careers. These approaches to ageing in film are obviously not exhaustive and develop over time. Most scholars who have published on ageing in film have roots in the humanities, and they tend to excel in dealing with the particularity and complexity of pictures. Relating their findings to the larger challenges of population ageing, and translating them into practice, remains a difficult undertaking. Finally, we share ideas about future directions in this field of study. First, filmmakers can remain creative in later life, an example being Manoel Oliveira, born in 1908 and probably the only director whose career spanned the period from the silent era to the digital age. Cohen-Shalev (2012) calls for scholarship on late-life creativity in cinema and points to the intricate relation between changes over time in the individual style of an artist and developments in the art of filmmaking due to technological enhancements. Second, the film industry increasingly interacts with viewers in every stage of the filmmaking process to generate a more tailored supply of entertainment experiences. As older people become more adept social media users, they might exchange ideas, preferences and stories in their own critical, virtual communities. This will potentially educate the primarily youth-oriented film industry into adopting more diversified images of later life. Changes in the relation between producers and new senior consumer markets could become an interesting field of inquiry.Third, as people in long-term care often spend many hours in front of the television, researchers should scrutinize the impact of this occupation 74

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on their wellbeing. How can film (and moving images in general) improve care? A pilot study (Hendriks, Hendrikx, Kamphof and Swinnen 2013) of the responses to film of people in the later stages of dementia and their degree of immersion in the visual world showed that film is capable of inviting verbal exchanges between residents as well as inspiring caregivers to introduce topics of conversation beyond basic needs and care routines. As to the prominence and promise of the study of film in cultural gerontology, we can only imagine a productive future.

References Addison, H. (2006) ‘ “Must the players keep young?”: Early Hollywood’s cult of youth’, Cinema Journal, 45(4): 3–25. Beugnet, M. (2006) ‘Screening the old: Femininity as old age in contemporary French cinema’, Studies in the Literary Imagination, 39(2): 1–20. Chivers, S. (2011) The Silvering Screen: Old Age and Disability in Cinema,Toronto: University of Toronto Press. Cohen-Shalev, A.M. (2012) Visions of Aging: Images of the Elderly in Film, second edn, Brighton: Sussex Academic Press. Dolan, J. (2013). ‘Smoothing the wrinkles: Hollywood, “successful aging” and the new visibility of older female stars’, in C. Carter, L. Steiner and L. McLaughlin (eds) The Routledge Companion to Media and Gender, London: Routledge. Gravagne, P. (2013) The Becoming of Age: Cinematic Visions of Mind, Body and Identity in Later Life, Jefferson: McFarland. Gullette, M. (2004) Aged by Culture, Chicago: Chicago University Press. Gullette, M. (2014) ‘Euthanasia as a caregiving fantasy in the era of the new longevity’, Age, Culture, Humanities, 1(1). Available online at http://ageculturehumanities.org/WP/euthanasia-as-a-caregiving -fantasy-in-the-era-of-the-new-longevity (accessed 31 March 2014). Hendriks, R., Hendrikx, A., Kamphof, I. and Swinnen, A. (eds). (2013) Delen in dementie: Onderzoeksreflecties, Maastricht: UM. Available online at www.agingstudies.eu/file/da897844be-6370–133a.pdf (accessed 9 April 2014). Kaplan, E.A. (2010) ‘The unconscious of age: Performances in psychoanalysis, film and popular culture’, in V.B. Lipscomb and L. Marshall (eds) Staging Age: The Performance of Age in Theatre, Dance, and Film, New York: Palgrave Macmillan. Katz, S. and Marshall, B. (2003) ‘New sex for old: Lifestyle, consumerism and the ethics of aging well’, Journal of Aging Studies, 17(1): 3–16. King, N. (2010) ‘Old cops: Occupational aging in a film genre’, in V.B. Lipscomb and L. Marshall (eds) Staging Age:The Performance of Age in Theatre, Dance, and Film, New York: Palgrave Macmillan. Leahy, S. (2006) ‘Simone Signoret: Aging and agency’, Studies in the Literary Imagination, 39(2): 21–42. Lipscomb, V.B. and Marshall, L. (eds) (2010) Staging Age: The Performance of Age in Theatre, Dance, and Film, New York: Palgrave Macmillan. Marshall, L. and Swinnen, A. (2014). ‘Let’s do it like grown-ups: A filmic ménage of age, gender, and sexuality’, in C. Harrington, D. Bielby and A. Bardo (eds) Aging, Media and Culture, Lanham: Lexington. Port, C. (2012) ‘No future? Aging, temporality, history, and reverse chronologies’, Occasion: Interdisciplinary Studies in the Humanities, 4. Available online at http://occasion.stanford.edu/node/98 (accessed 24 March 2013). Post, S. (1995) The Moral Challenge in Alzheimer Disease: Ethical Issues from Diagnosis to Dying, Baltimore: Johns Hopkins University Press. Seymour, M. (2009) ‘The curious case of aging visual effects’, FXguide. Available online at www.fxguide. com/featured/the_curious_case_of_aging_visual_effects/ (accessed 26 March 2013). Sobchack,V. (1999) ‘Scary women: Cinema, surgery and special effects’, in K. Woodward (ed.) Figuring Age: Women, Bodies, Generations, Bloomington: Indiana University Press. Swinnen, A. (2013) ‘Dementia in documentary film: Mum by Adelheid Roosen’, The Gerontologist, 53(1): 113–22. Swinnen, A. and Stotesbury, J.A. (eds) (2012) Aging, Performance, and Stardom: Doing Age on the Stage of Consumerist Culture, Aging Studies in Europe II,Vienna: LIT Verlag. Tincknell, E. (2012) ‘Goldie Hawn: An ageless blonde for the baby boomer generation’, in A. Swinnen and J.A. Stotesbury (eds) Aging, Performance, and Stardom: Doing Age on the Stage of Consumerist Culture, Aging Studies in Europe II,Vienna: LIT Verlag. 75

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Wearing, S. (2007) ‘Subjects of rejuvenation: Aging in postfeminist culture’, in Y. Tasker (ed.) Interrogating Postfeminism: Gender and the Politics of Popular Culture, Durham: Duke University Press. Wearing, S. (2013) ‘Dementia and the biopolitics of the biopic: From Iris to The Iron Lady’, Dementia, 12(3): 315–25. Woodward, K. (2006). ‘Performing age, performing gender’, NWSA Journal, 18(1): 162–89. Wulff, H.-J. (2008) ‘Als segelte ich in die Dunkelheit . . . Die ästhetische und dramatische Analyse der Alzheimer-Krankheit im Film’, in B. von Jagow and F. Steger (eds) Jahrbuch Literatur und Medizin (Band II), Winter: Heidelberg. Yahnke, R.E. (2010) ‘The experience of aging in feature-length films: A selected and annotated filmography’, in T.R. Cole, R.E. Ray and R. Kastenbaum (eds) What Does It Mean to Grow Old? A Guide to Humanistic Studies in Aging, Baltimore: The Johns Hopkins University Press.

Filmography Amour (2012) Directed by Michael Haneke. Austria, France and Germany: Canal+, France 3 Cinéma,Wega Film, Les Films du Losange and X-Filme Creative Pool. The Curious Case of Benjamin Button (2008) Directed by David Fincher. USA: Warner Bros, Paramount Pictures and Kennedy/Marshall Company. Death Becomes Her (1992) Directed by Robert Zemeckis. USA: Universal Pictures. The Iron Lady (2011) Directed by Phyllida Lloyd. Australia, USA and UK: Pathe, Channel Four Television and The British Film Institute. The Mother (2003) Directed by Roger Mitchell. UK: BBC Films, Free Range Films and Renaissance Films. The Notebook (2004) Directed by Nick Cassavetes. USA: New Line Cinema and Avery Pix. Something’s Gotta Give (2003) Directed by Nancy Meyers. USA: Columbia Pictures Corporation, Warner Bros and Waverly Films. Sunset Boulevard (1951) Directed by Billy Wilder. USA: Paramount Pictures. Wolke 9 (2008) Directed by Andreas Dresen. Germany: Peter Rommel Productions, Sentaor International and Rundfunk Berlin-Brandenburg.

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10 Popular music and ageing Ros Jennings

Music is pancultural, diverse and expressed creatively through many forms and genres across the globe (Davies, 2012). Sociological approaches to music and society have been helpful in highlighting relationships between power, status and cultural tastes and practices in relation to music, especially with regard to social stratification and the opposition of mass and elite cultures (Van Eijck, 2001, Chan and Goldthorpe, 2007). Boundaries between mass and elite musical cultures are becoming more porous than previously suggested. For example, the international success of Dutch violinist and orchestra leader, André Rieu’s almost ‘rock star’ approach to classical music (particularly Mozart, Strauss, opera and operetta) suggests a shift in classical performative strategies to reflect not just the informalization of societies since 1950 (Abbing, 2005) but also the pervasive influence of rock and roll culture. By creating concert spaces where film music and popular European genres such as German schlager and Dutch levenslied sit side by side with works by Strauss, Puccini and even Michael Jackson (2009 Vrijthof Concert, Maastricht, Netherlands), Rieu manufactures a concert space where a new type of ‘greying’ older audience, one that loves classical music but is also influenced by post-1950s popular music, can dance and sing, and where the orchestra members are dressed colorfully and actively convey fun and enjoyment in their musical performance, thereby challenging the traditional etiquette of the classical orchestra. The global success of English language pop music and its importance in the cultural life of Anglophone countries (for instance the centrality of pop music to both the closing ceremony of the Sydney 2000 Olympics in Australia and the opening and closing ceremonies of the London 2012 Olympics held in the UK) is indicative of the growing cultural importance of pop music. This has had a powerful influence in shaping the scope and content of academic studies of popular music and the approach taken to understanding of age and ageing. More specifically, despite pop music being a ‘broad and fuzzy’ category (Coulangeon, 2013, p.7), western academic studies have tended to concentrate only on a narrow spectrum of its output, namely English language post 1950s pop and rock and their close generic relations such as disco, hip hop and heavy metal. As Feld (2000) notes, with the exception of a few ‘crossover’ performers branded as ‘world music’ artists (for example, The Buena Vista Social Club, Cuba; Ladysmith Black Mambazo, South Africa) studies of non-western popular music arise mostly from the discipline of ethnomusicology and focus on indigenous musical forms (for example instrumentation, structure etc.), exploring contextual influences and relationships with tradition. Despite the technological 77

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facilitation of an increasingly global context for the production, distribution and reception of popular music from around the world, there is a clear difference in the ways that studies of western and non-western music address and think about notions of age. In studies of western popular music, ageing and old age are either ignored completely or considered problematic.This is much less the case in studies of non-western popular music where there is both a genuine and conceptual connectivity between popular music, ageing and tradition. Studies focusing on non-western popular music are comfortable discussing relationships between older and traditional forms of popular music and also popular music performed by older artists (for example, Malcolmson’s (2012) consideration of older bodies and danzón music in Mexico, or Poey’s (2012) reflections on Celia Cruz’s longevity as a Latina music performer). In contrast, studies of western popular music have, until relatively recently, been obsessed with youth and youth cultures and have avoided or marginalized older performers, audiences, practices and style. It is the therapeutic relationship with popular music in which older people are foregrounded in the west. Studies of music’s effect on mood and its ability in allaying disorientation and agitation (for example, Svansdottir and Snaedal, 2006, Sixsmith and Gibson, 2007) have contributed to clinical practices when caring for older people with dementia, whilst qualitative studies examining the psychological meanings of music in older people’s lives (Hays and Minichiello, 2005) have indicated that music can contribute to older people’s well-being. Popular music studies in the west have only just begun to extend critical cultural analysis beyond the previous narrow concentration on youth to engage with relationships built with popular music across the life course. The conceptualization of ageing within western popular music studies now stands at a crossroads, where critical approaches to ageing and old age are finally being debated, developed and adapted to consider ageing and relationships with popular music across the life course.This major reconfiguration of the subject area to look beyond youth as its defining element and to acknowledge the importance of ageing and old age in shaping individual and collective identifications, practices and pleasures amounts to a new turn within academic popular music studies in the west. The following chapter charts some of the main debates that have shaped contemporary western popular music studies in relation to ageing and identifies areas that would be useful as fields of engagement for cultural gerontology in relation to popular music in later life.

The social and cultural significance of music across the life course Music forms an important aspect of the cultural and social fabric of both individuals and nations (Clarke, 2012). In the 100 or so years since the invention of the gramophone and the advent of mass produced recorded music, musical interactions with audiences have extended beyond the direct experience of live performance (though this is still an important musical experience for many people) to a more mediated set of experiences predicated on evolving technological innovations. As a result, western (and now increasingly global) lives are saturated with multiple musical possibilities and experiences. Technology (including new forms of consumption and sharing via social media) has enabled popular music to be incorporated into both the mundane habits and the significant rituals of everyday life (from having a radio on in the background in the domestic or work setting, to the almost subconscious absorption of music we encounter when walking through shopping malls, to the explicit choice of music for weddings and funerals). In the twenty-first century, experiencing popular music is possibly becoming more significant. It is embedded in lives and quite literally accompanies us from cradle to grave and constitutes a life-long relationship for many people. Popular music provides vital individual, social (including

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intergenerational) and cultural connections to understand and interpret human identities across their life course (DeNora, 2000).

Ageing in/and popular music studies It is only in the twenty-first century that critical engagements involving the study of popular music across the life course and into old age have started to emerge (DeNora, 2000, Harrison and Ryan, 2010). Recently there have been direct attempts to put concepts of ageing at the center of approaches to the study of popular music (Bennett, 2006, Bennett and Taylor, 2012, Forman and Fairley, 2012, Jennings and Gardner, 2012), studies which pave the way for a new and dynamic area of critical engagement within popular music studies.The realization (certainly in the western world) of the possible impact of an increasingly ageing population coupled with the fact that many of the music cultures and subcultures previously associated with youth can no longer be considered to be youthful are now beginning to expand the focus of popular music studies beyond just that of youth tastes and practices towards interrogating the meanings and uses of popular music in interaction with ageing and old age. From the perspective of ageing studies and cultural gerontology, this tardiness in connecting with issues of ageing and older age is obviously lamentable but, as any review of the impetus and inspiration for the initial development of popular music studies quickly reveals, even the slightest turn towards the consideration of ageing and older age represents a dramatic transformation for the area of study. Quite simply, the theoretical genesis of popular music studies constructed old age as marginal, ‘unhip’ and irrelevant. The point of origin for popular music studies is 1950s America, the birth of rock and roll and the emergence of its associated youth and teenage identity groupings (Grossberg, 1987). Popular music studies thus became aligned with ideas of rupture (involving separation from the past) rather than with ideas of continuum (linking past, present and future experiences). The result was that an unintentional but unacknowledged form of ageism became embedded within the field of studies. Grossberg (1987) proclaimed that rock and roll was not only a genre of music but also an expressive context for strategies of youth identity—where ‘growing up’ became, at one and the same time, both desirable (to gain access to the mythologized aspirations of sex, drugs and rock and roll) and undesirable (because it also meant becoming ‘grown up’ and boring). Negative associations about ageing became intimately tied to notions of ‘growing up/being a grown up.’ Growing up, as Grossberg indicated, ‘signals the demise of the rock and roller and, in fact, no rock fans ever feel themselves to have grown up completely’ (1987, p. 188). If the originating scene of popular music studies was the birth of rock and roll, then its primary goal was to ‘legitimate the study of popular culture’ (Click and Kramer, 2007, p. 244). This entailed a battle with the elitism of existing high/low culture debates in relation to music (Paddison, 1982, Adorno, 2002). In the process of establishing legitimacy for the new area of study, popular music studies paradoxically also generated its own canon of what was worthy/unworthy of study. Radical genres and subcultures, musical icons and youth audiences (signifying rupture with the past) were all deemed worthy of study, whilst popular mainstream music genres (and by extension their often older audiences and fans) tended to be ignored. In creating these hierarchies of value, popular music studies (albeit unwittingly) reproduced many of the inequalities that its scholars were committed ideologically to opposing (Click and Kramer, 2007). Not only did youth connections with popular music become a more valued focus of study than connections with older age, but attitudes to musical genre also reflected particularly patriarchal understandings of gender and sexuality. The intervention of feminist approaches from the 1990s onwards exposed many of the ideological subtexts underpinning 79

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not only the music industry but music scholarship itself (Frith and McRobbie, 1990, Whiteley, 1997, Leonard, 2007), suggesting that understandings of popular music were incomplete and limited as a result.

Gender, genre, age and ‘late style’ performance In the last five years or so, the previously unthinkable has happened and (though youth studies are still dominant) a turn towards ageing has taken place within the academic context for popular music studies. This turn is due not only to pioneering academics in the field facing up to their own ageing process, but also because the iconic musicians and popular music stars that drove many of the key popular music debates (such as David Bowie, The Rolling Stones, Annie Lennox, Madonna) are now all beyond the age of 50 and thus meet the current (2012) World Health Organization (WHO) global definition of an older person. It is also evident that ‘the changing demographics of an ageing society are disrupting previous notions of pop and rock music as being the preserve of youthful artists and consumers’ ( Jennings and Gardner, 2012, p. 3). Many of the once youthful pop stars have achieved a longevity of career that was never anticipated, and consequently the core dynamic of rupture (with the past) that was associated with their rise to stardom has now morphed into one of continuum (where their past career and oeuvre informs their present and future). Pop and rock can be regarded as two of the foundational genres of modern mainstream popular music, and as a result form an important context for the examination of sociocultural attitudes to ageing in popular music as well as the musical performance of older pop and rock stars themselves. These two staple genres are dominated by normative associations about gender and sexuality that disguise the complexity of their construction, performances and consumption. In particular, female performers’ musical skills and creativity are rarely recognized as constituent parts of their success in the same way as male performers’ are (Mayhew, 1999, Click and Kramer, 2007). Gendered performance stereotypes have a significant impact on the ways that ageing performers are read by audiences and the media, as well as on the performance strategies that they pursue as they age. As Hawkins asserts: ‘music is sold on the basis of the pop star’s identity as much as the apparatus of marketing and production linked to the recording industry’ (2002, p. 12), and this is subject to the sociocultural tropes of ageing and ageism at work in the contexts in which the music and the performer are consumed. This becomes incredibly poignant if one considers that, originally, popular music genres such as rock and pop, their performers and their audiences, were not conceptualized as being able to age. Suddenly, the swaggering sexuality of the male rock star’s body and persona (so closely linked to idealized youthful heterosexual masculinity, authenticity and artistic honesty) becomes viewed through the lens of gendered ageist assumptions about physiological and sexual decline. The ageing of female performers is understood as a particularly traumatic process (Kaplan, 1999, Jennings, 2012). Interpreted representationally within dominant discourses of idealized youthful heterosexual feminine attractiveness, older female performance evokes a sexist inflected ageism, one that concentrates on appearance (physical body, style and age-appropriateness) and that can provoke vehement responses of disgust, fear and hatred towards even a well-managed ageing female body if cultural norms of femininity are considered to have been transgressed. For example, as Gorton and Garde-Hansen (2013) argue, since turning 50, one of the most successful female pop stars, Madonna, has been the object of particularly malicious forms of sexualized online ‘trolling’ and ‘body snarking.’ How popular music performers strategize the longevity of their career within the context of ageism and sexism varies, but inevitably involves the negotiation of their contemporary physical and cultural presence within the intertextuality of their performative history and recorded 80

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output ( Jennings, 2012). As Gullette asserts,‘we are aged more by culture than by chromosomes’ (2004, 101) and a negative cultural perception of ageing has a powerful impact on the ways later life popular musical performances are perceived. Physiological capacities related to ageing, such as vocal capacity, also have an important impact on audience reception.Voices evoke ‘signifying associations’ (Shank, 2006, p. 12) with the performer, and the voice is one of the central elements of the physiological influence on the act of interpretation. Performative late style is therefore constructed as much by the abilities of the voice as it is by other cultural factors. With proper management and care, current research would suggest that the continued practice of singing can help maintain vocal frequency, intensity, range and quality into the seventh decade (Prakup, 2012). Certainly, this is the case for the more mainstream popular music performers such as Shirley Bassey and Tom Jones who work with the support of voice coaches to maintain the authority and integrity of their performances. For the more ‘do-it-yourself ’ performers (mostly musicians and song-writers rather than just singers) who defined themselves against pre-rock and roll traditions and who pride themselves on their self-taught creativity (for instance Paul McCartney), the toll on the voice after decades of performance is not always so kind. Artists with heritages of physically based performances (for example Mick Jagger and Madonna) have prolonged their performance styles through grueling physical fitness regimes (echoing dominant western ideas of successful ageing through effective management of the body). Some other older popular music performers (for instance, Shirley Bassey, Courtney Love) have developed later life performance styles that resist, renegotiate and rebel against age-appropriate expectations (Jennings and Gardner, 2012), whilst others have secured continued commercial success by shifting generic style from contemporary rock and pop to ‘classic’ mainstream (for example Rod Stewart and his move from rock to American Songbook classics). Late style performance is a retrospective, diverse and complex construction with its own critical and ideological take on ageing and creativity (Hutcheon and Hutcheon, 2012). Thus, in addition to the key referents of age and ageing, critical understandings of late style are informed by both the musical and performative oeuvre that has gone before and the contemporary context of reception.

Life-long popular music practices The longevity of popular musical careers, production and performance also extends the possibilities of popular musical consumption, fandom and fan practices along the life course. As popular music has technologized into ‘the cloud’ (Wikström, 2009), permitting digital downloads and sharing, the music industry has been forced to diversify in order to pursue new revenue streams (Meier, 2011). Niche programming on radio stations featuring music from different decades has long been a radio staple but this is now extended to the production of niche radio stations (for example The Wireless [Age UK] for older listeners). Live performance is now, however, generally accepted as the place where performers (and the industry) make money. Popular music artists can now perform and have successful international tours in their 60s, 70s and beyond (for instance Paul McCartney, Tom Jones, Leonard Cohen, The Rolling Stones, Grace Jones, Annie Lennox, Petula Clark, Patti Smith). In this respect not only is there an emergent grey market for concert attendance (audiences who have stayed loyal to certain music but now also have the opportunity to see performers they missed when they were younger), but the increasingly mixed demographic for popular music concerts and festivals (including the noticeable intergenerational audience profile of the ’60s, ’70s and ’80s revival pop concert genre) suggests that previous age divisions around music seem also to be dissolving as musical signifiers loosen their direct connection with time and space. With nearly all recorded music now available in the 81

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cloud, the collective embeddedness of musical memories becomes more fragile whilst individual memories remain an ‘embodied, technologically enabled and culturally embedded construction’ (Van Dijck, 2006, p. 3). At this point in the twenty-first century, previous notions of an essential split in tastes between youth and older generations are no longer the case. The deepest division in musical identities and practices in the west is between those in in their late 70s and older (Connell, 2012) and those in the age groups below. Indeed, as Connell’s ethnographic study of the role of music and music technology in relation to the construction of generational identity suggests, musical identities between contemporary children and parents are much closer than ‘the wider gulf between these children’s grandparents and great grandparents’ (2012, p. 275). Current research now suggests (Connell, 2012, Forman, 2012, Van Dijck, 2006) that music remains an important symbolic resource as we age and forge our own later life identities. The proliferation in intergenerational connections forged in relation to older people’s choirs (particularly those that sing contemporary popular music) together with the success of related films about the life enrichment offered by such activities, such as in Song for Marion (Williams, 2012), are evidence of popular music’s role in late-life leisure and creative practices. The music and other cultural industries are now geared up to economically exploit ‘greying audiences’ as much as any other of their target economic groups, but there is currently very little thought devoted to those who sit outside current intergenerational consumption patterns. For those in their late 70s upwards, who personified the ‘radio/wireless’ generation and who saved to buy records when they were precious commodities, adaptation to newer types of technology as formats become outdated (for example records to CDs) becomes increasingly difficult without support. As music has become predominantly downloadable from the cloud, independently accessing their own musical tastes has become more problematic for this group of people. It is crucial that products, training and services are generated to address the wishes and needs (see Hylten-Cavalius, 2012) of those who, at the oldest end of the age spectrum, are the most isolated from the resources to continue constructing meaningful identities through popular music experiences and pleasures. Current lack of consumption is not ‘sufficient grounds for the attribution of irrelevance’ (Forman, 2012, p. 249), especially as continued access to music and associated products are particularly significant in the light of current research that indicates the contribution of music to vitality and well-being in later life.

Conclusion Music forms part of the bedrock of human cultural life.Technological advances in recording and distribution have generated more and more ways to access and consume all types of music and, certainly in the western world, also to embed it in the fabric of the life course from the moment of birth until the post-mortem rituals of burial, remembrance and commemoration. The interdisciplinary academic subject area of popular music studies has been slow to engage with the importance of music to people throughout their life course. As the area has matured and its scholars have started to come to terms with their own ageing and also that of their popular music icons, the privileging of youth (at the cost of all other connections with popular music) is slipping as the core focus of research.There is now recognition that popular music, its cultures, performances and fan practices require critical interrogation through an acknowledgement of a continuum of experiences, influences and positions that avoids the false dichotomy of young and old people and older and newer forms of popular music. For those who have grown up with the inheritance of rock and roll, popular music will be a contributing factor in facilitating Gullette’s (2004) dream of a time when we all might ‘feel at home’ at every age in the life course. 82

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Poey, D. (2012) “Long live the queen!: Celia Cruz’s longevity as a counterpoint of tradition and change” in R. Jennings and A. Gardner (eds) “Rock On”: Women, Ageing and Popular Music, Aldershot: Ashgate, 53–64. Prakup, B. (2012) “Acoustic measures in the voices of older singers and non-singers,” Journal of the Voice, 26(3) (May): 341–50. Shank, B. (2006) “Introduction to Part One” in A. Bennett, B. Shank and J.Toynbee (eds) The Popular Music Studies Reader, Abingdon: Routledge, 11–14. Sixsmith, A. and Gibson, G. (2007) “Music and the well-being of people with dementia,” Ageing and Society, 27(1) ( January): 127–45. Song for Marion (2013) Dir. P. A. Williams, UK/Germany. Svansdottir H. B. and Snaedal, J. (2006) “Music therapy in moderate and severe dementia of Alzheimer’s type: a case-control study,” International Psychogeriatrics, 8(4): 613–21. Van Dijck, J. (2006) “Record and hold: popular music between personal and collective memory,” Critical Studies in Media Communication, 23(5) (December): 357–74. Van Eijck, K. (2001) “Social differentiation in musical taste patterns,” Social Forces, 79: 1163–84. Whiteley, S. (ed.) (1997) Sexing the Groove: Popular Music and Gender, London and New York: Routledge. Wikström, P. (2009) The Music Industry: Music in the Cloud, Cambridge: Polity Press. World Health Organization (2012) “Definition of an older or elderly person.” Available online at www .who.int/healthinfo/survey/ageingdefnolder/en/index.html (accessed March 2013).

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11 Art, ageing and the body Michelle Meagher

At the age of 75, acclaimed American painter Alice Neel began work on her first and only self-portrait. In Self-portrait (1980), Neel is perched on the edge of a wide, blue-striped chair. Her hair is short and completely white; she wears gold-rimmed glasses. In her right hand she holds a brush, in her left a rag. Neel gazes directly at the viewer. She’s completely naked. This image has been described as shocking, endearing, and unconventional (see Dabbs 2012, Garrard 2006). It is a key image in the contemporary representation of old age, partly because it sidesteps the art historical conventions that so often link the old body with, on the one hand, degeneration and death, and on the other hand, wisdom and self-reflection. It is also significant that it is through self-representation that Neel explores the question of ageing. Like many of the artists discussed below, Neel begins to reflect on the matter of ageing in response to her own experiences of getting old. Indeed, much contemporary art that reflects on ageing is produced by artists who have moved into or beyond middle age, and much of their work is self-representational. The chapter first considers the ways in which art historians have talked about the matter of age in the history of western art, and then examines the emergence of art, mostly but not exclusively self-representational, that positions age and ageing as central themes of exploration.

Art historical approaches Art historian Linnea Dietrich describes ageing as a subject and theme in art as ‘uncharted territory’ (1999: 185). Indeed, there have been relatively few art historical investigations that centre on the matter of age. Those that do consider age tend to take one of two routes. The first is to consider the way in which age affects the artist, and the other is to consider what art can tell us about ageing in its historical and cultural contexts. Art historians have often used the term ‘old-age style’ or ‘late style’ to describe an apparent tendency on the part of artists of all variety of creative activity to produce in old age work characterized by—to use Kenneth Clark’s terms—‘a special character common to nearly all their work’ (1972/2006: 79, see also Rosand 1987, Sohm 2007). For Clark, the special character shared by old artists is a ‘transcendental pessimism’ (Clark 1972/2006: 80). For others, old age style is characterized by an abandonment of the body. Dietrich describes it this way: ‘having gained wisdom and spiritual vigor in their later years, these artists abandoned their weakening bodies, and 85

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concentrated on abstract or visionary—less physical—forms and themes’ (Dietrich 1996: 185). Dietrich, however, is deeply suspicious of both the view that spiritual understanding of later life comes at the cost of the body and the notion that there is something universally shared by artists in old age. More recently, Linda Hutcheon and Michael Hutcheon have challenged the ageism linked to broad generalizations about the work of old artists.They question and ultimately refuse ‘universalizing theories’ that link age with, for instance, serenity, wisdom, or a ‘consolidation of themes and techniques’ (Hutcheon and Hutcheon 2012: 2, see also Berlind 1994: 21). Another approach to age in art is to examine images of older people in order to consider what they might tell viewers about the socially constructed category of age. Herbert C. Covey (1991) maintains that when artists depict the aged or select old age as a topic, they also depict social attitudes and perceptions.With this in mind, social art historians have assessed the deployment of ageist stereotypes, paradigms, or themes in art. Old men and women often appear in western art as the embodiment of a final stage of life and a symbol of impending death. In The Three Ages of Man (1512–14), the celebrated early modern Italian painter Titian, for instance, represents three distinct periods of the human lifespan: childhood, adulthood, and old age. Old age is personified here by a balding man with a long white beard who sits contemplating two skulls. Skulls—widely recognized as symbols of death—are not infrequently included in paintings of older people, affirming the association of older people with death. Indeed, as Covey points out, the ‘theme of the elderly in contemplation of death can be observed in art over the centuries’ (1991: 173). Thus, one key paradigm for the representation of old age is through an association with decline and decrepitude. Another seemingly contradictory paradigm is the depiction of the old as wise and dignified. Covey describes Dutch painter Rembrandt van Rijn’s portrait of himself as an older man as characterized by ‘serenity, solemnness, and self-reflection’ (1991: 7). Additionally, it is important to recognize that the representation of age is mediated by artists’ cultural beliefs and values. In the artistic traditions of China, for instance, age is frequently celebrated—the 1507 Self Portrait by the Chinese artist Shen Chou, for instance, depicts the artist as serene, powerful, and vital in his eighties. In the face of these overarching paradigms, some art historians have examined representations of age in order to learn more about the roles played by the aged in specific historical moments and contexts. Erin Campbell, for instance, examines portraits of old women in Renaissance Italy to conclude that, contrary to common assumptions, they held positions of power and influence in the family and community (2010). Similarly, art historian Julia Dabbs examines three artists of the early modern period to argue that they actively disrupted artistic conventions of representing old women as ‘desiccated crones and devout widows’ (Dabbs 2012: 15). In their self-portraits, Sofonisba Anguissola, Rosalba Carriera, and Anna Dorothea Lisiewska-Therbusch depict themselves in old age as accomplished painting professionals and wise teachers. For Dabbs, this work constitutes an early intervention, demonstrating that ‘old age could be portrayed in a positive and powerful new light’ (2012, 15). These early modern painters set the stage for contemporary artists who, as discussed below, have often deployed images of old people in order to disrupt myths of old age.

Contemporary art practice Although the work discussed above reveals that old men and women have not been entirely removed from the visual field, it is clear that there is a dearth of diverse representations of the old and ageing. In the introduction to a special issue of Art Journal on the topic of ‘Art and Old Age,’ Robert Berlind notes that ‘much of today’s art reflects society’s deep resistance to dealing with the reality of ageing’ (1994: 19). Dietrich similarly describes ageing as a ‘relatively recent theme 86

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in art, introduced into the fields of art and art history largely . . . through the interventions of feminist art and theory, which asserts the value of personal experience as a valid subject in art’ (1999: 185–6). The work discussed in the remainder of this chapter explicitly addresses age from three broad and often overlapping perspectives. The first section discusses the work of artists who have been committed to producing works of art that carve out a position for the old body in the field of art. Against the limited visibility of old people in art, the artists discussed here approach the old figure as an aesthetic object worthy of representation on its own terms. The second section considers the resistant practices of ageing artists, mostly working in a feminist register and with strategies of performance. Shaped by their own experiences of cultural invisibility and marginalization, the artists discussed refuse to age gracefully and instead perform age in ways that draw attention to the constraining nature of the social conventions that attend ageing. The final section considers the work of artists who explore ageing in very personal and intimate ways. These works, which centre not only on age, but more specifically on the experience of ageing as a protracted experience of transformation, arguably map out a desirable future for art practice and theory. Though most of the works discussed here may be placed in the categories of portraiture, self-portraiture, and the nude, some works of art about ageing are non-figurative. For instance, Bruce Cannon’s The Time of Your Life (1997–8) is a sculptural work that functions as a countdown to its owner’s death—a computer inside a cast iron clock uses actuarial charts to determine lifespan and reports on the number of days of life that might be anticipated, or, should the work’s owner outlive the prediction, the number of days by which death has been cheated. Similarly reflecting on the lifespan, Micah Lexier’s David Grid (1995) is a grid of 75 photographs, depicting 75 men between the ages of 1 and 75, all named David. Here, Lexier visualizes the anticipated average lifespan of a Canadian man in the year the work was produced.

Against invisibility: putting old bodies into the picture Canadian photographer Jeff Wall’s 1992 photograph, The Giant, features a nude old woman standing on the landing of a stairwell in a library. Despite her imposing size—her figure has been digitally altered to make her four times larger than any other figure in the image—library patrons climbing stairs and sitting at tables seem not to notice her. Imposing but ultimately unnoticed, Wall’s giant woman ‘brilliantly captures the tension between visibility and invisibility as it is played out among elders in our society’ (Ellegood 1999: 65) The theme of visibility and invisibility is significant to many contemporary artists. American-based artist John Coplans positions his work against the invisibility of old bodies in modern western culture and art history. Coplans took up photography after retirement from a career as an art critic and journal editor. From the mid-1980s until his death in 2003, he produced self-portrait photographs that flaunt a body described by Chris Townsend as ‘pale, flabby, [and] hairy’ (Townsend 1998: 98). His work is comprised of large, massive-scale black and white photographs of his own body, most often his torso, always headless, wrinkled, sagging, and, in a word, old. These often surprising and strangely abstract photographs use the ageing nude figure to examine questions of scale, seriality, and repetition, but ultimately work to stake out a position for the old body in a field that has largely overlooked it. Also working in the medium of photography, German-born and London-based artist Melanie Manchot challenges the invisibility of old age in a series of photographs printed onto large canvases. Her model is her mother, named in the works’ titles as Mrs Manchot. In the early work, Manchot’s mother is figured before stark backdrops; she is nude and often posed in conventionally 87

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Figure 11.1  Melanie Manchot, Mrs Manchot Hands on Hip (from the Look at You Loving Me series), 1996 © Melanie Manchot courtesy Galerie m, Bochum, Germany

alluring ways—hands on her hips, or arms stretched behind her head. In later images, Manchot moves into colour and her mother is posed more naturally before epic landscapes—mountain ranges and frozen lakes. For Manchot, the work is collaborative. It is about the developing relationship she as a photographer has with her mother as model; it is also, importantly, a series that confronts a widespread discomfort with ageing. What distinguishes Manchot’s work from 88

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Coplans’s is not only that she is working in portraiture rather than self-portraiture, or with a female figure rather than a male, but that the body that she photographed is posed in ways that speak defiance (Pollock 2003: 195). Like Coplans, these photographs render an old body visible but, in that rendering, they speak back to the conventions of western art history that insist that it is only the eternally young that ought to be the subject of the female nude. Also working with the nude, photographer Ella Dreyfus’s series Age and Consent (1999) was inspired directly by an interest in the invisibility of ageing women’s bodies and the shame that many women associated with them. Like the photographs of Manchot’s mother, these images centre on the models’ desires to collaborate with the artist to engage in acts of self-revelation. Dreyfus describes their nude posing as courageous acts through which her models were able to confront their anxieties about their bodies. Manchot’s and Dreyfus’s work resonates with a similar practice by photographer Jacqueline Hayden. Like Dreyfus, Hayden began to photograph ageing bodies in order to disturb the alignment of beauty with youth (Ingalls 2000). Hayden’s silver gelatin photographic prints in a series called Figure Model (1991–6) position her ageing male and female models in (mostly) solitary poses before dark backdrops. Like the artists discussed above, Hayden is keen to challenge the invisibility of old bodies, but her project is decidedly set in conversation with the art historical genre of the nude. Rather than using her own body, or that of a relative or friend, Hayden hired practiced ageing figure models who were familiar with the classical poses conventionally associated with youth. The idealized body produced by that pose is disrupted by the reality of lived bodies—bodies that are scarred, wrinkled, sagging, and, ultimately, marked by life. In Ancient Statuary Series (1996–2000), Hayden uses digital technologies to transform the bodies of figure models into statues, often limbless, that are placed on plinths or in statue gardens. Her artist statement explains that ‘grafting older bodies into ancient statuary forms gave me the means to critically engage the visual history of ageing as one of invisibility’ (Hayden n.d.). These artists contribute to what Anca Cristofovici describes as the ‘the visual integration of the realities of old age into an aesthetic circuit’ (1999: 277). Certainly, for all of these artists, the key goal seems to be to put old bodies in the visual field in ways that counter the invisibility of the old and, in a general sense, position the old body as an object of aesthetic beauty. The goal of American feminist artist Suzanne Lacy is not to position women’s bodies as aesthetic objects into the field of art, but to use art to negotiate ways for the expression of unheard and undervalued voices in culture. Her Crystal Quilt project (1987) was a feminist experiment that brought together more than 400 women over the age of 60 to sit at tables set up in a Minneapolis shopping centre. Over tea and in groups of four, they talked about their experiences of ageing. Twenty-six years later, Lacy organized the similarly structured public art performance Silver Action (2013) at the Tate Modern gallery in London, bringing together ageing activists—all women over the age of 60 who had been and, in many instances, continue to be involved in political action. In Silver Action, the participants talk to one another and then record their impressions of their conversations. These works function to start up conversations, and to establish speaking positions for old women within the public sphere. Other artists, similarly alert to the invisibility of old age, have deployed visual and performance art as tools for the radical disruption of social perceptions of age and ageing.

Resistant performances: ‘doing’ age differently Informed by recent critiques of the social limitations placed on the old—especially old women—the artists discussed here refuse to ‘do’ their age appropriately (Woodward 1999, 2006). Whereas most of the artists discussed above appear to position age as an inevitable bodily state 89

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that ought to be embraced rather than ignored, others understand age as a socially constructed category. More than a constructed category, however, age is also a set of expected practices and enactments. Informed by critiques of the social limitations placed on old people—and specifically, the social regulations that surround feminine respectability in old age—these artists refuse the rules of old age, and in their refusals draw attention to the arbitrary and limiting nature of those regulations. This refusal begins with imagining other ways to be old. Japanese photographer Miwa Yanagi’s series, My Grandmothers (1999–), speaks to young women’s desires for a different sort of old age. In preparation for the series,Yanagi interviewed young women, asking them to describe the lives they imagine for themselves 50 years in the future.Yanagi constructs intricate tableaux inspired by the women’s imagined future selves. Yuka (2000), for instance, is a portrait of an unconventional grandmother. With hair dyed bright red,Yuka shrieks gleefully in the sidecar of a motorcycle—the interviewee’s story reveals that she is on the Golden Gate Bridge accompanied by a much younger boyfriend on a tour of America. Though not all of the images in My Grandmothers are explicitly disruptive of conventional expectations of women in old age, their variety indicates a desire to rethink what it means to age. Yanagi’s futures have been imagined by young women who have not yet directly encountered ageism; other artists—and more specifically, older artists—address the struggle that many women have with their ageing selves. Celebrated American artist Cindy Sherman, for instance, began to explore the matter of age in a series of photographs made in 2000 and then again around 2009. The portraits—all untitled, all Sherman in disguise—embody the ongoing struggle of many women to (fail to) live up to the impossible standards of a youth-obsessed culture (Respini 2012, see also Meagher 2002, 2014). If Sherman’s work explores the frustrations and failures associated with growing old in a culture that valorizes, celebrates, and fetishizes youth, British artists Rosy Martin and Kay Goodridge produce photographic and video work that embraces the unruliness of a body that will not, and indeed cannot, live up to those expectations. Sherman’s women characters might be described as outrageous, but not in the unruly sense of Martin and Goodridge’s—Sherman’s women want desperately to pass as younger than they are, to cling for a few more years to the pleasures and privileges of youth. Martin and Goodridge instead revel in the discord between their middle-aged bodies and conventional fantasies of feminine respectability. Working collaboratively, Martin and Goodridge produced several series of work under the title Outrageous Agers. Deliberately positioned to ‘peel off the stigma of old age’ (Gear 2000), the films, photographs, and visual collages that comprise this work depict the artists—both middle-aged white women—in unconventional and unexpected situations.Trying It On (1999), for instance, documents their experimentation with what would conventionally been deemed age-inappropriate clothing in the cramped changing room of a high street shop aimed at a young clientele.They try on short skirts, tight animal print dresses, and strapless tops.What really stands out is not just the anachronism of playing at being young, but the aggressive demonstration of sexuality in bodies that are post-menopausal, and imagined as post-sexual. Covey points out that sexual desires of old people have been treated with ridicule and distaste—for the aged, he writes, ‘sexual activity is taboo’ (Covey 1991: 169, see also Kauppinen 1991). Indeed, the desire to maintain a sexual identity is part of what makes the artists discussed above both unseemly and radically disruptive. Fuelled by a similar interest in the disruptive capacities of the female grotesque, in her Cougar for a Year (2012–13) Canadian artist Dayna MacLeod challenged herself to a durational performance project that involved wearing animal print clothing every day for a year. Interested in the ways that sexual mores shift with the slide into peri- or post-menopausal middle age, 90

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MacLeod embodies and intends to normalize the stereotype of the cougar, that disparaging category used to describe a woman over the age of 40 who, as MacLeod puts it, ‘aggressively demonstrates her (hetero)sexuality’ (MacLeod n.d.). Similar work is Canadian photographer Suzy Lake’s. In the mid-1990s, Lake imagined an alter-ego, Suzy Spice, a post-menopausal Spice Girls wannabe who dressed in platform shoes, spandex leggings, and plenty of animal print. Like the work of Martin and Goodridge, these performances highlight the impossibilities of measuring up to narrowly age-defined ideals of desirability. The work suggests the presence of social penalties that may be incurred from doing one’s age incorrectly. They also explore the potential freedoms associated with refusing to act one’s age.

Intimate reflections: representing the experience of ageing Rather than integrating the old into visual culture, or attempting to disrupt the conventions by which older people are imagined, many artists have engaged in intimate explorations of the experience of ageing. Some have done this through intergenerational comparisons that highlight what Cristofovici describes as the ‘permanently fluctuating relationship between a younger and an older self ’ (1999: 286). Terry Pollock’s Death Mask (1987) superimposes the artist’s face over a portrait of her grandmother; Hannah Wilke’s Portrait of the Artist with Her Mother (1978–81) positions Wilke’s young and vibrant body in contrast to her mother’s scarred and gaunt aged body; Speed-Split (1998) is a set of photographs of Consuelo Castaneda nestled naked into her mother’s body. American performance artist Martha Wilson’s Beauty Beastly (1974/2009) positions two nude images of the artist, one taken in 1974, and the other in 2009. The title of this work speaks to the lived experience of the old body as one marked by disgust, but the broader effect of the work is to reflect on the ways in which these bodies coexist in, to use Cristofovici’s terms, a ‘permanently fluctuating relationship’ (1999: 286). Though it is only in Wilson’s work that the two bodies are in fact the same body, all of these artists compel their viewers to reflect on the relationship between bodies that are young but will soon be old, and bodies that are old but were once young. Age emerges here as relational, as unfixed, and as an ongoing and fundamentally shared experience of embodiment. In Martha Wilson’s Chrysanthemum (2008), the artist photographs her profile and the crown of her head over several months, documenting the growing out of her signature red dye job and the slow emergence of white hair. Age here is represented as a process unfolding over a span of time; it is also represented as an experience that can be concealed (dyed) or that can be accepted (letting colour grow out). Wilson’s pared-down performance of her own ageing here and in her Beauty Beastly period enables viewers to think about what the transformations of age look and feel like.

Conclusion Contemporary artists, many of them moving into middle age, have taken up age and ageing as themes worthy of aesthetic interrogation and exploration. The work discussed here under three broad themes contributes to art by making a case for the inclusion of old bodies in the aesthetic field. This work draws attention to the impact that limiting expectations and ageist stereotypes have on the shared experience of age and, in some cases, models strategies for ‘doing’ age in vibrant and resistant fashion. Finally, the most intriguing and perhaps important work on the matter of age changes the conversation both within and without the field of art by insisting that age and ageing are not simply the concerns of those who have moved into the (always shifting) category of old age. From this perspective, ageing is a shared experience of all bodies. What 91

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emerges from the most exciting contemporary work is the realization that art has the capacity to reflect not only on age, but on the very idea of ageing, understood as something that we all, from the very beginning of our lives to their very ends, are experiencing. As the work described here indicates, age is now a viable and indeed important theme in art; it is a site of interrogation, challenge, reflection. But representations of age and ageing also have the capacity to dramatically alter the ways that ageing as a shared lived process has been relegated to the study of the old, to dramatically alter, in other words, the very ways in which ageing has been thought.

References Berlind, Robert. 1994 ‘Art and Old Age’, Art Journal, 53.1: 19–21 Campbell, Erin. 2010 ‘Prophets, Saints, and Matriarchs: Portraits of Old Women in Early Modern Italy’, Renaissance Quarterly, 63.3: 807–49 Clark, Kenneth. 2006 ‘The Artist Grows Old (1972)’, Daedalus 135.1: 77–90 Covey, Herbert C. 1991 Images of Older People in Western Art and Society, New York: Praeger Cristofovici, Anca. 1999 ‘Touching Surfaces: Photography, Ageing, and an Aesthetics of Change’ in Kathleen Woodward, editor, Figuring Age:Women, Bodies, Generations, Bloomington: Indiana University Press, 268–95 Dabbs, Julia. 2012 ‘Vision and Insight: Portraits of the Aged Woman Artist, 1600–1800’, Occasion: Interdisciplinary Studies in the Humanities, 4: 1–15 (arcade.stanford.edu/journals/occasion) Deitrich, Linnea. 1996 ‘Contemporary Art and Ageing’, Journal of Ageing and Identity, vol. 1.4: 251–61 Dietrich, Linnea. 1999 ‘Ageing and Contemporary Art’ in Sara Munson Deats and Lagretta Tallent Lenker, editors, Ageing and Identity: A Humanities Perspective, Westport, CT: Greenwood, 183–90 Ellegood, Anne. 1999 ‘Old Dogs, New Tricks’ in Marcia Tucker, editor, The Time of Our Lives (exhibition catalogue), New York: New Museum of Contemporary Art, July 15 to October 17: 58–71 Garrard, Mary D. 2006 ‘Alice Neel and Me’, Woman’s Art Journal 27.2: 3–7 Gear, Rachel. 2000. ‘The Old Hags are Laughing: A Response to Outrageous Agers’, Make 87 (March–May): 29 Hayden, Jacqueline. www.jacquelinehayden.net (artist’s webpage). Last accessed October 28, 2013 Hutcheon, Linda and Michael Hutcheon. 2012 ‘Late Style(s): The Ageism of the Singular’, Occasion Interdisciplinary Studies in the Humanities, 4: 1–11. Available online at arcade.stanford.edu/journals/occasion Ingalls, Zoe. 2000 ‘In the Unrelenting Eye of the Camera, Images of Our Own Mortality’, Chronicle of Higher Education 46.18: B2 Kauppinen, Heta. 1991 ‘Ageing in Art: Beyond Stereotypes’, International Journal of Ageing and Human Development 33.3: 217–32 MacLeod, Dayna. daynarama.com (artist’s website). Last accessed October 28, 2013 Meagher, Michelle. 2002 ‘Would the Real Cindy Sherman Please Stand Up? Encounters Between Cindy Sherman and Feminist Art Theory’, Women: A Cultural Review 13.1:18–36 Meagher, Michelle. 2014 ‘Against the Invisibility of Old Age: Cindy Sherman, Suzy Lake, Martha Wilson’, Feminist Studies 40.1: 101–43 Pollock, Griselda. 2003 ‘The Grace of Time: Narrativity, Sexuality, and a Visual Encounter in the Virtual Feminist Museum’, Art History 26.2: 174–213 Respini, Eva. 2012. ‘Will the Real Cindy Sherman Please Stand Up?’ in Cindy Sherman (exhibition catalogue), New York: Museum of Modern Art, February 26 to June 11: 12–53 Rosand, David. 1987 ‘Editor’s Statement: Style and the Ageing Artist’, Art Journal 46.2: 91–3 Sohm, Philip. 2007 The Artist Grows Old:The Ageing of Art and Artists in Italy, 1500–1800, New Haven, CT: Yale University Press Townsend, Chris. 1998 Vile Bodies: Photography and the Crisis of Looking, London: Prestel Woodward, Kathleen. 1999 Figuring Age:Women, Bodies, Generations, Bloomington: Indiana University Press Woodward, Kathleen. 2006 ‘Performing Age, Performing Gender’, NWSA Journal 18.1: 162–89

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12 Visual methods in ageing research Wendy Martin

Visual images are omnipresent in our lives. The visual permeates our daily lives, our academic work and our conversations, and is ‘inextricably interwoven with our personal identities, narratives, lifestyles, cultures and societies’ (Pink 2001 p.17).Visual culture has taken on an enhanced significance in the late twentieth and early twenty-first centuries due to technological and digital advances, the growth of modern media and the prominence of consumer culture. Central to people’s identities and subjectivities as they grow older is the proliferation of the visual—from visual technologies (via the digital, television, video, film, photography) to the visual images portrayed through art, paintings, sculpture, advertisements and visual images in newspapers and magazines and on television and social media (Rose 2012). The rise of the visual is moreover viewed as central to the emergence of cultural gerontology (Twigg and Martin 2014). Not only has there been an expansion in the use of visual imageries in social research, but visual methods and methodologies are now increasingly adopted in ageing studies. Incorporating the visual and visual methods into the research process is seen as a means to obtain significant insights into how micro processes of daily life are linked to wider socio-cultural discourses and performative aspects of culture often hidden within the everyday, to make visible the mundane and taken-for-granted, to elicit insights into social and embodied identities, to stimulate debate, and to reveal meanings and understandings in context. This chapter aims to capture some of these developments, to explore how visual methods can be incorporated into ageing studies and to examine the possibilities and challenges of visual methodologies in ageing research.

Developing a visual methodology Developing a visual methodology involves the production and use of visual materials that are integral to the research process (Knowles and Sweetman 2004). Within the research process, Harrison (2002) has distinguished between visual images that are a ‘resource’ (that is, a method to generate data) and visual images as the substantive ‘topic’ (that is, the focus and the subject of enquiry). A further distinction can be made between visual images that are ‘found’ as they already exist in the social world (for example, films, photograph albums, magazines, social media images) and visual images that are produced as part of a research project (Rose 2012). Visual 93

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methods can be divided into three broad, often interconnected, activities: the visual as a form of data, visual images as a way to generate more data and the visual as a way to represent concepts and findings in research (Knowles and Sweetman 2004). Visual images portray partial views of the world rather than an all-encompassing ‘truth’, in which meanings can be socially constructed by both the person who produces the image and the audiences that view the images. For Rose, researching the visual is a cultural constructionist approach in which, ‘Interpreting images is just that, interpretation, not the discovery of their “truth” . As Hall suggests, it is therefore important to justify your interpretation. To do that you will need to have an explicit methodology’ (2001, p. 2). When developing a visual methodology and an analytical strategy, it is hence crucial to be explicit, clear, robust, transparent and systematic to ensure research quality and research integrity. The use of visual methods is also not there simply to illustrate or elaborate an aspect of the research project that could be considered as ‘a largely redundant visual representation of something already described in the text’ (Banks 2001, p. 144). The use of visual images in the research process aims instead to elicit a different type of data that will enhance our understanding and knowledge of age and ageing (Harper 2002). The visual is often used alongside other forms of evidence (Rose 2012) and needs to be appropriate and ethical in relation to each specific research context (Pink 2001). There are three sites at which meanings of a visual image can be made: the site of production when an image is created; the site where the image itself is situated; and the site or sites where an image is viewed by various audiences (Rose 2012). There are some key analytical approaches that are used to analyze visual representations, including semiology (the study of signs), which explores how images make meaning; content/context analysis, which is systematic with four key processes: find images, devise categories to code images, code and analyze; and discourse analysis, which focuses on discursive dimensions, including power and the social practices within which the image is embedded (Rose 2012). All visual images have their own histories and narratives that can be explored and analyzed; there are many complex layers of meanings (Grady 2004) within a visual image so that a researcher needs to look with a critical and questioning eye to consider and understand how images work; for visual images are not only a (passive) reflection of social context but have their own (active) effects, for example, the production and reproduction of social difference (Rose 2012). Age and ageing are important social differences.

Possibilities and challenges in visual research Due to technological developments there are now many different and less expensive ways of including the visual. There are a number of authors who set out different approaches and techniques associated with visual research (for example, Emmison and Smith 2000; Banks 2001; Pink 2001, 2012; Knowles and Sweetman 2004; Back 2007; Stanczak 2007; van Leeuwen and Jewitt 2010; Harper 2012; Rose 2012). A brief overall consideration of the rationale for and the possibilities of using visual methods in the research process may include: to explore aspects of the visual, in particular, the taken-for-granted nature of the visual within daily life; to elicit insights into people’s social worlds and embodied identities; to facilitate memories, such as of events and of the biographical; to allow repeated viewing; video captures movement and promotes the observation of behaviour, embodied interactions and body language; to facilitate a participatory approach when participants are significantly involved in the research process; and to support and illustrate concepts and findings in research. There are also key issues and complexities to consider when developing a visual methodology, which include: as the visual can be found everywhere, it is necessary to decide and to 94

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justify how and why specific visual images are being used in the research process; the research may result in having too much data to manage and analyze, such as a large amount of video or photographs; the risk of possible hostility to the camera and areas where photography may be difficult; a full consideration of ethical, copyright and photo reproduction issues; to consider how equipment may affect the situation being researched; to question whether important contextual details may be missed; representation and the visual, and to consider the key question ‘what does a visual image mean?’; to examine the relationship between textual and visual data; to explore questions of validity and reliability, sampling and bias (for example what is seen, or not seen?; how and by whom is it seen?); to be aware that the method may not be as inclusive of people with visual impairments; to be critical and reflexive about the researcher and participant relationships and power within the research process (for example, who takes the photographs?, who chooses and analyzes the visual images?); and to not underestimate the time, resources and technical expertise needed to conduct and disseminate visual research. The expansion of visual methods in social research has led to increasing attention on ethical and photo reproduction issues (Wiles et al. 2012; Rose 2012). The key areas of debate within visual research are issues around consent, anonymity and copyright (Rose 2012). All these aspects need to be considered in relation to each specific project and context throughout the research process, from ethical approval, to fieldwork, to collaborating with participants, and dissemination.

Visual representations and age Visual representations of age and ageing operate in a ‘visual culture that systematically devalues and erases age’ (Twigg 2013, p. 101). A significant factor in this has been the rise of consumption culture that presents an idealized visual sphere of aspiration and desire, which has resulted in a predominant culture of body perfectionism. Visual culture is now saturated with images of youth and bodily perfection, and increasingly focuses attention on appearance as central to identities, bodies, self-worth and social status (Featherstone 1995; Featherstone and Hepworth 1995a, b). Old bodies are increasingly viewed as a disruption to the visual field; as Hepworth argues, the ‘look of age’ is ‘considered unwelcome and undesirable’ (2000, p. 40), which directly affects older people who are increasingly required to age without appearing to do so (Katz 2001, 2005).Visual representations are therefore a powerful force that shapes and reshapes the lives of people as they grow older and the ways their own identities, experiences and everyday lives are mediated, experienced, valued and understood (Twigg and Martin 2014). There has been a notable increase in the exploration and analysis of visual representations of mid to later life. The majority of visual methods research in ageing studies has been on visual representations, with researchers often working with visual images that are found and already exist in the social world. This includes researching visual images found in popular media (Dolan and Tincknell 2012; Ylänne 2012), advertisements (Lee et al. 2007; Williams et al. 2007, 2010a, 2010b; Ylänne et al. 2009; Ellison 2014), magazines (Featherstone and Hepworth 1995b; Lewis et al. 2011; Twigg 2013; Hurd Clarke et al. 2014; Marshall and Rahman 2014), film (Markson 2003; Robinson et al. 2007), family photographs (Bytheway and Bornat 2012), art (Blaikie and Hepworth 1997; Wainwright 2004; Abastado et al. 2005), photographic images (Blaikie 1997; Bytheway 2003), health promotion (Martin 2012) and social media (Levy et al. 2014). Key themes that have emerged from the analysis of visual representations in later life are the alternative positive and negative images of ageing portrayed; stereotypical representations of age and ageing; the gendered nature of visual representations; the visibility and invisibility of ageing bodies; and the role and significance of consumer culture and the media. 95

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Visual methods within the research process Visual methods are often used in combination with other research techniques (such as in-depth interviews, focus groups, ethnography) within the research process. Visual images can be made during the research process by researchers and professional photographers or by the people who are being researched. The range of visual methods can take many forms, including film, video, photographs, maps, diagrams, paintings, models, art, memory books, diaries and collages. A number of visual researchers in ageing studies promote the idea that visual research is collaborative and/or participatory, as the power dynamics within the research process are changed. Relationships between the researcher, participant and visual images are not, however, unproblematic and do therefore need continually to be reflected upon.This section will explore the following research techniques within the context of age and ageing: photography, photo-elicitation and the video camera.

Photography Photographs can be produced in ageing research by researchers and professional photographers. The project Representing Self—Representing Ageing, funded by the New Dynamics of Ageing cross-council research programme in the United Kingdom (UK), for example, involved professional photographers in the creation of various imageries of ageing. Women were invited to creative workshops and worked in collaboration with a photographer as a means to create their own imageries of the ageing process. The visual images were viewed as an artistic challenge to stereotypical images of growing older; on analysis, the visual images were broadly themed as ‘nostalgic / melancholic’ or ‘humorously carnivalesque’ (Richards et al. 2012). In Figure 12.1 Hermi portrays her own creative representation of ageing. Figure 12.2 shows the photographer Rosy Martin to highlight the collaborative and creative nature of these encounters. MacMaster (2012) has also used creative photography to explore images and identities of women. Orr and Phoenix (2014) photographed people in mid to later life as they participated in their usual physical activities to obtain insights into sensual experiences associated with doing sport and physical activity. Photographs can also be taken by the people being researched. In my own research project Photographing Everyday Life: Ageing, Lived Experiences, Time and Space, funded by the Economic and Social Research Council, UK, the focus was to explore the significance of the ordinary and day-to-day, and focus on the everyday meanings, lived experiences, practical activities and social contexts of people in mid to later life. In order to make these everyday lives visible, the project involved photographic diaries in which a diverse sample of 62 women and men took photographs of their different daily routines to create a weekly visual diary. This approach is participatory in the sense that participants are in control of the cameras and they can decide what to photograph (or not). The research provided insights into narratives and meanings of everyday life, and revealed rhythms and patterns that underlie habitual and routinized daily lives, including the role of time and routines and the use of public and private space (see Figures 12.3 and 12.4). Rush et al. (2012) used ‘photovoice’ when older people took photographs for one week to represent perceptions and experiences of risk. Another technique, known as auto-photography, has been utilized in research to explore embodied identities of mature bodybuilders (Phoenix 2010) and ageing and identity amongst older people on low incomes (Kohon and Carder, 2014). 96

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Figure 12.1  Hermi’s creative representation of ageing

Photo-elicitation Photo-elicitation is ‘based on the simple idea of inserting a photograph into a research interview’ (Harper 2002: 13). The visual images are often photographs but can be any form of imagery, such as art, objects, artefacts, diagrams and illustrations.The visual images are often used as a reference point, the focus of a discussion between researcher and participants, in order to 97

Figure 12.2  Rosy Martin, photographer Copyright for Figures 12.1 and 12.2 belongs to the Representing Self—Representing Ageing project, funded by the New Dynamics of Ageing cross-council research programme (grant number: RES-356–25–0040)

Figure 12.3  Daily Routine

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Figure 12.4  Work Routine Copyright for Figures 12.3 and 12.4 belongs to Dr Wendy Martin, Brunel University London, Photographing Everyday Life: Ageing, Lived Experiences, Time and Space project, funded by the Economic and Social Research Council, UK (grant number: RES-061–25–0459)

explore aspects of the participant’s experiences, knowledge, self-identities, emotions, representations and perceptions (Pink 2001). The purpose of involving visual images within the research interview is not to generate more information but to elicit different types of responses and data (Harper 2002). Photo-elicitation in ageing studies has been used to explore urban space and lived experiences (Byrnes 2011); visual art making and subjective well-being amongst older women (Reynolds 2010; Reynolds et al. 2011); the experience of doing physical activity (Orr and Phoenix 2014); and in health promotion (Martin 2012). Following an analysis of visual images of active ageing, Martin (2008, 2012) conducted photo-elicitation as part of in-depth interviews that explored the perceptions and experiences of people in mid to later life regarding their bodies, emotions and risk in daily life. In response to the visual images portrayed, the participants did mirror the alternative images of active (positive) and passive (negative) ageing.Whilst the participants did predominately distance themselves from the identity of growing older, on viewing the visual images it was evident that there was a much more complex and nuanced process, in which participants both identified with and resisted the image of being old(er). For example, on viewing an image that portrayed a couple, Sylvie, aged 52 years, responded: I think they are older than me. They may not be. But they feel older than me and I don’t feel like that at all. I think what I am getting at, it is bit of a mean thing, I don’t like to categorize myself as ‘old’, now I am in that box in one sense, but I don’t want to be in that box.

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The use of photo-elicitation therefore resulted in different and more textured understandings of ageing identities.

Video cameras Video based research normally involves either the researcher filming, or the participant being given a video camera to film dimensions of their social worlds. The ability for the researcher to have repeated viewings allows rich and contextual analysis of social interactions, body language and aspects of the participants’ daily lives. Ward and Campbell (2013) used video recordings as part of a mixed method study about how older people with dementia experienced care-based hair salons. In particular, the research highlighted the multisensory nature of hair care, and elicited rich data on embodied experiences of people with dementia, the significance of the senses to create meaningful worlds and bodily interactions and understandings. Silverman (2013) conducted a microethnograghy to explore the lived experiences of women caregivers caring for an older person. The research involved video recording small daily moments of care that could be seen again later and further analyzed. As the aim was to capture natural moments of care, the video camera was at times fixed on a tripod and at times moved with the researcher. Another video camera technique involves participatory video, which promotes a participatory approach and has been used, for example, in actively involving people with early onset dementia in video research (Capstick 2012). Video as a research method therefore appears to capture important insights into ageing bodies, as well as enhance our understanding of sensory and environmental contexts and of embodied interactions. For Pink (2011), visual research often appeals to a range of senses, for example, touch, sight, sound, movement, embodiment, in which visual images and the multisensory are interconnected. The use of photography and visual imageries in ageing research does also open up possibilities to enhance public engagement by communicating research findings to multiple and diverse

Figure 12.5  Photographing Everyday Life Exhibition; Brunel University London 100

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Figure 12.6  Photographing Everyday Life Exhibition; Brunel University London Copyright for Figures 12.5 and 12.6 belongs to Dr Wendy Martin, Brunel University London, Photographing Everyday Life: Ageing, Lived Experiences, Time and Space project, funded by the Economic and Social Research Council, UK (grant number: RES-061–25–0459)

audiences. This has led to creative ways to disseminate social science data, for example, via the means of the arts and humanities. At the end of the Photographing Everyday Life: Ageing, Lived Experiences, Time and Space project we created and disseminated our key findings via a photographic exhibition (see Figures 12.5 and 12.6). Within the exhibition we created a series of installations, mosaics, photographic images and digitized displays with the aim to portray our research findings in an interactive, creative and engaging way.

Conclusion There has been an increase in the use of visual methods in ageing research. The majority of this research has involved analyses of visual representations found in the social world. There is now an increasing amount of ageing research that incorporates visual methods into the research design to provide insights into embodiment, social identities and everyday life. Visual research has produced important insights into ageing bodies, gendered identities, ageing identities, daily life, care environments and our sensory worlds. A range of visual methods have been incorporated into ageing research, including photography, photo-elicitation and video cameras. Digital and technological developments also provide a new landscape and possibilities for visual methods and methodologies. As digital technologies become increasingly incorporated into the daily lives of people in mid to later life, it will be important for ageing researchers to be attentive to and research the visual imageries that can surround digital technologies that may both challenge and reinforce ideas about ageing (and youth) in complex and, at times, contradictory ways. As visual methods further develop in ageing research there will also be more opportunities for innovative ways to engage with people in mid to later life, as well as for social scientists and arts 101

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and humanities to closely collaborate, an aim at the heart of the emergence of cultural gerontology, in our shared desire to understand the complex and diverse lived experiences of people as they grow older.

Acknowledgements Data in this chapter has been drawn from the Photographing Everyday Life: Ageing, Lived Experiences, Time and Space project, funded by the Economic and Social Research Council, UK (grant number: RES-061–25–0459). I would like to acknowledge the excellent work of and collaborations with Dr Katy Pilcher (Aston University) and Dr Veronika Williams (University of Oxford). Many thanks to Dr Lorna Warren (University of Sheffield) for allowing me to discuss and portray her research project Representing Self—Representing Ageing, funded by the New Dynamics of Ageing cross-council research programme (grant number: RES-356–25–0040).

References Abastado, P., Guiramand, G. and Bousquet, B. (2005) Signs of ageing: the lifespan and self-representation in European self-portraits since the fifteenth century. Ageing and Society, 25(2): 147–58. Back, L. (2007) The Art of Listening. Oxford: Berg. Banks, M. (2001) Visual Methods in Social Research. London: Sage. Blaikie, A. (1997) Beside the sea: visual imagery, ageing and heritage. Ageing and Society, 17: 629–48. Blaikie, A. and Hepworth, M. (1997) Representations of old age in painting and photography, in Jamieson, A., Harper, S. and Victor, C. (eds), Critical Approaches to Ageing and Later Life. Buckingham: Open University Press, 101–17. Byrnes, M. (2011) A city within a city: A ‘snapshot’ of aging in a HUD 202 in Detroit, Michigan. Journal of Aging Studies, 25: 253–62. Bytheway, B. (2003) Visual representations of late life, in Faircloth, C. (ed.), Aging Bodies: Images and Everyday Experience. Oxford: AltaMira. Bytheway, B. and Bornat, J. (2012) The oldest generation as displayed in family photographs, in Ylänne, V. (ed.), Representing Ageing: Images and Identities. Basingstoke: Palgrave Macmillan. Capstick, A. (2012) Participatory video and situated ethics: avoiding disablism, in Milne, E. J., Mitchell, C. and de Lange, N. (eds), Handbook of Participatory Video. Maryland: AltaMira Press. Dolan, J. and Tincknell, E. (eds) (2012) Aging Femininities:Troubling Representations. Cambridge: Cambridge Scholars Press. Ellison, K. (2014) Age transcended: a semiotic and rhetorical analysis of the discourse of agelessness in North American anti-aging skin care advertisements. Journal of Aging Studies, 29: 20–31. Emmison, M. and Smith, P. (2000) Researching the Visual: Introducing Qualitative Methods. London: Sage. Featherstone, M. (1995) The body in consumer culture, in Featherstone, M., Hepworth, M., and Turner, B. (eds), The Body, Social Processes and Cultural Theory. London: Sage, 170–96. Featherstone, M. and Hepworth, M. (1995a) The mask of ageing and the postmodern lifecourse, in Featherstone, M., Hepworth, M., and Turner, B. (eds), The Body, Social Processes and Cultural Theory. London: Sage, 371–89. Featherstone, M. and Hepworth, M. (1995b) Images of positive ageing: a case study of Retirement Choice magazine, in Featherstone, M. and Wernick, A. (eds), Images of Ageing: Cultural Representations of Later Life. London: Routledge, 29–47. Grady J. (2004) Working with visible evidence: an invitation and some practical advice, in Knowles, C. and Sweetman, P. (eds), Picturing the Social Landscape: Visual Methods and the Sociological Imagination. London: Routledge, 18–31. Harper, D. (2002) Talking about pictures: a case for photo elicitation. Visual Studies, 17(10): 13–26. Harper, D. (2012) Visual Sociology. Abingdon: Routledge. Harrison, B. (2002) Seeing health and illness worlds—using visual methodologies in a sociology of health and illness—a methodological review. Sociology of Health and Illness, 24(6): 856–72. Hepworth, M. (2000) Stories of Ageing. Buckingham: Open University Press. 102

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Hurd Clarke, L., Bennett, E. and Liu, C. (2014) Aging and masculinity: portrayals in men’s magazines. Journal of Aging Studies, 31: 26–33. Katz, S. (2001) Growing older without ageing?: positive aging, anti-ageism, and anti-aging. Generations, 25: 27–32. Katz, S. (2005) Cultural Aging: Lifecourse, Lifestyle and Senior Worlds. Peterborough, Ontario: Broadwood. Knowles, C. and Sweetman, P. (eds) (2004) Picturing the Social Landscape:Visual Methods and Sociological Imagination. London: Routledge. Kohon, J. and Carder, P. (2014) Exploring identity and aging: auto-photography and narratives of low income older adults. Journal of Aging Studies, 30: 47–55. Lee, M., Carpenter, B. and Meyers, L. (2007) Representations of older adults in television advertisements. Journal of Aging Studies, 21: 23–30. Levy, B., Chung, P., Bedford, T. and Navrazhina, K. (2014) Facebook as a site for negative age stereotypes. The Gerontologist, 54(2): 172–76. Lewis, D., Medvedev, K. and Seponski, D. (2011) Awakening to the desires of older women: deconstructing ageism within fashion magazines. Journal of Aging Studies, 25: 101–9. MacMaster, M. (2012) Growing old for real: women, image and identity, in Leontowitsch, M. (ed.), Researching Later Life and Ageing: Expanding Qualitative Research Horizons. Basingstoke: Palgrave Macmillan. Markson, E. (2003) The female aging body through film, in Faircloth, C. (ed.), Aging Bodies: Images and Everyday Experience. Oxford: AltaMira. Marshall, B. and Rahman, M. (2014) Celebrity, ageing and the construction of ‘third age’ identities. International Journal of Cultural Studies. Published online 3 June 2014. doi: 10.1177/1367877914535399 Martin, W. (2008) Embodying ‘Active’ Ageing: Bodies, Emotions and Risk in Later Life. University of Warwick, Unpublished Thesis. Martin, W. (2012) Visualising risk: health, gender and the ageing body. Critical Social Policy, 32(1): 51–68. Orr, N. and Phoenix, C. (2014) Photographing physical activity: using visual methods to ‘grasp at’ the sensual experiences of the ageing body. Qualitative Research. Published online 24 July 2014: 1–19. doi: 10.1177/1468794114543401. Phoenix, C. (2010) Auto-photography in aging studies: exploring issues of identity construction in mature bodybuilders. Journal of Aging Studies, 24: 167–80. Pink, S. (2001) Doing Visual Ethnography. London: Sage. Pink, S. (2011) A multisensory approach to visual methods, in Margolis, E. and Pauwels, L. (eds), The Sage Handbook of Visual Methods. London: Sage, 601–14. Pink, S. (ed.) (2012) Advances in Visual Methodology. London: Sage. Reynolds, F. (2010) ‘Colour and communion’: exploring the influences of visual art-making as a leisure activity on older women’s subjective well-being. Journal of Aging Studies, 24: 135–43. Reynolds, F.,Vivat, B. and Prior, S. (2011) Visual art-making as a resource for living positively with arthritis: an interpretative phenomenological analysis of older women’s accounts. Journal of Aging Studies, 25: 328–37. Richards, N.,Warren, L. and Gott, M. (2012) The challenge of creating ‘alternative’ images of ageing: lessons from a project with older women. Journal of Aging Studies, 26: 65–78. Robinson, T., Callister, M., Magoffin, D. and Moore, J. (2007) The portrayal of older characters in Disney animated films. Journal of Aging Studies 21: 203–13. Rose, G. (2001) Visual Methodologies: An Introduction to the Interpretation of Visual Materials, second edn. London: Sage. Rose, G. (2012) Visual Methodologies: An Introduction to Researching with Visual Materials, third edn. London: Sage. Rush, K., Murphy, M. and Kozak, J. (2012) A photovoice study of older adults’ conceptualizations of risk. Journal of Aging Studies, 26: 448–58. Silverman, M. (2013) Sighs, smiles, and worried glances: how the body reveals women caregivers’ lived experiences of care to older adults. Journal of Aging Studies, 27: 288–97. Stanczak, G. (2007) Visual Research Methods: Image, Society, and Representation. London: Sage. Twigg, J. (2013) Fashion and Age: Dress, the Body and Later Life. London: Bloomsbury Academic. Twigg, J. and Martin, W. (2014) The challenge of cultural gerontology. The Gerontologist. First published online 28 June 2014. doi:10.1093/geront/gnu061 van Leeuwen, T. and Jewitt, C. (2010) Handbook of Visual Analysis. London: Sage. Wainwright, S. (2004) Embodied vulnerability in the art of J. M. W. Turner: representations of ageing in Romantic painting. Ageing and Society, 24(4): 603–16. 103

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Ward, R. and Campbell, S. (2013) Mixing methods to explore appearance in dementia care. Dementia, 12(3): 337–47. Wiles, R., Coffey, A., Robinson, J. and Prosser, J. (2012) Ethical regulation and visual methods: making visual research impossible or developing good practice? Sociological Research Online, 17(1): 8. Williams, A.,Ylänne,V. and Wadleigh, P.M. (2007) Selling the ‘elixir of life’: images of the elderly in an Olivio advertising campaign. Journal of Aging Studies 21(1): 1–21. Williams, A., Wadleigh, P.M. and Ylänne, V. (2010a) Images of older people in UK magazine advertising: toward a typology. International Journal of Aging and Human Development, 71(2): 83–114. Williams, A.,Ylänne,V.,Wadleigh, P.M. and Chen, C.-H. (2010b) Portrayals of older adults in UK magazine advertisements: relevance of target audience. Communications: The European Journal of Communication Research, 35(1): 1–27. Ylänne,V. (ed.) (2012) Representing Ageing: Images and Identities. Basingstoke: Palgrave Macmillan. Ylänne, V., Williams, A. and Wadleigh, P.M. (2009) Ageing well? Older people’s health and well being as portrayed in UK magazine advertisements. International Journal of Ageing and Later Life, 4(2): 33–62.

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13 Ethnographies of ageing Cathrine Degnen

Ethnography is a powerful research technique. Put in the most succinct of terms, it requires spending extensive amounts of time with people who are—in the course of their normal lives—doing and experiencing the things that one wishes to better understand as a social scientist. This chapter explores ethnographic approaches to the study of ageing through time, across a variety of cultural settings and across disciplines. It contextualizes ethnographic principles as based on participant observation and originating in anthropology, but as premised on a particular research perspective: namely, empathy with the ‘other’. The chapter also considers what strengths and challenges ethnographic methods bring to research on socio-cultural ageing processes and the experiences of older people themselves.

Ethnography and participant observation Ethnography is an immersive methodology that requires time and patience. It also requires, crucially, openness to ways of being in and perceiving the world that are unfamiliar and perhaps uncomfortable for the researcher. The insights that such immersion can generate are virtually unattainable to the same extent via any other research method. The ethnographic method was first developed in the early 1900s by anthropologists working in places that were both culturally and geographically distant. Also called participant observation, this is a technique used by researchers who want to better understand social and cultural worlds by approaching them from within, seeking through ‘being there’ to gain insight into the worldview of research subjects themselves. Bronislaw Malinowski, one of the founding figures of British social anthropology, is commonly cited as the inventor of participant observation. Forced by the onset of the First World War to remain in his Trobriand Islands fieldsite for over 2 years, Malinowski’s resulting account of Trobriander culture and social organization (1922) remains a core text in contemporary anthropology still today. It highlights many key tenets of ethnographic practice. These include the importance of building understanding by participating in and sharing daily experiences over an extended period of time with the host culture. Acquiring fluency in local languages and in local forms of meaning are also central aspects of ethnographic research. So too is the ability and willingness to build a strong rapport with both the host community and individual research participants. 105

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The ethnographic method and older age Older age per se was not usually an explicit concern of early anthropologists. However, given the holistic approach advocated within anthropology more generally, all aspects of life were of interest to ethnographers in their endeavours to build an in-depth account of a particular cultural system. Thus, despite the lack of a specified body of work on ageing in classical anthropology, themes highly relevant to the study of older age are discussed in many anthropological texts. These include topics such as intergenerational relations, shifting social status due to older age, age grades and gendered differences across the life course. Additionally, while remaining largely unacknowledged, many anthropologists across a wide range of fieldwork settings have relied in part on the accounts of older people as sources of cultural expertise and knowledge. The perspectives and experiences of people in the latter stages of life have thus greatly contributed to the ethnographic record, helping to form much of the classical anthropological canon, even if the resulting data was not explicitly recognized as shaped by or analyzed within such generational terms (Vesperi 1985: 20). Beginning in the late 1960s and early 1970s, however, this pattern began to change. Ageing and older age became for the first time an explicit topic of anthropological research. This shift was aligned with both the development of feminist approaches in anthropology and the then-nascent sub-field of medical anthropology. The former area of study highlighted the distinction between ‘sex’ and ‘gender’ and debates over nature/nurture, and fostered a politicized commitment to tackling social inequalities. A growing scholarly attention to such issues also raised awareness of related concerns around ageing.This was in regards to the highly stigmatized position of older people in Western societies (and elsewhere) as well as the deeply gendered parameters of older age. In a parallel and overlapping fashion, the emergent field of medical anthropology began demonstrating the marked interrelatedness of supposedly discrete categories of the social and the biological, as well as the ways in which health, illness, wellbeing, and healing are culturally embedded systems. Together, feminist theory and the development of medical anthropology helped foster an intellectual environment within which older age itself demanded ethnographic attention. Key pieces in this period include Margaret Clark and Barbara Anderson’s Culture and Aging (1967), Jennie Keith’s Old People New Lives (1977), Barbara Myerhoff ’s Number Our Days (1979), and Maria Vesperi’s City of Green Benches (1985).

Dilemmas Despite more than 3 decades having passed since the research on which they are based was conducted, these ethnographies still provide both important insights into the experiences of older age and instructive lessons in the use of ethnographic methods to study older age. For instance, Keith’s Old People New Lives (1977) is based in a purpose-built residence for retired French construction workers and their wives just to the east of Paris in Bagnolet, France. Her research questions centre on the processes of community formation in this residence at that point in time. She writes eloquently about predicaments presented by her arrival as a 26-yearold American doctoral student wishing to live in and study a residence for retired people. Early on in her research, Keith ‘wrestled with the problem of explaining what I was doing there’ to the residents, wanting to avoid deception at all costs but also having a limited number of suitable social roles available to her to adopt in the residence due to her very young age (1977: 27–8). Ultimately, she described herself to the residents as someone wanting to understand what older people thought of this kind of living arrangement. This was welcomed by the residents, and her research proceeded. 106

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Keith also writes about a dilemma faced by all ethnographers: how to meet people, become immersed in the social life of the fieldwork setting and begin building relationships (1977: 28–33). In her case, it was the centrality of the dining room for lunchtime meals at the residence that initially facilitated her integration. Each ethnographic setting has its own parameters that are locally appropriate for achieving these goals of participant observation. The adeptness of the researcher in perceiving them and integrating into them is often what the success (or otherwise) of the research rests on.

Visibility A third ethnographic lesson Keith’s research calls attention to is the issue of visibility (1977: 27). Ethnographers are thrust into a highly visible position when they enter the field.This is because they are matter out of place. They often stand out and become themselves a source of social curiosity and inquisition. This, for most novice ethnographers, is an unfamiliar and unsettling experience. Negotiating visibility and treating it with care are essential ethnographic skills, but often not easy ones to contend with. Visibility can serve as a highly valuable way of making contacts and explaining one’s presence in the field. But it can also unwittingly position the researcher in particular social networks that in turn make it difficult to access others, especially if there are strong factions in the fieldsite. Furthermore, while visibility is a common experience among most ethnographers, for ethnographers of older age it can serve as a sharp reminder of just how persistently age-segregated social life can be. In Britain, for example, older and younger people tend to interact regularly only within care- or family-based relationships. There is very little scope in the social imagination for, say, friendship relations whose ages span several decades (Degnen 2012: 140).Thus, a younger researcher among an older research population is rendered visible by virtue of difference in age as well as in difference of life experience. In this case, visibility is simultaneously an aspect of the ethnographic encounter and serves meaningfully as a tool for data collection and analytic reflection on how social difference is constructed, reproduced and experienced in that particular cultural setting.

Alterity Myerhoff ’s work, begun in 1972, is based in a day centre for older Eastern European Jewish people living in Los Angeles. She, too, is interested in how this group of older people created a sense of community in the face of wider social indifference, ‘a counterworld, inventing their own version of what made “the good life” ’ (1979: 20). Myerhoff focuses on the use of narrative as well as ritual for how meaning and identity are forged by the group. Three years later in 1975,Vesperi started her own ethnographic research in St Petersburg, Florida.Vesperi’s research is concerned with the negative cultural construction of older age, working in a context where city-leaders were trying to reinvent the city’s image and effectively seeking to erase from view the low-income older people who no longer matched this vision. Together, Myerhoff and Vesperi’s monographs bring directly into focus a fourth crucial aspect of ethnography and ageing: alterity. As the centre of anthropological inquiry, ethnographic participant observation has its roots in exploring and accounting for profound cultural difference. This is a task that requires empathy, a willingness to confront one’s own assumptions about the order of the world and to adapt to other ways of perceiving the world. Like Keith, both Myerhoff and Vesperi write about their attempts to enter into the lifeworlds of the older people they work with, but also about their awareness that this is not an entirely foreign world as it might have been in more traditional fieldwork settings.That is to say, ethnographers working in a different cultural setting 107

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can and do eventually leave the field to return home, whether that be across an ocean or down the road. An irony at the heart of ethnographic approaches to older age however is that this is a future many researchers will one day live for themselves. Ageing is a shared destination of most people, despite social norms promoting highly stigmatized visions of older people who are portrayed and treated as the Other. Ethnographic accounts of older age help us understand that while ‘our subjects are not ourselves, they are indeed our “selves” as we will become’ (Vesperi 1985: 20). Myerhoff, for her part, writes that ‘identifying with the “Other” [. . .] is an act of imagination, a means for discovering what one is not and will never be. Identifying with what one is now and will be someday is quite a different process’ (1979: 18). Ethnography is attuned to the complexity and messiness of everyday life. Consequently it is well suited to demonstrating detrimental social patterns. This includes, for example, ‘how the most negative aspects of aging have been codified into a normative model for all older people’ (Vesperi 1985: 65) and how older people are often otherized. Ethnographic approaches to ageing, by seeking to put the perspectives and experiences of older people themselves at the centre of inquiry, are a powerful tool for revealing and challenging these processes of otherization and alterity.

A developing field These early ethnographic contributions by Myerhoff, Keith and Vesperi provide useful reflections by each author on their own work, and in turn help reveal crucial points about ethnographic endeavours on ageing more broadly. Since their ground-breaking efforts, an impressive array of ethnographers has begun exploring ageing. Unsurprisingly many of these researchers have been anthropologists, based in both Western and non-Western settings. This body of work is theoretically, empirically, culturally and geographically wide-ranging. Key authors in the field include Haim Hazan, working on issues of transformed temporality and selfhood in a variety of fieldsites including an inner-city London day care centre for older Jewish people and a University of the Third Age group in England (1980, 1984, 1996); Sharon Kaufman’s work in the United States on identity, continuity and the self (1986); Andrew Dawson on ageing and post-industrial transformation in the north of England (1990, 2002); Judith Okely’s research in Normandy, France, on classed difference in clubs for older people (1990); Keith et al.’s cross-cultural comparison of ageing in Botswana, Ireland, the United States, and Hong Kong (1994); Susan Pickard in South Wales, UK, on continuity and change over the life course (1995); Dorothy and David Counts’s work with retired North Americans pursuing a nomadic lifestyle as part of the RVing community (1996); Sarah Lamb’s research in West Bengal, India, exploring interconnnected Bengali notions of ageing, personhood, social relations, the body and gender (1997, 2000); Charlotte Ikels work in Hong Kong and China on issues around dementia as well as differences between rural and urban settings in terms of intergenerational relations and filial piety (1980, 2002); Susan Rasmussen in Niger with Tuareg people, exploring notions of ageing, the life course and personal destiny (1997); Lawrence Cohen in north India on senility, old age and discourses of modernity (1998); Lisa Cliggett’s ethnographic account that considers the gendered dimensions of what being ‘old’ means for older Gwemba Tonga people in Zambia (2005); Caroline Oliver’s monograph examining the experience and concept of ‘positive ageing’ among older British migrants to Spain, with a particular focus on the identity paradoxes they are confronted by, and therefore the ways in which the life course mediates migrant experiences (2007); and Cathrine Degnen’s research in the north of England in a former coal mining area on the ways in which temporality, narrativity and social memory intersect to shape people’s experiences of ageing in a place that has undergone profound socio-economic transformation (2012). 108

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In addition to the community-based studies above, a significant number of authors have used participant observation in nursing homes (such as Johnson 1971, Gubrium 1975, Shield 1988, Hockey 1990, Savishinsky 1991, Diamond 1992, Henderson and Vesperi 1995, Reed-Danahay 2001), and have trained their ethnographic sights on dementia (including Herskovits 1995, Leibing and Cohen 2006, Chatterji 2008,Taylor 2008). From such modest beginnings, it is thus clear that the ethnographic body of work on ageing now demonstrates an impressive breadth of intellectual inquiry and empirical knowledge, encompassing a wide spectrum of cross-cultural contexts and theoretical perspectives. Furthermore, while anthropology has led the way in regards to establishing ethnographic approaches to ageing, ethnography is itself a method and a perspective on the move. The ethnographic method is one that now greatly extends beyond its original disciplinary base. Researchers in other disciplines have adopted aspects of ethnographic methods in their own work as ageing studies scholars. Notable examples include human geographer Graham Rowles (1983) on the role of place attachment in the maintenance of a sense of identity and belonging in older age; sociologist Pia Kontos’s research on dementia and embodiment (2004); human geographers Peter Hopkins and Rachel Pain on home and experience (2007); and social psychologist Steven Sabat (2001) on personhood and dementia.

Challenges With its valorization of life as lived and of immersive principles that prioritize first hand experiences, ethnographic research methods are flexible, responsive, and adaptive. This permits the researcher to follow the data across multiple sites of meaning making and through complex social terrains. In turn, as ethnography immerses the researcher directly in the lives and social worlds of fellow human beings, there are a number of ethical issues that ethnographers must be mindful of. This is the case not just in preparation for research and when conducting fieldwork but also when writing, sometimes many years after leaving the field. Primary among these are the responsibilities of researchers towards their research participants to prioritize participants’ wellbeing, to negotiate freely-given informed consent, to guard against harmful consequences of the research, and to protect confidentiality and the anonymity of the research participants (ASA 2011). Debates about the consequent strengths and weaknesses of such an approach have been well rehearsed elsewhere (see for example Atkinson and Hammersley 2007). These include the subjective and interpretivist qualities of ethnographic research and a tendency to rely on smaller numbers of research participants rather than large data sets. Both can open the method to accusations of non-representativeness. Indeed, it is not a method that suits every research question. It is however without equal as a technique for those seeking to better understand patterns of social and cultural systems of meaning and practice from an emic perspective. However, using ethnographic methods to study older age does present certain dynamics that are distinct to it alone and worth considering in more detail here. These include, for example, the common expectation that ethnography will occur over a long period of time, often many decades in duration, and across repeat visits. However, for researchers using participant observation to study ageing, this temporal dimension is not always possible to the same extent. This is especially the case when working with individuals who are the ‘oldest old’. Researchers might instead find themselves working sequentially over a period of time with multiple older cohorts. This has the disadvantage of requiring that entirely new research relations be repeatedly established with new individuals, rather than being able to build long-term relations with the same individuals. But, on the other hand, it also means that generational differences may become more apparent to the researcher over time as they move 109

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from working with one ageing cohort to the next. Alternatively, if the ethnographer’s work on ageing is based within a community study, they may find themselves working 10 or 15 years later after an initial period of research in the same community but with the now aged children of the first cohort of research participants. Individuals who were initially middle-aged during the first period of research would now themselves be entering a new life stage of older age. Such a fieldwork scenario in turn opens up exciting possibilities for tracing the ageing process through socio-historical and personal time. Another dynamic that is particular to ethnographers of older age is the temporal chasm in life experience between (typically but not always) younger researchers and older research participants. As mentioned above, in an age-segregated society this can present its own challenges, particularly in terms of how the researcher comes to be integrated in the fieldsite given the limited roles usually socially permitted between generations. But this is also a research dynamic that is witnessing modest change due to two factors. The first is the increasingly participatory and co-produced research models of some ethnographers whereby older people are not simply research subjects but also research collaborators. Approaches like this that include older people as co-researchers are part of a move towards greater transparency and accountability in social science. They recognize and seek to redress power dynamics of research by reconfiguring the hierarchical relationship between researcher and researched into a more egalitarian and dialectical model. Collaborative research also promotes space for the experience, knowledge and life priorities of the people being studied to come more clearly to light and inform the research process, unsettling more traditional hierarchies of expertise and knowledge creation. A second factor is the gradual ageing of an entire cohort of cultural gerontologists, who are now differently able to reflect on the ageing process. Given the subjective and reflexive nature of ethnographic work, the positionality of the individual researcher matters. This includes of course researchers’ own personal relationship with ageing. The accounts of researchers writing in the 2008 The Journal of Aging Studies special edition, volume 22(2), offer an instructive example of this. Entitled ‘Coming of Age: Critical Gerontologists Reflect on Their Own Aging, Age Research and the Making of Critical Gerontology’, these authors address precisely this point. While the contributors are not all ethnographers, they write movingly about how research personas and perspectives shift as one ages.This correspondingly inflects both research questions asked and conclusions reached.

Conclusion Ethnographic approaches to the study of ageing permit unique opportunities to better understand life as lived by older people themselves. Due to the vagaries, contradictions, and messiness of everyday life, ethnographic methods are also time consuming and challenging. Ethnography is demanding, requiring substantial patience, empathy, openness of mind, and a willingness to critique one’s own assumptions. Ageing, once on the fringes of ethnographic inquiry, with older people as an unacknowledged yet deeply significant source of data, has begun to receive the sustained and systematic attention it deserves. The ethnographic literature on ageing now spans a substantial range of both cultural settings and theoretical perspectives. This has added substantially to the contribution ageing studies scholars are making to the state of knowledge about the life course. Using ethnographic methods to study ageing presents some challenges particular to it. These include issues of access to the field, visibility, and alterity, and fewer opportunities to conduct longitudinal research with the same cohort. It can also include a temporal chasm between researcher and researched, a factor that is especially prominent in highly age-segregated societies. 110

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Such issues in turn raise the question for ageing studies of how social and cultural theory might be developed in new directions if experiences of ageing (both of research participants and researchers) were used to inform theoretical perspectives on social life more widely. Ethnographic methods can help drive such an agenda forward as they offer a critical perspective on social realities and how these come to be. They present a counterfoil to partial visions of older age that frame ageing and older people simply as Other. This is because an ethnographic approach seeks to understand life and meaning from within, refocusing attention onto older people as people first and foremost, attuned to all the complexity, diversity, and vitality that this represents.

References ASA (2011) Association of Social Anthropologists of the UK and the Commonwealth (ASA) Ethical Guidelines for Good Research Practice. Available online at www.theasa.org/downloads/ASA%20ethics%20guide lines%202011.pdf (accessed 23 January 2013). Atkinson, P. and Hammersley, M. (2007) Ethnography: Principles in Practice, third edn, New York: Routledge. Chatterji, R. (1998) ‘An ethnography of dementia’, Culture, Medicine and Psychiatry, 22 (3): 355–82. Clark, M. and Anderson, B. (1967) Culture and Aging: An Anthropological Study of Older Americans, Springfield, IL: C. C.Thomas. Cliggett, L. (2005) Grains from Grass: Aging, Gender, and Famine in Rural Africa, Ithaca, NY: Cornell University Press. Cohen, L. (1998) No Aging in India: Alzheimer’s, Bad Families, and Other Modern Things, Berkeley: University of California Press. Counts, D. and Counts, D. (1996) Over the Next Hill: An Ethnography of RVing Seniors in North America, Orchard Park, NY: Broadview Press. Dawson, A. (1990) ‘Ageing and change in pit villages of North East England’, unpublished thesis, University of Essex. ——— (2002) ‘The mining community and the ageing body: towards a phenomenology of community?’ in V. Amit (ed.), Realizing Community: Concepts, Social Relationships and Sentiments, London: Routledge, 21–37. Degnen, C. (2012) Ageing Selves and Everyday Life in the North of England:Years in the Making, Manchester: Manchester University Press. Diamond, T. (1992) Making Gray Gold: Narratives of Nursing Home Care, Chicago: University of Chicago Press. Gubrium, J. (1975) Living and Dying at Murray Manor, New York: St Martin’s Press. Hazan, H. (1980) The Limbo People: A Study of the Constitution of the Time Universe amongst the Aged, London: Routledge & Kegan Paul. ——— (1984) ‘Continuity and transformation among the aged: a study in the anthropology of time’, Current Anthropology, 25 (5): 567–78. ——— (1996) From First Principles: An Experiment in Ageing, Westport, CT; London: Bergin & Garvey. Henderson, J. and Vesperi, M. (1995) The Culture of Long-Term Care: Nursing Home Ethnography, Westport, CT: Greenwood. Herskovits, E. (1995) ‘Struggling over subjectivity: debates about the “self ” and Alzheimer’s Disease’, Medical Anthropology Quarterly, 9 (2): 146–64. Hockey, J. (1990) Experiences of Death: An Anthropological Account, Edinburgh: Edinburgh University Press. Hopkins, P. and Pain, R. (2007) ‘Geographies of age: thinking relationally’, Area, 39 (3): 287–94. Ikels, C. (1980) ‘The coming of age in Chinese society: traditional patterns and contemporary Hong Kong’, in C. Fry (ed.), Aging in Culture and Society: Comparative Viewpoints and Strategies, New York: Bergin Publishers, 80–100. ——— (2002) ‘Constructing and deconstructing the self: dementia in China’, Journal of Cross-Cultural Gerontology 17 (3): 233–51. Johnson, S. (1971) Idle Haven: Community Building among the Working Class Retired, Berkeley: University of California Press. Kaufman, S. (1986) The Ageless Self: Sources of Meaning in Later Life, Madison: University of Wisconsin Press. 111

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Keith, J. (1977) Old People New Lives: Community Creation in a Retirement Residence, Chicago: University of Chicago. Keith, J., Fry, C., Glascock, A., Ikels, C., Dickerson-Putman, J., Harpending, H. and Draper, P. (1994) The Aging Experience: Diversity and Commonality Across Cultures, London: Sage. Kontos, P. (2004) ‘Ethnographic reflections on selfhood, embodiment and Alzheimer’s disease’, Ageing & Society, 24 (6): 829–49. Lamb, S. (1997) ‘The making and unmaking of persons: notes on aging and gender in north India’, Ethos, 25 (3): 279–302. ——— (2000) White Saris and Sweet Mangoes: Aging, Gender, and Body in North India, Berkeley: University of California Press. Leibing, A. and Cohen, L. (eds) (2006) Thinking about Dementia: Culture, Loss, and the Anthropology of Senility, New Brunswick, NJ; London: Rutgers University Press. Malinowski, B. (1922) Argonauts of the Western Pacific: An Account of Native Enterprise and Adventure in the Archipelagoes of Melanesian New Guinea, London: Routledge & Kegan Paul. Myerhoff, B. (1979) Number Our Days, New York: Dutton. ——— (1984) ‘Rites and signs of ripening: the interweaving of ritual, time and growing older’, in D. Kertzer and J. Keith (eds), Age and Anthropological Theory, Ithaca, NY: Cornell University Press, 305–30. Okely, J. (1990) ‘Clubs for le troisième âge: communitas or conflict’, in P. Spencer (ed.), Anthropology and the Riddle of the Sphinx: Paradoxes of Change in the Life Course, London: Routledge, 194–212. Oliver, C. (2007) Retirement Migration: Paradoxes of Ageing, London: Routledge. Pickard, S. (1995) Living on the Front Line: A Social Anthropological Study of Old Age and Ageing, Aldershot: Avebury. Rasmussen, S. (1997) The Poetics and Politics of Tuareg Aging: Life Course and Personal Destiny in Niger, DeKalb: Northern Illinois University Press. Ray, Ruth and Cole, Thomas (eds) (2008) ‘Coming of Age: Critical Gerontologists Reflect on Their Own Aging, Age Research and the Making of Critical Gerontology—Special Issue in Memory of Mike Hepworth 1938–2007’, The Journal of Aging Studies 22(2). Reed-Danahay, D. (2001) ‘ “This is your home now!”: conceptualizing location and dislocation in a dementia unit’, Qualitative Research, 1 (1): 47–63. Rowles, G. (1983) ‘Place and personal identity in old age: observations from Appalachia’, Journal of Environmental Psychology, 3 (4): 299–313. Sabat, S. (2001) The Experience of Alzheimer’s Disease: Life through a Tangled Veil, Oxford: Wiley-Blackwell. Savishinsky, J. (1991) The Ends of Time: Life and Work in a Nursing Home, Westport CT: Bergin & Garvey. Shield, R. (1988) Uneasy Ending: Daily Life in an American Nursing Home, Ithaca, NY: Cornell University Press. Taylor, J. (2008) ‘On recognition, caring and dementia’, Medical Anthropology Quarterly, 22(4): 313–35. Vesperi, M. (1985) City of Green Benches: Growing Old in a New Downtown, Ithaca, NY; London: Cornell University Press.

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14 Ageing, narrative and biographical methods Joanna Bornat

‘Biographical methods’ is a term commonly used to include a variety of loosely related approaches that draw on the self as a central source: narrative studies, life history, oral history, storytelling, autobiography, life writing, biography, auto/biography, reminiscence, life narrative. Indeed, in their comprehensive overview of the field, Sidonie Smith and Julia Watson identify 52 different types of approach (2001). Researchers and writers who work with these traditions tend to work in parallel, often not recognizing each other’s existence, working with their own literary canon. The range of types of data is similarly extensive, including diaries, letters, notebooks, interactive websites, photographs, weblogs and written personal narratives, as well as standard research tools such as interviews, questionnaires and, again, diaries. History, psychology, sociology, social policy, anthropology, literary studies and neurobiology have provided guidance and inspiration in various ways. With so many different forms, disciplinary influences and types of data, how best to give shape and meaning to any approach to managing and interpreting that might be of use to cultural gerontology? Out of the many biographical approaches, this chapter focuses on three that appear most frequently in the literature and that share the common features of drawing on interviews and interpreting memories of past experience: oral history; the biographical narrative interpretive method (BINM); and narrative analysis.

Biography in ageing research Gerontologists have traditionally made surprisingly little use of biographical methods. Where the individual older person has been the focus, the approach has tended to be on the psychology of ageing, the ageing mind or changing cognitive states. The idea that the individual’s reflections on their own ageing, or that ageing itself, might be situated in cultural or historical contexts, individually experienced, has come rather late to gerontology. There have of course been significant exceptions. These include Jaber Gubrium in the US, who has emphasized the contribution of individual narratives of ageing in his work (Gubrium 1993) and Peter Coleman in the UK who has consistently sought to draw on life review and reminiscence in his explorations of the psychology of older people (Coleman 1986; Coleman et al. 2013). However, change has been on the way. James Birren, in an edited collection, Aging and Biography, noted a rapidly 113

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increasing interest in individual accounts of ageing, arguing that ‘there is something absorbing about reading a personal narrative about a long life and the way in which a person views the experiences of growing up and growing old and puts them into perspective’ (Birren 1996, p. ix). Gerontologists reflecting on their own ageing are rare, but with the popularity of biographical approaches, these too are beginning to emerge. For example, the special issue of the Journal of Aging Studies includes sixteen prominent critical gerontologists who reflect on the development of gerontology in relation to their own life experience (Ray 2008).

Three biographical methods The turn to a biographical approach in sociological research (Chamberlayne et al. 2000) has been accompanied by an extensive literature linking back to humanistic approaches in sociological research and historiography (Thompson 2000; Plummer 2001; Roberts 2002; Seale et al. 2004; Thomson 2007; Goodwin 2012). Biographical approaches are popular amongst students and in research in part because they have an immediacy that is both engaging and compelling. They also draw on many of the most telling and enduring epistemological and methodological issues in the human sciences, taking in debates on validity, memory, subjectivity, standpoint, ethics, voice and representivity, amongst others (Chamberlayne et al. 2000, p. 3). The three methods identified share certain antecedents, but with individual differences that bring out the distinctiveness of each. A common starting point is the ‘Chicago School’. During the first 40 years of the twentieth century, members pioneered the collection of testimony and drew on observations under realistic conditions with studies of urban society, poverty and street gangs and migrants (Plummer 2001). An accompanying significant development came with Herbert Mead’s concept of ‘the self ’ (1934), which stressed the significance of language, culture and non-verbal communication, emphasizing the roles of social interaction and reflection in the development of the individual’s sense of who they are. He suggested that the self might be understood in relation to an individual’s subjective relationship to social or historical contexts. This challenged approaches that gave primacy to the investigator’s or commentator’s perspective. Sociology was to take a rather different turn subsequently, towards a more positivist, statistically based methodology and a functionalist driven theorizing on a grand scale. C.Wright Mills’ response to ‘abstracted empiricism’ and ‘grand theory’ was a call for a humanistically informed approach. Writing in the late 1950s and influenced by the narrowness of thought that the Cold War was imposing on US sociologists, he called for ‘a sociological imagination’, which would bring out the interactions between the individual, their biography and wider social structures: We have come to know that every individual lives, from one generation to the next, in some society; that he [sic] lives out a biography, and that he lives it out within some historical sequence. By the fact of his living he contributes . . . to the shaping of this society and to the course of history, even as he is made by society and by its historical push and shove. (Mills 1959, p. 6) Mills’s interdisciplinary embrace of biography has had a lasting influence, and has provided the link between the early days of the Chicago School and later twentieth century developments in European sociology (Treviño 2012). Gerontologists seeking to follow his humanistic approach, situating individual agency and understanding within broader determining structures, of generation, space and time, as well as class, gender and ethnicity, have turned to biography as an appealing methodology. 114

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Oral history Oral history, researching the past through memory by means of recorded interviews, has a long association with and awareness of the perspective from late life through its engagement with older research participants. In terms of method it is interdisciplinary, embedded as it is within history but drawing on sociological methods of data collection and analysis (Thompson 2000). As a result the interview here is more than simply a tool for extracting information about the past, and is perceived as an object in itself, with particular characteristics produced in the telling of life events. Accusations that in its early years oral history was overly concerned with empiricism and validity (Thomson 2007) have been responded to variously, but most eloquently by Portelli who argued, in the article ‘What makes oral history different’, that ‘it tells us less about events than about their meaning’ (emphases original) and that ‘the unique and precious element which oral sources possess in equal measure is the speaker’s subjectivity’ (1981, p. 67). His emphasis on individual meaning was in keeping with oral history’s partisan approach to history making, using the method to understand experiences of oppression and marginalization and to challenge dominant historical narratives (Frisch 1990; Thompson 2000; Portelli 2003; Abrams 2010; Thomson 2013). Of all the three methods, oral history has, at least since the early 1980s in the UK, engaged most directly with the worlds of older people, with its focus on practical and beneficial outcomes when older people are encouraged to reminisce (Bornat 2011). This has helped to sensitize oral historians to the contribution that age and gender make to the social relationship of the interview. The recognition of subjectivity as a means to both understand and represent the past has been a significant development. Feminist oral historians took a leading role, with Luisa Passerini’s study of women’s experiences of fascist Italy providing both inspiration and means to exploring and interpreting memory along gender lines (Passerini 1979; Bornat and Diamond 2007). Different approaches have followed. Thomson’s interviews with four women who migrated to Australia in the 1960s were developed as a joint enterprise in remembering, life review and interpretation of personal experience (Thomson 2011). Summerfield was interested in how women’s memories of their lives in the UK during the Second World War are in a dialogue between present and past in which the images of a popular culture of heroism did not always match their experience of enduring those years (Summerfield 1998). Portelli’s oral history of Harlan County, Kentucky, is at once a social, cultural and political history that draws on individual accounts by men and women of generational change in one of the most impoverished and exploited regions of the USA (Portelli 2011).

Biographical narrative interpretive method (BNIM) The second of the three methods is an approach known as the biographical narrative interpretive method (BNIM), developed in Germany during the 1980s by Fritz Schütze. He was greatly influenced by ‘third generation Chicagoans’ such as Anselm Strauss, Howard Becker, Erving Goffman and others (Apitzsch and Inowlocki 2000, p. 58). His interview method and approach to analysis was subsequently refined by Gabriele Rosenthal (2004). This involves the separating out of the chronological story from the experiences and meanings that are also present in the interview responses. The process depends on an understanding of the biographical interview as a process of constant movement between past, present and future, in which the interviewee might not be fully aware of the contexts and influences in their life. Chamberlayne and colleagues developed the method further (Chamberlayne et al. 2000) with a 115

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systematization of the interview into three ‘subsessions’. Follow-up questions, drawn from a narrative offered in answer to a single opening question asking for an account of the interviewee’s life, are then followed by questions asking for more narrative detail. Finally there is a third subsession in which more experiential themes are developed (Wengraf 2013). From this a psycho-biography is constructed (Wengraf 2001, p. 347) aided by a process of hypothesizing based on a classification of text segments from the transcribed interview. The preference is for groups of people to work together as they explore the accounts presented. This phenomenological approach to understanding biographical data focuses on the individual’s perspective within an observable and knowable historical and structural context and what it is to be the person who is narrating, identifying decisions taken at the various turns and patterns of a life (Wengraf 2001, pp. 305–6). Chamberlayne and King developed a particular interest in applying the method to theorizing and explaining the impact of social welfare policies by engaging with the subjectivity and agency of welfare recipients, linking private and public spheres as these are experienced, expressed and represented through individual accounts (Chamberlayne and King 2000). Ensuing research (see Wengraf [2013] for a detailed listing) tends to focus on health related topics, migration and social welfare issues with older people: see for example Brannen and colleagues’ study of four-generation families (2004) or Nicholson’s exploration of the researcher’s emotional experience while interviewing an older couple’s experiences of frailty in late old age (2009).

Narrative analysis The third area of biographical activity also traces its origins to the Chicago School. Narrative analysis centres the author as source, but whereas early sociologists generated accounts in order to capture the reality of city life as a source of observation, more recent narratologists such as Catherine Kohler Riessman see the story as a whole greater that the sum of its parts, as a system of ‘sequence and consequence’ (Riessman 2004, p. 706). Andrews and colleagues describe narrative research as ‘a historically-produced theoretical bricolage’ but helpfully offer a categorization into: accounts of experiences of a past event; personal narratives and meanings that are to be discovered in ephemera such as letters, objects, photo albums, speech excerpts; and narratives that emerge from ‘co-construction’ as in shared conversations and dialogue. For all these, an evaluation of the role of the audience is central (Andrews et al. 2008, p. 4–5; see also Riessman 2008). Narrative researchers identify a difference between researchers who are interested in how people use or perform narratives and those for whom narratives are of interest for what they reveal of unconscious motivations. They point to a division between ‘big’ and ‘small’ narratives: the micro snippet as opposed to a life history. Finally, they identify the influence of a poststructuralist approach that emphasizes subjectivity, the production of narratives, the identification of silences and the influence of power in the forming of narratives (Andrews et al. 2008, pp. 4–9; see also Riessman 2008). For Riessman, what is essential in any approach to narrative analysis is that the ‘teller’ is kept at the centre with analysis ‘starting from the inside’ but not ignoring the influence of power in determining what is said, by whom and how (Riessman 1993). In all this, the perspective of the interpreter—their particular theoretical stance, ‘cultural habitus’ (Hammersley 1997) and personal history—will play a part. An example of this approach is Andrews’s study of political activists that links history and biography in case studies from four countries, the UK, USA, Germany and South Africa, as she considers lifelong commitment to causes (Andrews 2007).

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Comparing the three methods All three of the approaches that I have briefly outlined make innovative and creative contributions to the development of biographical methods. Each places emphasis on the interview as an example of social interaction, stressing the contribution of reflexivity and the significance of difference; each places emphasis on subjectivity and insights derived from recognition of meanings and emotions on both sides of the dialogue. Context too has a value that is incorporated into analysis with the varied temporalities of contexts coming into play as memory of times past interweaves with present and future time. However, there are also differences, and this last part of the chapter will focus on these, with examples from the author’s own work.

The interviewer–interviewee relationship Each approach positions the interviewer and interviewee rather differently in relation to one another. BNIM’s separation of interviewer and interviewee, through the privileging of the interviewee’s account in the first phase and the interviewer’s in the second, excludes the possibility of including responsive interactions or dialogic elements. Narrative analysis, in its focus on the structure of the account, also diminishes the dialogic aspects emergent in an interview, with evidence of the interviewee’s presence typically being excised from the text being analyzed once the structure of the account becomes the main focus. An oral history approach, in contrast, sees the interviewer as an integral part of the data generation process and as having a presence that requires acknowledgement (Portelli 1997; Bornat 2004). The dialogic nature of an oral history approach can play a significant part in old age research, as an example from the Timescapes programme’s ‘The Oldest Generation’ project shows. This involved interviewing people over 75 about family life and their relationships with younger family members, alongside a diary of their activities kept by another member of the family. In the main these interviews presented wholly positive accounts of early experiences, family building and transitions into late life. What was told could be in some way owned by the family (Bornat and Bytheway 2012). Difficult episodes, such as deaths of children, would have to be included in ways that were acceptable to this wider audience and within the context of the interview and the project overall. One woman found a way to deal with the difficult subject of her son’s suicide by telling the story of his death from multiple perspectives within the family and from within her own life and within the interview dialogue.This was a story that she doubtless would have told herself many times but perhaps not in this way, for, as Plummer argues, oral history and life history interviews draw on ‘researched and solicited stories . . . [that] do not naturalistically occur in everyday life; rather they have to be seduced, coaxed and interrogated out of subjects’ (Plummer 2001, p. 28). What emerged was the product of a dialogic partnership, which was context dependent yet met her needs as narrator, while providing the project with insights into the resources that she, a mother and grandmother in late life, is able to draw on to deal with an existential blow.

Making use of memory A further distinction between the three methods comes with the different ways in which each makes use of memory. Memory plays a function in the present and is as much about telling stories, bearing witness or confessing to past involvements and actions as it is about establishing the identity of the self in the present. It draws on and engages with collective representations and

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can change according to audience, stimuli and time of life (Draaisma 2004). While providing a window on the past, with eyewitness accounts of events and experiences, recall by older people can be multi-faceted in the temporalities that it evokes and draws on. Here for example is a South Asian overseas-trained doctor reflecting on his experience as a geriatrician working in the UK. On being asked as part of an interview about his career, if he thought his background and experience shaped the way he wanted to care for older people, he answered: I don’t know. But I felt [for] them and look at them when they were young and pretty and the way they talk about driving their ambulance, the women, and working at the armaments and fighting for the vote, which the world enjoys. I get respect. (Dr L028, born India, 1927, came to UK 1953, interviewed for ‘Overseas-trained South Asian doctors and the development of geriatric medicine’, ESRC grant reference number: RES-062–23–0514. Deposited at the British Library, catalogue no. C1356/31). Within his account are not only a doctor’s perception, his feelings and admiration for his patients, but also their life histories and the history of the twentieth century. In such ways oral history offers us insights into the ways in which memory is used in late life, providing us with access to experiences that might otherwise be unreachable, not being documented or even recognized as having value. Neither BNIM nor narrative analysis, with their focus on the psycho-social and narrative form, gives the same value to memory as an individual and social practice demonstrating individual agency as well as providing unique empirical content.

Interviewee voice The last distinction concerns the ways the three approaches position the interpreter in relation to the originator of the data, the interviewee. Oral history from early on has positioned itself as having a democratic purpose (Frisch 1990; Thomson 2007). Thus the memories of older people and their modes of recall are prized for their authenticity and their challenges to dominant accounts of the past. The practice is valued for the opportunity it presents to reverse inequalities of age, gender and ethnicity (Thompson 2000). What has emerged is a practice that seeks to maintain the integrity of the original interview and of the interviewee by maintaining interpretive distance. When differences of age are added to gender or ethnicity, this becomes of even greater significance. This does not rule out empathy, an appreciation of the subjectivity of the interviewee or the identification of silences or spaces in accounts, as Butalia’s investigation into the ‘indescribable’ (1998, p. 360) experiences of Partition so well exemplifies. To identify the subjectivity of interviewees, to put oneself in their place, to draw out understandings that are not necessarily articulated in the words of the transcript are all recognizable and shared interpretive practices. But to go beyond this and to seek out subconscious motivations or ways of thinking is surely over-interpretation and risks distancing interviewees from their own words. So, for example, BNIM’s psychodynamic approach to data analysis, which involves not being ‘seduced by the interviewee’s current (and us-directed) story’ and constructing one’s ‘own account of the “objective events” that have marked the person’s life, of the event structures that provide the bigger and smaller contexts of the telling of the story’ (Wengraf 2013, p. 199), is distant from an oral history practice that both seeks and recognizes the effects of empathy. Similarly, to seek out causes and consequences by interpreting in narrative, storied, forms is to risk imposing a framework of a different order. As Borland so honestly and eloquently asks, based on the experience of interviewing her grandmother (Borland 1991), how far should an analysis be taken if it runs the risk of rendering a life unrecognizable to the research participant? 118

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Conclusion This review of biographical methods used in ageing research has focused on three approaches: oral history, the biographical interpretive method and narrative analysis. These tend to be the most popular amongst researchers who seek ways to generate and to understand individual life experience. They differ in relation to the nature of the interviewer–interviewee relationship, how memory is used and how the interviewee’s voice is interpreted. Each also traces its development from the Chicago School of early twentieth century sociology, though again each has taken a different path, influenced by European traditions of research and philosophy. So far as research into age and ageing is concerned these three approaches make contrasting offers. BNIM invites interpretations that draw out unconsciously expressed motives and seek to emphasize the development of subjectivities within historical contexts. Narrative analysis focuses on the construction and role of the story in explaining and even determining lives. Both draw on the long view, emphasizing the importance of reflection over time and across contexts. Oral history, with its focus on power inequalities in the interview, its understanding of the interview as a dialogue and its focus on memory as source and as process, perhaps offers more to the researcher who is interested in researching experiences of ageing and the effects of time and place on how accounts are generated while preserving the authority of the speaker.

References Abrams, L. (2010) Oral History Theory, London: Routledge. Andrews, M. (2007) Shaping History: Narratives of Political Change, Cambridge: Cambridge University Press. Andrews, M., Squire, C. and Tamboukou, M. (eds) (2008) Doing Narrative Research, London: Sage. Apitzsch, U. and Inowlocki, L. (2000) ‘Biographical analysis: a “German” school?’ in P. Chamberlayne, J. Bornat and T.Wengraf (eds), The Turn to Biographical Methods in Social Science, London: Routledge, 53–70. Birren, J., Kenyon, G., Ruth, J., Shroots, J. and Sevensson, T. (eds) (1996) Aging and Biography: Explorations in Adult Development, New York: Springer. Borland, K. (1991) ‘  “That’s not what I said”: Interpretive conflict in oral narrative research’, in S. B. Gluck and D. Patai (eds), Women’s Words:The Feminist Practice of Oral History, London: Routledge, 63–75. Bornat, J. (2004) ‘Oral history’, in C. Seale, G. Gobo and J. Gubrium (eds), Qualitative Research Practice, London: Sage, 34–47. Bornat, J. (2011) ‘Remembering in later life: generating individual and social change’, in D. Ritchie (ed.), The Oxford Handbook of Oral History, New York: Oxford University Press, 202–18. Bornat, J. and Bytheway, B. (2012) ‘Working with different temporalities: archived life history interviews and diaries’, International Journal of Research Methodology, 15, 4: 291–99. Bornat, J. and Diamond, H. (2007) ‘Women’s history and oral history: developments and debates’, Women’s History Review, 16, 1: 19–39. Brannen, J., Moss, P. and Mooney, A. (2004) Working and Caring over the Twentieth Century: Change and Continuity in Four-Generation Families, Basingstoke: Palgrave Macmillan. Butalia, U. (1998) The Other Side of Silence:Voices from the Partition of India, New Delhi: Penguin Books. Chamberlayne, P. and King, A. (2000) Cultures of Care: Biographies of Carers in Britain and the Two Germanies, Bristol: The Policy Press. Chamberlayne, P., Bornat, J. and Wengraf, T. (eds) (2000) The Turn to Biographical Methods in Social Science, London: Routledge. Coleman, P. (1986) Ageing and Reminiscence Processes: Social and Clinical Implications, Chichester: Wiley. Coleman, P., Koleva, D. and Bornat, J. (2013) Ageing, Ritual and Social Change: Comparing the Secular and the Religious in Eastern and Western Europe, Farnham: Ashgate. Draaisma, D. (2004) Why Life Speeds up as You Get Older: How Memory Shapes our Past, Cambridge: Cambridge University Press. Frisch, M. (1990) A Shared Authority: Essays on the Craft and Meaning of Oral and Public History, New York: SUNY. Goodwin, J. (2012) Sage Biographical Research,Volumes 1–4, London: Sage. 119

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Gubrium, J. (1993) ‘ Voice and context in a new gerontology’, in T. Cole,W. A. Achenbaum, P. Jakobi and R. Kastenbaum (eds), Voices and Visions of Ageing:Toward a Critical Gerontology, New York: Springer. Hammersley, M. (1997) ‘Qualitative data archiving: some reflections on its prospects and problems’, Sociology, 31, 1: 131–42. Mead, G. H. (1934) Mind, Self and Society from the Standpoint of a Social Behaviorist, Chicago: University of Chicago Press. Mills, C. W. (1959) The Sociological Imagination, New York: Oxford University Press. Nicholson, C. (2009) ‘Researcher emotions: a way into the experiences of frail older people’, Journal of Social Work Practice, 23, 4: 451–59. Passerini, L. (1979) ‘Work, ideology and consensus under Italian Fascism’, History Workshop, 8: 82–108. Plummer, K. (2001) Documents of Life 2, London: Sage. Portelli, A. (1981) ‘What makes oral history different’, History Workshop, 12: 96–107. Portelli, A. (1997) ‘The massacre at Civitella val di Chiani (Tuscany, June 29, 1944): myth and politics, mourning and common sense’, in A. Portelli, The Battle of Valle Giulia: Oral History and the Art of Dialogue, Madison: University of Wisconsin Press, 140–60. Portelli, A. (2003) The Order Has Been Carried Out: History, Memory and Meaning of a Nazi Massacre in Rome, Basingstoke: Palgrave Macmillan. Portelli, A. (2011) They Say in Harlan County: An Oral History, New York: Oxford University Press. Ray, R. E. (2008) ‘Foreword: Coming of age in critical gerontology’, Journal of Aging Studies, 22, 2: 97–100. Riessman, C. K. (1993) Narrative Analysis, Newbury Park: Sage Riessman, C. K. (2004) ‘Narrative analysis’ in M. S. Lewis-Beck, A. Bryman and T. F. Liao (eds), Encylopedia of Social Science Research Methods, London: Sage. Riessman, C. K. (2008) Narrative Methods for the Human Sciences, Thousand Oaks: Sage. Roberts, B. (2002) Biographical Research, Buckingham: The Open University Press. Rosenthal, G. (2004) ‘Biographical research’, in C. Seale, G. Gobo and J. Gubrium (eds), Qualitative Research Practice, London: Sage, 48–64. Seale, C., Gobo, G. and Gubrium, J. (eds) (2004) Qualitative Research Practice, London: Sage Smith, S. and Watson, J. (2001) Reading Autobiography: A Guide for Intepreting Life Narratives, Minneapolis: University of Minneapolis Press. Summerfield, P. (1998) Reconstructing Women’s Wartime Lives, Manchester: Manchester University Press. Thompson, P. (2000) The Voice of the Past, third edn, Oxford: Oxford University Press. Thomson, A. (2007) ‘Four paradigm transformations in oral history’, Oral History Review, 34, 1: 49–70. Thomson, A. (2011) Moving Stories: An Intimate History of Four Women across Two Countries, Manchester: Manchester University Press. Thomson, A. (2013) Anzac Memories: Living with the Legend, second edn, Melbourne: Monash University Press. Treviño, A. J. (2012) The Social Thought of C.Wright Mills, London: Sage. Wengraf, T. (2001) Qualitative Research Interviewing: Biographical Narrative and Semi-Structured Methods, London: Sage. Wengraf, T. (2013) BNIM Short Guide Bound with the BNIM Detailed Manual. Interviewing for Life-Histories, Lived Periods and Situations, and Ongoing Personal Experiencing Using the Biographic-Narrative Interpretive Method (BNIM). Available from [email protected].

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Section II

Embodiment

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15 Embodiment Introduction Julia Twigg and Wendy Martin

In the past, social gerontology was reluctant to engage with the body, seeing it as a retrogressive topic that threatened to take the subject back to the biological determinism that had previously marked its treatment. Since then, however, there has been a flowering of work on the body and embodiment, to the extent indeed that these have become among the most characteristic themes of the new cultural gerontology. In her chapter, Emmanuelle Tulle explores the theoretical processes that have created this new interest in embodiment. She shows how a focus on embodiment foregrounds lived experiences of being old, opening up new questions of identity and subjectivity. As she notes, bodies bear messages about social location. Gender is one of the most marked: a feature explored further in chapters by Calasanti and King, and Hearn and Wray, in the section on ‘Identities and Social Relationships’. Laura Hurd Clarke and Erica Bennett explore embodiment through their analysis of the politics of appearance, examining the negative social consequences of looking older, and exploring how older men and women feel about the ageing process as it impacts on their appearance, demonstrating how these responses are shaped by dominant cultural norms and ideals, including ones actively promoted by the beauty industry in its attempt to co-opt older bodies into a commercialized culture of anti-ageing.Their chapter is notable for its systematic inclusion of material on difference in relation to sexuality, ethnicity and social class, something often missing in this field. Richard Ward focuses on a particular feature of appearance, that of hair, which, as he notes, has a malleability that gives it a distinctly expressive and discursive quality. He locates his analysis in the context of wider meanings of becoming old, made visible here in hair loss or greying. Ward’s chapter is significant because it shows how cultural approaches often associated with younger old people can be extended to frail, cognitively impaired ones also. Pia Kontos enhances the theme in relation to embodiment and dementia by highlighting the interconnections of dementia and the body with history, culture, power, and discourse that recasts dementia as an embodied experience. Julia Twigg in a parallel analysis focuses on clothing and dress, arguing that these encapsulate a number of key debates in cultural gerontology in relation to: the interplay between the biological and the cultural; the changing definition of age; and the significance of cultural phenomena such as consumption in shaping, defining and enabling its performance. With Stephen Katz’s chapter we move to a different analysis, one centred on a specific bodily event in the form of falls and their cultural meanings. Katz notes how falling is not an isolated event but a phenomenological 123

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process that transforms the person into a ‘faller’.Through an active focus on falling, older people are increasingly made subject to governance and surveillance as risky bodies. Kelly Joyce, Meika Loe and Lauren Diamond-Brown turn to the role of science and technology in the constitution of older bodies, focusing in particular on pharmaceuticals and assistive technologies. They draw particular attention to questions of inequality, intersectionality and power in relation to gerontechnology, noting how intended users are often imagined narrowly, as white, middle class, predominantly male, heterosexuals with disposable income and a desire to defy age. Lastly, Kate de Medeiros and Helen Black explore the embodied experience of pain and suffering in old age and vividly illustrate how culture frames perceptions and experiences of pain and suffering in later life.

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16 Theorising embodiment and ageing Emmanuelle Tulle

The body is inescapable. This is amply illustrated when we age. It seems obvious to state that becoming and being old has a physical component. However, how we describe this component, the importance we attribute to it to explain other aspects of ageing, brings the bodily aspect of ageing into a different realm, that of the social and the cultural. It also makes bodily ageing amenable to critical analysis and theorising. This chapter will show how theorising embodiment can provide us with the means to question assumptions about what becoming and being old might look and feel like, offering alternative perspectives and more satisfying, more humane ways of envisaging later life.This will be accomplished in four key steps. In the first step the key debates and conceptual developments that are constitutive of the sociology of the body, what has been referred to as the turn to the body in sociology, will be outlined. These will, in the second step, provide the springboard from which to consider the theoretical tools that have brought ageing and old bodies into visibility. In the third step, the chapter will show how these tools have led to the identification and examination of questions of identity and the lived experiences of becoming and being old. In the fourth step, the chapter will offer a reflection on the extent to which these developments enable us to rethink and re-imagine the social positioning of the old.

Invisible bodies Bodies have long been avoided as objects of sociological inquiry (Shilling 2007). Until the 1980s, bodies were seen as biological entities left to psychology and biology.This served to assert the distinctive identity and legitimacy of sociology as the study of capitalism and industrial society, social order and social interaction. The focus was on finding regularities and laws in the social world, as manifested in rational action. Underpinning this strict division of intellectual labour was a particular epistemological basis to knowledge in Western society: Descartes’ or Cartesian dualism. Descartes, whose work arose out of the European Enlightenment, sought to establish human ontology, proposing that our mind and body were two different substances that fulfilled different functions and operated almost independently of each other for the purpose of apprehending the world and finding our place in it. He gave greater value to the mind, the body being mainly a shell to house it, 125

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machine-like and devoid of intelligence. This position had the following implications: it prioritised cognition over physical or emotional aspects of lives; and it created a binary opposition, between mind and body. This binary opposition has had a long-term impact on what knowledge about bodies has developed. In turn, this has had implications for how individuals and populations are controlled, issues to which we will return once we outline how the sociology of the body has developed out of a critique of Cartesian dualism.

The turn to the body in sociology Since the 1980s there has been a somatic turn (Turner 2008), that is, a turn to the body (Cregan 2006), in sociology. As Shilling (2007) showed, this refocusing of sociological enquiry resulted from a rediscovery of the body in the writings and concerns of key sociological theorists, such as Marx, Weber and Durkheim. It was understood that industrial production, urbanisation, the rise of modern science and bureaucracy affected bodies by reshaping them, transforming social relations and emotional responses. However there was no direct or explicit engagement with the body as a target of sociological enquiry in its own right. Therefore the bodily dimension of social and individual life remained undeveloped. The body was, Shilling (2003) argued, ‘an absent presence’, reflecting our cultural ambivalence towards bodies. The rediscovery of the body was a watershed in sociology and it led to an explosion of interest in body issues. This was facilitated by several factors, notably a growing critique of Cartesian dualism and more widely of the reliance in Western thought on binaries (Scott and Morgan 1993). Shilling (2007) identifies other key factors (some cultural, others analytical): the rise of consumer culture; the concern with healthy living; the rise of second wave feminism; technological advances focused specifically on changing or correcting the materiality and functionality of bodies; an interest in the self, identity and the making of the modern subject; a shift of approach from social order to the regulation of populations; and the discovery of individual lived experience and agency. Two epistemological/theoretical challenges to Cartesian dualism that came to inform and constitute the new sociology of the body were social construction perspectives and phenomenology. Each yielded very specific sets of research questions. Before we turn to a brief review of these positions, a note on the concept of embodiment is warranted. The term embodiment captures the complex and dynamic nature of bodies, as objects and subjects, as the ‘foundation of the conscious mind’, ‘generative of social relations and human knowledge’ (Shilling 2012: xii), and therefore as social and cultural. It also denotes the dynamic relationship we develop with our bodies: we have bodies but we also are bodies. Finally, embodiment enables us to problematise the relationship between body matters and identity. The social construction perspective was inspired by Berger and Luckmann’s (1967) seminal book in which they posited that there was no objective reality and knowledge outside social systems. Reality was made visible in social interactions and became institutionalised when there was widespread acceptance of its truth. Language and symbols therefore play a crucial role, because they are the means by which reality is articulated and shared. One illustration of the way a critical social construction analysis operates is in feminist scholarship. In Volatile Bodies, Grosz (1994) showed that women are constructed first and foremost in terms of their bodies: women are controlled by their emotions and their biology, which renders their bodies unruly and dangerous. Feminine embodiment stands in opposition to controlled, dependable, strong masculine embodiment, ruled by mindfulness and rationality. Women’s embodiment is understood within a binary frame. The binary therefore produces the truth of women’s bodies. Social construction approaches to embodiment have been critiqued. Turner (2008: 251) argues that some aspects of human bodies, such as impairment, ageing or death, are ‘less socially 126

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constructed than others’ because biological ageing and death cannot be arrested. Here Turner perhaps confounds social construction with the total mastery of physiological manipulation. For Gilleard and Higgs (2000) this type of critique is a red herring. Indeed, the strength of a social construction approach is that it focuses on the cultural conditions in which bodies are understood, managed and ultimately experienced. Nevertheless, Williams and Bendelow (2002) have drawn attention to how social construction analyses leave the materiality and lived experience of bodies undocumented. Attending to this dimension of experience requires the adoption of a phenomenological stance. Phenomenological understandings of bodies have been influenced by a critic of Cartesian dualism, the French philosopher Maurice Merleau-Ponty (1942, 1945). Merleau-Ponty proposed that we inhabit our bodies and that over time we develop a symbiotic and synthetic relationship with them. Indeed in the course of our lives we incorporate habits that become meaningful automatisms, the manifestations of practical mastery, and render our actions pre-reflective. Phenomenology shifts the focus away from cognition as the sole condition for meaningful agency and turns instead towards experience as embodied and bodies as ‘knowing’ (Latimer and Shillmeier 2009). Taking a phenomenological stance thus enables investigations of lived experiences of bodies, foregrounding social actors. Both positions have been useful to the development of new perspectives in old age. This is particularly so as body matters are at the heart of ageing as experience but also as the target of social and cultural practices. The chapter now turns to the discovery of the salience of body matters in later life.

The body in ageing Peter Öberg (1996) drew attention to the paradoxical situation that until the publication of his paper the body had been largely excluded as an explicit focus of investigation and theorisation in studies of ageing, despite widespread understandings of ageing as having a bodily dimension. The discursive underpinnings for how we represent and understand bodily ageing had been left unexplored. Öberg’s essay resonated, and theoretical debates about embodiment have since taken place, transforming ageing studies, and also contributing to the further development of the sociology of the body. We can therefore turn to these theoretical developments and the insights they have bequeathed about ageing and embodiment. Although Michel Foucault made no specific reference to old age and ageing in his work, his conceptual apparatus has proven useful in showing how, since the nineteenth century, old age and old bodies have been constructed—primarily as biological entities. Stephen Katz (1996, 1997) identified the birth of clinical medicine as a key threshold in the modern construction of old age and ageing. Firstly, bodily ageing represented ‘a crisis of thought’ in this new medicine because its biological characteristics disrupted a neat distinction, which clinical mapping was endeavouring to establish, between health and disease. Biological ageing was both normal and pathological (Tulle-Winton 2000). Secondly, clinical medicine turned the problems of ageing into sets of ‘universal dilemmas’ (Katz 2000: 137–8), homogenising experience. Thirdly, these problems were explained by the construction of ageing as inevitable decline. Fourthly, the emergence of this new medicine created a network of experts (physicians) who appropriated ageing bodies (Katz 1996). Biomedicine therefore provided the main discourse within which ageing bodies were apprehended. Within this discourse, ageing bodies became largely passive bodies, the victims of their decline as well as a problem and a burden. Symbolically, declining bodies are disruptive bodies that contravene cultural norms, in particular the trend towards greater bodily control, that is, the control of function.To understand how 127

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this has arisen, we turn to Elias and the civilising process. Norbert Elias has examined changes in how we relate to and act with our bodies. His work shows that we cannot take for granted the value system that is attached to normative embodiment. In what Elias (1978) refers to as the ‘civilising process’, taking place over the longue durée of historical time, we in the West have shifted towards the adoption of the codes of bodily engagement originating in Court society, manifested in greater self-restraint of emotional and physical urges and increased reflexivity, corresponding to the greater privatisation and individualisation of social life. Over time, spitting, smells, bodily functions, the display of nakedness, etc. have become subjected to codes of behaviour demanding greater regulation. The failure to obey these codes can attract sanctions, for instance physical marginalisation and the denial of agency. As we enter old age, bodily changes take place that escape our control, for example incontinence. They contravene the civilising process, evoking disgust and making us liable to sanctions, both physical and symbolic. In the Loneliness of the Dying (1985) Elias showed that the penalty to be paid by the dying for not being able to rein in the terminal incontinence of their physiology was impersonal, and largely inhumane, treatment. Julia Lawton’s (1998) ethnographic study showed that dying in hospices was a symbolic way of sequestering bodies perceived as ‘unbounded’ and therefore dirty, thus reinforcing the construction of living bodies as bounded and hygienic. These practices of sequestration are applied, by experts, to the bodies of very old people. They point to the negative status of bodily ageing. There is also evidence that ageing embodiment is subjected to other modalities of regulation. Biopower is a concept first used by Foucault (1982: 208) to capture the centrality of the body in the control of modern populations, that is, how human beings are regulated, ‘made subjects’. Older people are subjected to biopower in a variety of ways. Gilleard and Higgs (2000, 2013) have drawn attention to the emergence and consolidation of new norms of bodily ageing facilitated by consumption. Tulle (2008a) has focused on the reconstruction of biological ageing into two processes: primary (referring to the built-in senescence of all organic and inorganic organisms) and secondary (referring to the decrements arising out of ‘lifestyle’ factors, such as inactivity, poor diet, smoking—in sum, risky behaviours largely attributed to poor decision-making). This has opened the way for an understanding of ageing bodies as malleable, and whose declining tendencies can and should be intervened into, rather than fatalistically accepted. Pickard (2013) identifies neoliberalism in late capitalism as having transformed the ideological landscape in which these norms have emerged. Although population ageing is still viewed largely as a burden on Western economies, the solution to minimise this is now placed in the hands of older people themselves. Active ageing, mostly understood as economically productive ageing (Boudiny 2013), the adoption of healthy lifestyles, and the prizing of ageless appearance (via fitness, clothing, cosmetic management) is the new goal that older people should actively pursue. It denotes the adoption of an instrumental orientation toward bodies (Tulle 2008b) as part of ageing. Katz (2000) argues that these new expectations operate as ‘behavior management’ (p 135). So far we have outlined the discursive, ideological, symbolic and cultural conditions that have yielded specific kinds of bodies: medicalised bodies, of decline initially and, more recently, more malleable ones, unbounded bodies and regulated bodies. Now we turn to the implications of these conditions for identity.

Aged identities Public representations of older bodies are largely stereotypical and negative and they reflect back images in which older people might not wish to recognise themselves (Blaikie 1999).

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How older people respond to such negative constructions has been theorised by Featherstone and Hepworth (1991) as the Mask of Ageing thesis. This thesis encapsulates how ageing social actors attempt to salvage their reputation—that is, their cultural worth—in the face of the negative social constructions associated with decline. Articulated by the widely used trope of affirming that they don’t feel old, even amongst people who have experienced age-related illnesses (see for instance Tulle and Dorrer 2012), ageing actors conceive of their visibly old bodies as a mask that covers an ageless, and thus more valuable, self. The elision of the body in favour of an ageless self finds expression in what Gilleard and Higgs (2000) have referred to as the negotiation of Third Age identities. The Third Age denotes the emergence of an affluent and physically well cohort of older people who via consumption gained access to new independence and cultural presence (Laslett 1991). It provides opportunities for reclaiming a valuable sense of identity in which physical ageing is not given primacy. Andrews (1999) has critiqued the Mask of Ageing thesis—or rather what it reflects as a new cultural norm—arguing that it has encouraged a rejection of ‘agedness’ and adoption of agelessness as the way to maintain meaningful identity.The status of bodily ageing therefore remains pivotal. Indeed the body must eventually show its age, a harbinger of what Gilleard and Higgs (2000) call the Fourth Age, the age of extreme agedness and disability.

Lived experiences of bodily ageing To recover the complexity, variability and perhaps richness of being old and very old, we must therefore consider phenomenological insights. Taking such a perspective enables us to explore how people experience the materiality of their bodies in specific and practical situations. Laz (1998, 2003) has argued that older women’s physicality is not ‘natural’ but learnt: women are encultured into physical feebleness. Men’s bodies also change. They undergo physiological changes, becoming soft, shapeless and leaky, which transgress traditional masculine norms (Calasanti and King, 2007). A phenomenological approach therefore enables us to understand intimate embodied action as cultural, mediated by external factors, such as gender expectations, not as pre-social or somehow ‘natural’. It also enables a challenge to stereotypes about extreme experiences of ageing, in particular the extent to which we can continue acting meaningfully when cognitive function is impaired. A good illustration is that provided by Pia Kontos (2004) who, with the concept of ‘body intentionality’, showed that people affected by Alzheimer’s disease can continue to have meaningful agency. Agency arises precisely because our actions and their extant intentions have been laid deeply into us during our lifelong apprenticeships. Doing something therefore need not necessarily be a conscious decision because the urge has been laid down over time through repetition with intention, so that action and intention become integrated. Listening carefully to the lived experience of the fleshiness of ageing bodies gives us the opportunity to make visible experiences that hitherto have been hidden. As we can see, lives are experienced in particular structural conditions that render phenomenological experiences socially meaningful. This gives rise to two related issues. The first is prompted by Shilling (2005) himself and his claim that the sociology of the body should be able to capture bodies as generators of social change. The second issue is how we know that significant social change has taken place.

Ageing, embodiment and social change In ageing studies, the concern with ageing embodiment as a vector of social change is beginning to be addressed. Indeed, what is emerging from an embodied ageing studies is that ageing 129

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social actors try to resist the loss of symbolic capital that accompanies the erosion of what Pierre Bourdieu (1978) called physical capital. Hurd (1999) has examined how older women tried to maintain their status in a seniors’ centre, drawing attention to the emphasis on self-disciplining and appearance management (not to appear old) that they engaged in. In other work with her collaborator, she has noted that older women’s bodily strategies to respond to ageism in fact represented a reaffirmation of the salience of age as a contributor to negative symbolic capital (Hurd Clarke and Griffin 2007). Perhaps more optimistically, Sandberg (2013) used Grosz’ (1994) concept of ‘open materiality’ to bring to light how older men reported finding pleasure in their ‘sagging’ bodies, a position completely at odds with dominant constructions of masculine sexuality. The work of Twigg (2007, 2012) on dress in later life or Tulle’s (2008b) on physical activity is a direct questioning of the extent to which specific modalities of bodily engagement challenge what Twigg (2007) called the age order. The very old, for instance, are hampered in their ability to offer resistance to it. Thus the work reviewed so far is a reminder that bodies carry within themselves messages about social location. Gender as well as class (and ethnicity) are inscribed in and on bodies. The theoretical insights of Bourdieu (1978, 1984) can be harnessed to evaluate the extent to which particular orientations to ageing bodies do represent evidence of significant social and cultural change. The concepts of habitus and capital offer some promise. We inherit our orientations to our bodies from our habitus, which is from our class position. The term habitus relates to the set of habits we acquire from our parents and our social surroundings and, crucially, the social patterning of these habits. Habits are the externalisation of class-based bodily practices, and this patterning can be conceptualised as body schema. Other manifestations of our habitus are our physical and cognitive dispositions and aspirations. The concept of capital brings into focus the competition for distinction that takes place between class groups and explains how the elite use different types of capital to reproduce their social advantage. Bourdieu (1984) identifies four types of capital—economic, cultural, material and symbolic—the possession and mastery of which is consistent with habitus and with class position. There is a fifth—physical capital (Bourdieu 1978)—which relates to the possession of socially and culturally valued bodily attributes that could confer distinction (for instance, not looking old, or being in good health). Whilst a privileged habitus might confer greater physical capital—in the form of fitness or a youthful appearance and the ability to pay for its maintenance through surgery and other ‘anti-ageing’ interventions—the concern, both social and individual, with bodily ageing and the erosion of symbolic capital that it presages cuts across class. Thus, via bodily ageing, age itself could arguably be conceptualised as a source of habitus, defined as incorporated age awareness and the corresponding disposition to engage in strategies designed to maintain or enhance physical capital (Tulle 2008b), in line with wider economic, social, political and symbolic norms. A traditional critique of Bourdieu’s work is that it describes ‘social reproduction’ at the expense of social change and that it focuses largely on class.Whilst this critique has merit, gender has been successfully incorporated into his conceptual apparatus (Laberge 1995). His work can also help us evaluate critically modalities of embodiment that, without critical scrutiny, might wrongly be perceived as liberating.

Conclusion The turn to bodies in sociology and ageing studies reflects the tremendous social and cultural transformations that have taken place in Western societies. These have affected how old age has been problematised, with a particular focus on its embodiment. What has animated the 130

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reflections presented in this chapter is the persistent tension between recognising the specificities of bodily ageing and not using these to normalise decline narratives. Addressing ageing embodiment is about recognising difference as well as complexity, but also problematising agelessness as a viable solution to bodily ageing. We have also hinted at the role of binaries in producing knowledge about ageing bodies that is generally oppressive. At the same time we have to bring comfort to many whose bodies are a source of pain and distress (Frank 2012) and we have to address social and cultural inequalities. Our role as cultural gerontologists is to map out ageing experiences and embodiment, the better to interrogate them for their potential to restore symbolic capital to all of us as we become old.

References Andrews, M. 1999, ‘The seductiveness of agelessness’, Ageing and Society, vol. 19, no. 3, pp. 301–18. Berger, P. and Luckmann, T. 1967, The Social Construction of Reality: A Treatise in the Sociology of Knowledge, Anchor Books, New York. Blaikie, A. 1999, Ageing and Popular Culture, Cambridge University Press, Cambridge. Boudiny, K. 2013, ‘ “Active ageing”: from empty rhetoric to effective policy tool’, Ageing and Society, vol. 33, no. 6, pp. 1077–98. Bourdieu, P. 1978, ‘Sport and social class’, Social Science Information, vol. 17, no. 6, pp. 819–40. Bourdieu, P. 1984, Distinction: A Social Critique of the Judgement of Taste, Harvard University Press, Cambridge, MA. Calasanti, T. and King, N. 2007, ‘ “Beware of the estrogen assault”: Ideals of old manhood in anti-aging advertisements’, Journal of Aging Studies, vol. 21, no. 4, pp. 357–68. Cregan, K. 2006, The Sociology of the Body: Mapping the Abstraction of Embodiment, Sage, London. Elias, N. 1978, The Civilising Process:The History of Manners, Basil Blackwell, Oxford. Elias, N. 1985, The Loneliness of the Dying, Basil Blackwell, Oxford. Featherstone, M. and Hepworth, M. 1991, ‘The mask of ageing and the postmodern lifecourse’ in The Body: Social Process and Cultural Theory, eds M. Featherstone, M. Hepworth and B.S. Turner, Sage, London, pp. 371–89. Foucault, M. 1982, ‘The subject and power’ in Michel Foucault: Beyond Structuralism and Hermeneutics, eds H.L. Dreyfus and P. Rabinow, second edn, Chicago University Press, Chicago. Frank, A.W. 2012, ‘The varieties of my body: pain, ethics and illusion’ in Routledge Handbook of Body Studies, ed. B.S. Turner, Routledge, London, pp. 389–95. Gilleard, C. and Higgs, P. 2000, Cultures of Ageing: Self, Citizen and the Body, Pearson, Harlow. Gilleard, C. and Higgs, P. 2013, Ageing, Corporeality and Embodiment, Anthem Press, London. Grosz, E. 1994, Volatile Bodies:Toward a Corporeal Feminism, Routledge, London. Hurd, L.C. 1999, ‘ “We’re not old!”: older women’s negotiation of aging and oldness’, Journal of Aging Studies, vol. 13, no. 4, pp. 419–39. Hurd Clarke, L. and Griffin, M. 2007, ‘The body natural and the body unnatural: beauty work and aging’, Journal of Aging Studies, vol. 21, no. 3, pp. 187–201. Katz, S. 1996, Disciplining Old Age: The Formation of Gerontological Knowledge, University Press of Virginia, Charlottesville, VA. Katz, S. 1997, ‘Foucault and gerontological knowledge: the making of the aged body’ in Foucault:The Legacy, ed. C. O’Farrell, Queensland University of Technology, Kelvin Grove, pp. 728–35. Katz, S. 2000, ‘Busy bodies: activity, aging and the management of everyday life’, Journal of Aging Studies, vol. 14, no. 2, pp. 135–52. Kontos, P. 2004, ‘Embodied selfhood: redefining agency in Alzheimer’s disease’ in Old and Agency, ed. E. Tulle, Novascience, Hauppauge, NY, pp. 111–28. Laberge, S. 1995, ‘Toward an integration of gender into Bourdieu’s concept of cultural capital’, Sociology of Sport Journal, vol. 12, no. 2, pp. 132–46. Laslett, P. 1991, A Fresh Map of Life:The Emergence of the Third Age, Harvard University Press, Harvard. Latimer, J. and Shillmeier, M. (eds) 2009, Un/Knowing Bodies, Blackwell, Oxford. Lawton, J. 1998, ‘Contemporary hospice care: the sequestration of the unbounded body and dirty dying’, Sociology of Health & Illness, vol. 20, no. 2, pp. 121–43. Laz, C. 1998, ‘Act your age’, Sociological Forum, vol. 13, no. 1, pp. 85–113. 131

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Laz, C. 2003, ‘Age embodied’, Journal of Aging Studies, vol. 17, no. 4, pp. 503–19. Merleau-Ponty, M. 1942, La structure du comportement, PUF, Paris. Merleau-Ponty, M. 1945, Phénomenologie de la perception, Tel Gallimard, Paris. Öberg, P. 1996, ‘The absent body: a social gerontological paradox’, Ageing and Society, vol. 16, pp. 701–19. Pickard, S. 2013, ‘A new political anatomy of the older body? An examination of approaches to illness in old age in primary care’, Ageing and Society, vol. 33, no. 6, pp. 964–87. Sandberg, L. 2013, ‘Affirmative old age: the ageing body and feminist theories on difference’, International Journal of Ageing and Later Life, vol. 8, no. 1, pp. 11–40. Scott, S. and Morgan, D. 1993, Body Matters: Essays on the Sociology of the Body, Falmer, London. Shilling, C. 2003, The Body and Social Theory, second edn, Sage, London. Shilling, C. 2005, The Body in Culture,Technology and Society, Sage, London. Shilling, C. 2007, ‘Sociology and the body: classical traditions and new agendas’, The Sociological Review, vol. 55, pp. 1–18. Shilling, C. 2012, The Body and Social Theory, third edn, Sage, London. Tulle, E. 2008a, ‘Acting your age? Sports science and the ageing body’, Journal of Aging Studies, vol. 22, no. 4, pp. 340–47. Tulle, E. 2008b, Ageing, the Body and Social Change: Running in Later Life, Palgrave, Basingstoke. Tulle, E. and Dorrer, N. 2012, ‘Back from the brink: ageing, exercise and health in a small gym’, Ageing and Society, vol. 32, no. 7, pp. 1106–27. Tulle-Winton, E. 2000, ‘Old bodies’ in The Body, Culture and Society: An Introduction, eds P. Hancock, B. Hughes, E. Jagger et al., Open University Press, Buckingham, pp. 64–83. Turner, B.S. 2008, The Body and Society: Explorations in Social Theory, third edn, Sage, London. Twigg, J. 2007, ‘Clothing, age and the body: a critical review’, Ageing and Society, vol. 27, no. 2, pp. 285–305. Twigg, J. 2012, ‘Adjusting the cut: fashion, the body and age on the UK high street’, Ageing & Society, vol. 32, no. 6, pp. 1030–54. Williams, S.J. and Bendelow, G.A. 2002, The Lived Body: Sociological Themes, Embodied Issues, second edn, Routledge, London.

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17 Gender, ageing and appearance Laura Hurd Clarke and Erica V. Bennett

We often hear the adage that one should not judge a book by its cover. In making assumptions about people that are based solely on their appearances, we inevitably miss the depth and complexities of their personalities and accumulated life experiences. However, research has long established that appearances do matter in the ways that people are regarded, evaluated and treated, particularly those individuals who deviate from conventional norms or ideals of physical attractiveness. In this chapter, we will explore the nature of idealized appearances for men and women, the social consequences of looking older and how older men and women feel about and respond to the ageing process. We consider the socio-cultural research and theorizing pertaining to appearance, work motivations, gendered ageism, the double standard of ageing, consumer culture and the concept of the mask of ageing. We explore how older adults’ perceptions of their ageing appearances are shaped by dominant cultural norms and ideals. We investigate how attitudes towards and investments in appearance vary by sexual orientation, ethnicity/ culture and social class. We conclude by suggesting future avenues of research and theorizing.

Why do appearances in later life matter? The idealized appearances of men and women privilege youthfulness, healthiness and physical fitness (Grogan 2008).Women are expected to be thin yet voluptuous (Bordo 2003); while men must strive to be lean, muscular and physically imposing (Lorber and Moore 2007). As such, the physical realities of ageing, including the onset of wrinkles, the sagging of flesh and weight gain, among other bodily changes, pose serious challenges to older adults’ sense of self and social currency (Hurd Clarke 2010). There is a wealth of literature that has explored the impact of ageism on older men’s and women’s experiences in the workplace (Wilks and Neto 2012), during medical encounters (Gott, Hinchliff and Galena 2004) and in the context of interactions with younger individuals (Minichiello, Browne and Kendig 2000). This research reveals the perils of being, as well as looking, older, including discrimination, negative stereotyping, loss of opportunities, social invisibility and decreased well-being and self-esteem. The research further suggests that ageism is particularly injurious to older women, who are more likely than men to experience discrimination linked to their appearance and sexuality (Walker et al. 2007). 133

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Sontag (1997) has argued that there is a ‘double standard’ whereby the physical signs of ageing are more accepted among men, particularly those who are wealthy and powerful and thus may retain their social currency and be regarded as distinguished and sexy in later life. Sontag’s assertion has been critiqued for failing to capture the diversity and complexity of experience (Krekula 2007). Her argument that men’s and women’s appearances are perceived and valued differently reflects gender socialization. Men are taught to see their bodies as vehicles of action and to focus on accomplishments in the economic realm (Connell 1995). In contrast, female bodies are prized insofar as they are aesthetically pleasing, and women are, therefore, socialized to be concerned with their appearances and the achievement of the young, slim, toned beauty ideal (Franzoi 1995). At the same time, theorists are divided as to whether or not attention to appearance is solely the result of gender socialization, or the product of calculated decision-making. Some feminists contend that for women in particular, investments in appearance (including diet and exercise, and the use of hair dye, makeup, and non-surgical and surgical cosmetic procedures) are driven by feminine beauty ideals and norms arising from patriarchal oppression and ageism (Bordo 2003). In contrast, others suggest that attending to one’s appearance is a means by which women may enhance their erotic or cultural currency deriving from their physical, sexual and social attractiveness (Hakim 2011). Davis (2003) argues that women are not ‘cultural dopes [. . .] [but rather] competent actors with an intimate and subtle knowledge of society’ (p. 13) who make conscious and informed choices within and because of dominant discourses associated with female beauty and idealized femininity. Theorizing about men’s engagement in appearance work is more limited, in part because the pursuit of physical attractiveness has not been traditionally associated with idealized masculinity (Bordo 1999). Indeed, men are taught that concern for one’s appearance is a feminine, if not emasculating, endeavour that should be avoided, downplayed or framed in terms of health promotion. However, both men and women face growing pressure to engage with consumer culture in order to discipline their bodies, as society becomes ever more appearance obsessed, and bodies are used as barometers of individuals’ health and morality (Gilleard and Higgs 2000). Within this climate, looking ‘good’ and appearing ‘healthy’ are increasingly about being youthful, while ageing and seeming to be ‘old’ are ever more risky for both men and women who may, as a result, be found sexually undesirable, socially irresponsible and culturally invisible. Finally, there is also some scholarly debate about the relationship between appearance and identity in later life. On the one hand, several theorists have argued that the ageing body masks ‘the essential identity of the person beneath’ (Featherstone and Hepworth 1991: 379) and that individuals have an ‘ageless self ’ or ‘an identity that maintains continuity despite the physical and social changes that come with old age’ (Kaufman 1986: 7). Certainly, numerous studies have found that older adults often perceive that their chronological ages and resultant appearances do not reflect their subjective identities or felt ages (Kleinspehn-Ammerlahn, Kotter-Gruhn and Smith 2008). However, Andrews (1999) contends that the concept of “ ‘agelessness’ is itself a form of ageism, depriving the old of one of their most hard-earned resources: their age” (p. 301). Pointing to the growing cultural pressure to remain youthful in later life in terms of appearance, behaviour and functional ability, Andrews (1999) asserts that the bifurcation of the perceived young self from the ageing body as it is expressed in the concept of a masked or ageless self is reflective of the societal devaluation of oldness and a means by which older adults strive to distance themselves from those who have capitulated to the perils of growing older (Hurd 1999).

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Older men’s perceptions and experiences of their ageing bodies Arising from the differing norms and ideals of masculinity and femininity, older men and women perceive and experience their bodies in diverse ways. The relatively little research that has explored older men’s body image suggests that they place less importance on appearance and have higher self-esteem than their female counterparts in later life (Ferraro et al. 2008). However, other literature indicates that older men experience a decrease in feelings of attractiveness and self-esteem as they age, as a result of the equating of sexual desirability with youthfulness (Baker and Gringart 2009). Decreases in functionality (such as loss of strength, independence and able-bodiedness), as well as physically disfiguring chronic conditions have also been found to influence older men’s perceptions of and feelings about their bodies. In particular, changes to men’s functional abilities and, to a lesser degree, their appearances pose a threat to their sense of having achieved and maintained idealized masculinity (Hurd Clarke, Griffin and the PACC Research Team 2008). To date, there has been little investigation of older men’s perceptions and experiences of appearance work. The existing research reveals that younger men are increasingly dissatisfied with their bodies and engage in weight training, vigorous exercise and dieting (Ridgeway and Tylka 2005) and, to a lesser extent, cosmetic surgery (Atkinson 2008). Men often associate being overweight with a lack of control and weakness, which contravenes norms of idealized or hegemonic masculinity (Grogan and Richards 2002). However, men perceive dieting to be a feminine practice, thus discounting restrictive eating as an appropriate means by which to acquire an ideal, muscular, masculine body (Gough 2007). Consequently, men who diet typically suggest that they restrict their food intake for health rather than appearance reasons (Sloan, Gough and Conner 2010).

Older women’s perceptions and experiences of their ageing bodies The research that has explored older women’s perceptions and feelings about their ageing bodies reveals that, like their younger counterparts, they are largely displeased with their appearances (McLaren and Kuh 2004). In particular, older women frequently indicate that their weight is central to their perceptions of body dissatisfaction (Hurd 2000, Slevin 2010). That said, research also suggests that older women tend to be less dissatisfied than younger women with their weight, in part because weight gain in later life is considered to be normal, if not inevitable, resulting in a lowered motivation to diet or engage in other weight-reduction efforts (Tunaley, Walsh and Nicolson 1999). Moreover, older women may resist the thin ideals promoted in the contemporary media and express a preference for more curvaceous bodies as they point to icons of their youth as exemplars of beauty (Hurd Clarke 2002). There is some debate about the importance of appearance for women in later life irrespective of their negative perceptions and feelings about their bodies. Some of the existing research indicates that older women place more emphasis on their functional abilities than their appearances (Liechty and Yarnal 2010) and that the onset of health issues precipitates a reorganization of priorities as the women’s physical exteriors become less salient to their sense of identity and well-being (Hurd 2000). Tiggemann (2004) summarizes this research by noting: ‘In simple terms, with age women’s bodies deteriorate, they remain equally dissatisfied, but it matters less to them’ (p. 35). Even as appearances may lose their salience to older women, the rise of the anti-ageing beauty market has further complicated women’s relationships with their bodies. Indeed, women

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often indicate that in addition to their weight, their feelings of displeasure with their ageing appearances are related to the onset of wrinkles (Hurd Clarke 2010), grey hair (Ward and Holland 2011) and bodily sagging (Slevin 2010). Faced with a growing means of hiding the signs of ageing and maintaining youthful appearances through engagement with consumer culture, older women frequently express openness, if not a sense of obligation, to employ cosmetic surgery and the use of non-surgical cosmetic procedures (Hurd Clarke 2010).

Sexual orientation and appearance satisfaction Attitudes towards and investments in appearance have been found to vary according to sexual orientation, ethnicity and social class. In this and the ensuing two sections, we consider these factors and their influence on older men’s and women’s conceptualizations of and responses to idealized norms of masculinity and femininity. To begin, although there is a dearth of literature on older gay men, the research on younger gay men reveals that they have greater body dissatisfaction than their heterosexual counterparts (Peplau et al. 2009).Younger gay men are also more likely than heterosexual men to use restrictive or disordered eating as well as exercise to achieve the ideal male body (Tiggemann, Martins and Kirkbride 2007). Theorists have suggested that these appearance-related differences may be due to the privileging of body awareness within gay culture (Drummond 2006), as well as the perception that muscularity signifies health within a community coping with the effects of HIV/AIDS (Levesque and Vichesky 2006). Additionally, the idealization of youthfulness in gay culture results in ‘accelerated ageing’ (Wahler and Gabbay 1997: 14) whereby ‘homosexual men are considered middle-aged and elderly by other homosexual men at an earlier age than heterosexual men in the general community’ (Bennett and Thompson 1991: 66). Thus, aged bodies are less accepted and gay men report greater dissatisfaction with their appearances in later life than heterosexual men (Tiggemann et al. 2007). Moreover, gay men experience stronger pressure than heterosexual men to engage in appearance work, including but not limited to cosmetic surgery, in order to achieve and retain youthful physical exteriors ( Jones and Pugh 2005). Like the research on older gay men, there are relatively few studies that have explored older lesbian women’s perceptions and feelings about their bodies. Research focused on younger lesbian women has found that they are less dissatisfied with their appearances than younger heterosexual women (Bergeron and Senn 1998). Some scholars maintain that differing beauty ideals within the lesbian community mediate the negative influences of western feminine norms of physical attractiveness (Bergeron and Senn 1998). That said, some studies have found that lesbian women are as dissatisfied as heterosexual women with their appearances and that gender socialization influences body image perceptions to a greater extent than sexual orientation (Peplau et al. 2009). Thus, lesbian women convey the ‘normative discontent’ (Rodin, Silberstein and Striegel-Moore 1984: 267) with their physical appearances that is also expressed by their heterosexual counterparts (Slevin 2006). The literature focused on older lesbian women echoes these findings and reveals that they often express dissatisfaction with their weight and consider ageing to be detrimental to their appearances (Huxley 2013). Nevertheless, Slevin (2006) asserts that lesbian women’s experiences with homophobic discrimination enable them ‘to resist and to be more positive about some aspects of being old women’ (p. 265).

Ethnicity and appearances in later life Researchers are increasingly turning their attention to the influence of culture on the body attitudes and expectations of individuals across the life course. Although studies investigating the 136

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intersection of gender, ethnicity and age remain limited, there are indications that non-European men tend to be more satisfied with their appearances and to adhere to differing masculine body ideals. For example, older African-American men report greater body satisfaction than men of European descent as well as a greater acceptance of heavier body weight (Aruguete, Nickleberry and Yates 2004). Although we are unaware of any research focused on older Asian men, Watt and Ricciardelli (2012) found that younger men of Chinese ancestry living in Australia were largely satisfied with their appearances and tended to assess their physical exteriors from multiple angles, including muscularity, height and self-presentation, rather than simply emphasizing body size and shape as markers of masculine desirability, as has been found to be the case for men of European descent. Similarly, the few studies that have explored how older women of non-European cultural backgrounds perceive their bodies reveal greater satisfaction and less concern than women of European descent with body weight (Schuler et al. 2008). Research with younger African-American women reveals that they tend to engage in less dieting and often reject thinness as a standard of beauty (Overstreet, Quinn and Agocha 2010). Acculturation has also been found to influence women’s appearance-related attitudes. The older Muslim women in Dunkel, Davidson and Qurashi’s (2010) study were less likely than their younger Muslim female counterparts to attempt to achieve a thin body. Similarly, Kishinevsky (2004) studied Russian-American mother-daughter-grandmother relationships, finding that middle-aged mothers were more likely than their ageing mothers to be dissatisfied with their bodies, with the latter feeling that they did not need to engage in beauty work practices in old age.

Social class and appearances There is a growing body of theory and research investigating the relationships between social class and body attitudes and practices. In particular, scholars have drawn on Bourdieu’s (1984) concept of habitus or ‘the socially acquired, embodied systems of schemes of disposition, perceptions and evaluations that orient and give meaning to practices’ (p. 17). Bourdieu (1984) contends that body practices vary by social class and gender as men and women acquire distinct tastes and habits related to their social positions, which in turn generate differing forms of economic and cultural capital. Bourdieu (1984) has argued that physical capital declines with age as men lose their functional abilities (for example, to engage in sport) and women’s appearances deviate from youthful norms. There is currently no research investigating the links between social class and appearance for older men, but for women in later life it is relatively extensive. The latter research reveals that older women of higher social class backgrounds tend to be less satisfied than older women from working-class backgrounds with their appearances (McLaren and Kuh 2004). That said, Dumas, Laberge and Straka (2005) reported that both the affluent and working-class older women in their study invested less in their appearances as they aged due to the increased focus on taking care of others. Additionally, the older African-American women of middle and upper middle-class backgrounds in Slevin and Wingrove’s (1998) study were more positive than their European counterparts about being old, but also expressed weight and appearance-related worries, suggesting that social class may influence body image to a greater extent than ethnicity.

Conclusion In the preceding sections, we have outlined the major findings and avenues of scholarship in the research concerning appearance in later life. This literature reveals that appearances matter 137

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to older adults and to the ways that they are perceived and valued (or not) by others. For both older men and women, the loss of culturally idealized appearances leads to threats to their sense of identity and social worth. The negative consequences of having an aged looking body are heightened by the increasing societal emphasis on appearances as markers of health and the equating of youthfulness with physical attractiveness. Body changes are more deleterious for women, whose social value continues to be strongly linked to their physical appearances. That said, given the increasing body dissatisfaction among younger men, there is evidence that appearances are becoming ever more important for older men. At the same time, the existing literature suggests that older adults’ attitudes to and investments in their appearances are influenced by their social positions, including their sexual orientation, ethnicity and social class. In the future, it will be imperative for scholars to more fully outline the nuances of older men’s attitudes towards and investments in their bodily exteriors, particularly given the changing social context in which how one looks is increasingly important, and the growing entanglement of health and appearance. Similarly, theorists will need to continue to develop a better understanding of how age relations shape older women’s attitudes to their bodies and their engagement with anti-ageing health and beauty practices.The field also needs much more investigation into and theorizing about how sexual orientation, culture and ethnicity and social class influence older men’s and women’s perceptions of and experiences related to their bodies’ ageing and aged appearances. Additionally, research and theorizing about the interrelationships between disability, appearance and masculinity and femininity ideals warrant further analysis given the ableism and ageism that underlie current successful ageing discourses and neo-liberal ideologies. Finally, additional scholarship and theorizing concerning the connections between ageism, appearance, identity and well-being across the cohorts of individuals in later life will promote better understanding of men’s and women’s embodied experiences of ageing and the life course.

References Andrews, M. (1999) ‘The seductiveness of agelessness’, Ageing and Society, 19(3): 301–18. Aruguete, M.S., Nickleberry, L.D. and Yates, A. (2004) ‘Acculturation, body image, and eating attitudes among Black and White college students’, North American Journal of Psychology, 6(3): 393–404. Atkinson, M. (2008) ‘Exploring male femininity in the “crisis”: Men and cosmetic surgery’, Body and Society, 14(1): 67–87. Baker, L. and Gringart, E. (2009) ‘Body image and self-esteem in older adulthood’, Ageing and Society, 29(6): 977–95. Bennett, K.C. and Thompson, N.L. (1991) ‘Accelerated aging and male homosexuality: Australian evidence in a continuing debate’, Journal of Homosexuality, 20(3–4): 65–76. Bergeron, S.M. and Senn, C.Y. (1998) ‘Body image and sociocultural norms: A comparison of heterosexual and lesbian women’, Psychology of Women Quarterly, 22(3): 385–401. Bordo, S. (1999) The male body: A new look at men in public and in private, New York: Farrar, Straus & Giroux. Bordo, S. (2003) Unbearable weight: Feminism, Western culture, and the body, Berkeley and Los Angeles: University of California Press. Bourdieu, P. (1984) Distinction: A social critique of the judgement of taste, Cambridge, MA: Harvard University Press. Connell, R.W. (1995) Masculinities, Cambridge: Polity. Davis, K. (2003) Dubious equalities and embodied differences: Cultural studies and cosmetic surgery, New York: Rowman & Littlefield. Drummond, M. (2006) ‘Ageing gay men’s bodies’, Gay and Lesbian Issues and Psychology Review, 2(2): 60–5. Dumas, A., Laberge, S. and Straka, S.M. (2005) ‘Older women’s relations to bodily appearance:The embodiment of social and biological conditions of existence’, Ageing and Society, 25(6): 883–902. Dunkel, T.M., Davidson, D. and Qurashi, S. (2010) ‘Body satisfaction and pressure to be thin in younger and older Muslim and non-Muslim women: The role of western and non-western dress preferences’, Body Image, 7(1): 55–65. 138

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Featherstone, M. and Hepworth, M. (1991) ‘The mask of ageing and the postmodern life course’, in M. Featherstone, H. Hepworth and B.S. Turner (eds), The body: Social process and cultural theory, Thousand Oaks: Sage. Ferraro, F.R., Muehlenkamp, J.J., Paintner, A., Wasson, K., Hager, T. and Hoverson, F. (2008) ‘Aging, body image, and body shape’, The Journal of General Psychology, 135(4): 379–92. Franzoi, S.L. (1995) ‘The body-as-object versus the body-as-process: Gender differences and gender considerations’, Sex Roles, 33(5/6): 417–37. Gilleard, C. and Higgs, P. (2000) Cultures of ageing, Toronto: Prentice-Hall. Gott, M., Hinchliff, S. and Galena, E. (2004) ‘General practitioner attitudes to discussing sexual health issues with older people’, Social Science and Medicine, 58(11): 2093–103. Gough, B. (2007) ‘ “Real men don’t diet”: An analysis of contemporary newspaper representations of men, food, and health’, Social Science and Medicine, 64(2): 326–37. Grogan, S. (2008) Body image: Understanding body dissatisfaction in men, women, and children, London and New York: Routledge. Grogan, S. and Richards, H. (2002) ‘Body image: Focus groups with boys and men’, Men and Masculinities, 4(3): 219–323. Hakim, C. (2011) Honey money:The power of erotic capital, London and New York: Allen Lane Press. Hurd, L. (1999) ‘ “We’re not old”! Older women’s negotiation of aging and oldness’, Journal of Aging Studies, 13(4): 419–39. Hurd, L. (2000) ‘Older women’s body image and embodied experience: An exploration’, Journal of Women and Aging, 12(3/4): 77–97. Hurd Clarke, L. (2002) ‘Beauty in later life: Older women’s perceptions of physical attractiveness’, Canadian Journal on Aging, 21(3): 429–42. Hurd Clarke, L. (2010) Facing age:Women growing older in anti-aging culture, Toronto: Rowman & Littlefield. Hurd Clarke, L., Griffin, M. and the PACC Research Team (2008) ‘Failing bodies: Body image and multiple chronic conditions in later life’, Qualitative Health Research, 18(8), 1084–95. Huxley, C. (2013) ‘A qualitative exploration of whether lesbian and bisexual women are “protected” from sociocultural pressure to be thin’, Journal of Health Psychology, doi: 10.1177/1359105312468496. Jones, J. and Pugh, S. (2005) ‘Ageing gay men: Lessons from the sociology of embodiment’, Men and Masculinities, 7(3): 248–60. Kaufman, S.R. (1986) The ageless self: Sources of meaning in late life, Madison: University of Wisconsin Press. Kishinevsky, V. (2004) Russian immigrants in the United States: Adapting to American culture, New York: LFB Scholarly Publishing LLC. Kleinspehn-Ammerlahn, A., Kotter-Gruhn, D. and Smith, J. (2008) ‘Self-perceptions of aging: Do subjective age and satisfaction with aging change during old age?’ Journal of Gerontology: Psychological Sciences, 63B(6): P377–85. Krekula, C. (2007) ‘The intersection of age and gender: Reworking gender theory and social gerontology’, Current Sociology, 55(2): 155–71. Levesque, M.J. and Vichesky, D. (2006) ‘Raising the bar on the body beautiful: An analysis of the body image concerns of homosexual men’, Body Image, 3(1): 45–55. Liechty, T. and Yarnal, C.M. (2010) ‘Older women’s body image: A lifecourse perspective’, Ageing and Society, 30(7): 1197–218. Lorber, J. and Moore, L.J. (2007) Gendered bodies: Feminist perspectives, Los Angeles: Roxbury Publishing Company. McLaren, L. and Kuh, D. (2004) ‘Women’s body dissatisfaction, social class, and social mobility’, Social Science and Medicine, 58(9): 1575–84. Minichiello,V., Browne, J. and Kendig, H. (2000) ‘Perceptions and consequences of ageism:Views of older people’, Ageing and Society, 20(3): 253–78. Overstreet, N.M., Quinn, D.M. and Agocha, V.B. (2010) ‘Beyond thinness: The influence of a curvaceous body ideal on body dissatisfaction in black and white women’, Sex Roles, 63(1/2): 91–103. Peplau, L.A., Frederick, D.A.,Yee, C., Maisel, N., Lever, J. and Ghavami, N. (2009) ‘Body image satisfaction in heterosexual, gay, and lesbian adults’, Archives of Sexual Behaviour, 38(5): 713–25. Ridgeway, R.T. and Tylka, T.L. (2005) ‘College men’s perceptions of ideal body composition and shape’, Psychology of Men and Masculinity, 6(3): 209–20. Rodin, J., Silberstein, L. and Striegel-Moore, R. (1984) ‘Women and weight: A normative discontent’, in T.B. Sonderegger (ed.), Nebraska Symposium on motivation, 32, Psychology and gender, Lincoln: University of Nebraska Press. 139

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Schuler, P.B., Vinci, D., Isosaari, R.M., Philipp, S.F., Todorovich, J., Roy, J.L.P. and Evans, R.R. (2008) ‘Body-shape perceptions and body mass index of older African American and European American women’, Journal of Cross-Cultural Gerontology, 23(3): 255–64. Slevin, K.F. (2006) ‘The embodied experiences of old lesbians’, in T.M. Calasanti and K.F. Slevin (eds), Age matters: Realigning feminist thinking, New York: Routledge. Slevin, K.F. (2010) ‘ “If I had lots of money . . . I’d have a body makeover”: Managing the aging body’, Social Forces, 88(3): 1003–20. Slevin, K.F. and Wingrove, C.W. (1998) From stumbling blocks to stepping stones: The life experiences of fifty professional African American women, New York: New York University Press. Sloan, C., Gough, B. and Conner, M. (2010) ‘Healthy masculinities? How ostensibly healthy men talk about lifestyle, health and gender’, Psychology and Health, 25(7): 783–803. Sontag, S. (1997) ‘The double standard of aging’, in M. Pearsall (ed.), The other within us: Feminist explorations of women and aging, Boulder: Westview Press. Tiggemann, M. (2004) ‘Body image across the adult life span: Stability and change’, Body Image, 1(1): 29–41. Tiggemann, M., Martins,Y. and Kirkbride, A. (2007) ‘Oh to be lean and muscular: Body image ideals in gay and heterosexual men’, Psychology of Men and Masculinity, 8(1): 15–24. Tunaley, J.R., Walsh, S. and Nicolson, P. (1999) ‘ “I’m not bad for my age”: The meaning of body size and eating in the lives of older women’, Ageing and Society, 19(6): 741–59. Wahler, J. and Gabbay, S. G. (1997) ‘Gay male aging: A review of the literature’, Gay and Lesbian Social Services, 6(3): 1–20. Walker, H., Grant, D., Meadows, D., and Cook, I. (2007) ‘Women’s experiences and perceptions of age discrimination in employment: Implications for research and policy’, Social Policy and Society, 6(1): 37–48. Ward, R. and Holland, C. (2011) ‘ “If I look old, I will be treated old”: Hair and later-life image dilemmas’, Ageing and Society, 31(2): 288–307. Watt, M. and Ricciardelli, L.A. (2012) ‘A qualitative study of body image and appearance among men of Chinese ancestry in Australia’, Body Image, 9(1): 118–25. Wilks, D.C. and Neto, F. (2012) ‘Workplace well-being, gender and age: Examining the “double jeopardy” effect’, Social Indicators Research, 114(3): 875–90 doi: 10.1007/s11205–012–0177–7.

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18 Hair and age Richard Ward

There is a malleability to hair that gives it a distinctly expressive and discursive quality. For this reason it has long attracted attention in the analysis of culture and identity (Synott 1987). But hair is also part of the body, and these bodily origins have often been overlooked in efforts to deconstruct the hairstyle as a cultural artefact. In this chapter we consider hair and its relationship with ageing. In order to fully appreciate the significance of hair with regard to the meaning and experience of growing old, we must not only consider the signifying properties of the hairstyle, but also the lived experience of the ageing body. As Katz has argued of embodiment more generally, it is ‘a materialising process whereby the vicissitudes of physical and biographical ageing are grounded in bodywork practices, routines and environments’ (2011, 192–3). Consequently, the cultural expectation that we manage our hair, as it grows or recedes, becomes tangled, greasy, split or brittle, means that it is not only a necessary part of our regime of self-care but also integral to an ongoing and embodied biographical narrative. Hair can feature prominently in the relationship we have with ourselves over time. As it changes, hair helps us to recognize our own ageing (Hockey and James 2004). How we respond to the greying of hair often reveals something of our attitude to ageing. And this process, by which we make sense of our own ageing bodies as a response to how others see us, has long been a preoccupation for cultural gerontology and efforts to theorize the ageing self (for example, Biggs 1997, Featherstone and Hepworth 1991). The intention here is to acknowledge the rich and varied ways in which hair has and can be used to support our understanding of ageing and the lifecourse. The discussion is organized around the differing temporal frames that hair itself embodies: from the gradual process of greying or balding that may take years; the weeks or months during which it grows; to the more day-to-day ‘bed-head’ knotted disorder that we face each morning and are required to tackle before presenting ourselves to the world. Ageing identities are implicated in each of these time-frames; therefore, to manage our hair is to engage with what it means to grow old.

Hair in time Our relationship with our hair, the efforts we make to manage it and the meanings it holds are temporally organized. Hair can mark time, different styles reflecting trends in fashion or more personal milestones, but it also embodies the passage of time at the level where our biological 141

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and biographical ageing intersect. Distinct from chronometric time, ‘hair-time’ is intimately linked to and frames our subjective experience of ageing. Paying attention to hair over time reveals it to be both a social and bodily process, while underlining the interplay between these two processes. Instead of seeing hairstyles as ‘snapshots’ of identity frozen in time, we come to understand hair as part of an ongoing and culturally situated embodied relationship with our self and others. Of the still limited debate on hair in the context of ageing there are three temporal frames to which particular attention has been paid.

Hair in years: the politics of grey The broadest framing of the relationship of hair and ageing is the period, often of years, over which it begins to show visible signs of age by changing in colour and texture, also sometimes thinning or balding. However, it is the greying of hair that has received the most detailed attention in discussions of ageing. In the UK, and across Europe and North America, attention has been paid to the iconic nature of grey hair as a signifier of old age. Alongside wrinkles and a stooped posture it is among those disaggregated features that constitute what Bytheway (2005) has described as ‘the sight of age’.Through grey hair, the micro-politics of the ageing body can be linked to a broader system of ageism and the social exclusion of older people (Bytheway 2011). Alongside chronological age, the sight of age is a common basis or ‘trigger’ for age discrimination, and grey hair has been shown to figure prominently in how social judgements are made in Western cultures (e.g. Hurd Clarke and Griffin 2008, Ward and Holland 2011). Grey hair thus links the individual to a broader and undifferentiated collective (Holland and Ward 2012). Ahmed’s (2004) commentary on hate crime is relevant here, as she suggests it is a process based on the way particular emotions ‘stick’ to certain bodies; hence, ‘what is at stake in hate crime is the perception of the group in the body of the individual’ (p. 55). From this perspective, greying hair is part of what constitutes the ‘stickiness’ of the older body, rendering it vulnerable to discrimination and to visceral emotional responses. Grey hair thus anchors the cultural construction of ageing in the lived experience of the older person. The process of going grey marks a gradual diminution in symbolic capital, much in the way that ageing skin has been constructed in the marketing of skincare products (Coupland 2007), the micro-penalties incurred at an individual level applying unequally between women and men. Parallels can also be drawn here to Mercer’s (1994) reading of black hair as the annulment or negation of beauty. For women especially, to be beautiful is to be ‘not old’, and much in the way that Mercer revealed how untreated (un-straightened) black hair was once linked to a broader rationale for racism, so untreated (un-dyed) grey hair works to position older people as the antithesis of a beauty aesthetic normatively linked to youthfulness (Twigg 2007). Research that has engaged directly with older people reveals how the practice of hair-dyeing encapsulates the tensions and dilemmas that women, and increasingly men as well, face in the management of appearance (Gerike 1990). Decisions about when or if to dye one’s hair are part of a broader dilemma that disaggregates older consumers. Hence, Ward and Holland (2011) and Hurd Clarke and Korotchenko (2010) found that many women in the UK and North America were caught between the compulsion to ‘fight age’ and hence to be judged ‘not old’ or to resist the intrinsically ageist message behind this anti-ageing discourse, but at the risk of being marginalized or socially excluded as a result. Based on interviews with older women, Hurd Clarke and Korotchenko (2010) draw direct connections between hair colour and employment prospects, and even the maintenance of relationships, and paint this dilemma as one that is inescapable as we age. 142

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Hence, grey hair is often experienced as desexualizing, while the process of going grey has been linked to experiences of social invisibility, a condition that Ward and Holland (2011) argue is collectively imposed on older women. Accounts offered of the experience of going grey thereby show how the meaning of ageing reveals itself through the responses of others, and suggests an underlying social consensus that exists towards the disciplining of older bodies. However, the meanings attached to grey hair are fluid and, it has been argued, have become increasingly contested, not least through the diversification of identities in old age and the different lifestyles now pursued as people age (Gilleard and Higgs 2013).

Hair in weeks and months: in the hairdresser’s chair Another significant time-frame in relation to hair is the period during which it grows, eventually requiring cutting or re-styling.This ongoing process and the environments in which it is cut and styled have also attracted attention within social gerontology. Hair salons, like many other domains related to fashion and appearance management, are intensely gendered spaces, but are also ordered by age and income (Drummond 2004, Twigg and Majima 2011). High end, high street salons have long sought to appeal to a younger clientele with disposable income and achieve this by creating an atmosphere most comfortable from a youthful perspective through choice of music, design, images on the wall and other targeted paraphernalia (Cohen 2010a,Yeadon-Lee 2012). Even the age-range of the workers signals the targeting of youth. As Robinson and colleagues (2007) have pointed out, these are spaces where it is difficult for older hairdressers to operate without feeling increasingly conscious of their age. However, as Furman (1997) and Symonds and Holland (2008) have shown, salons that serve a predominantly older customer-base have emerged, and these environments play a distinctive role in the negotiation of gendered ageing. Based on ethnographic research in a New York salon frequented largely by older Jewish women, Furman’s (1997) seminal account of salon culture underscores how such spaces support the collective articulation of ageing identities. For Furman, the salon is a place where older women’s lives and experience are validated and recognized against a backdrop of broader patterns of social exclusion and ageism. Resistance to socio-cultural oppressions is embedded in the way that older women treat one another—with respect, affection, and attentiveness; in conversations, and gestures that affirm and hence make visible older women’s pride in and attention to their bodies, and that acknowledge the pain, suffering and loss that accompany embodiment. (1997, p.168) Furman discovered that the salon provided scope to resist certain negative connotations of being and looking old, albeit against the backdrop of an ageist culture that pervaded the way the clientele viewed themselves. Furman, a social ethicist, critiques the manner in which the places created by older women are often dismissed as insignificant and morally irrelevant. Instead, the salon is shown to be a place of mutual care and support, where the telling of stories draws people into ‘shared universes of meaning’, becoming a site of collective agency. Here, parallels can be drawn with the emergence of black hair salons and barbershops in the US and UK, which evolved as spaces of resistance to a dominant aesthetic of beauty tied to whiteness (Banks 2000, Tate 2009). Considerable interest has also been shown in the role played by hairdressers in the lives of older people. In the US especially, experiments have been conducted into how hairdressers 143

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might adapt their relations with customers to include offering advice on health and well-being (Solomon et al. 2004). Training has been offered to support recognition of early signs of dementia or depression and to discuss helping strategies with informal carers, so that the close and ongoing relations between hairdressers and their clients might be utilized as the new frontline of healthcare with links to practitioners and service providers (Anderson et al. 2009; Wiesenfeld and Weis 1979). Commentators have pointed to the closeness and faux-familial-type bonds that can develop over time, and hence the potential for hairdressers to provide social support and care-giving in their contact with older customers (Cowen et al. 1979). The embodied practices of hairdressers are also relevant to these relationships (Robinson et al. 2007). In her work with beauticians, Paulson (2008) suggests that workers can guide their clients to alternative ways of styling the older body, thus showing how intercorporeal relationships can foster new forms of embodiment in old age, at least in relation to appearance management. By contrast, in a study of older people’s experience of age discrimination, Ward and Holland (2011) identified certain tensions that exist between hairdressers and their older clients. The authors argue that hairdressers serve as arbiters of appropriateness in relation to appearance, gender and age, and cite commentaries from older women where they report feeling pressured to adopt certain age-appropriate styles. Such encounters reveal how hairdressers orientate their clients to normative constructions of ageing. This process appeared most explicit in response to dissident ageing identities, such as efforts by older lesbian women to get their hair cropped short. Nonetheless, the authors note that hairdressing can be an important source of self-esteem for older women, where transformative work upon appearance is linked to feeling good. Tate (2009) argues that through styling, hair is transformed into a commodity. As such, certain enduring styles can acquire a cultural biography of their own. As Biddle-Perry (2013) has observed recently, the permanent wave, which has its origins in the early part of the twentieth century, was once associated with youthful self-expression, marked by infinite variation, and lauded in fashion magazines. Over time it has become synonymous with the ‘Pensioner’s hairdo’, its status as a commodity transformed through its association with a particular cohort of women who have now reached old age. This pattern of lifelong loyalty to certain styles is supported by secondary analysis of the Family Expenditure Survey. Twigg and Majima (2011) found marked differences in patterns of expenditure on hairdressing and salon attendance according to women’s age. The authors showed that women who began visiting salons in the 1950s and ’60s—a time of the ‘salon look’ that required regular styling—have maintained weekly salon visits throughout the life course.This has enabled them to maintain the same or a similar style to that first adopted in youth. Such patterns were found to diverge from women of younger age cohorts, who chose more easily managed styles in keeping with domestic regimes of daily showering. Symonds and Holland (2008), drawing on interviews conducted in salons in South Wales, report a similar phenomenon. Many older women sought to maintain the ‘same hairdo’ against a backdrop of social, environmental and physical change. Resisting pressures to follow fashion, the rationale for styling was shown to be more personalized, linked to biography and the social networks in which respondents were embedded. As one woman explained: ‘I always have the same blow dry, but I like it a bit curly. That’s how my husband used to like it. He’s been dead for 27 years now, but I keep it the same’ (‘Connie’ cited in Symonds and Holland 2008). This emphasis on sameness, and resistance to fluid or disposable identities, reveals how styling can provide a basis for managing transitions. In Connie’s case, her hairstyle is used to embody memory. Hence, styling can be linked to agency in the lives of older people, in ways that resist dominant patterns of consumption or the pressure to observe certain rules of conduct and self-presentation upheld by the fashion and beauty industries. 144

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Hair from day to day: transitions to care and support A third time-frame embodied by hair relates to the daily, even hourly, deeply routinized and repetitive tending of our hair, as a constituent of self-care. The process of maintaining a style or image, after sleep and throughout the day, as we wash, brush and generally smooth down, tease out, tuck under or tousle our hair, is integral to the presentation of self. Yet as Twigg (2000) points, out these micro-practices acquire a different set of meanings in later life. Laxity over appearance, such as hair left unwashed or uncombed, is open to being read as an indicator of cognitive impairment, frailty and vulnerability. Indeed, unkempt hair has long been an iconic feature in the depiction and cultural representation of madness, a disordered appearance being assumed to signal a disordered mind (Gilman 1996, Ward and Holland 2011). There is then a particular investment in maintaining our appearance in later life as a response to this cultural encoding of appearances at the intersection of old age and mental illness. Yet the everyday consumer practices related to the management of appearance in later life have attracted limited scholarly attention to date. A particular silence surrounds patterns of consumption and the meanings they convey for those described as being in ‘deep old age’ (Featherstone and Hepworth 1989) or the ‘Fourth Age’. As Gilleard and Higgs (2013) recently observed: ‘Gerontological research is full of studies of functional impairments and disabilities, but it is difficult to find much written about how people can, and do, strive to remain fashionable and keep up appearances when corporeal limitations are present’ (p.130). Under conditions of the ‘Fourth Age’, the potentialities of the body as a source of self-expression or as a site of pleasure and enjoyment have been overlooked as ageing bodies are treated as somehow ‘outside of culture’ (Katz 2011, Twigg 2000). Instead, they are ‘determined by biology and discussed almost entirely in terms of physiological processes requiring expert surveillance’ (Pickard 2013, p. 8). The question here then concerns the transitions associated with corporeal capacity, memory and cognition, and in particular the moment when assistance is required to undertake what are described as ‘activities of daily living’ (to borrow from the language of health and social care). What processes are involved when care of the self becomes the domain of body work undertaken by another, and where the management of appearance becomes tangled up in a broader intercorporeal and intersubjective dynamic? To date, this transition has been given scant consideration, and there is an overwhelming assumption in the policy and practice literature that hair care, styling and more generally the management of appearance are easily assumed by another, to be subsumed within the daily task-oriented routines of care provision. Nonetheless, there is every indication that people are resistant to total immersion in what Gilleard and Higgs (2013) describe as the ‘institutionalisation of frailty’. Cohen (2010b) for instance draws attention to the growing number of mobile hairdressers visiting the homes of people who are unable to reach a salon, while Ward and Campbell (2013), undertaking research in dementia care, highlight the hitherto overlooked care-based hair salon as a significant space for alternative forms of body work and understandings of the body to those practised in care. These services offer a form of expression and a means to maintain social belonging in ways that are distinct from the categorization and clustering of individuals according to disease categories, or the level and complexity of their care needs. However, the transition to care often involves the stripping away of the social context in which hairdressing and appearance work acquire meaning. As Crossley (2006) points out, body techniques such as hairstyling have a ritual quality that marks ‘the transition of self from one situation to another’ (p.108). For instance, the Friday night ritual of getting ready for going out—having a wash; applying makeup, aftershaves and deodorants; getting dressed; and styling our hair—has the power to effect ‘an existential transition from [the] mundane workday mode 145

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to the “soiree” self ’ (p.108). Yet, much of this broader social context is no longer accessible for those in care, with the result that many of the established prompts to maintain and manage appearance disappear. In a recent overview of the literature on appearance and care, Ward and Campbell (2013) highlight the way in which institutions such as care homes can appropriate the appearances of residents for the purposes of care—for instance upholding a generalized standard of appearance in order to demonstrate the quality of care delivered. Under such conditions, as Lee-Treweek (1997) points out, a smart appearance is treated as the endpoint or output of care, with few opportunities for self-authorship by residents themselves. Ward and Campbell (2013) and Campbell (2012) argue that both the cultural and the embodied and sensuous dimensions of support with maintaining appearance are too often overlooked in care, despite the potential opportunities to uphold meaning and personhood through participation in the familiar processes of the salon. Such insights suggest that a focus on hair and the practices associated with it might reap rewards for how we understand the lived experiences of those who require or reside in care, in ways that extend beyond mainstream gerontology’s present narrow focus on impairment, deficit and need.

Conclusion This chapter has explored just some of the different ways in which hair offers a potentially fruitful focus for cultural gerontology. We have seen that hair can provide a springboard for cultural analyses that draw clear links between everyday phenomena and broader social patterns. And, as this chapter has shown, a focus on hair provides opportunities to engage with some of the enduring and over-arching questions concerning ageing: the nature of identity; autonomy and agency; embodiment; and the discursive and culturally constructed nature of old age. Hair practices reveal and uphold intersections of class, gender, race and sexuality with age and provide a means of understanding how these intersections are expressed and experienced in the context of everyday life. They are part of the story we tell of ourselves, but also a means of telling that story, and are hence an important resource for embodied agency.That said, the story of hair and ageing remains a largely feminized one, and its relationship to ageing masculinities is yet to be explored in any detail. At a subjective level hair itself is part of our embodied histories and, as outlined here, offers its own distinctive time-frames through which we engage with our body and understand ourselves. Ultimately, hair is a challenge issued by the body—to which we must respond at a subjective, collective and cultural level. And for this reason it is both a worthy and legitimate focus in efforts to study and understand what it means and how it feels to grow old.

References Ahmed, S. (2004) The Cultural Politics of Emotion, New York: Routledge. Anderson, K. A., Cimbal, A.M. and Maile, J. J. (2009) Hairstylists’ relationships and helping behaviors with older adult clients, Journal of Applied Gerontology, 29.3: 371–80. Banks, I. (2000) Hair Matters: Beauty, Power, and Black Women’s Consciousness, New York: New York University Press. Biddle-Perry, G. (2013) My generation: a hair historical perspective on stylistic strategies in old age, Paper presented at Appearance, Ageing and the Life Course Conference, Manchester, 26 April 2013. Available online at www.ihs.manchester.ac.uk/events/futureworkshops/MICRA_Hair_and_Care_Project /My_Generation.pdf. Biggs, S. (1997) Choosing not be old? Masks, bodies and identity management in later life, Ageing and Society, 17: 553–70. Bytheway, B. (2005) Ageism, in Johnson, M. L., Bengston, V. L., Coleman, P. G. and Kirkwood, T. B. L. (eds), Cambridge Handbook of Age and Ageing, Cambridge: Cambridge University Press. 146

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Bytheway, B. (2011) Unmasking Age:The Significance of Age for Social Research, Bristol: Policy Press. Campbell, S. (2012) A close shave: masculinity and bodywork in dementia care, Graduate Journal of Social Science, 9.3. Available at online at http://gjss.org/images/stories/volumes/9/3/Campbell.pdf. Cohen, R. L. (2010a) When it pays to be friendly: employment relationships and emotional labour in hairstyling, Sociological Review, 58.2: 197–218. Cohen, R. L. (2010b) Rethinking ‘mobile work’: boundaries of time, space and social relation in the working lives of mobile hairstylists, Work, Employment and Society, 24.1: 65–84. Coupland, J. (2007) Gendered discourses on the ‘problem’ of ageing: consumerized solutions, Discourse and Communication, 1.1: 37–61. Cowen, E. L., Gesten, E. L., Boike, M., Norton, P., Wilson, A. B. and DeStefano, M. A. (1979) Hairdressers as caregivers, 1: a descriptive profile of interpersonal help-giving involvements, American Journal of Community Psychology, 7.6: 633–48. Crossley, N. (2006) Reflexive embodiment in contemporary society, Maidenhead: Open University Press. Drummond, Helga (2004), See you next week?: A study of entrapment in a small business, International Small Business Journal, 22: 487–502. Featherstone, M. and Hepworth, M. (1989) Ageing and old age, in B. Bytheway, T. Keil, P. Allat and A. Bryman (eds), Becoming and Being Old: Sociological Approaches to Later Life, London: Sage. Featherstone, M. and Hepworth, M. (1991) The mask of ageing and the post-modern life course, in Featherstone, M., Hepworth, M. and Turner B. (eds), The Body: Social Process and Cultural Theory, London: Sage. Furman, F. K. (1997) Facing the Mirror: Older Women and Beauty Shop Culture, London: Routledge. Gerike, A. E. (1990) On gray hair and oppressed brains, in Rosenthal, E. R. (ed.), Women, Aging and Ageism, New York: Harrington Park Press. Gilleard, C. and Higgs, P. (2013) Ageing, Corporeality and Embodiment, London: Anthem Press. Gilman, S. L. (1996) Seeing the Insane, Lincoln: University of Nebraska Press. Hockey, J. and James, A. (2004) How do we know that we are aging? Embodiment, agency and later life, in Tulle, E. (ed.), Old Age and Agency, New York: Nova Biomedical. Holland, C. and Ward, R. (2012) On going grey, in V.Ylänne (ed.), Representing Ageing: Images and Identities, London: Palgrave Macmillan. Hurd Clarke, L. and Griffin, M. (2008) Visible and invisible ageing: beauty work as a response to ageism, Ageing and Society, 28: 653–74. Hurd Clarke, L. and Korotchenko, A. (2010) Shades of grey: to dye or not to dye one’s hair in later life, Ageing and Society, 30: 1011–26. Katz, S. (2011) Hold on! Falling, embodiment, and the materiality of old age, in Casper, M. C. and Currah, P. (eds), Corpus: An Interdisciplinary Reader on Bodies and Knowledge, New York: Palgrave Macmillan. Lee-Treweek, G. (1997) Women, resistance and care: an ethnographic study of nursing auxiliary work, Work, Employment and Society, 11.1: 47–63. Mercer, K. (1994) Welcome to the Jungle: New Positions in Black Cultural Studies, London: Routledge. Paulson, S. (2008) ‘Beauty is more than skin deep’: An ethnographic study of beauty therapists and older women, Journal of Ageing Studies, 22: 256–65. Pickard, S. (2013) Biology as destiny? Rethinking embodiment in ‘deep’ old age, Ageing and Society, published online 11 April 2013. Robinson, V., Hockey, J. and Hall, A. (2007) Negotiating sexual and gender boundaries, in C. Beckett, O. Heathcote and M. Macey (eds), Negotiating Boundaries? Identities, Sexualities and Diversities, Newcastle: Cambridge Scholar Publishing. Solomon, F. M., Linnan, L. A., Wasilewski,Y., Lee, A.-M., Katz, M. L. and Yang, J. (2004) Observational study in ten beauty salons: results informing development of the North Carolina beauty and health project, Health, Education and Behaviour, 31.6: 790–807. Symonds, A. and Holland, C. (2008) ‘The same hairdo’: the production of the stereotyped image of the older woman, in Ward, R. and Bytheway, B. (eds), Researching Age and Multiple Discrimination, London: Centre for Policy on Ageing. Synott, A. (1987) Shame and glory: a sociology of hair, The British Journal of Sociology, 38.3: 381–413. Tate, S. A. (2009) Black Beauty: Aesthetics, Stylization, Politics, Farnham, Surrey: Ashgate. Twigg, J. (2000) Bathing:The Body and Community Care, London: Routledge. Twigg, J. (2007) Clothing, age and the body: a critical review, Ageing and Society, 27: 285–305. Twigg, J. and Majima, S. (2011) Consumption and the constitution of age: expenditure patterns on clothing, hair and cosmetics among post-war ‘baby boomers’, www.clothingandage.org (accessed 12 June 2012).

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Ward, R. and Campbell, S. (2013) Mixing methods to explore appearance in dementia care, Dementia, 12.2: 337–47. Ward, R. and Holland, C. (2011) ‘If I look old, I will be treated old’: hair and later-life image dilemmas, Ageing and Society, 31: 288–307. Wiesenfeld, A. R. and Weis, H. M. (1979) Hairdressing and helping: influencing the behaviour of informal caregivers, Professional Psychology, 10: 786–92. Yeadon-Lee,T. (2012) Doing identity with style: service interaction, work practices and the construction of ‘expert’ status in the contemporary hair salon, Sociological Research Online, 17: 4.

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19 Dress and age Julia Twigg

Dress has been a neglected topic in gerontology, which has tended to focus on areas such as dependency and frailty, and the social welfare approaches to these. Dress suffers—particularly under its guise as ‘fashion’—from being seen as lightweight and frivolous, something distant from the lives and interests of older people or the assumptions of those who study them. But dress in fact encapsulates a number of key debates within cultural gerontology: the complex interplay of the biological and the cultural in ageing; the changing definition and location of old age; the emergence of the Third Age; and the significance of fields such as consumption in shaping, defining and enabling its performance. The analysis of dress thus contributes to the wider project of cultural gerontology, helping to shift the debate away from the narrow focus that has often marked mainstream gerontology, towards a fuller, more plural account of later years, and one that explores the everyday embodied lives of older people.

Traditions of analysis Clothing has predominantly been analysed within the tradition of fashion studies (Steele 1997, Braham 1997, Breward 2003, Welters and Lillethun 2011). This literature, however, rarely addresses old age. The values of the fashion world are strongly youth oriented, and fashion studies—and indeed the related field of cultural studies—have reflected these values in their own analyses, which have largely effaced age. Work on fashion has also analysed it in terms of material production (Jones 2006). Fine and Leopold (1993) present this global industry as the Fashion System, the nexus of commercial, design and media influences that together provide the principal source of changing aesthetic judgements about clothing, determining the choices available in the market.The bulk of commercial production in this system—which might better be termed the garment industry—takes the form of relatively stable ‘unfashionable’ items. The dress of many older people, especially older men, is largely sourced from this sector. More fruitful for the analysis of age and dress has been the large body of work drawing on social anthropological and sociological approaches, particularly those that focus on the lived reality of dress (Miller 1987, 2005, Entwistle 2000, Guy et al. 2001, Clarke and Miller 2002, Weber and Mitchell 2004, Crane and Bovone 2006, Woodward 2007). Dress is understood to denote the assemblage of clothes and other items into looks; and the term is wider than either 149

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‘fashion’, with its connotations of repeated systematic change and of fashionability, or ‘clothing’, with its more limited meaning. Here dress is recognised as part of the everyday deployment of material artefacts in the process of ongoing meaning making (Miller 1987). Such approaches link well to the growing perception of consumption as a continuing process, not confined to the moment of purchase but extending over time through the appropriation and use of objects.The ways in which clothes continue to operate in a wardrobe exemplifies this. Weber and Mitchell (2004) have shown how what they term ‘dress stories’ can be central to how we narrate our lives, with items of dress—what we wore when—acting as potent memory objects linking us to the past in directly material ways. Such techniques are particularly useful in exploring age and the passage of time, and they link to the renewed interest in narrative and biography in cultural gerontology (Kenyon and Randall 1999, Ray 2000, Bornat 2002), allowing people to reflect on moments and changes in their own lives and the location of these in distinctive historical periods exemplified in dress. Recently they have also been used fruitfully in work with people with dementia (Kontos 2004, Twigg and Buse 2013, Buse and Twigg 2014).

Gender Dress is a highly gendered field. For some analysts, indeed, gender is the key to how fashion operates (Wilson 1985, Davis 1992,Tseëlon 1995); and it is certainly the case that gender differentiation is one of the most marked features of dress codes cross-culturally. In the West fashion has long been constituted as a feminised field, intimately linked with, and expressed through, the lives of women, who typically shop more frequently for clothes, spend more money on them and engage more fully with the topic through the media. Second wave feminism was ambivalent about—even hostile to—fashion, but the rise of post-modern feminism shifted the debate towards seeing dress, and related areas of appearance and body management, as an inevitable aspect of social life, a form of expressivity and one linked to a distinctive women’s culture (Wilson 1985, Dyhouse 2010). Reflecting this, most current and past work on dress focuses on the lives of women; and this is true also of the small body of work that addresses age (Gibson 2000, 2013, Fairhirst 1998, Hutchinson et al. 2008, Hurd Clarke et al. 2009, Twigg 2013). Interest in dress by men has been negatively coded in recent Western culture, though this is beginning to change with the emergence of metrosexual man and the rise of forms of consumption aimed at this group; and these influences have begun to impact on older men, particularly affluent Third Agers. As a group, however, they remain largely divorced from the world of fashion. The lack of work on older men and dress also reflects a wider neglect of men and masculinity in gerontology generally.

Age ordering Clothes, as Breward (2000) argues, are one of the ways in which social difference is made concrete and visible. We are accustomed to this in relation to the key identities of class, gender, race; but it is true of age also. Age indeed needs to be recognised as a key identity, though one that has been systematically neglected by social theorists. Clothes have a long history of being age ordered, understood here as the systematic patterning of cultural expectations according to an ordered and hierarchically arranged concept of age (Twigg 2013). Forms of dress are deemed appropriate—or, more significantly, inappropriate—for people as they age. Though always subject to historical specificity, there are common features to age related dress in the West. For women they focus on: more covered up clothing, with longer lengths and higher necks; less showy, fashionable or overtly sexy styles; and darker, lower toned colours. The meaning of these 150

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partly rest on negative judgements about the body in age, which is perceived as a form of abjection, a falling away from the youthful ideal that is valorised and celebrated in surrounding visual culture, so that for an older woman to be socially acceptable, her body needs to be hidden. Old women wearing ultra-fashionable or sexually explicit dress have long been the mainstay of misogynistic imagery that draws on the Vanitas tradition in art (Tseëlon 1995), something that is still reflected in muted form in the British cultural trope of ‘mutton dressed as lamb’ (Fairhirst 1998). Pressure to tone down, to retreat from styles that make claims to social notice is part of this, expressing a wider cultural and sexual marginalisation. This pattering illustrates the way dress is ideological (Barnard 1996), part of the process whereby social groups establish, sustain and reproduce positions of power, relations of domination and subordination, contributing to how inequality is made natural, proper and legitimate. Many of the features of age related dress—the low tones, the drab colours, the retreat from fashionability or display—act to make manifest and reinforce the marginalisation and denigration of the old. They underwrite at a visual level the structural exclusion imposed on older people, naturalising at the bodily level processes that are social and cultural. These processes mirror at a cultural level those earlier analysed by the political economy or critical gerontology school, at a social and economic one (Estes 1979, Phillipson and Walker 1986, Estes and Binney 1989, Arber and Ginn 1991). Indeed, the fashion world with its valorisation of youth can be seen as part of the wider culture, entrenching what Calasanti (2003) terms age relations in the form of ‘organised systems of inequality that privilege younger adults at the expense of older people’ (199).

Have things changed? Recently there has been a growing sense that norms are changing, and that older people in the West need no longer tone down or retreat into invisibility in the way they did in the past. Such perceptions are widely current in the media, and caught by such phrases as ‘60 is the new 50’ . . . or 40. It is often asserted that the baby boomer generation—itself a media dominated, fluid and intellectually incoherent term—will refuse to don the mantle of age, will continue to wear their jeans and pursue youthful, fashionable styles. At an academic level, these ideas are encapsulated in the reconstitution of ageing thesis that argues that a series of social, cultural and demographic shifts have together transformed the experience of later years in the late twentieth and early twenty-first centuries, repositioning older people nearer the mainstream. Integrative structures such as consumption and lifestyle behaviour are seen to support a new version of the life course in which later years are part of an extended plateau of middle life, at least until serious ill health disturbs this (Gilleard and Higgs 2000, Öberg and Tornstam 1999, 2001). Such changes, it is suggested, are reflected in cultural fields such as dress. Evidence from Twigg’s (2013) study supports both continuity and change in dress norms. All the women in her UK-based study were aware of the pressure to tone down; and most accepted and internalised the strictures of age ordering, particularly in relation to hiding the aged body; a finding reflected also in Hurd Clarke and colleague’s (2009) Canadian work. Narratives were marked by the need for older women to be ‘careful’ and to avoid styles no longer ‘appropriate’. For some, this was accompanied by a sense of regret at exile from an area of pleasure in their lives and sense of estrangement from the cultural practices of femininity. For them, femininity was linked to youthfulness—a connection deeply rooted in the values of the wider culture—and loss of its expression in dress a source of sadness. Some described the ‘changing room moment’ when they had looked at their reflection in the mirror and seen that a familiar and well-loved style no longer suited. Some had retreated from active engagement with dress, no longer finding 151

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the pleasure in it they had in the past. Indeed, why engage with an area of life that offers diminishing returns? But there was also clear evidence of change. Respondents in Twigg’s study felt that their lives were different from those of their mothers at their age, and that this was reflected in the sorts of clothes they wore, which were much more mainstream and youthful in feel. Many still followed fashion trends, though in a modest way.They were clear that they did not want to wear clothes that were ‘too young’ for them; but they also wanted to avoid ones that were ‘too old’, a finding also found in Klepp and Storm-Mathisen’s (2005) Norwegian work. They were keen to avoid the drab, frumpy dress they associated with age, epitomised for them in elastic waists, pleated skirts, chitzy prints. Above all they were determined to eschew Crimplene, a fabric that has taken on symbolic status for this generation as a marker of all that is drab and old in dress. Design directors of major garment retailers concurred with these views.They were clear that the market had changed, and they reported that customers were looking for a younger, more ‘modern’ look that integrated them with the mainstream. This was also endorsed by fashion journalists, who similarly recognised that their readers had a different attitude, and were looking for a more youthful, up-beat presentation. Colour was significant in this context. Dress for older women has traditionally been described in terms of low, drab colours—the greys and beiges of old age. But ranges aimed at older women are now marked by a clear use of colour, so that older customers, including those in their seventies and eighties, are embracing colour in a way that they had not in the past.This supports the view that older women have become more confident about being visible, present in the public eye.

Moving younger Across the fashion system there is a persistent language of ‘moving younger’ that reflects the processes of cultural change referred to above. Indeed, the prevalence of such language is itself evidence of the way in which later years are shifting their cultural meaning and location. But there are two other ways in which we can understand this language of ‘moving younger’. Clothes need to be seen as part of consumption culture, aspirational goods promoted in terms of a dream of an idealised self. That is the central dynamic that fuels the constant pursuit of goods, and this is particularly significant in the case of fashion, where retailers are selling into a saturated market. Just as that idealised self is slimmer, smarter, richer than the reality, so too is it younger. As a result retailers persistently present their goods as aimed at a younger market than is in fact the case: using young models to display their clothes; selecting promotional settings that emphasise youthful zest; weeding their ranges to lift the offer visually. This produces a dynamic whereby everyone—retailers and customers alike—are trying to ‘move younger’. What underlies these pressures, of course, is the systematic operation of ageism, in which dress is increasingly implicated in anti-ageing strategies. The second, and different, way in which we can understand the language of ‘moving younger’ is in terms of the processes of fashion themselves, and in particular the dynamics of style diffusion. Since the time of Simmel, fashion has been analysed in terms of competitive emulation in which styles diffuse down the class hierarchy as they are successively adopted and abandoned by social elites as lower groups take them up (Simmel 1904, Bourdieu 1984, Steele 1997). More recently, with the wider democratisation of fashion and the rise of street styles, a more plural fashion system has developed in which the styles diffuse in more variable and complex ways. As part of this, Crane (2000) argues that youth has replaced class as the engine of fashion. By this interpretation, age ordering has not gone. It is still significant; it is just that it has taken on a new form. Rather than simply denoting social position as in the past, age is now caught up in the 152

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dynamic of fashion itself. What we are observing is not that the dress of older people is moving younger, but that styles are diffusing older, as they pass from the centre of fashionability in the youth market to the periphery in the older one. These changes in relation to the dress of older people are rooted in material developments in the Fashion System, notably the influx of cheap clothing that has resulted from the massive growth of production in the Far East and other low cost economies since the 1990s. This has intensified the fashion cycle, enabling a true democratisation of fashion in the sense of fast, cheap, fashion related styles available to the population as a whole. This includes older women, who have increasingly been drawn into the faster shopping cycle, to the extent indeed that women in the UK over 75 are now shopping for clothes as often as those 16–34 did in the early 1960s (Twigg and Majima 2014). In Twigg’s study, even working-class older women on low incomes (UK Pensioner Credit) were able to enjoy buying new clothes. Retailers and marketers are aware of the potential of the grey market (Metz and Underwood 2005, Drolet et al. 2010). With declining numbers of young people—the traditional engine of fashion—they are keen to colonise the older market, significant sectors of which have relatively high disposable incomes. But they have not always been successful in doing so. A number of women in Twigg’s (2013) study fell into the category of ‘frustrated shoppers’, unable to find their lives reflected in the clothes that were on offer. Fashion journalists concurred with this judgement, believing that retailers were failing to imagine their older customers correctly. It is certainly the case that fashion is a highly youth oriented field, and designing for or selling to older people has little prestige.

Body and dress: adjusting the cut So far we have treated clothing and age as cultural phenomena. But we need to recognise the ways in which the dress styles interact with the body and its changes. In age the body alters: waists thicken, stomachs expand, shoulders move forward, busts for women lower (Goldsberry et al. 1996). This means that designers have to adjust the cut of their clothes. A large scale study undertaken in the UK in the early twenty-first century, Size UK, charted these changes systematically, developing a specific model of the mature figure to help the fashion industry fit the older customer (Bougourd and Treleven 2010). Part of the skill is to accommodate these changes, so that the garment fits, but in ways that do not detract from its fashionability and that—ideally—subtly alter the presentation of the body, assisting the wearer to appear nearer the fashionable norm.Tailoring has long performed this function for men. In relation to age, this can mean adding details that adjust or ‘help’, for example shoulder pads in a blouse or jersey, which restore the body nearer the youthful norm. Some adjustments for the older body however reflect not so much physiological changes as the negative cultural evaluation of them—for example the practice of avoiding low necks, sleeveless dresses, short skirts, all of which expose the body. Designers aiming at the older market avoid them. Adjusting the cut to make it fit better, or conform more closely to cultural perceptions of what is appropriate, can, however, have the effect of ‘ageing’ the garment, writing into its very structure information about the sort of body that will inhabit it. This is most clearly visible in ranges aimed at distinctly older women, where the cut is markedly different, with lower bust seams and undefined waists. Mainstream retailers face a difficult marketing task here of signalling that their clothes are relevant to this group, will fit their bodies and their requirements, while also avoiding the negative connotations of being aimed at an older market. Customers have themselves internalised ageist values, and many in pursuit of younger looks are reluctant to shop at outlets too openly aimed at the older market. 153

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Disciplining the body in age: dress and governmentality Clothes can also be understood as part of wider set of body practices or performances, in which dress can be understood in Entwistle’s (2000) terms as ‘situated body practice’, operating as part of the micro social order.We have already noted this in relation to questions of age ordering. But these disciplinary practices operate in two additional and distinctive ways in relation to age. The first concerns avoiding the dereliction of age. In general, being correctly dressed is a requirement for engaging successfully with the social world. Entwistle (2000) notes how unease and anxiety attach to failing to meet the standards required by the moral order of the social space. But in relation to older people, lapses of dress—gaping flies, hanging hems, visible stains from food or worse—are not just offenses against these, but pointers to a darker future of social exclusion and reclassification. The bodies of older people are thus judged more harshly than those of the young, and subject to tighter discipline if they are to avoid feared states of dereliction. Older people are also subject to new performance norms in relation to fashionability and youthfulness. Over the last decade older people have increasingly been drawn into the orbit of fashion. This has largely been interpreted positively, representing a form of empowerment, a throwing off of the limitations and cultural constraints traditionally associated with age. Much has been made of the baby boomer generation’s determination to resist age related styles, and the negative messages that go with shabby, old fashioned, self-effacing dress. Like many cultural phenomena, however, these developments face two ways. New freedoms have brought new requirements. As older people are drawn more and more into the culture of consumption, so they are required to impose new forms of bodily discipline and self surveillance that show commitment to resisting age, through strenuous dieting, beauty practices or up-to-date clothes. Ageing well, as Katz (2001) and others have pointed out, is increasingly interpreted as ageing without appearing to do so; clothing and dress are increasingly implicated in this moral enterprise. As a result, older people can find themselves monitoring their dress to avoid out-of-date, unfashionable or ageing looks that signal moral failure in this new culture of positive ageing. Just as men, according to Katz and Marshall (2003), are required to be ‘forever functional’ in regard to sexuality, so women are increasingly under pressure to be ‘forever fashionable.’

Conclusion Dress allows us to think about the day to day embodied lives of older people. It forms the vestimentary envelope that presents the body to the world. Bearing the imprint of culture, it displays the way ageing is both a bodily and a cultural matter. It allows us to pursue a material analysis in which physical objects of day to day life embody and act on the lives of older people, shaping their experiences, providing them with prompts with which to perform age. Changes in the dress code can therefore be used as a means of analysing change in the cultural location of older people. As we have seen, empirical work around dress does support the contention that the lives of older people have become more fully integrated with the mainstream, particularly for those who can be regarded as living in the Third Age, with consumption acting to support and enable this integration. Evidence also supports, however, some degree of continuity with the dress norms of the past, and the ways these embody the abiding presence of ageist meanings in culture.

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20 Science, technology and ageing Kelly Joyce, Meika Loe and Lauren Diamond-Brown

Today’s elders are technogenarians; that is, science and technology are integrated into the everyday life experience of old age (Joyce and Loe 2010). Science and technology are major forces in the social construction of ageing, and ageing is an often unacknowledged component of technoscientific imagination and practice. Joyce and Mamo’s (2006) call to ‘gray the cyborg’ asks scholars to critically examine the relationships between science, technology and ageing. This chapter focuses on two cases—pharmaceuticals and ambient assistive technologies—to explore how cultural contexts shape these technologies and how these technologies in turn shape the culture and experience of ageing. The chapter highlights the global north, in part because this is where the percentage of old people over 65 already does or imminently will account for 20% of a nation’s population (Kinsella and He 2009) and because this has been the focus on social science research published in English. Social scientists have long recognized the centrality of biomedicine in defining ageing, with pharmaceuticals as a primary intervention of science and technology in elders’ lives (Loe 2004, Marshall 2010, Williams et al. 2012). In the European Union, North America and Japan, the potential markets and challenges of ageing populations are inspiring new technological development aimed at elders and their caregivers. Nations, industries and universities are investing significant resources to develop technologies that manage ageing bodies and minds. Five cultural themes emerge from the literature on science, technology and ageing: medicalization, ageism, the desire for control, social inequality, and understandings of independence. This chapter introduces these cultural contexts as they relate to gerontechnologies, and then critically analyzes them in relation to pharmaceuticals and ambient assistive technologies. Technogenarians remain central to the analysis by examining how they reify, re-appropriate and resist cultural assumptions about old age in their use or non-use of technology.

Cultural contexts Medicalization of ageing Medicalization, or the process by which non-medical processes are defined as medical problems, creates new definitions of health and expectations of normality and markets (Clarke 157

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et al. 2003, Conrad 2007). As part of this trend, more and more aspects of ageing are defined as disease or pre-disease (Estes and Binney 1989). The line between normal ageing and disease is further blurred as anti-ageing medicine and paradigms of successful ageing challenge previously accepted ideas of the normality of decline in old age (Fishman et al. 2008, Mykytyn 2008, 2010). With new definitions of ‘natural’ ageing in circulation and social norms that legitimate medical intervention, the possibilities for biotechnologies of enhancement become a moral matter where ageing requires intervention.

Ageism Ageism is discrimination against old people and ageing; it takes place in social structures and institutions (Calasanti 2003), as well as on a personal level through internalization and in­teractions (Brooks 2010). Ageism acts on stereotypes of old people as frail, lonely, dependent, and technologically illiterate (Loe 2010). Hegemonic ideas of ageing make these stereotypes and the stigmatization of the old seem natural and taken for granted. Critical gerontologists challenge this by highlighting the historical and cultural specificity of current forms of ageism. Of particular interest to social scientists are the recent trends of anti-ageing medicine and the cultural narrative of ‘successful ageing.’ While these paradigms of ageing resist many of the negative stereotypes associated with old age, they also encourage ageism by reifying the undesirability of old age. Furthermore, they make it an individual’s responsibility to actively resist growing old through technology use. With old age framed as a techno-scientifically mediated choice, old people who do not resist signs of ageing or do not have the means to resist may experience more intense ageism (Brooks 2010).

Control The desire for control may be understood through Foucault’s (1977) thesis on biopower, which identifies the body as a primary site of social control, and through theories of technocracy, where all authoritative knowledge is reduced to rational technoscientific understanding (Reynolds 1991). The desire to manage the body through science and technology can be traced back to Descartes and the elevation of mind over body where a project of mindful, calculable control aims to organize the chaotic sensuous world. While these ideas have existed for centuries, recent advancements in biomedicine and technology increase the possibility for technoscientific interventions that aim to dissect, separate, and control nature, or in this case old bodies and ageing (Romanyshyn 1989). These interventions take place in a context in which old people are particularly vulnerable to surveillance and control. For example, old people may have caregivers who are granted decision-making power over the types of interventions old people are given. The issue of control is also important to old people themselves, who struggle between the desire for autonomy and the confidence of safety. The fear and denial of death doubly contributes to a desire for control of the body as one approaches life’s end.

Inequalities and the intersection of difference While ageism and technocracy affect the entire population, the implementation and effects of technologies vary across differences such as gender, race, nation, class and sexuality (Calasanti and Slevin 2001, Joyce and Mamo 2006, Kinnunen 2010). The intersection of ageism with difference produces unique local embodiments and meanings. An examination of inequality, intersectionality and gerontechnology is important for locating vectors of power in the process 158

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of technology creation, use and meaning. Critics argue that intended users are often narrowly assumed to be white middle-class heterosexuals with disposable income and the desire to defy old age (Calasanti and King 2005, Mykytyn 2010).Those who are structurally or culturally marginalized by hegemonic ideals face consequences of seeming inferior, cast as ‘old’ in a negative light, or blamed for their ‘decline.’

Independent or interdependent? Gerontechnology is often designed for the isolated atomized individual as opposed to an individual interconnected in a community. This perspective locates solutions at the individual level rather than the social or structural. The focus on individual solutions takes place within a broader philosophy of liberalism that ‘holds that individuals have an intrinsic inclination towards self-sufficiency and separateness,’ rather than focusing on the health and wholeness of communities (George and Whitehouse 2011, 592). Research that focuses on elders’ use of technology reveals more socially bound meanings, suggesting a mismatch between designer and user understandings of independence and interdependence in old age.

The case of pharmaceuticals The pharmaceutical industry is central to the biomedicalized construction of ageing. While early theorists viewed physicians as the primary drivers of medicalization, today the pharmaceutical industry is crucial to the creation and definition of disease through its dominance over clinical research and scientific scholarly knowledge, direct-to-consumer advertising and lobbying power (Bell and Figert 2012, Conrad 2007, Hawthorne 2005). Pharmaceuticalization, or the ‘translation or transformation of human conditions, capabilities and capacities into opportunities for pharmaceutical intervention,’ often works in tandem with medicalization, but it has the potential to reach beyond it (Williams et al. 2011: 12). The expansion of the pharmaceuticalization of old age occurs through various mechanisms, such as lowering the diagnosis thresholds for conditions such as osteoporosis (Welch et al. 2012), expanding the terrain covered by cognitive enhancement (Williams et al. 2012), the creation of completely new pathologies such as erectile dysfunction (Conrad 2007, Fishman 2007, Loe 2004), and by transforming normal life experiences into ‘undesirable,’ but ‘manageable’ states such as menopause (Bell 1987, Utz 2011). The expansion of pharma’s role in defining life’s problems is confounded by what Courtney Everts Mykytyn (2010) calls the ‘culture of liberation,’ whereby individuals liberate themselves from undesirable social or biological forces. This ultimately leads to a ‘culture of perfectibility’ where people have the freedom and responsibility to pursue consumerist solutions to health problems, including the spiritual, emotional and physical dynamics of life. In the context of ageing, these ideas overlap with ageism and the pharmaceuticalization of old age to make pharmaceutical consumption a ‘personal health responsibility.’ Ageing individuals are bombarded with messages about how to use pharmaceuticals to discipline their bodies to alleviate disease, manage risk and produce optimum functioning. New pharmaceutical interventions change norms of old age, and old people are expected to live up to new expectations of virility and youth. While some old people find the societal expectation that one should extend youthful capabilities and characteristics into old age empowering, others find that it encourages feelings of guilt for not managing their old age in the ‘right’ way (Brooks 2010, Calasanti and King 2005). This particular ‘pharmaceutical imagination’ views the world from a certain race, class, gender, sexuality and age lens, which has potentially oppressive consequences for those on the margins (Calasanti and Slevin 2001). 159

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Researchers analyzing the pharmaceutical imagination highlight the shifting representations of old age as new biotechnologies hit the market. Calasanti and King (2005) find that media representations of masculinity in the United States changed with the introduction of erectile dysfunction drugs and anti-ageing ‘virility’ therapies. In the 1990s, old men in the media were portrayed as loving grandparents who enjoyed old age as a time to relax from gender role expectations and express feminized characteristics of sentimentality and care. By the 2000s, the ideal emphasized ‘playing hard’ and ‘staying hard,’ where old men must endlessly maintain a hyper masculine youthful vigor grounded in ‘male dominance and physical prowess’ (Calasanti and King 2005, 10). Sociologists also investigate how the pharmaceuticalization of erectile dysfunction is shifting sexual norms in old age (Calasanti and King 2005, Loe 2004, Marshall 2010). Loe (2004) argues that the ‘Viagra phenomenon’ reduces sex to penile performance, then equates penile performance with masculine identity, where a man’s self-worth and social standing are reduced to the hardness and sustainability of his erections. Viagra is an early example of a blockbuster anti-ageing drug that exemplifies the ‘medicalization of discontent,’ wherein complex sociopsychological problems are reinvented as simple medical conditions. Loe shows how, in order to create the market for Viagra, impotence is reinvented as erectile dysfunction and frigidity as female sexual dysfunction. In each case, the identified problem is shorn of its social, cultural, emotional and psychological elements, leaving a core physiological dysfunction that is intrinsic to the individual and independent of society. This can be ‘cured’ with a specific medical treatment. In short, the problem is designed to fit the treatment, not the reverse. In the case of Viagra, this ‘cure’ exacerbates the wider problem, ensuring the continuing growth of the condition, the treatment, and the profits from drug sales. In the United States, this medicalizing of discontent was facilitated by the passage of legislation permitting direct-to-consumer drug advertising, online drug sales and the entanglement of health professionals and drug marketers. The pharmaceuticalization of menopause is another area of study. Comparing narratives of menopause and ageing across mother and daughter pairs (mothers born 1920–30s, daughters born 1950–55), Utz (2011, 148) notes,‘The mothers defined menopause as a developmental transition and considered it a time of self-evaluation and priority setting.’ In contrast, the daughters defined menopause as a problem of estrogen deficiency. The daughters grew up in an era where pharmaceutical technology was used to manage their reproductive health through their whole lives, a significant difference from their mothers. Yet it is not only the shift in the pharmaceuticalization of reproductive health that affects the daughters’ narratives. Daughters also understood menopause in an ‘anti-ageing’ perspective where ageism, pharmaceuticalization, ideas about individual control and gender converged to form the meaning of menopause and ageing in their lives. Abigail Brooks (2010) obtained similar results in her interviews with older women about anti-ageing interventions. She explains, ‘Aesthetic anti-ageing surgeries and technologies project a new paradigm of ageing, one that echoes the successful ageing directives of individual responsibility, effort, and work on the body, but also intensifies and expands these directives’ (251). Women’s use of technology is part of their practice of doing gender, race and class in old age. Women who refuse anti-ageing technologies have feelings of frustration and guilt in the face of shifting norms, and some women of color resist white versions of feminine ageing and subscribe to their own ethnic cultural meanings (Brooks 2010). As people who are already used to controlling their health with drugs age, the opportunities for pharmaceutical intervention will only expand (Bell and Figert 2012). Biotechnology is not limited to treatment of disease, but expands into lifestyle enhancement and towards prevention of risks and inevitable ‘symptoms’ of growing old. Going forward, social scientists can investigate the consequences of new norms for ageing as well as how social and economic inequalities shape individualized consumer solutions. 160

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The case of ambient assistive technologies Technologies created for old people range from simple everyday devices, such as a telephone with hearing or visual enhancements, to ambient systems that equip the home with electronic technologies that respond to people and their actions. We here focus on two ambient assistive technologies: sensors and robots. Sensors, which can be placed in the home or nursing home, track movement, actions and biometrics and are monitored by experts, and at times caregivers, in remote locations. Unlike earlier medical alert technologies that required the person to push a button as a call for help, modern sensor technology aims to create a passive agent; that is, the design itself does not require the person being monitored to do anything for the technology to work. Robots designed for elders serve a range of functions, including monitoring of wellness, lifestyle management and assistance with daily tasks, cognitive engagement, telecommunication, companionship and therapy. Governments, industry and public-private hybrids are researching and developing both sensors and robots for eldercare. Netcarity (2013), a 4-year European project, for example, tested sensors that measure elders’ mood status; their eating, exercise and social interaction habits; and vital signs. While sensor technology can be used independently, it is increasingly designed for use with other ambient technologies. CompanionAble, a EU-funded project, integrated sensors with Hector, a fully autonomous robot assistant. Designed to be a companion and to help with things such as taking medication and household tasks, Hector works with sensors to monitor a person’s physical and emotional wellbeing, offers interactive games and provides a video connection to family and health care providers.While earlier robots designed for elders serve mainly therapeutic purposes and are primarily used in hospitals and nursing homes (e.g. Paro), the robots currently in development are surveillance, companion and task oriented and are designed for private homes (e.g. Carnegie Mellon’s HERB and Honda’s ASIMO). Michael Millenson (2013) addresses social control and privacy concerns related to ambient surveillance technologies. While some old people find security in knowing that their every move is tracked, others are alarmed by this degree of information gathering. This might be especially true for elders who have suffered systematic discrimination and have less trust in authority. Research has shown that elders do prefer to remain at home for ‘normalcy, continuity in self-identity, autonomy, and control’ (Loe 2010, 320), but that feeling unsafe in the home and struggling to perform everyday tasks are primary reasons for moving to assisted living facilities (Petersson et al. 2012). At the same time, for some elders the threat of privacy and personal identity loss is greater than the risk of physical injury or even death (Brittain et al. 2010, Wigg 2010). When does the risk of health overpower the risk of privacy and the sacrifice of autonomy? Who should decide if surveillance technologies will be used, the elders themselves or their caretakers? Furthermore, although ambient assistive technologies are said to assist elders who are forgetful and unable to independently manage their health regiments, some old people intentionally reject their ‘personal health responsibilities.’ Venn and Arber (2012) found that refusing to take medication is one way that older adults restore and embody autonomy. With sensors and robots monitoring medicine use, this self-determination may be taken away, and it raises the question whether there will be consequences for ‘non-compliance.’ Surveillance technologies are often employed for reasons of safety, security and independence of older persons, though they are also used to monitor and manage behavior. With governments committing millions to develop these technologies, we must critically question what assumptions about safety, health and wellbeing are built into the technologies and what elements of life are systematically eliminated. For instance, could the increase in data from constant surveillance lead to overmedicalization? 161

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What might be the consequences of medicalizing the home? What would be lost if technology replaces human care networks? When research focuses on how elders use technology, it reveals multiple meanings of ageing and speaks to the complexity of the cultural dimensions of technology (Loe 2011, Twigg 2000). Louis Neven’s (2010) research on the consumer testing of IRio, a companion robot designed for elders in the Netherlands, found that participants refused to domesticate the technology. All participants said the robot was fun and useful, but not for them; the participants felt the intended user was ‘housebound, old, lonely, feeble and in need of care and attention, and they did not want to be equated with this person’ (341). Neven argues that ageism prevented elders from adopting the technology; the robot symbolized an ‘old’ undesirable other. The Georgia Institute of Technology (USA) conducted a study in 2012 into how people aged 65–93 felt about using a robot in their homes; participants were enthusiastic about having the robot perform tasks such as emptying the trash and doing the dishes, but they did not want a robot performing personal care tasks such as bathing or for social activities (Smarr et al. 2014). These results suggest that there are complex symbolic meanings attributed to these activities and the involvement of technology in them. Exploring old people’s creative technological solutions to the challenges of ageing illuminate why elders accept or reject technology use. Technology in the everyday life of old people shows that elders come up with simple solutions to ensure safety, such as telephone trees, where a friend or family member calls someone else every morning to check in (Loe 2011). This allows elders to maintain social relationships, privacy and security, and is affordable. In contrast to ambient assistive technology, a phone tree builds on interconnection rather than independence. George and Whitehouse’s (2011) research on ‘brain fitness’ technologies presents a strong critique of technology developed for the isolated individual. Supporting previously explored criticisms of gerontechnologies as individualized and exclusive consumer solutions to the medicalization of ageing, they argue that health is a community and social issue where interdependency is essential; they run a community-based intergenerational program to engage elders with youth through the use of technology together. An interdependency model highlights how younger people gained mentorship and meaningful intergenerational relationships through interaction with elders, and transforms elders from being viewed as community burdens to assets. Despite the idealization of independence in old age, research has revealed older people’s emphasis on interdependent autonomy. A study on elders’ perceptions of assistive technology installed in their homes in Sweden found that ‘their reliance on the social environment was considered a prerequisite for feeling safe and for being able to use and benefit from technology’ (Petersson et al. 2012, 808). In other words, technology that was created for independence was only embraced by elders who had people they could depend on. Petersson et al. found that these elders differentiated between independence and autonomy, and prioritized the latter. While the robot Hector offers video streaming communication, most ambient assistive devices focus on the physical rather than social environment, and almost always on private spaces. Centering elders’ perspectives calls for interventions that increase social interaction and access to community spaces, and maintain autonomy (Brittain et al. 2010, Petersson et al. 2012). The emphasis on ageing in place (and the technological innovations being created to make it happen) thus requires critical analysis to identify which values and perspectives are privileged.

Conclusion Technology, science and ageing cannot be isolated from analysis of cultural contexts. The two work in tandem, co-producing the design and use (or non-use) of technologies and scientific 162

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knowledge (Joyce 2006, Oudshoorn 2003). Building on work that brings ageing to the sociology of science, technology and biomedicine (Joyce and Loe 2010), this chapter investigated two cases—pharmaceuticals and ambient assistive technology—to demonstrate how cultural contexts shape these technologies and how these technologies in turn shape the culture and experience of ageing. Through turning a critical eye on gray cyborgs (Joyce and Mamo 2006), the role of technology in the social construction and lived experience of ageing is analyzed, revealing power and taken for granted ideas about ‘normal’ ageing, health and quality of life. Investigating the cultural contexts of ageing, science and technology demonstrates how medicalization, ageism, a desire for control over the body and ageing, social inequalities and notions of independence co-produce gerontechnology innovation, development and use in the global North. More research is needed to better understand how cultural contexts, ageing and technology are co-produced in a broader range of nations. Elders’ negotiation of technology highlights their agency in deciding how technologies will or will not be used. Revealing how old people use technology creatively also challenges the ageist assumption that old people are technologically illiterate (Joyce and Loe 2010). However agential they might be, research also shows old people to be subject to hegemonic ideas about ageing that shape norms, values and expectations.The body of work reviewed here demonstrates that new technologies are shaped by cultural contexts and motivations for profit and technocracy; in turn, these new technologies have the potential to help re-define the experience and meaning of old age in powerful ways. The social, political and economic forces of these changes do not happen universally, but with variance across social location in terms of access and meaning. As technogenarians reify, re-appropriate and resist technologies, their meanings and actions shape the culture of ageing that technologies support and exploit. As governments and industry place an increased emphasis on research and development of pharmaceutical and technological solutions to manage ageing populations, critical analyses of the interplay between cultural values and gerontechnologies are needed.

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Foucault, M. (1977) Discipline and punish: the birth of the prison, New York: Pantheon Books. George, D.R. and Whitehouse, P.J. (2011) ‘Marketplace of memory: what the brain fitness technology industry says about us and how we can do better,’ The Gerontologist, 51(5): 590–96. Hawthorne, F. (2005) Inside the FDA: the business and politics behind the drugs we take and the food we eat, Hoboken, NJ: John Wiley & Sons. Joyce, K. (2006) ‘From numbers to pictures: the development of magnetic resonance imageing and the visual turn in medicine,’ Science as Culture, 15(1): 1–22. Joyce, K. and Loe, M. (2010) ‘A sociological approach to ageing, technology and health,’ Sociology of Health and Illness, 32(2): 171–80. Joyce, K. and Mamo, L. (2006) ‘Graying the cyborg: new directions in feminist analyses of ageing, science and technology,’ in T. Calasanti and K. Slevin (eds), Age matters: realigning feminist thinking, New York: Routledge. Kinnunen, T. (2010) ‘A second youth: pursuing happiness and respectability through cosmetic surgery in Finland,’ Sociology of Health & Illness, 32: 258–71. Kinsella, K. and He,W. (2009) US Census Bureau, International Population Reports, P95/09–1, An Ageing World: 2008. Washington, DC: US Government Printing Office. Loe, M. (2004) The rise of Viagra: how the little blue pill changed sex in America, New York: New York University Press. Loe, M. (2010) ‘Doing it my way: old women, technology and wellbeing,’ Sociology of Health and Illness, 32(2): 319–34. Loe, M. (2011) Ageing our way: lessons for living from 85 and beyond, New York: Oxford University Press. Marshall, B.L. (2010) ‘Science, medicine and virility surveillance: “sexy seniors” in the pharmaceutical imagination,’ Sociology of Health & Illness, 32(2): 211–24. Millenson, M. (2013) ‘The big-brother model of assisted living,’ The Atlantic, January 11. Mykytyn, C.E. (2008) ‘Medicalizing the optimal,’ Journal of Ageing Studies, 22(4): 313–21. Mykytyn, C.E. (2010) ‘A history of the future: the emergence of contemporary anti-ageing medicine,’ Sociology of Health & Illness, 32(2): 181–96. Netcarity (2013) www.netcarity.org/ (accessed 9/1/2013). Neven, L. (2010) ‘But obviously not for me: robots, laboratories and the defiant identity of elder test users,’ Sociology of Health & Illness, 32(2): 335–47. Oudshoorn, N. (2003) The Male Pill: a biography of a technology in the making, Durham, NC: Duke University Press. Petersson, I., Lilja, M. and Borell, L. (2012) ‘To feel safe in everyday life at home—a study of older adults after home modifications,’ Ageing & Society, 32(5): 791–811. Reynolds, P.C. (1991) Stealing Fire: the atomic bomb as symbolic body, Palo Alto, CA: Iconic Anthropology Press. Romanyshyn, R. (1989) Technology as symptom and dream, New York, NY: Routledge. Smarr, C.-A., Mitzner, T.L., Beer, J.M., Prakash, A., Chen, T.L., Kemp, C.C. and Rogers, W.A. (2014). ‘Domestic robots for older adults: attitudes, preferences, and potential,’ International Journal of Social Robotics, 6(2): 229–47. Twigg, J. (2000) Bathing, the Body and Community Care, London: Routledge. Utz, R.L. (2011) ‘Like mother, (not) like daughter: the social construction of menopause and ageing,’ Journal of Ageing Studies, 25(2): 143–54. Venn, S. and Arber, S. (2012) ‘Understanding older peoples’ decisions about the use of sleeping medication: issues of control and autonomy,’ Sociology of Health and Illness, 34(8): 1215–29. Welch, G., Schwartz, L.M. and Woloshin, S. (2012) Overdiagnosed: making people sick in the pursuit of health, Boston, MA: Beacon Press. Wigg, J.M. (2010) ‘Liberating the wanderers: using technology to unlock doors for those living with dementia,’ Sociology of Health & Illness, 32(2): 288–303. Willams, S., Martin, P. and Gabe, J. (2011) ‘The pharmaceuticalization of society: a framework for analysis,’ Sociology of Health and Illness, 33(5): 710–35. Williams, S.J., Higgs, P. and Katz, S. (2012) ‘Neuroculture, active ageing and the “older brain”: problems, promises and prospects,’ Sociology of Health & Illness, 34: 64–78.

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21 Ageing, risk and the falling body Stephen Katz

Joseph Sheldon, the British geriatrician whose survey The Social Medicine of Old Age (1948) became a leading reference for identifying the features of ‘normal’ population ageing, was also one of the first physicians to recognize the problem of falling. In his paper, ‘On the natural history of falls in old age’ (1960), Sheldon categorized 500 falls (experienced by 202 people) primarily into ‘accidental falls,’ followed by ‘drop-attacks’ (falling without warning), ‘trips’ and ‘vertigo.’ Some falls happen for unknown reasons. While Sheldon offered medical explanations where possible, what strikes today’s reader is his attention to his subjects’ experiences, including the challenges to getting back on their feet after falling. They understand their falls as a part of a bodily negotiation with gravity and thus they ‘complain bitterly of inability to preserve their balance as they did when they were younger’ (Sheldon 1960: 1685). Environments (including stairs), illumination, slippery surfaces and obstacles matter as much as physical stability. In the end, Sheldon says that falling in old age is fascinating ‘because at this stage of life Nature resembles the engineer who may release the unexpected’ (Sheldon 1960: 1690). After Sheldon, fall research developed slowly (see Speechley 2011), perhaps because fallers were not yet problematized as clients of expertise and falling itself was still considered an incidental and often inexplicable aspect of the ageing process. As mainstream gerontology drew stark medical, residential and moral boundaries between independence and dependence, older people would naturally come to fear falling as a stigmatizing decline in status and sense of resilience. For these reasons, researchers discovered that falls could be trivialized or underplayed by older individuals, even though fall research consistently neglected to take their stories into account or acknowledge ‘the unexpected,’ as Sheldon had done. Newall and colleagues comment that ‘while everyday minor problems might be understood as exacerbated in older age, the converse may be said for some major problems’ (2006: 337). This statement is relevant to the relationship between fall expertise (research and prevention) and faller experience because, while falls have become a global health issue, they are also trivialized, paradoxically, at the level of embodied experience. Thus, falls form an intersection point between the inside and outside of ageing, which this chapter takes as an opportunity to review the research and professional discourses on falls and falling in old age. In particular, the focus is on the subjective dimension of the ageing body, including the phenomenology of gravity and its material contexts, with examples drawn mainly from Britain, Canada and the United States. The concluding section explores the 165

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importance of the falling body to the critical conversation between ageing studies, body studies and cultural gerontology.

The scope of falls as a major social problem The professional literature portrays falls as a major problem of rising injuries, hospitalizations and deaths amongst ageing populations. In America, between 45 percent and 61 percent of nursing home residents fall each year, resulting in significant cases of hip fractures, with the mortality rates in the year following the fracture estimated at between 14 percent and 35 percent (Carroll et al. 2008: 213). In Canada falls have become a main cause of injury, a reason for entering care facilities, a factor in morbidity and a growing expense to the healthcare system. According to Ward-Griffin and colleagues, ‘Falls are the second leading cause of hospitalization in Canada for women 65 years and older and the fifth leading cause of hospitalization for men of this age’ (2004: 308). The annual direct healthcare costs of falls in Canada are $2.4 billion. In the UK, 50 percent of older residents in hospitals and care homes fall at least once a year (Oliver 2008: 248) and hip fractures result in more hospital admissions than any other type of injury (Bunn et al. 2008: 450). Falls are also the most common cause of accidental death for those 75 years and older. While the fall rate for community-dwellers 65 years and older is 30 percent, it is 40 percent for those 80 years and older. Other studies note that rates of falls amongst discharged patients are higher than in the community at large (Hill et al. 2011) and that falls are higher amongst women than men (Horton 2006). The World Health Organization’s WHO Global Report on Falls Prevention in Older Age (2007, hereafter referred to as the WHO Report), estimates that between 28 percent and 35 percent of people 65 years and older fall each year, with the fall rate and cases of death by injury increasing with age (WHO Report 2007: 1–2). While this statistical picture on falls leaves little doubt that a healthcare disaster is in the making, what is typically missing from it is the person (and the body) who falls. The WHO Report, in articulating a global perspective on fall research, fits within current health and welfare policies that cluster somatic status in old age around factors of residence, dependency, mobility and social support. As such, here and in related literature, the ageing body is configured as a risky body, with over 400 risk factors assumed to be related to falling (Speechley 2011). For those individuals who do fall and are subject to one or more risk factors, their bodies not only fall down but also fall out of the social sphere’s functional spaces of certainty, utility and mobility. In the terrible moment of a hard, unintentional fall, our culture’s ambivalence about the ageing body as one that lacks the control to ‘hold on’ or ‘stay up’ comes tumbling to the fore.The failure to resist gravity, both as an outside force and as a bodily ‘center,’ while acceptable in many other circumstances at many other ages, is a signifier of decline when it happens in later life. Thus falling is not an isolated event but a phenomenological process that transforms a person into a ‘faller’ and mobilizes a point of entry for them into the multiple professional worlds of care, risk and prevention programs; hospital and community centers; and insurance and medical planning. The WHO Report states that a fall is ‘inadvertently coming to rest on the ground, floor or other lower level, excluding intentional change in position to rest in furniture, wall or other objects’ (2007: 1). Such an operational definition is needed, states the Report, because otherwise research would leave ‘room for interpretation to study participants’ resulting ‘in many different definitions of falls. For example, older people tend to describe a fall as a loss of balance, whereas health care professionals generally refer to events leading to injuries and ill health’ (WHO Report 2007: 1).Yet, as Sheldon illustrated, ‘many different definitions of falls’ are an advantage to understanding the fall experience as is the role of personal interpretation and narrative (1960). Loss of balance along with ‘trips’ and ‘slips’ are primary reasons people cite for falling, because they 166

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describe what it feels like to fall in an embodied, phenomenological sense. However, these feelings, where gravity overwhelms in unexpected ways and uncertain places, can become trivialized within a global and static risk model of the ageing body, a problem that is exacerbated in fall prevention programs.

Fall prevention and the administration of risk Given the scope of the financial and human costs of falls, fall prevention has become a sizable field of its own. It ties together health governance, research, community living and professional care, with microsociological concerns about lifestyle, behavior, environment and intervention. The fall prevention literature’s lengthy list of ‘multifactorial’ causes includes problems with medications, unsafe environments, assistive technologies, physiological and vision limitations, and psychological states such as fear of falling.To counter these problems prevention programs work through the promotion of healthy choices for individuals to change behavior around exercise, diet and lifestyle, and to adapt supportive home modifications (e.g. Prevention of Falls Network Europe, www.PROFANE.eu.org). Again, the WHO Report is a model discourse in this regard by posing ‘active ageing’ as a key preventative strategy, especially for women assumed to be challenged by muscle and bone density decline following menopause (WHO Report 2007: 18). While research indicates that ethnicity is a factor for differences in fall rates (Stanaway et al. 2011) and that various cultural resources exist for fall prevention (Reyez et al. 2006), the point is that a globalizing discourse linking risk, ageing and falling prevails. Fall prevention is also the subject of a growing advice industry, with popular titles such as The Complete Guide to Fall Prevention (2012), How to Prevent Falls: Better Balance, Independence and Energy in Six Simple Steps (2007), and Fall Prevention: Don’t Let Your House Kick You Out (2006). Hence, prevention discourse adds older individuals’ lifestyle, residence and, above all, bodies to the risk inventories for falls. For instance, the epidemiological risk of falling for a person 65 years or older supposedly rises to one fall per year. Thus, ‘the best approach to preventing falls in any group of older persons requires knowledge of where that group sits on the risk spectrum, because this will determine the type and amount of services required as well as the program effectiveness’ (Markle-Reid et al. 2010: 121). However, some analyses have shown that the costs of fall prevention services are not always knowable and in some instances can even ‘cost more than they save’ (Jenkyn et al. 2012: 133). Where fall prevention aims at lifestyle risks, not all lifestyle risks of falling are actually risks or causes of falls (Speechley 2011). In addition, the coordination of fall evaluation or home inspection expertise designed to assess risks is complex and not standardized (Tinetti et al. 2006). Even individual choices about installing assistive, risk-preventative devices such as grab-bars, non-slip surfaces and easy-to-reach faucets evoke larger issues of social support and affordable ‘age-friendly’ housing. For example, in Canada, where 10 percent to 15 percent of all at-home falls not due to loss of consciousness happen in bathrooms, fewer bathtub grab-bars are installed in privately owned than publically owned buildings. Since one-third of all Canadian seniors live in apartment buildings, this is a political issue about imposing safety regulations around residential upgrading (Edwards et al. 2006). Meanwhile, the risks of institutional environments that contribute to falls can be underplayed; for instance, in hospitals and care institutions older patients frequently fall in their rooms, hallways and bathrooms, due in part to staff shortages or lack of training (Zecevic et al. 2012). Institutional settings may also contribute to under-reporting, since falls have few witnesses and data become of questionable quality due to staff time pressures (see Peel 2011). But the central problem with fall prevention is the lack of participation by older people themselves. When consulted about their views on fall prevention programs, older people think 167

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that falls are less important than other health factors, which the professional documentation of risk fails to acknowledge (Ballinger and Payne 2002, Bunn et al. 2008). In an Australian study of post-discharge fall prevention for older individuals, the authors discover that ‘program designers had little knowledge about older peoples’ views about falls and their perceptions of barriers that prevented engagement with risk reducing behaviours’ (Hill et al. 2011: 654). Further, in the research literature ‘no studies have evaluated older peoples’ knowledge or self-efficacy about falls and falls prevention strategies in the post-discharge period’ (654), despite the fact that ‘suggested strategies such as being careful, moving slowly, or avoiding hazards did not appear to be conceptually supported by the research evidence’ (Hill et al. 2011: 658). However, older people are keenly aware of the phenomenological relationship between their ageing bodies and their material environments (see Mahler and Sarvimäki 2010). When older people are judged to be at risk of falling, their participation in a fall prevention program can be stigmatizing, which can amplify the fear of falling and, paradoxically, create resistance to healthy (and fall-preventing) physical activities (e.g., Edwards et al. 2003, 2006). Certainly the unappealing advice given to women to wear unattractive hip padding or special shoes can only add to the visibility of this label (Yardley et al. 2006: 512). For these and other reasons, fall prevention participation can affect a person’s sense of their own biographical ageing. As Paul Kingston notes, falling is ‘a powerful metaphor of decline’ (2000: 218) and a ‘status passage’ because falls are embarrassingly publicized and become part of one’s bio-identity. Thus fall prevention, where it centers on the measurement of risk factors to the exclusion of a person’s responses to falling (Laybourne et al. 2008) and narratives of experiences over time (Oliver 2008), creates a conflict between a self-understanding of embodied life and a risk-embedding, evidence-based assessment of it. It is not surprising that positive programs that stress maintaining independence, weight reduction, having fun, building strength with confidence, and, above all, not being judged by age, are the most successful (Nyman 2011). Finally, gender rarely figures in fall professional discourse except where it notes that women fall more often and suffer more injuries than men. The patronizing double image that both naturalizes women as physically weaker and more risk-prone (especially after menopause) and reviles feminine strength and risk-taking as unfeminine encourages older women to see their own bodies as vulnerable (Reventlow et al. 2006, Grenier and Hanley 2007, Horton 2006, Martin 2011). But gender differences in the risks and experiences of falls have cultural determinants. For example, women are often given a higher number of medications compared to men, which can cause dizziness and loss of stability. A British study also found that in cases of injury recovery at home, female carers encouraged autonomy, self-esteem and reasonable risk-taking, while male carers practiced more protective and sometimes coercive caring styles, especially where the care-recipient was female (Horton and Arber 2004). Hence gendered relations of power can become concentrated in the treatment of women fallers, whose older bodies may have already been subject to a stereotyping ‘misery perspective’ (Krekula 2007).

The falling body and cultural gerontology The relationship between the human body and the phenomenology of falling lies at the core of our human bipedal evolution. As Garrett Soden states, the challenge to consciously control falling and stay upright has meant that: playing with gravity may provide the most intense examples of the flow phenomenon, because gravity is the constant and unyielding force in which we evolved; it unfailingly arouses our primal brain; it lets us reliably slip in and out of our protective frame without 168

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the vagaries of a human opponent; and it unequivocally focuses all our attention on the here and now. (Soden 2003: 272) Indeed, the making of our biological and social bodies could only happen through risk-taking and ‘playing with gravity’ because these are the means by which we explore our environments and animate our competence. Walking, shopping, visiting, wandering, dancing, gardening and playing might all involve some level of risk of falling, but an exclusive focus on preventing falls may also cut the health benefits of such activities and reinforce passive behavior (Ballinger and Payne 2002). If we expect older people to be responsible self-carers, then we have to respect the risk-taking and experimentation that comes with the adjustments to ageing. These include a better sense of how the phenomenology of gravity, as a fluid and nomadic experience, intertwines reasonable risk-taking and risk-prevention as embodied skills. We also need to rethink the connection between walking, staying upright and falling. For example, in the community, professional definitions of walking and falling can narrowly assume that ‘walkable’ environments are also accessible, safe and risk-aversive. However, in parallel to fall studies, walkability research sidelines the perceptions and experiences of residents by focusing on the particular features of their environments, such as pedestrian-friendly streets (Andrews et al. 2012). Different bodies and mobilities are also measured against active and able-bodied individuals who walk in unaided and unencumbered ways. Thus, the research ‘reduces the challenges faced by disabled people to a “dilemma of access” rather than addressing the significant embodied experiences and emotions of being “out of place” in disabling city environments shaped by economic, political and cultural forces’ (Andrews et al. 2012: 1928). For older people at risk of falling, walking is not simply ‘exercise,’ but a relay of challenges filled with hard surfaces, unexpected obstacles, speeding vehicles and dizzying social spaces. How would urban design, community planning and fall prevention programs be different if older people were better consulted or if their embodied experiences were better understood? While we cannot trust our bodies not to fall, neither can we understand or prevent falls without including the phenomenological and material relationships between body, environment, experience and subjectivity. This call to critical thinking links the sociology of the falling body with current work on embodied ageing in cultural gerontology (Calasanti 2005, Twigg 2006, Tulle 2008, Gilleard and Higgs 2013), which stresses the inseparability of physical ageing from lived material contexts. Twigg’s work on ageing and clothing argues that the meaning of growing older is culturally and reflexively mediated through the clothes we wear (Twigg 2013). Tulle’s work on sport running (2008) elaborates the materialization of embodied ageing as grounded in routine athletic practices and the maintenance of physical capital. Other research on the embodied experience in dementia has produced imaginative therapeutic models of personhood that restore the centrality of the body to considerations of person-centered care and treatment (Kontos 2005, Kontos and Naglie 2009, Leibing 2008, Ward et al. 2011). Such critical inquiries constitute a field of the materiality of embodied ageing that draws on the structural, feminist, and phenomenological work of Bourdieu, Butler, Elias, Foucault, Merleau-Ponty and others to draw attention to the absence of bodies and embodiment in social research on ageing. In so doing, they cast the materiality of embodied ageing into a perspective that includes the physical exigencies of ageing within the lived everyday experiences of older people. In particular, the materiality of embodied ageing challenges the tendency to obscure or biologize the body in Fourth Age or old, old age in relation to overly positive successful models of Third Age lifestyles (Katz 2005). The promotion of the diversity and possibilities of healthy ageing in retirement has actually deepened the negative aspects of ageing and dependency 169

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associated with the Fourth Age as a kind ‘a metaphorical “black hole” of ageing’ where active agency, cognitive mindfulness, physical mobility and biographical selfhood are seen to collapse (Gilleard and Higgs 2010: 125). At the same time, the focus on the material conditions of bodily life counteracts social constructivist models that, while criticizing dominant medicalizing narratives, also neglect the physical realities of ageing and disabled bodies, leaving them outside of culture, history and experience. As James and Hockey comment, ‘All too often within contemporary sociological theorizing about health, the brute material facts of sickness, disability and disease, and the physical changes that occur in the body, become bracketed off ’ (2007: 11). Thus, the issue of falls and the materiality of the ageing body converge as a nexus connecting the physical, biographical, phenomenological and cultural realms, where embodiment becomes the material ground from which to challenge both biological and constructivist reductionism.

Conclusion An older individual who reaches for a grab-bar to facilitate a bathtub transfer on a slippery ­bathroom floor as they attempt to manage the risk of falling is moving within a materialized microcosmic world of the grab-bar, the bathtub, the bathroom and the residence. These ­elements, in turn, coalesce into an intimate assemblage of spaces and relationships tied to resilience and dependence, as they intersect with macro-worlds of health, safety, social support and quality of life. It is also a moment of negotiation between the body and its environment in an ageist culture obsessed by the fear of loss of physical control, where a fall commonly symbolizes a passage into declining old age.Yet the older body that falls, resists falling or is at risk of falling is a window through which to view the contingent nature of the ageing process itself, and the ways in which biography, culture, politics and biology are braided together. Just as the embodiment of ageing has a subjective dimension, the subjectivity of ageing has a physical dimension that is materialized in the activities, environments and social systems in which we grow older and find meaning, including those disregarded spaces and trivialized moments where bodies might fall and drop out. In these ways, falls provide a multidisciplinary opportunity for all of us in the sciences, the professions, the social sciences and the humanities to advance critical and caring perspectives on the ageing body and the human spirit.

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Stanaway, F. F., Cumming, R. G., Naganathan, V., Blyth, F. M., Handelsman, D. J., Le Couteur, D.G, Waite, L.M., Creasey, H. M., Seibel, M. J. and Sambrook, P. N. (2011) ‘Ethnicity and falls in older men: Low rate of falls in Italian-born men in Australia,’ Age & Ageing, 40: 595–601. Tulle, E. (2008) Ageing, the Body and Social Change, London: Palgrave Macmillan. Twigg, J. (2006) The Body in Health Social Care, London: Palgrave Macmillan. Twigg, J. (2013) Fashion and Age: Dress, the Body and Later Life, London: Bloomsbury Publishing. Ward, R., Campbell, S., Kehoe, P., Raja, A., Hardman, P. and Inchbold, D. (2011) ‘Remember the body: Promoting physical health in dementia care,’ Journal of Dementia Care, 19: 26–9. Ward-Griffin, C., Hobson, S., Melles, P., Kloseck, M.,Vandervoort, A. and Crilly, R. (2004) ‘Falls and fear of falling among community-dwelling seniors: The dynamic tension between exercising precaution and striving for independence,’ Canadian Journal on Aging, 23: 307–18. World Health Organization (2007) WHO Global Report on Falls Prevention in Older Age, Geneva: Author. Yardley, L., Donovan-Hall, M., Francis, K. and Todd, C. (2006) ‘Older people’s views of advice about falls prevention: A qualitative study,’ Health Education Research, 21: 508–17. Zecevic,A. A., Chesworth, B. M., Zaric, G. S., Huang, Q., Salmon,A., McAuslan, D.,Welch. R. and Brunton, D. (2012) ‘Estimating the cost of serious injurious falls in a Canadian acute care hospital,’ Canadian Journal on Aging, 31: 139–47.

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Conceptions of the body are central not only to substantive work in the dementia field, but also to the philosophical underpinnings of the entire discipline of gerontology, where Western assumptions about the mind, body, and self affect theoretical perspectives and research paradigms alike. These same conceptions also influence the culture and organization of health care practices. In the last decade there has been a notable increase in efforts to expand understandings of dementia by incorporating the body; theorizing its interrelationship with history, culture, power, and discourse; and exploring implications of embodiment discourse for dementia care practice. Contributing to these efforts have been scholars from around the globe, including Canada (see for example Katz 2012, 2013, Kontos and Martin 2013, Kontos 2012a, Phinney and Chesla 2003), the United States (see for example Basting 2006, 2009, McLean 2006), the United Kingdom (see for example Coaten 2002, Downs 2013, Twigg 2007, 2010, Ward and Holland 2011), Sweden (see for example Hydén 2013, Hydén and Örulv 2009, Nyström and Lauritzen 2005), the Netherlands (see for example Hendriks 2012), and Australia (see for example Matthews 2006, Millett 2011). Emerging from this critical scholarship are explorations of dementia as subject to the constructive effects of surveillance, cultural priorities and discursive conventions, and also the potential of the body for creative self-expression.This emerging subfield of dementia studies has critically examined and called into question epistemological traditions (notably Cartesianism) that have been privileged in Western thinking for centuries and that have largely determined the ways in which dementia has been perceived in the health and social sciences. In this sense, a focus on the body and embodiment has greatly expanded the discourse on dementia through a rethinking of the cultural commitment to body/mind, body/self, and the biological/ social oppositions and assumptions.This shift has, in turn, contributed significantly to improving the quality of dementia care. The aim of this chapter is to critically explore and review dimensions of this expanding research and literature, specifically in relation to three key themes to date: embodiment and selfhood; surveillance and discipline; and innovations in dementia care practice.

Embodiment and selfhood Important theoretical developments in embodiment and dementia have advanced a more integrated approach to understanding selfhood, memory, and the body, and their interactions with 173

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the immediate and larger social order. This work forms an important theoretical foundation for problematizing the neurocultural imperatives that are driving current conceptions of memory and the ageing brain (Leibing and Cohen 2006), deconstructing the Enlightenment’s ‘cerebral subject’ (Katz 2012, 2013) that is based on the coupling of memory, mind, and selfhood. As such, it presents a significant challenge to the assumed loss of self that pervades much of the literature on dementia (Davis 2004, Cooney 2003). Efforts to disentangle the self from the cognitive categories on which it is presumed to depend, and grounding it in corporeality have been accomplished through historical analyses (Katz 2012, 2013), as well as philosophical (Hughes 2013, Kontos 2012a, Matthews 2006, Millett 2011) and empirical explorations (Kontos 2004, Kontos 2012b). While this scholarship has advanced important theoretical understanding of how the body is a site for the inscription of discourse and the making of particular subjectivities, it has focused to a lesser extent on how capacities, senses, and experiences of bodies are central to the exercise of human agency. The significance of the body, as a primary site for knowing the world that Merleau-Ponty (1962) speaks of, forms a small but critical focus for understanding the embodied experience of living with dementia. Matthews (2006) draws on Merleau-Ponty’s notion of ‘body-subject’ to argue that aspects of personhood are sedimented in habits of the body, and thus persist despite severe cognitive impairment. Millet’s work (2011) is significant here since, though he has moved away from what he deems a problematic reliance on notions of human self and personhood, he similarly draws on the tradition of phenomenology—with its focus on sensory ways of being in the world—to understand how persons with dementia continue to engage with their environment via the senses (sound, smell, taste, touch, feeling), and through their use of language and gestural communication. McLean (2006) draws on the phenomenological concepts of embodiment, subjectivity, inner experience, and continuity to argue that, far from the assumed meaninglessness and irrelevance of speech in dementia, coherence can be produced in the process of performing a life story. Hydén and Örulv (2009) and Hydén (2013) similarly attend to the embodied dimensions of storytelling, emphasizing performative coherence rather than textual coherence. Phenomenological analyses have also informed an understanding of dementia symptoms—slowing down, being lost, and being ‘blank’—as explored by Phinney and Chesla (2003). Kontos advances these examinations of the lived body through a theoretical formulation known as ‘embodied selfhood’ that foregrounds pre-reflexivity and socio-cultural ways of being-in-the-world when examining bodily intentionality. Embodied selfhood takes its theoretical bearings from Merleau-Ponty’s reconceptualization of perception (1962) and Bourdieu’s concept of habitus (1977, 1990). It advances a notion of selfhood that considers both the body’s power of natural expression, as manifest for example in basic bodily movements and the co-ordination of visual, tactile, and motor aspects of our body, and the style or content of bodily movements derived from primary socialization and cultural upbringing.These integrated dimensions of the pre-reflective body have been empirically captured in religious and artistic practices (Kontos 2006), food preferences (Kontos et al. 2010b), clothing (Twigg 2010, Twigg and Buse 2013), and bodily dispositions that disclose expressions of class distinction (Kontos 2004) and that convey the prior vocation of persons with dementia (Kontos and Naglie 2007a, b). These examples highlight how coherence, distinctiveness, and creativity can be discerned amongst persons with dementia through attention to the propensities and movements of the body. Body-self and body-world relations have important implications for understanding care environments and therapeutic relationships regarding people with dementia. This is explored in

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the next section on embodied narratives of surveillance and discipline of the body in dementia and dementia care.

Surveillance and discipline Scholars have extended Foucault’s insights critically to examine the ways in which bodies are rendered docile through rigorous and continuous ‘bodywork’ to maintain and marshal bodies, and to disguise and contain their ‘negativities’ (Cohen 2011). For example, contextualization of the body into the discursive regimes of a medico-legal system highlights how docility is informed by the power/knowledge scripts of medical discourses of care. ‘Somatic surveillance’ relies on monitoring technologies for tracking, recording, and transmitting data on the movement of bodies. Even the place and routine of sleep are highly regulated (Martin and Bartlett 2007, Williams 2005). Martin and Bartlett (2007), for example, critically examine how dormant bodies are perceived as disrupting institutional care routines. Spending too long in bed, for example, restricts the ability to manage other aspects of personal care, such as bathing and diet, due to rigid care schedules that assign specific times for personal care. Thus sleep/wake patterns are structured by abstraction, rationality, and commodified allocation of time rather than the timings of the body. Research on mealtimes further problematizes the emphasis in care homes on order and mechanistic efficiency, in that important embodied and social aspects of dining, such as the enactment of rituals that are tied to the family, home, and immediate community (Genoe et al. 2010), are mitigated by the transformation of the dining setting from one of social dining to that of efficient dietary intake (Diaz Moore 1999, Hung and Chaudhury 2011). This research underscores how the nursing home is not only a source of concrete care and caregiving, but is implicated in ascribing to residents of long-term care what Gilleard and Higgs term the ‘de-civilised’ body (2000, p. 168), central to which is the transgression of bringing bodily functions under social control. The desired containment of the disruptive body reflects the larger prevailing culture wherein ‘the morphology of corporeality in the late phases of dementia comes to signify the abject or the grotesque’ (Stirling 1995, p. 150). The deep abjection of dementia is evidenced by the anxieties associated with the sexual expression of persons with dementia. Despite the fact that intimacy, affection, and flirtation are positive and meaningful aspects of communication that may support and cement relationships with and between people with dementia (Hubbard, Tester, and Downs 2003), consensual sexual expression has been found to be deemed problematic when it occurs (Archibald 2002, Ward et al. 2005). Further, given the orthodoxy of the medical discursive system, homosexual or lesbian sexual activity is viewed with particular ambivalence and often presented as a symptom of disinhibition (Archibald 2002, Stirling 1995). The outward presentation of residents’ bodies is another key site of institutional regimes of discipline.The clothing regimes in nursing homes standardize modes of dress (Iltanen-Tähkävuori, Wikberg, and Topo 2012) with fabrics that require no ironing, trousers that are permanently fastened to prevent exposure, and dresses or overalls that open at the back to make it difficult for the wearer to undress on their own, and for ease of toileting. The ‘hard, plastic, easy wipe, easycare polyester world’ (Twigg 2010, p. 226) of nursing homes creates the classic look of the ‘dementia patient.’ Hairstyle and makeup have also been shown to be subsumed into formal caring routines in ways that inscribe the body with meanings reflective of organizational and institutional priorities, thereby disrupting biographical continuity in a person’s appearance (Ward and Holland 2011, Ward and Campbell 2013).

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Critical analyses such as these have highlighted the materializing effects of institutional regimes on the body. However, important advances in practice remind us that the narrative of discipline and surveillance does not capture all aspects of embodiment.

Embodied innovations in dementia care practice Founded on a new ethic of care that respects individuals with Alzheimer’s disease as embodied beings, novel approaches in dementia care practice are contributing significantly to improving the quality of dementia care (Downs 2013). Attention to embodiment in dementia care has made a significant contribution to care practices by offering an alternative discourse to the pervasive one of pathology (Kontos 2005, Kontos et al. 2010b, Matteau et al. 2003). Building on the seminal work of Kitwood (1997), it offers a more comprehensive understanding of the body by illuminating the complex interrelationship between the body, the interactional, environmental, socio-cultural, and broader sociopolitical landscapes that influence care practices, and the experiences of persons with dementia (Dupuis, Wiersma, and Loiselle 2012, Kontos et al. 2010a). It further facilitates a paradigmatic shift from viewing behavior as a ‘problem’ to be controlled to understanding movements and gestures as meaningful self-expression. Thus, in contrast to an emphasis on dysfunction and control, the emphasis is on the support of meaningful and even creative ways that persons with dementia can express themselves. This broadens the scope and opportunities for the development of interpersonal relationships through communication, and ultimately improves the quality of life of care recipients. Creative expression programs (Fritsch et al. 2009) are emerging interventions to improve the quality of care and life of persons with dementia in long-term care settings. These programs feature arts-based approaches (visual arts, dance, music, poetry, storytelling, and drama), which draw significantly on the body’s potentiality for innovation and creative action, and significantly support non-verbal communication and affect. Given their facilitation of expressions of emotional experiences through bodily movements and gestures (Nyström and Lauritzen 2005), arts-based approaches have more broadly been grouped under the ‘emotion-oriented approach’ to dementia care (Palo-Bengtsson and Ekman 2002). One of the most common arts-based interventions is music (Raglio et al. 2008, Svansdottir and Snaedal 2006).The power of music to enliven and engage persons with dementia is captured in an extraordinarily moving documentary, Alive Inside, produced by Michael Rossato-Bennett (2012). The film follows social worker Dan Cohen, who creates personalized iPod playlists for people in elder care facilities with various conditions, especially dementia. The project is devoted to improving quality of life by reconnecting residents of long-term care with the music they love. The director posted a clip from the documentary on YouTube prior to the premiere of the film. The clip features Henry Dryer, who lives in a nursing home and mostly sits slumped over the tray attached to his wheelchair with his arms folded. He does not speak, and rarely moves. When a personal support worker puts headphones on him, attached to an iPod playing his favorite music, Henry begins to shuffle his feet, his folded arms rock back and forth, his eyes open wide, and he is totally animated by the music. When asked what his favorite music was when he was young, he responds ‘Cab Calloway’ and breaks into Calloway-style scat talking, followed by a soulful rendition of what he says is his favorite Calloway song—‘I’ll be Home for Christmas.’ Reports of the sparing of musicality in dementia (Cuddy and Duffin 2005, Pickles and Jones 2006), as in the case of Henry, suggest that even in advanced stages of dementia it is not a rare phenomenon. Displacing the primacy of cognitive consciousness and underscoring the significance of bodily or embodied consciousness has enormous potential for informing our

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understanding of the continued implementation of musical intention in the face of neurological impairment (Kontos, 2014). The significance of the body’s potential for innovation and creative action in dementia is further evidenced by other forms of artistic expression such as physical movement and dance (Coaten 2002, Palo-Bengtsson and Ekman 2002, Guzmán‐García et al. 2012). Dance therapy—therapeutic dance, dance movement therapy, social dance, and dance-based exercise—is premised on dance being a form of communication in which emotions are mediated and transformed into bodily movements and bodily expressions (Nyström and Lauritzen 2005). Storytelling and theatrical approaches (Basting 2009) similarly draw on embodiment as an interactive resource, offering ‘failure-free’ contexts (Fritsch et al. 2009) for improvisational engagement. A relatively new development is elder-clowning, where professional clowns/artists use spontaneity, humor and empathy, as well as expressive tools such as song, musical instruments, dance, role-play, and improvisation, to engage individuals with dementia (Hendriks 2012, Warren and Spitzer 2011, 2013). As dementia varies in manifestation and severity, the goal of interaction can vary, from seeking to break the monotony of the institutional routine and provide stimulation, to heightening the intersubjective engagement of socially isolated or reclusive residents and improving residents’ feelings of well-being (Warren and Spitzer 2011). Yet common to all interactions in elder-clowning is sensitivity to affect, communication in the immediate present, intersubjective relating, and empathy. The field of design for dementia care environments is another area of innovation that draws significantly on the complicity between embodiment and place. Recognizing nursing homes in terms of spatial and social locations (or dislocations) (Reed-Danahay 2001) has challenged researchers to rethink behaviors in dementia as reasonable responses to the environment rather than as pathological traits (Day et al. 2000, Jones and van der Eerden 2008). In contrast to the transience emphasized by most nursing homes, with their neutral colors, the smell of a hospital ward, and resemblance to a place of work rather than home (Reed-Danahay 2001), innovations in the design of dementia care environments seek to facilitate connection, enhance memory, and foster identity (Day et al. 2000). For example, de-centralizing residents’ rooms into living clusters to simulate and reconstruct neighborhood relationships, and creating ‘town-centres’ that provide retail and social space (Wang and Kuo 2006), are largely premised on the complicity between place and the embodiment of a history of engaging in similar such settings (Bourdieu 1990, Mayol 1998). While this work has largely concentrated on indoor care settings, such as day centres and residential homes, it is important to note that there have also been advances in the design of the outdoor environment for persons with dementia, which have drawn on similar insights regarding the interrelationship between the body, place, and identity (Blackman, Van Schaik, and Martyr 2007, Mitchell et al. 2003).

Conclusion The main thrust of the embodiment enterprise in dementia studies is the interrogation of the substantial effects of the politics of the production and reproduction of the body. This has effectively destabilized dementia as a taken-for-granted category, and elaborated how dementia participates in other ensembles of knowledge and practice. The embodiment scholarship has generated critical texts on the interrelationship between the body and social and political processes in the production and expression of dementia, though not at the expense of attention to the body as an animate organism. The meaning of human agency proffered in phenomenological conceptions of the body provides a critical complement to approaches to the body as

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acted on, as historically ‘inscribed’ from without. In this sense, dementia is understood not as an independent neurological process, but rather as an experience through which nature, history, culture, power, and discourse all speak simultaneously. The research terrain is open for further cultivation of a rigorous scholarly analysis of embodiment in the context of dementia. Important substantive and methodological areas for future exploration in the study of embodiment and dementia include: important aspects of diversity and social difference; the emerging rights-based discourse in dementia studies that focuses on notions of citizenship and inclusion (Bartlett and O’Connor 2007) and that could usefully explore links between vulnerability, social rights, and embodiment (Turner 2003, 2004); and exploration of creative ways to research bodies and embodiment as experienced by people with dementia, including sensory, visual, and participatory methods. These areas for further inquiry can generate important new theoretical perspectives and open up new concerns and issues in this emerging subfield of dementia studies.

Acknowledgements Dr Pia Kontos is presently supported by a Canadian Institutes of Health Research (CIHR) New Investigator Award (MSH-87726, 2009–2014), which facilitated the writing of this chapter.

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Experiences of pain and suffering are often seen as part of old age (Kirsch & Smith, 2000; Helme & Gibson, 2001; Gagliese & Melzack, 1997). This raises the question: do elders themselves view pain and suffering as a ‘normative’ part of old age? To explore this question, the chapter first considers the concept of pain, a word that at times has been used interchangeably with suffering; the differences and similarities between the two in the context of old age; and why such differences are crucial to an adequate understanding of the experience of suffering in old age. Finally, research findings on the meanings that older adults give to the suffering experience will provide a context through which to consider whether gerontological research has acquired adequate ways to grasp and interpret elders’ experiences of pain and suffering.

Pain Pain is primarily conceptualized as an experience of the body, though most people will also experience emotional pain (Cassell, 1982). For example, Chapman and Gavrin (1999) describe pain as ‘a threat or damage to one’s biological integrity’ (p. 2233). The International Association for the Study of Pain, as cited by Flor (2001), defines pain as ‘unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage’ (p. 1099). Stated simply, pain is the sensation associated with adverse events (Fordyce, 1988). As Hide, Bourke and Mangion (2012), whose work focused on perspectives on pain in the eighteenth century and their influence on modern views, have argued, ‘pain has been under­ stood to be a universal yet intensely personal experience [. . .] it differs from person to person, social group to social group, and it changes over time and space’ (p. 1). Pain, according to them, is deeply rooted in the historical and cultural context. It is not a sensation devoid of a greater social framework. In gerontology, pain, which is often used in conjunction with the term suffering, has been largely explored from a health stance rather than through the lens of personal meaning. For example, Gagliese and Melzack (1997) looked at chronic pain in older people, and found that although the majority of older people experienced pain intense enough to interfere with normal function, many did not receive appropriate pain management.The focus of the study was on why pain is unsuccessfully treated, however, not on what pain means or how it is experienced. 181

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In a similar vein, Helme and Gibson (2001) conducted a review of studies of pain in older people to estimate its prevalence. Although most studies included in their review rely on self-report of severity and duration of pain, the authors note that the context of painful symptoms and the meanings attributed to them shape the experience of pain. Overall, they found that although reports of pain increase with age, they do so only until around age 80, when reports of pain decline or hold steady for reasons not clearly understood. They speculate that stoicism, unwillingness to label something as painful, or assumptions that pain is a normative part of ageing may partially explain the decline. As with Gagliese and Melzack’s (1997) findings, these authors found that pain was assumed to be a part of ageing, and that pain exists outside of a cultural or social context. It should be noted that there are numerous other studies that examine pain and ageing, the overwhelming majority of which focus on pain in relation to a particular disease or disorder (e.g., pain and prostate cancer, pain and hip fracture). Few studies have looked at pain as a concept and even fewer at how older people themselves view the experience or meaning of pain and whether they consider it to be a normal part of ageing.

Suffering Suffering has been defined in medical, psychological, and religious idioms as ‘the state of severe distress associated with events that threaten the intactness of the person’ (Cassell, 1982: 240); ‘a threat to our composure, our integrity, and the fulfillment of our intentions’ (Reich, 1987); and ‘being aware of the many ways humans can be or are broken’ (Black, 2006a). These definitions share the perception of the all-encompassing nature of suffering as a threat to an integrated existence or to the ‘wholeness’ of a human being. The threat that suffering portends is made to the entire self. For this reason Cassell (1982) described suffering as a consequence of personhood. He commented that ‘bodies do not suffer; persons do.’ Frank (1992) suggested that when talking about suffering it is important to allow for its ‘bigness’—it may result from a life-changing illness, a psychological break, or a crisis of the soul. In addition to the ‘bigness’ of suffering, Black (2006a) argued that there was a ‘littleness’ of suffering in old age that must also be considered. This littleness of suffering includes daily frustrations, humiliations, no second chances to right a mistake, and loneliness. Because a human being cannot be separated into parts, it is the entire person—the body, mind, and spirit—that is assaulted in the major events of life or the moment-by-moment experiences of everyday life that can be defined as suffering (Black, 2006a). When considering what comprises ‘suffering,’ it is important to consider two different ways in which the term is used. One is in an everyday sense of having a condition, as in, ‘I suffer from arthritis.’ The second is as a state of being, such as, ‘I suffer because I have lost hope.’ Distinguishing the two uses of suffering—first, as a verb describing discomfort associated with the presence of a chronic illness and, second, as an existential state of being that seems impossible to resolve—is helpful when considering the place of suffering in ageing (Strang et al., 2004). For example, since many older people have multiple comorbid conditions, it could be said that in the first use of the word, many older people suffer from multiple health situations. However, saying that many older people suffer in the second use, to denote that they are experiencing a deep threat to self because of something, suggests a very different level of experience. An example might be useful. An older woman, when asked to define suffering during an interview on the meaning of suffering in older age, said, ‘A broken arm.’ When asked, ‘Do you mean the pain of a broken arm?,’ the woman replied, ‘Not the pain so much but the fear.’ She

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then explained: ‘I went to my granddaughter’s wedding. I wore a long dress, high heels. I felt beautiful. At the reception I walked across the dance floor and slipped and fell [crying].That was three years ago. I could not handle it. I could not get over it. I still can’t’ (Black, 2006b). This example reveals the second meaning of suffering—as an existential negative state of being that implicates the entire person (Becker, 1999; Cassell, 1982, 1991; Charmaz, 1999; Strang et al., 2004). It includes a sense of self, whereby the self is both actor and acted upon, watcher and watched, and subject and object of life experiences (Black & Rubinstein, 2004). It also includes a real and embodied fear of what would happen if she fell. The sense this woman had of her ‘self ’ as a beautiful woman was ruptured by a fall visible to all the guests at the wedding. To say ‘I suffer because of my fear of falling’ is substantially different from saying ‘I suffered from a fall.’ Her broken arm symbolizes suffering not because of the physical pain but because it represents a break with her former sense of self. It is her awareness that this former sense of self can become at any moment disrupted, incomplete, and broken (Kahn & Steeves, 1986) that causes suffering. Unlike pain, which features in the clinical care literature, suffering has more often been explored in religious and philosophical studies. Few research studies focus directly on suffering in the general population (Rodgers & Cowles, 1997). In the ageing literature, suffering has been limited to: how old people themselves define suffering (Black & Rubinstein, 2004; Black, 2006a); causes of suffering in older age (Black & Rubinstein, 2004); and generativity (investing oneself in future generations) and suffering (de Medeiros, 2009). In an ethnographic pilot study, Black and Rubinstein (2004) asked 40 older men and women about their definitions, descriptions, and theories about suffering. There were as many different notions of suffering as respondents in this study. Overall, suffering was a construct under which the respondents placed a variety of extreme and negative experiences (Black & Rubinstein, 2004; Black, 2006a). In disclosing incidents, events, or time periods of suffering, elders revealed suffering’s contextual nature; personal biography and cohort history informed their experiences and definitions of suffering. In this study, Black (2006a) and Black and Rubinstein (2004) identified three overarching themes of suffering: lack of control over self, suffering as loss, and suffering as having value. The first, suffering as lack of control over self, described older adults’ feeling of betrayal by their body or life circumstances. For example, a 79-year-old man, when asked what he could not control in his life, replied, ‘The big things: ageing, illness, life, death.’ For this man, perhaps ageing and illness portend death, which is the ultimate lack of control of the self. This speaks clearly to the experience of suffering (Black & Santanello, 2012). The second theme, suffering as loss, speaks to old age as a time of mourning. Older adults frequently experience the loss of significant others or those who shared a cohort history, the loss of health, and the rupture of a relationship with themselves through dementia. Suffering as loss may also refer to a depletion from within. Closely linked with the first theme, the lack of control, suffering as loss speaks to older adults’ fears or experiences of changing skills or strengths related to their ability to make choices about the major and minor events and incidents in their lives. Choice is important here. In fact, many elders named ‘having a choice’ as significant in whether an experience was named suffering. De Medeiros (2009), in her case study of suffering and generativity, describes an 85-year-old man who was staving off a form of loss—loss of self—through creative expression (e.g. poetry, woodworking). To address this loss, he would bring a small wooden dog he had carved, along with poetry he was writing, to various social settings, including the interview. Both the poems and the wooden dog therefore functioned as a conduit for connecting to others and reliving key moments from his life associated with each creation. In this way, he created a sense of permanence that combatted the sense of fading away

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that he associated with suffering. Fading away, for him, described how something (e.g. a piece of steel that rusted) or someone continued to become less over time, eventually disappearing. For him, the thought of fading away caused an extreme threat to self that he addressed by creating more permanent extensions of himself (e.g. poems, art). The third theme, the value of suffering, speaks to elders’ beliefs in benefits that emerge in the wake of suffering, especially suffering as interpreted through cultural or religious belief systems. These are explored more fully in the next section. Here the value of suffering is related to its meaning. Black (2006a) found that, for some elders, searching for and finding meaning in suffering was a significant activity. A crucial aspect of finding meaning was interpreting the suffering according to one’s worldview, belief system, and place in time. Because suffering is not a discrete experience with one cause, a linear course and a consistent expression, memories of past suffering may influence the present, present suffering may color the past, and an anticipated suffering may shadow both present and past. Likewise, suffering is laden with cultural connotations; it is constructed, represented, and paraphrased by symbols that are shared within a culture (Martin, 1987).

The language of suffering Perhaps one of the reasons for the dearth of articles on suffering in particular in old age involves challenges in the language of suffering. Sociologist Iain Wilkinson (2001) cites Max Weber (1946) when pointing out the difficulty of articulating suffering by writing, ‘In almost every instance where writers venture to comment upon “the brute fact that suffering exists,” they struggle to find a language which is adequate to express and think through what happens when we are beset by this experience’ (p. 423). We are unsure not only of how we should define suffering, but also how we should talk about it. If we look and listen carefully, we may note that suffering itself is a unique form of communication (Black, 2006a) that uses several languages. Certainly suffering is spoken through the body. As the first means of self-revelation, the body is the medium through which one experiences oneself and the world (Murphy, 1987). When the boundaries of the body break down through suffering, the body becomes stigmatized through lack of mobility, distorted configuration, obvious pain, or conspicuous silence. In other words, facial expressions and bodies communicate suffering, and individuals make sounds, such as cries or groans, that are part of the experience. Changes that occur in elders’ identities and roles also speak of suffering. Aged sufferers may assume a new or restructured role, such as a ‘sick person,’ ‘housebound elder,’ or ‘patient,’ which is framed by their current circumstances of illness, pain, or loss. Altered roles may be a form of suffering itself. Likewise, to recreate an identity based on illness or loss requires the difficult work of acknowledging the altered facts of one’s life and measuring losses against what remains. Or, older persons may rework roles and identities in order to maintain a self concept that accommodates who they were, are, and want to remain with the new facts of old age and suffering. Most writers on suffering agree that another language of suffering is narrative. Just as the body reveals pain, suffering can be revealed by new identities more in keeping with a diminished lifestyle. Telling a story also communicates suffering. A narrative embeds the story of suffering within the elder’s life story; within the aspects of his or her identity, such as age, class, ethnicity, and gender; and in the multi-layered vantage of older age. Stories of suffering may re-integrate a self fragmented by suffering (Scarry, 1985). Narrative ‘repair’ may be accomplished by explaining a cause, effect, and probable outcome of personal suffering. Yet, we cannot discuss the languages of suffering without mentioning silence. In her book Suffering, Dorothee Söelle (1975) reports that language is integral to the ‘progress’ of suffering,

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and that a primary feature is muteness. For some experiences of suffering, whether they occurred in the distant past or currently persist, there may be no words, or no desire for words, to describe them.

Suffering, culture, and belief systems Culture as native starting point to understanding how pain and suffering are experienced and made known is defined as the shared blueprint of both the local and larger worlds into which people are born and take part in shaping. Thus, as a lived experience, suffering is informed by a personal culture’s (smaller, local, familial) and shared culture’s (larger, public, societal) systems of meaning, such as the way a family or a society makes sense of a negative incident or event. An experience of suffering also takes personal biography and cohort history into account. An experience that in one culture (either smaller or larger) might be defined as suffering, might not be in others. For example, a 78-year-old woman who lived alone described ‘not hearing another human voice throughout the day except on TV’ as suffering. An older man who lived in a community shelter described suffering as the ‘constant talk—chatter, arguments, laughing’ he could not escape. Suffering, like culture, speaks itself through a particular actor with a particular story (Reissman, 1997). For the woman and man described above, suffering was described in relation to personal experience and interpretation. What can be considered suffering in one person’s story is not necessarily suffering in another’s. Suffering also speaks through social institutions and religious belief systems, both of which are related closely to culture.Veena Das (1997) argues that social institutions themselves produce suffering, while also producing the ways through which suffering may be understood. Initiation rituals, for example, provide a context whereby enduring pain has a transformative meaning, something that although unspoken is understood by other members of a given culture. Belief systems are important in the sense of finding meaning as a source of comfort for suffering or fending it off. Individuals, families and cultures may look to their belief systems to make sense of suffering in general, and specifically of a loved one’s suffering or one’s own. A belief system may offer answers to questions such as the ageless ‘Why?’ A crucial aspect is its ability to support a continuous worldview that may be threatened with rupture through suffering. A belief system operates within several dimensions. Each might offer meaning for those world or life events that are mysterious, frightening, or pain-producing, such as suffering, but also some sense of control over such events. Religious institutions represent places where ideas of suffering and its meaning and value are communicated and modeled. For example, Kimble (2000) describes the Christian tradition as accepting the reality of suffering as something that everyone will encounter at some point in their lives, that suffering and dying are filled with meaning, and that suffering is redemptive in that it can lead to positive, inward contemplation. The stories of Job and Jesus, for example, provide examples of tolerance, acceptance, and virtue in suffering. In the Buddhist tradition, Tarling (2012) describes suffering as ‘a fundamental constituent of being, a punishment for sins committed in a previous incarnation’ (p. 114). The fact of suffering’s existence forms the first of the four noble truths, that life is full of suffering, people suffer because of wants, suffering is not inevitable, and one can follow a path that will lead to an end of suffering. In addition, models and religious teachings provide a way for people to not only understand their suffering (e.g. it is a necessary part of life) but to also understand how to bear their suffering. In a study on views of suffering and redemption in patients coping with cancer, Käppeli

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(2000) interviewed 29 Jewish and 71 Christian cancer patients ranging in age from 20 to 96, to understand the role that religion played in mediating their suffering. The author reported that most of the participants related their illnesses to ‘something transcending its worldly nature and context’ (p. 85). In short, their religious views enabled them to frame their experience as something meaningful. Davies (2011), however, suggests that our consciousness of suffering has shifted away from a religious view to a medical one, and that there is a tendency to pathologize suffering. Suffering, then, becomes not only ineffable, but defective or deviant. In his essay about suffering from a historian’s standpoint, Kimble (2000) argued that, in contrast to the past, ‘a rather odd and oppressive judgment has also fallen upon the person who is suffering. His or her suffering is viewed as avoidable, the result of a defective personality structure, a lack of enlightenment, or even irresponsibility’ (p. 149). In looking at how suffering had been viewed across several historical time periods, Kimble asserts that suffering, which was once a virtue, has now become a source of weakness. The growing emphasis on personal responsibility, according to Kimble, has resulted in transforming the sufferer into someone who is somehow implicated in his or her own suffering rather than a victim.

Conclusion In this chapter we have highlighted some key aspects of pain and suffering that are linked to identity and ageing (Black & Rubinstein, 2004). In doing so, we noted the role of institutions and culture in shaping how pain and suffering are experienced, and how suffering in particular is communicated, and understood. Although in gerontology pain is often addressed from a medical aspect, it is not often dealt with conceptually, and its links with, and differences from, suffering are rarely addressed. The fact that suffering is so rarely mentioned in gerontology except in the context of pain raises some curious questions.What risks does the acknowledgment of suffering pose, and for whom? Why is the language of suffering so elusive? What would happen if we initiated open dialogue about suffering, much in the same way that there are growing dialogues about death and dying? We suggest that suffering exists as the silent enemy of ageing, that, like many other aspects of older age, suffering has become a problem that needs fixing through better health, diet, and exercise. Although several studies have explored the experiential problems of old age, such as decline, fear, illness, loneliness, and grief, the infusion of the experience of suffering into daily chores or thoughts has rarely been addressed as a central focus of study. Research has neglected the intimacy and banality of elders’ suffering, and the way in which suffering corrodes or strengthens worldviews, values, and spiritual beliefs. If a theory of suffering is notably absent from research on suffering, perhaps it is because a general theory of suffering cannot hold the depth and breadth of personal suffering. What is needed is greater attention to the constructions and paradoxes of suffering in old age and the role of belief systems and institutions, including gerontology, to shape how suffering is experienced and made known. Also needed is an understanding of how suffering is conceptualized and experienced in a variety of settings, such as long-term care. Does context provide a different way through which to interpret experience and meaning and ultimately to either challenge or support self and identity? Gaining further insight into how suffering can be meaningful or meaningless is also worthwhile. For example, silent, stoic suffering can be a virtue, while voiced suffering can be a detriment. By embracing suffering as a concept important to the human condition and one worthy of study, we may help others lay claim and give voice to their suffering. 186

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Acknowledgments This work was supported by a grant from the National Institute of Aging, 5R01AG021112–3, Robert L. Rubinstein, P.I.

References Becker, G. (1999). Disrupted Lives: How People Create Meaning in a Chaotic World, Berkley: University of California Press. Black, H.K. (2006a). Soul Pain:The Meaning of Suffering in Later Life, Amityville, NY: Baywood. Black, H.K. (2006b) ‘The sacred self: Suffering narratives in old age,’ Omega: Journal of Death and Dying, vol. 53, no. 1–2, pp. 69–85. Black, H.K. and Rubinstein, R.L. (2004), ‘Themes of suffering in later life,’ Journal of Gerontology: Social Sciences, vol. 59B, pp. S17–24. Black, H.K. and Rubinstein, R.L. (2009), ‘The effect of suffering on generativity: Accounts of elderly African American men,’ Journal of Gerontology: Social Sciences, vol. 64(B), pp. 296–303. Black, H.K. and Santanello, H.R. (2012), ‘The salience of family worldview in mourning an elderly husband and father,’ The Gerontologist, vol. 52(4), pp. 472–83. Cassell, E.J. (1982), ‘The nature of suffering and the goals of medicine,’ New England Journal of Medicine, vol. 306, pp. 639–45. Cassell, E.J. (1991), ‘Recognizing suffering,’ Hastings Center Report, vol. 21, pp. 24–31. Chapman, C.R. and Gavrin, J. (1999). ‘Suffering: the contributions of persistent pain,’ The Lancet, vol. 353, pp. 2233–7. Charmaz, K. (1999), ‘Stories of suffering: subjective tales and research narratives,’ Qualitative Health Research, vol. 9, 362–82. Das,V. (1997), ‘Sufferings, theodicies, disciplinary practices, appropriations,’ International Social Science Journal, vol. 49, pp., 563–72. Davies, J. (2011), ‘Positive and negative models of suffering: an anthropology of our shifting cultural consciousness of emotional discontent,’ Anthropology of Consciousness, vol. 22, pp. 188–208. de Medeiros, K. (2009), ‘Suffering and generativity: repairing threats to self in old age,’ Journal of Ageing Studies, vol. 23, pp. 97–102. Flor, H. (2001), ‘Health psychology of pain,’ in N.J. Smelser and P.B. Baltes (eds), International Encyclopedia of the Social & Behavioral Sciences, Oxford: Pergamon, pp. 10990–5. Fordyce, W.E. (1988), ‘Pain and suffering: a reappraisal,’ American Psychologist, vol. 43, pp. 276–83. Frank, A.W. (1992), ‘The pedagogy of suffering: moral dimensions of psychological therapy and research with the ill,’ Theory & Psychology, vol. 2, pp. 467–85. Frankl,V. (1959), Man’s Search for Meaning, New York: Washington Square Press. Gagliese, L. and Melzack, R. (1997), ‘Chronic pain in elderly people,’ Pain, vol. 70, pp. 3–14. Helme, R.D. and Gibson, S.J. (2001), ‘The epidemiology of pain in elderly people,’ Clinics in Geriatric Medicine, vol. 17, pp. 417–31. Hide, L., Bourke, J. and Mangion, C. (2012), ‘Introduction: perspectives on pain,’ Interdisciplinary Studies in the Long Nineteenth Century, no. 19. Available online at http://19.bbk.ac.uk. Kahn, D.L. and Steeves, R.H. (1986), ‘The experience of suffering: conceptual clarification and theoretical definition,’ Journal of Advanced Nursing, vol. 11, pp. 623–31. Käppeli, S. (2000), ‘Between suffering and redemption,’ Scandinavian Journal of Caring Sciences, vol. 14, pp. 82–8. Kimble, M.A. (2000), ‘Ageing in the Christian tradition,’ in T.R. Cole, R. Kastenbaum and R. Ray (eds), Handbook of the Humanities and Ageing (second edn), New York: Springer Publishing, pp. 142–54. Kirsch, D.L. and Smith, R.B. (2000), ‘The use of cranial electrotherapy stimulation in the management of chronic pain: a review,’ NeuroRehabilitation, vol. 14, 85–94. Murphy, R.F. (1987), The Body Silent, New York: W.W. Norton. Reich, W.T. (1987), ‘Models of pain and suffering: foundation for an ethic of compassion,’ Acta Neurochirurgica, Suppl. vol. 38, pp. 117–22. Reissman, C. (1997), Narrative analysis, Newbury Park, CA: Sage. Rodgers B.L. and Cowles, K.V. (1997), ‘A conceptual foundation for human suffering in nursing care and research,’ Journal of Advanced Nursing, vol. 25, pp. 1048–53. 187

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Scarry, E. (1985), The Body in Pain: The Making and Unmaking of the World, Oxford: Oxford University Press. Söelle, D. (1975), Suffering, Philadelphia: Fortress Press. Strang, P., Strang, S., Hultborn, R. and Arnér, S. (2004), ‘Existential pain—an entity, a provocation or a challenge?’ Journal of Pain and Symptom Management, vol. 27, pp. 241–50. Tarling, N. (2012), ‘The meaning and the experience of suffering: a historian’s perspective,’ in Perspectives on Human Suffering, Amsterdam: Springer, pp. 113–19. Weber, F.M. (1946), Essays in Sociology, translated, edited and with an introduction by H.H. Gerth and C. Wright Mills, London: Oxford University Press. Wilkinson, I. (2001), ‘Thinking with suffering,’ Cultural Values, vol. 5, p. 421.

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Section III

Identities and social relationships

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24 Identities and social relationships Introduction Julia Twigg and Wendy Martin

Identity has been one of the central themes of the cultural turn, whether through a focus on categories such as gender, ‘race’, ethnicity, class, sexuality, or through an exploration of the complex and fluid ways in which identity is experienced in post-, late- or high-modernity. In her chapter Barbara Marshall explores the shifting bases for identity formation in later life. Drawing on social theory, she outlines how traditional anchors of identity have eroded, to be replaced by ones that are more individualistic, embodied and consumption-based, and in which reflexivity and self-fashioning are central. In understanding questions of identity scholars increasingly deploy the concept of intersectionality. Toni Calasanti and Neal King note how jeopardy is not simply additive, but alters in complex ways that reflect the intersections between social and cultural categories. Central to their analysis is a concept of power. Categories such as gender, race or class do not simply describe differences but refer to power relations between subordinated and dominant groups; among these are groups constituted by age. Jeff Hearn and Sharon Wray address the contested territory of gender, reviewing the different ways in which gender and gendered relations have been theorized, outlining the implications of this for age studies. They reflect, in particular, on the way new theorizing within poststructuralist, discursive and deconstructive approaches has troubled what were traditionally perceived as fixed identities in relation to gender and age. Traditionally, sex and sexuality were not central topics in social gerontology. However under the impact of poststructuralist theorizing, especially that derived from Foucault, and reflecting cultural changes in the discursive constitution of older people in popular culture, the subject has increasingly come to be studied. Noting the long history of negative depictions of sexuality in old age, Linn Sandberg explores the significance of the emergence of a new cultural trope of ‘sexy seniors’, with its links to ideas of successful ageing in which remaining sexually active is part of a wider set of disciplinary practices aimed at creating healthy, responsible, successful (and gendered) subjects. Sandberg’s account focuses on heterosexuality, but in the following chapter Yiu-tung Suen reviews current understandings of lesbian, gay, bisexual and transgender ageing, highlighting the distinctive experiences of the current cohort of LGBT older people. In doing so he reflects on how work in this area does not just address identity and relationships but raises questions of how we understand the nature of ‘care’ in relation to these groups. Though gender and, to a lesser degree, sexuality are now recognized as central themes in cultural gerontology, Sandra Torres argues that ethnicity has not received the theoretical or empirical attention in 191

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age studies that it deserves. In reviewing the emergence of ethno-gerontology, she highlights in particular the impact of globalization on international migration and the challenges this presents to our established understandings. Turning to specific social relationships, Sara Arber, Virpi Timonen and Anne MartinMatthews address two of the most distinctive social positionings of later years, those of widowhood and grandparenthood. Arber and Timonen emphasize how the doing of grandparenthood is in the process of changing dynamically as it is negotiated through different social and cultural locations. Grandparenthood is part of ‘doing family’. It often intersects with assumptions around intergenerational care and its role in supporting the labour market participation of younger women. But in doing so older people may find that these demands interact with new cultural expectations that older people will be active agers, either in the labour market themselves or pursuing the new individualistic and consumption oriented opportunities—and freedoms—of the Third Age. For Martin-Matthews widowhood needs to be understood as both a status and a process, though one that is refracted through culture; and she draws on this wider cultural context to explore how widows are represented in film, literature, visual imagery, personal narrative and social media. She notes how in many societies widows are required to don specific forms of dress, pointing up the wider significance of material culture in shaping the lives of older people. Widowhood is often associated with loneliness, an experience that is in turn thought to characterize old age. But Christina Victor and May Pat Sullivan in their chapter question this assumption, pulling apart the different strands of the condition and subjecting them to critical analysis. Michael Fine in his chapter on cultures of care shows how this classic territory for social gerontology is also amendable to cultural analysis. Liz Lloyd addresses the Fourth Age and the challenges to identity formation presented by this stage of life.The Fourth Age is marked by failing health in which individuals can come to see themselves, and be seen, in the new category of someone who is ‘frail’ or a ‘service user’. Lloyd draws on Archer’s work on reflexivity to explore the tensions presented by this last stage of life. Matthew Carroll and Helen Bartlett review the impact of the imperative of active ageing, with its embedded moral injunctions, across various western and non-western cultures. In doing so they re-iterate the diversity of the experiences and meanings of ageing.

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25 Intersectionality and age Toni Calasanti and Neal King

Social gerontologists often misunderstand intersectionality, equating it with attention to diversity or difference. However, an intersectional approach moves us beyond observation of difference to specify relations of inequality between groups. Though it implies diverse experiences of ageing, intersectionality does not designate independent groups to be studied separately, but instead relates groups, in terms of institutionalized activities that maintain inequality. Legal scholar Kimberle Crenshaw coined the term ‘intersectionality’ to suggest how ‘the intersection of racism and sexism factors into Black women’s lives in ways that cannot be captured wholly by looking at the race or gender dimensions of those experiences separately’ (1991: 1224). Since the publication of her work, the list of inequalities has lengthened to include such statuses as sexuality and age (King 2006); and scholars continue to debate which of those intersect, in the sense that Crenshaw meant, and how to measure the complex effects (Choo and Ferree 2010, McCall 2005). For instance, old age is a time of many hardships for women; but being old does not mean that all aspects of womanhood grow worse with advancing age. Neither does it mean that a theorist should add disadvantages in order to conceive of any group’s experience, as a theory of double jeopardy might predict. Indeed, old women find themselves cast aside from sexual markets, less often subject to the compulsory heterosexuality that saddles and exploits younger women. The jeopardy does not double with age but alters in more complex ways. Despite its increased visibility and use within the social sciences over the last 20 years, this approach remains rare in age studies. Our goal here is to provide an overview of intersectionality, and briefly show its use.

Systems of inequality Social gerontologists readily discuss differences based on such status characteristics as age, gender, race, and sexuality. But correlating a binary variable such as gender with the behaviors or situations of later life does not necessarily equate with the study of inequality. Men have lower life expectancies than women, for instance, and one may note their higher rates of cigarette smoking or alcohol use in a study of gender and health, but intersectionality must tie these behaviors to

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power-based relations among groups: not just women and men, but also groups distinguished by such other inequities as race, class, age, and sexuality. Social inequalities comprise relations in which some groups lose authority, status, and wealth, and are stigmatized by others, and in which those disparities in life chances are justified as natural, divinely ordained, and/or rational and thus beyond dispute. Such privileges and subordination exist in relation to one another (Glenn 1999), which means that the privileges of any one group are tied to the disadvantages of at least one other (Choo and Ferree 2010, McCall 2005). The study of intersections of such inequities begins with the insight that reports of aggregate life chances of such large groups as women and men hide substantial differences in income and other aspects among them (Crenshaw 1991, McCall 2005). Hurtado (1989) theorizes that these disparities emerge from the bonds between various groups of women and the most privileged members of any Western society: elite, white men.That is, life chances are shaped by the fact that such ‘white men use different forms of enforcing oppression of white women and of women of Color’ (Hurtado 1989: 843). Noting the longstanding segregation of family ties by race, a divide once codified in law, Hurtado argues that it ‘creates differences in the relational position of the groups—distance from and access to the source of privilege, white men. Thus, white women, as a group, are subordinated through seduction, women of colour, as a group, through rejection’ (844). Hurtado’s theory makes interrelations concrete, by specifying the ways in which all other groups relate to the most privileged among them. Quoting Nancy Henley, Hurtado (1989: 850) argues that many oppressed groups in American society ‘are often physically separated, by geography, ghettos, and labor hierarchies, from power centers.’ People of Color, as a group, do not have constant familial interactions with white men. Indeed, just as systems of labor and property ownership segregate groups by class, so do educational institutions and nationalized retirement schemes that construct old people as unproductive and dependent (Estes, Biggs and Phillipson 2003: 29). Furthermore, relations of sexuality have marked off those who do not bond sexually with members of the opposite sex as outcasts from legally recognized families and as objects of public scorn and even violence. In this system of intersecting inequalities, groups that might otherwise remain segregated link up with elite men, in kinship or commerce, as providers of services, as family or as menial labor paid as little as possible (Glenn 1992, Jones 1985). Those most likely to enjoy the most privilege either do business as peers of, or belong to families of, such elite men. Longstanding sensitivities to age, sexuality, and race, as well as gender and class, in courtship and marriage means that most people of color, most old people, and most poor people face rejection and segregation from elite men as partners or wives. Many high-status men go out of their way to take younger women as romantic partners, which means that most old women are cast aside from erotic markets just as many women of color find themselves rejected. Those whom elite men do not desire, at least at the moment, to provide such service may be cast aside as useless or driven away as threats (for example see Calavita 1996). Old men who have enjoyed elite status find themselves ushered from those ranks by ageist dismissal of their productivity. In the global North, old people mostly leave the labor force on which their professional status depends, either retiring by choice to become consumers or pushed out as unproductive (Graebner 1980, Phillipson 1982). The work they do next goes unpaid, within familial and community networks; and others may define their status as beneficiaries of pension plans and insurance programs as burdensome (Gee 2000). 194

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The embeddedness and naturalization of these relations means that they tend to be invisible, especially to those who are privileged by them. For example, how families divide and compensate domestic labor affects men and women throughout their lives, as workplace experiences of respect and level of remuneration, and later as retirement income. National pension schemes in the global North tend to be based on (white, middle class, heterosexual) men’s occupations and patterns of work, assuming careers in the public realm and unpaid support at home (usually from women). Because most groups naturalize men’s positions within families, they see their retirement privileges as only fair. As a system of inequality, age involves more than physical changes or the cumulative impact of other inequities over the life course; it is a source of disparity in its own right, in that those deemed ‘not old’ benefit from the ageism and maintain control of valued resources. Equations of old age with decline and frailty justify limiting the autonomy and authority of old people, who find themselves marginalized in the labor market and then find it more difficult to be heard and influence decisions made about their bodies (Calasanti 2003, Calasanti, Slevin and King 2006). When they become dependent on the state, they are seen as less than full citizens (Wilson 2000: 161). The stigma and exclusion attendant on old age is such that people seek to avoid it at all costs, even distancing themselves from those who are seen to be old (Hurd Clarke 1999). To this point, we have discussed systems of inequality in general and pointed to some specific hierarchies of relevance to contemporary societies of the global North. Below, we discuss how these inequalities relate to one another in responses to the ageing of our bodies.

Intersectionality and ageing bodies Recent social science has viewed bodies as being both constructed and physically real (Laz 2003). For instance, the physiological shifts that we link to puberty and middle age may be equally powerful, but groups interpret them differently. An intersectional approach to ageing theorizes the effect of relations of inequality on ways that people experience such bodily changes. Bodies are cultural objects to the extent that people use them as markers to distinguish between groups among them (for example, women from men, adults from children); and they are effective hegemonically to the extent that groups naturalize those constructions as beyond their control. Such use of bodies as culture allows people not only to differentiate but also to include or exclude groups and thereby justify and maintain inequalities. People mark group memberships, such as those related to age, in terms of anything from how people shape and adorn their bodies to how they move and feed them. Several constructions of bodies and persons as causal forces in their own rights help to turn daily activities into ageist outcomes and thus contribute to intersecting inequalities. First, neo-liberal policies attach primary causal force and civil rights to ‘individual’ persons (George and Whitehouse 2011), and assign personal responsibility for risks that they might otherwise handle collectively (Phillipson 2009). This has resulted in greater emphasis on individual control of bodies, sending any given person to the ‘marketplace . . . [to] make himself [sic] whole’ (George and Whitehouse 2011: 592). Second, many groups naturalize a youthful health as a quality to read off bodies and then equate that visible ‘health’ with moral goodness, thus assigning people responsibility for adopting and sustaining whatever they naturalize as healthy lifestyles in the uses of their bodies (Smirnova 2012, Hurd Clarke 2011: 51). Failure to appear healthy permits others to stigmatize a person as unfit. By associating visible ageing with bodily decline, groups treat physical appearances of youth as markers of health and thus personal goodness.Third, a ‘faith in the ability of science and technology to deliver innovations that contribute to human well-being’ (George and Whitehouse 2011: 592) contributes to treating the normal 195

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processes of ageing as pathologies that can be treated medically by interventions on bodies. In these constructions, any outward sign of age indicates a disease of the body that personal discipline and medical science can and should cure. To the extent that bodies look different, they are subject to classification by age and judgment about the attractiveness, productivity, and good health of the individuals and indeed the groups to which they belong. Taken together, these activities coalesce into belief in personal control over the beauty, productivity, and health of bodies through such means as technologies, diet and exercise, and consumer lifestyles (Estes, Biggs and Phillipson 2003). If people control their health, and others can infer that health from how their bodies look, then those who appear unhealthy and old can be seen to deserve their exclusion. Old people may be blamed for not having taken advantage of new technologies and scientific knowledge to alter their lifestyles and hamper the ageing of their bodies. As Jones and Pugh (2005) assert, physical signs of ageing bodies, such as wrinkling or sagging skin, are ‘symbols of a lack of control, which is unacceptable . . . . Not to resist signs of physical decay may be perceived as evidence of moral decline’ (254–5). All of this comes under the rubric of intersectionality because the ways in which people mark or perceive bodies as ‘old’ vary with gender, race, class, and sexuality. For instance, women, accorded status in part for their sexual attractiveness to men, appear to be old at younger ages than do men. Such women’s senses of selves as women rest on attractiveness, which helps to drive the use of a range of cosmetic procedures (for example, Hurd Clarke 2011, Smirnova 2012). Because elite men focus their sexual attention almost exclusively on younger women overtly styled to draw their admiration, thin, soft, short-skirted, and high-heeled bodies have become hallmarks of the ‘feminine’, from which wrinkling or sagging of skin detracts. Indeed, while people use clothing as a form of self-expression, the options for older women’s bodies are more constrained, especially for women of higher classes (Twigg 2012, Dumas, Laberge and Straka 2005), which rules out many of the markers of femininity that men look for in younger women. And Hurd Clarke (2011) has found that present cohorts of old women are more concerned about the presence of wrinkles than the older women she interviewed previously. In the past, cosmetic surgery was the principal means available to women to eliminate wrinkles; but today’s marketing of such technologies as Botox results in greater pressures to eradicate signs of old age. By contrast, men appear, at least in the popular culture that celebrates their accomplishments, to be more concerned with their abilities to compete with other men: remaining in jobs and pursuing sex-segregated athletics deemed to be highly skilled (Calasanti and King 2005, 2007). While men may be concerned to limit body weight in pursuit of youthful appearance (for example, Slevin 2008), many reject dieting as ‘feminine’ behavior (Hurd Clarke and Korotchenko 2011). They focus instead on bodily strength or musculature and attribute any dieting to their concern for ‘health’ (Hurd Clarke and Korotchenko 2011). For example, Lodge and Umberson (2013) find that middle-aged men’s experiences of their bodies are shaped by how their bodies function, and the old men that Slevin (2008) interviewed described their bodies using the classic machine metaphor that emphasizes function. One respondent compared his body to a car that needs to be oiled, greased, fueled, and maintained so it does not fall apart (Slevin 2008: 39). Solimeo (2008) found that old men with Parkinson’s disease were more willing to go out if they felt that they appeared physically capable in public settings. Their status as men thus relies heavily on the appearance of bodies as fit, strong, and able to work or play in male-dominated activities. Although research among younger men suggests that gay men are more concerned about appearance than are their heterosexual peers (Hurd Clarke and Korotchenko 2011), we know less about such variations among their older counterparts. While Slevin’s (2008) study of older gay and heterosexual respondents uncovered few differences in how they felt about their weights 196

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or appearance per se, it may be that the specter of ageism becomes more important as comments from both groups ‘underscored the appeal of looking youthful or at least not looking old’ (40). Regardless of sexuality, most of the men reported engaging in strenuous activities as a way of denying or minimizing the effects of ageing on their bodies. However, research suggests that the appearance of ageing bodies proves more problematic for gay men, many of whom wish to attract high-status men. Lodge and Umberson (2013) found that, among their middle-aged respondents, gay but not heterosexual men reported concerns with their attractiveness. And Heaphy (2007: 206) finds that, among the gay respondents in his United Kingdom study, many ‘shared a belief that their ageing bodies mark them as unwelcome in gay identified places.’Thus, while concern with the consequences of appearance might manifest in different ways, or their reasons might have varied by sexuality, there is little doubt that ageism and resultant loss of privilege figured in. We also glean hints of the intersections of age, sexuality, and gender in the scant research on ageing lesbians. Slevin (2006) finds the lesbians she interviewed to be concerned both about bodies in general and weight in particular, and in ways similar to their heterosexual counterparts. She concludes that, despite expectations that they would not be concerned about attractiveness to men, their status as women in a heteronormative context mattered. However, Winterich (2007) finds that the younger and less economically advantaged lesbians in her study were less influenced by appearance and weight expectations than were their heterosexual counterparts. Indeed, research finds that class shapes older women’s bodily experiences, in often complex ways. Drawing on interviews with francophone women in Quebec, Canada, Dumas, Laberge and Straka (2005) argue that social class serves to differentiate older women’s experiences of their bodily appearances because of their different access to economic and cultural capital. Working-class older women, for example, ‘are not far removed from economic hardship’ and thus while they are aware of certain beauty standards, they would gain few rewards for trying to living up to these instead of focusing on other aspects of well-being, such as being loved, being at peace, and experiencing good health. By contrast, elite older women, with more direct connections to elite men and thus more economic and cultural capital, enjoy both the time and resources to engage in more practices geared at both health and appearance without compromising other aspects of well-being (Dumas, Laberge and Straka 2005). At the same time, class intersected with age relations to influence responses to old women’s bodies. Working-class women were more accepting of their bodies’ ageing and more able to deal with their marginalization. By contrast, elite women reported greater dissatisfaction and difficulties with their bodies and resultant exclusion. Further, more affluent women used bodily appearance as a distinguishing characteristic within their own class, disparaging some members for dressing or acting inappropriately for their age (for example, wearing dresses that are too short) and class (buying mass-produced clothing or not using the ‘best’ facial creams) (Dumas, Laberge and Straka 2005). In addition, while women from both groups gradually ‘dissociated themselves from, and revaluated, the norms of youth, and . . . [adopted] a more inclusive conception of appearance’ (Dumas, Laberge and Straka 2005: 899), in so doing, they affirmed age relations by marginalizing women deemed not to act in age-appropriate manners, who attempted to live up to beauty ideals reserved for youth.Thus, class differences among women are based on more than financial resources available; the belief in technology and the moral dictate to shape one’s body in particular ways varies according to the power relations that result from class privileges and disadvantages. And in the end, old women find themselves marginalized whether or not they attempt to live up to ideals of youthful beauty that draw the admiration of elite men. Race relations intersect as well, in that both African-American older men and women are more accepting of a variety of bodies, including those that are heavier and thus further outside 197

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of the narrow range of ‘beauty’ as assessed in elite circles (Hurd Clarke and Korotchenko 2011). Winterich’s (2007) study suggests that ageing African-American women may be less concerned with youthful appearance standards, a finding that dovetails with Slevin and Wingrove’s (1998) findings concerning professional, African-American women’s feelings about their bodies. Given that research finds that African Americans are more satisfied with their bodies at younger ages, it may well be that youthful body standards—that is, what counts as a young appearance—may themselves be race- and class-based. Just as global and race relations help to drive the marketing and consumption of skin lightening products (for example, Glenn 2008), age relations combine with them to produce the anti-ageing industry, which operates as resistance to group membership (Smirnova 2012, Marshall and Katz 2006, Calasanti and King 2007, Calasanti 2007). Anti-ageing advertisements depict ageing women’s bodies as being ‘at risk’ of loss of beauty without the aid of their products and services (Smirnova 2012); and they present old men as potentially manly but in need of consumer regimens to remain so. Men’s bodies must ‘play hard’ and ‘stay hard’ to avoid stigma (Calasanti and King 2005). (Hetero)sexual function, maintained as a form of individual resistance, appears crucial in the discourses of anti-ageing (Katz and Marshall 2003, Marshall and Katz 2006). Women are to appear attractive, in relation to elite men; men are to perform, in accordance with ideals derived from behaviors (including lavish consumption) of elite men. Anti-ageing advertisements tend to depict either white people or non-whites who look white—with lighter skin tones and professional-class attire. Nowhere is there the suggestion of research that has shown, for example, a greater appreciation for ageing bodies among old, African-American middle class women (Slevin and Wingrove 1998). The costs of many of the products or services also put them beyond the reach of working-class persons.

Conclusion Drawing from and expanding on the preliminary models of Hurtado and Crenshaw, we suggest links between distributions of resources and relations between elite men and the other groups around them. We see this as a matter of culture, the activities that distinguish groups, and as a matter of bodies, which groups use to naturalize the distinctions among them and thus legitimate inequalities. We find patterns in the assessments of bodies that suggest intersections of those relations: focus on function and work in evaluations of men’s bodies, focus on beauty in the assessments of women’s, and variations of such focus by race, sexuality, and class, as they affect people’s bonds with elite men. Old age disqualifies from high status, such that merchants urge men to fight losses of function and promise to preserve women’s youthful appearances. Such discourses link good health, for which they hold consumers personally responsible, to attractiveness and receptiveness for women and to valued work and aggression for men. These patterns hardly tell the whole story of uses of bodies to maintain inequities.We merely suggest questions that intersectional scholarship can raise in cultural gerontology.

References Calasanti, T. M. 2003. Theorizing age relations. In: Biggs, S., Lowenstein, A. and Hendricks, J. eds, The need for theory: Critical approaches to social gerontology for the 21st Century. Amityville, NY: Baywood, 199–218. Calasanti, T. M. 2007. Bodacious Berry, Potency Wood and the aging monster: Gender and age relations in anti-aging ads. Social Forces, 86(1), 335–55. Calasanti, T. M. and King, N. 2005. Firming the floppy penis: Age, class, and gender relations in the lives of old men. Men and Masculinities, 8(1), 3–23. 198

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Calasanti, T. M. and King, N. 2007. ‘Beware of the estrogen assault’: Ideals of old manhood in anti-aging advertisements. Journal of Aging Studies, 21(4), 357–68. Calasanti, T. M., Slevin, K. F. and King, N. 2006. Ageism and feminism: From ‘et cetera’ to center. NWSA Journal, 18(1), 13–30. Calavita, K. 1996. The new politics of immigration: Balanced-budget conservatism and the symbolism of Proposition 187. Social Problems, 284(3), 284–305. Choo, H. Y. and Ferree, M. M. 2010. Practicing intersectionality in sociological research: A critical analysis of inclusions, interactions, and institutions in the study of inequalities. Sociological Theory, 28(2), 129–49. Crenshaw, K. 1991. Mapping the margins: Intersectionality, identity politics, and violence against women of color. Stanford Law Review, 43(6), 1241–99. Dumas, A., Laberge, S. and Straka, S. M. 2005. Older women’s relations to bodily appearance: The embodiment of social and biological conditions of existence. Ageing & Society, 25(6), 883–902. Estes, C. L., Biggs, S. and Phillipson, C. 2003. Social theory, social policy and ageing: A critical introduction. Maidenhead: Open University Press. Gee, E. M. 2000. Population politics:Voodoo demography, population aging, and social policy. In: Gee, E. M. and Gutman, G. M. eds, The overselling of population aging. New York: Oxford University Press, 5–25. George, D. R. and Whitehouse, P. J. 2011. Marketplace of memory:What the brain fitness technology industry says about us and how we can do better. The Gerontologist, 51(5): 590–6. Glenn, E. N. 1992. From servitude to service work: Historical continuities in the racial division of paid reproductive labor. Signs, 18(1), 1–43. Glenn, E. N. 1999.The social construction and institutionalization of gender and race: An integrative framework. In: Ferree, M. M., Lorber, J. and Hess, B. B. eds, Revisioning gender.Thousand Oaks, CA: Sage, 3–43. Glenn, E. N. 2008.Yearning for lightness: Transnational circuits in the marketing and consumption of skin lighteners. Gender & Society, 22(3), 281–302. Graebner,W. 1980. A history of retirement:The meaning and function of an American Institution, 1885–1978. New Haven, CN:Yale University Press. Heaphy, B. 2007. Sexualities, gender and ageing. Current Sociology, 55(2), 193–210. Hurd Clarke, L. 1999. ‘We’re not old!’: Older women’s negotiation of aging and oldness. Journal of Aging Studies, 13(4), 419–39. Hurd Clarke, L. 2011. Facing age:Women growing older in anti-aging culture. Lanham, MD: Rowman & Littlefield. Hurd Clarke, L. and Korotchenko, A. 2011. Aging and the body: A review. Canadian Journal on Aging/La Revue canadienne du vieillissement, 30(3), 495–510. Hurtado, A. 1989. Relating to privilege: Seduction and rejection in the subordination of white women and women of color. Signs, 14(4), 833–55. Jones, J. 1985. Labor of love, labor of sorrow: Black women, work, and the family from slavery to the present. New York: Basic Books. Jones, J. and Pugh, S. 2005. Ageing gay men: Lessons from the sociology of embodiment. Men and Masculinities, 7(3), 248–60. Katz, S. and Marshall, B. L. 2003. New sex for old: Lifestyle, consumerism, and the ethics of aging well. Journal of Aging Studies, 17(1), 3–16. King, N., 2006. The lengthening list: Age relations and the feminist study of inequality. In: Calasanti, T. M. and Slevin, K. F. eds, Age matters: Realigning feminist thinking. New York: Routledge, 47–74. Laz, C. 2003. Age embodied. Journal of Aging Studies, 17(4), 503–19. Lodge, A. C. and Umberson, D. 2013. Age and embodied masculinities: Midlife gay and heterosexual men talk about their bodies. Journal of Aging Studies, 27(3), 225–32. Marshall, B. L. and Katz, S. 2006. From androgyny to androgens: Re-sexing the aging body. In: Calasanti, T. M. and Slevin, K. F. eds, Age matters. New York: Routledge, 75–97. McCall, L. 2005. The complexity of intersectionality. Signs: Journal of Women in Culture and Society, 30(3), 1771–800. Phillipson, C. 1982. Capitalism and the construction of old age. London: Macmillan. Phillipson, C. 2009. Reconstructing theories of aging: The impact of globalization on critical gerontology. In: Bengtson,V. L. ed., Handbook of theories of aging (second edn). New York: Springer, 615–27. Slevin, K. F. 2006. The embodied experiences of old lesbians. In: Calasanti, T. M. and Slevin, K. F. eds, Age matters: Realigning feminist thinking. New York: Routledge, 247–68. Slevin, K. F. 2008. Disciplining bodies: The aging experiences of older heterosexual and gay men. Generations, 32(1), 36–42. 199

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Slevin, K. F. and Wingrove, C. R., 1998. From stumbling blocks to stepping stones: the life experiences of fifty professional African American women. New York: New York University Press. Smirnova, M. H. 2012. A will to youth: the woman’s anti-aging elixir. Soc Sci Med, 75(7), 1236–43. Solimeo, S. 2008. Sex and gender in older adults’ experience of Parkinson’s Disease. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 63(1), S42–8. Twigg, J. 2012. Adjusting the cut: Fashion, the body and age on the UK High Street. Ageing & Society, 32(06), 1030–54. Wilson, G., 2000. Understanding old age: Critical and global perspectives. Thousand Oaks, Calif.: Sage. Winterich, J. A. 2007. Aging, femininity, and the body:What appearance changes mean to women with age. Gender Issues, 24(3), 51–69.

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26 Gender: implications of a contested area Jeff Hearn and Sharon Wray

Gender is a contested area.There is no single or simple definition.When ‘gender’ is considered in cultural gerontology, it is common to focus on ‘women,’ ‘men and women’ or ‘relations between them.’ Much research uses this two-gender model to examine gender differences. However, gender is just as relevant in relations between women, and between men, with hierarchies within genders, relations of gender, sex and sexuality, and intersections of genders and other social divisions. To state the obvious, older men are just as gendered as older women. As gender relations have become more recognized within cultural gerontology and its engagements with feminist theory, the very notion of gender itself has become more problematized. In reviewing what has now become a rather large field within cultural gerontology, we outline five broad formulations of theorizing around gender: gender based on sex; masculinity/femininity and sex roles; gender categoricalism, gender structures, and structurally contextualized practices; poststructuralist, discursive and deconstructive approaches; and the material-discursive. Though contrasting, these positions overlap and intersect, as do their implications for cultural gerontology.

Gender based on sex Sex and sex differences are often naturalized as fixed in biology. The sexed body can be understood as determinate: the biological formulation of what is female or male. Biological approaches to the female/male body have been founded on instinct, territoriality, physical size, chromosomal difference and hormonal difference. Primary sex characteristics generally refer to chromosomal structure; secondary sex characteristics include: gonadal structure; genital development; hormonal structure; presence/absence of breasts and certain body hair. Yet, up to 6–7 weeks’ gestation, female and male embryos have externally identical genitalia; after that, at every stage the basic pattern for the human is female, away from which development may proceed to produce the male. There are major chromosomal variations beyond the most common XX and XY types, with fifteen types of intersexuality. Critical feminist biologists, such as Fausto-Sterling (2000), have developed sophisticated, grounded accounts of how biology does not neatly conform to a two-sex female/male model but is much more variegated in many possible sexes. The idea of ‘the natural body’ is persistent in everyday, professional, medical and academic discourses. Ageing is widely seen as natural decline, with its complementary medicalization. 201

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Women’s bodies are often (and more likely than men’s to be) positioned as closer to the biological and the realm of the inferior ‘natural’ (Balsamo 1996). Feminists have demonstrated how biological and medical accounts of female and male are based on gendered, socially constructed definitions and stereotypes (Martin 1991, Grosz 1994). In relation to ageing, older bodies are often socially constructed as oppositional to young bodies, similar to how female and male bodies are positioned as binary opposites. What is deemed as ‘natural’ for older women and men is gendered, with discourses of masculinity/femininity and successful ageing entwined (Calasanti and King 2007, Smith et al. 2007).

Masculinity/femininity and sex/gender roles The concept of gender has spawned kindred terms, such as gendering or gendered, referring to how people, situations, objects and schemas can be given meaning, empirically and analytically, through gender and gender relations. The distinction of sex, as biological sex differences, from gender, as socio-cultural constructions of sex differences (Oakley 1972), has led to much empirical research on sex/gender differences and their social assumptions and perceptions (Maccoby and Jacklin 1974). These have often focused on psychological scales measuring ‘masculinity-femininity,’ sex/gender roles and gender socialization.There are, however, problems with this approach (Eichler 1980), including cultural specificity, relative lack of analysis of power, change and social structures, methodological difficulties in constructing measurement scales and reification of masculinity/femininity as singular qualities. Even so, the sex/gender model has prompted path-breaking work on gender relations, especially at psychological, interpersonal and cultural levels. Feminist theorization and research on ageing is relatively new (pace de Beauvoir 1972). Early in the 1980s, Macdonald and Rich wrote about ageism and berated the ‘silence of the old’ in the women’s movement (1984, 111). Until relatively recently there had been neglect of the interrelationship between sexism and ageism. In cultural gerontology this absence of research on gender issues and gender roles has been highlighted by feminist writers who have explored the relations between ageism and gender power relations (Arber and Ginn 1991, Arber and Evandrou 1993, Bernard and Meade 1993, Maynard 1999, Arber et al. 2003). Estes (2005, 552) points out ‘gender is a crucial organising principle in the economic and power relations of the social institutions of the family, the state, and the market,’ and this shapes women’s and men’s experiences of ageing and access to resources in old age. One of the topics explored by feminist writers in relation to economic and power relations is the gendering of work roles across the life course and into old age. Gender divisions of labor influence the type of work women have access to, and their opportunities to accrue lifetime earnings and adequate pensions (Ginn and Arber 1999, Ginn 2003). Women are often involved in care work, which is itself ‘quintessentially gendered’ (Twigg 2004, 68), with the identity of careworker constructed around hegemonic feminine traits associated with emotion, body and nature. Pensions are strongly linked to work histories, and women are more likely to be involved in lower paid work and domestic and childcare responsibilities, which impact on their state and non-state pension (Foster and Smetherham 2013). This means that older women are often relatively poor due to ‘their active participation in social reproduction, as mothers, grandmothers, daughters and wives, that restricts their employment and pension-building’ (Foster and Smetherham 2013, 99). Although women predominate in care work, older men are often involved in caring for their spouse in later life (Davidson et al. 2000, Ribeiro et al. 2007). One key finding is that men engaged in care work negotiate and maintain their masculine identity by deriving ‘some sense of 202

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worth, and almost paradoxically, reaffirming their sense of masculinity’ (Ribeiro et al. 2007, 311). This can be seen in the ways men approach grandfatherhood, often influenced by gendered discourse. Grandfathers may find themselves caught between a more traditional masculinity that characterised their experiences as fathers and current expectations about gender roles that challenge the earlier gender order (Scraton and Holland 2006). More generally, constructions and images of men and masculinity are dominated by those of younger and ‘middle years.’ Indeed, the younger male body is often used as the ideal standard for manliness, linked in turn to expectations for ‘men to be independent, tough, assertive, emotionally restrictive, competitive’ (Smith et al. 2007, 326). The natural aged body, which does not conform to youthful masculine or feminine ideals, may be perceived to have aged unsuccessfully in contrast with ‘successful,’ positive, consumer-oriented ageing (Calasanti and King 2005). Anti-ageing medicines such as Viagra and testosterone supplements are advertised as ways to turn back the biological clock and (re)affirm heterosexual masculine identities (Marshall and Katz 2006, Potts et al. 2006, Calasanti and King 2007). Equally, women are expected to preserve their femininity as they grow older. However, as Sontag (1972, 31) famously said, ‘Men are “allowed” to age without penalty, in several ways, that women are not.’ A double standard of ageing persists, with women more pressured to maintain a ‘natural’ youthful body and appearance than men.

Gender categoricalism, gender structures and structurally contextualized practices Some socio-cultural perspectives on gender have articulated categoricalist or structuralist concepts of gender relations, such as patriarchy, gender orders, gender contracts and systems of male dominance. Sometimes such structural approaches have been developed through standpoint theory, in which knowledge is linked directly to social positioning, and sometimes to sexual difference theories, in which the social and bodily foundation of sex/gender is emphasized as being a source of knowledge. In the late 1970s, critiques of the concept of patriarchy and relatively fixed categorical approaches to gender (Rowbotham 1979) appeared, resulting in differentiated, pluralized approaches to gender. This reformulation fitted closely with revisions of patriarchy as historical, multiple structures (Walby 1986, 1990, Hearn 1987, 1992). Gender can now be seen as being about both plural femininities and masculinities, including hegemonic masculinity, as structurally contextualized power-laden gender practices (Carrigan et al. 1985). In this view, when men do ‘women’s work’ or are ‘coming to terms’ with disability (Gerschick and Miller 1995) or are in old age ‘striving to maintain the male façade’ (Alex et al. 2008), they may still conform to hegemonic masculinity (cf. Hearn and Sandberg 2009). Categoricalist and structuralist concepts of gender relations are evident in gerontological accounts where a ‘double’ and/or ‘triple’ jeopardy approach has been used to explain gender inequality in later life (Sontag 1972, Arber and Ginn 1991, Estes 2001). Here the focus is on women’s experiences of ageing and how they differ from those of men. It is argued that older women have been ignored in social gerontology and feminism, and that this has exacerbated their existing invisibility and disadvantage in society (Arber and Ginn 1991). In this view, patriarchal relations shape women’s experiences of ageing, and the combination of sexism and ageism means they are more likely than men to be stigmatized and marginalized in later life (Arber and Ginn 1991). A problem with this approach is its underlying assumption that ageing is more problematic for women. Yet evidence suggests women use different strategies to resist negative stereotypes and remain in control of their lives as they age (Wray 2003, 2004). This is evident in the way older women maintain a sense of self through resisting definitions of ‘frail’ 203

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or ‘homebound’ (Grenier and Hanley 2007, 218). Nevertheless, a focus on the difficulties older women face may inadvertently reproduce and reinforce categorical approaches that assume gender to be only about women (Krekula 2007).Yet research on men’s experiences has shown that they also find ageing a difficult experience (Canham 2009). The male ageing body, often associated with weakness, invisibility and dependency, runs counter to hegemonic masculinity: contradictorily, older men may benefit through sexism, are often, but not always, culturally ­disadvantaged through ageism (Hearn 1995). It is also evident that the use of categories as a conceptual tool may exacerbate the essentialist view of identity as fixed and unchanging. To avoid this, Heaphy (2007) argues that sexuality should not simply be ‘added’ into existing conceptualizations of age and gender. Rather, it should be placed at the center to illuminate how sexuality intersects with gender to influence ‘the material, social and cultural resources that individuals have access to in their negotiations of ageing and later life’ (Heaphy 2007, 207). Explorations of alternative sexual practices and experiences, and how sexualities intersect with age, class, ethnicity and other categories, provide insights into the multiple forms ageing identities take. Indeed, ‘gerontological approaches [more generally] have often made ethnic and cultural experiences of later life invisible’ (Wray 2003, 511).

Poststructuralist, discursive and deconstructive approaches Since the mid-1980s increasing attention has been paid to gendered practices and processes, multiple/composite masculinities and femininities, life stories and subjectivities, and the social construction of sexualities. Such insights are often developed within poststructuralist approaches. Gender may be (per)formed as ‘subjectivities’ and ‘subject positions’ in and as discourse(s). A pervasive constraint in conceptualizing gender is the persistence of dichotomies: woman/ man; feminine/masculine; femininity/masculinity; female/male. While these are clearly important differentiations, they speak to only part of the possibilities of what gender might be or become. The very distinction between sex and gender also brings difficulties: it may imply that biology is pre-social, though biology is constituted in the social (Bondi 1998). Challenges to dichotomous views of gender come from sexuality studies, queer studies (that problematize gender and sexuality categories), transgender studies (focusing on transgender people and the wider implications of transgender) and crip theory (that brings these studies together with disability studies). Gender, or gendering, may be an unfinished, performed process, in which gender is made by doing in immediate practice, not by being a certain gender, or from any essence or fixed categories.This returns us to sociological debates around social and linguistic constructions of sex and sexual difference (Garfinkel 1967, Kessler and McKenna 1978). Somewhat similarly, so-called post-positions ‘take apart the gendered social order by multiplying genders or doing away with them entirely’ (Lorber 2005, 12). Connections with other social divisions and differences are central here, as are deconstructions of sex, sexuality and gender, and even abolition of taken-for-granted social-sexual-gender categories. Femininity and masculinity are not static categories but change across the life course, taking on different meanings over generation and time. As Spector-Mersel (2006, 70) has argued, ‘masculinities are bound to social clocks that ascribe different models of manhood to different periods in men’s lives.’ The same could be said about femininities, temporally situated in life stories and histories. Yet within gender studies and social gerontology there has been a lack of work on the interrelationship of historical (generational) and lifespan time, and how these intersect with age and gender to produce diverse life stories (Spector-Mersel 2006). In this respect, Jackson’s (2003) autoethnographic work on ageing, combining grounded description, reflexivity and non-heroic autobiographical ‘fragmentary body-selves’ is welcome. 204

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It has been argued there is a dearth of research on and theorization of the experiences of older lesbian, gay, bisexual and transgender people, which are often represented as fixed, largely stable, categories (Cronin 2004, Heaphy 2007, Brown 2009). This has resulted in a silencing of the experiences of LGBT elders in gerontological theories that often prescribe heteronormative perspectives on ageing and the life course characterized by marriage, reproduction, family and eventually grandchildren (Brown 2009). Heteronormativity refers to the organization of society around heterosexuality as the norm, resulting in the ‘belief that heterosexuality is superior to homosexuality’ (Cronin and King 2009, 70). Cultural gerontology has now seen the beginning of analysis of non-normative constructions of gender and sexuality, with attempts to move from fixed categoricalism towards research that emphasizes complex formations of unstable identities across the life course (Cronin and King 2010). This ‘troubling’ of what are perceived as stable fixed identities (Butler 1990) is the main analytical theme of queer theorists (Seidman 1997). Age, alongside other identities of gender and sexuality, is theorized as a social construct that is unstable, fluid and subject to regulation through power/knowledge discourse. The disciplinary power of heteronormativity is destabilized when older lesbian, gay, bisexual, transgender, transsexual, queer and intersexual (LGBTTQI) experiences are made visible as political ‘identities that because of heteronormativity both reproduce and transgress existing norms’ (King and Cronin 2010, 7). Identities of age, gender and sexuality intersect, creating new possibilities for ageing gendered bodies that contest hierarchical binaries of young/old, heterosexual/homosexual, woman/man. This may offer new ways of thinking about how heteronormative attitudes and behaviors influence what it means to ‘age successfully.’ A recent qualitative study exploring the experiences of ‘successful ageing’ amongst LGBT older adults found that they face unique challenges as they age. Many had ‘accumulated experiences of social exclusion and marginalization across the life course’ (Van Wagenen et al. 2013, 11). Heteronormative assumptions may underpin health and social care policy and practice, with fixed gender/sexual identity categories inadvertently affecting the type of care seen as appropriate in later life (King and Cronin 2010).

The material-discursive The intersection of poststructuralist and materialist approaches to gender is such that human-nature relations, even matter itself, can be reconceptualized as contingent processes. Humans thence appear as combinations of systems of production and reproduction, however fragmentary, of ideology and discourse, and relations to non-human nature and things. An important influence in moves towards incorporating the discursive in the material was Dorothy Smith’s (1990) work connecting political economy, texts and relations of ruling, and inspiring the material-discursive (Hearn 1992). Science and Technology Studies scholars have coined such terms as material-semiotic actors (Haraway 1992) and human–non-human assemblies to address human–non-human and human-machine relations. In recent studies of gender and science, there is a (re)turn to materialism, but beyond a strict separation of the material and the discursive/semiotic (Alamo and Hekman 2008). Butler (1993, 9) expounded on how discourse comes to (become) matter as ‘a process of materialisation that stabilises over time to produce the effect of boundary, fixity, and surface.’ Barad (1998) shifted focus onto how matter comes to matter, extending discussion to non-human matter. Gender and sex are not separable from bodily matter, and ‘matter’ is constructed, partly through human/non-human species interactions (Haraway 1989, 2008). Although ageing bodies are socially and culturally constructed, they also have a material physiological dimension that cannot be denied. Ageing has a corporeal reality that includes 205

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perceptions and experiences of illness and death, yet this is often denied in cultural constructions focusing on the denial and avoidance of ageing. Hence, there is a need to recognize the physical realities of growing older in a way that is able to conceptualize ‘nature as a social text’ (Twigg 2004, 60). Furthermore, the boundaries between nature/culture and male/female are artificial; there is nothing essentially female or natural about women’s bodies. As Grosz argued, ‘human biology must be always already cultural in order for culture to have any effect on it’ (1987, 7 italics in original). This means that the ageing body is not ‘natural,’ but is given meaning through cultural discourses: the ‘natural’ sexed body cannot be outside culture (Hurd Clarke and Griffin 2007, 188). The appearance of ageing bodies may be altered though technological and cosmetic interventions and practices that may be used to resist the bodily changes associated with ageing. Research in this area has highlighted the way that women and men seek out anti-ageing cosmetics, surgical procedures, and pills, in order to avoid being stereotyped as old in an ageist culture (Davis 1995, Calasanti and King 2007). Hurd Clarke and Griffin (2007) explored how older women, aged 50 to 70, distinguished between natural and unnatural ageing. Women in their fifties were more likely than those older to ‘reject the unmodified body’ and use technological beauty interventions to resist the physical realties of ageing in order to pass for ‘a normal, unmodified, and youthful body’ rather than one that has undergone technological intervention (2007, 198). According to the women, a defining feature of a good intervention was the extent to which it looked ‘natural.’ Hurd Clarke and Griffin (2007, 199) conclude that the current obsession with youthfulness and female beauty that normalizes beauty work technologies is ‘an inherently ageist extension of the cyborg in contemporary society.’ In ageist western societies, where ageing bodies are often regarded as non-sexual and in decline, it is not surprising that older men and women embrace cosmetic products in order to maintain a youthful body and appearance that complies with normative expectations of heterosexual femininity and masculinity (Twigg 2004). In contrast, the idea that cosmetic surgery is an ageist practice enabling people to deny that they are growing older has been challenged. Garnham argues that when older people use cosmetic surgery, they engage in a form of self-care that allows them to restyle the older body and subvert ageist stereotypes. Accordingly, cosmetic surgery can be a creative self-reflexive act that makes it possible for older people to ‘design ‘older’ (Garnham 2013, 40), that is, to use their agency to make their own ageing and old age in novel and very different ways. Criticizing those who refashion their bodies privileges an essentialist notion of a ‘naturally’ ageing body, and may reinforce oppressive judgments of how an ageing body should look. Both women and men choose to use various interventions to alter the appearance of their bodies to ‘look better’ rather than younger (Garnham 2013).

Conclusion Whichever way gender, and the variations of difference around gender, are understood, individual and collective differences in relation to age, class and ethnicity may be formed intersectionally, resulting in views that solidify, contest or deconstruct difference.The question of gender and intersectionality, or more precisely gendered intersectionalities and intersectional gender(s), is a challenge for theorizing gender and age(ing). It is not enough to simply add gender to existing frameworks: women are not only women, men are not only men. Instead, the challenge is to theorize the interconnections of age, gender(s), sexualities, ethnicities, and other social divisions, and their location in time, place and culture. Cultural gerontology offers major opportunities to

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explore the fascinating multiplicity of ways identities intersect, and importantly how dimensions of time, culture, life history and location overlay these.

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Ginn, J. and Arber, S. (1999) Women’s pension poverty: Prospects and options for change. In S. Walby (ed.), New Agendas for Women, 75–97. Basingstoke: Macmillan. Grenier, A. and Hanley, J. (2007) Older women and ‘frailty’: Aged, gendered and embodied resistance. Current Sociology 55(2): 211–28. Grosz, E. (1987) Notes towards a corporeal feminism. Australian Feminist Studies 5: 1–16. Grosz, E. (1994) Volatile Bodies:Towards a Corporeal Feminism. Bloomington: Indiana University Press. Haraway, D.J. (1989) Primate Visions: Gender, Race, and Nature in the World of Modern Science. New York: Routledge. Haraway, D.J. (1992) The promises of monsters: A regenerative politics for inappropriate/d Others. In L. Grossberg, C. Nelson, and P. Treichler (eds), Cultural Studies, 295–337. New York: Routledge. Haraway, D.J. (2008) When Species Meet. Minneapolis: University of Minnesota Press. Heaphy, B. (2007) Sexualities, gender and ageing: Resources and social change. Current Sociology 55(2): 193–210. Hearn, J. (1987) The Gender of Oppression. New York: St. Martin’s. Hearn, J. (1992) Men in the Public Eye. London: Routledge. Hearn, J. (1995) Imaging the aging of men. In M. Featherstone and A. Wernick (eds), Images of Aging: Cultural Representations of Later Life, 97–115. London: Routledge. Hearn, J. and Sandberg, L. (2009) Older men, ageing and power: Masculinities theory and alternative spatialised theoretical perspectives. Sextant: Revue du Groupe Interdisciplinaire D’Etudes sur les Femmes et le Genre 27: 147–63. Hurd Clarke, L. and Griffin, M. (2007) The body natural and the body unnatural: Beauty work and aging. Journal of Aging Studies 21: 187–201. Jackson, D. (2003) Beyond one-dimensional models of masculinity: A life-course perspective on the processes of becoming masculine. Auto/Biography 11(1/2): 71–87. Kessler, S.J. and McKenna, W. (1978) Gender: An Ethnomethodological Approach. New York: John Wiley. King, A. and Cronin, A. (2010) Queer methods and queer practices: Re-examining the identities of older lesbian, gay, bisexual adults. In K. Browne and C.J. Nash (eds), Queer Theories and Social Science Research, 85–96. Farnham: Ashgate. Krekula, C. (2007) Reworking gender theory and social gerontology. Current Sociology 55: 155–71. Lorber, J. (ed.) (2005) Gender Inequality: Feminist Theories and Politics. Los Angeles: Roxbury. Maccoby, E.E. and Jacklin, C.N. (1974) The Psychology of Sex Differences. Stanford, CA: Stanford University Press. Macdonald, B. with Rich, C. (1984) Look Me in the Eye: Old Women, Aging and Ageism. London: Women’s Press. Marshall, B.L. and Katz, S. (2006) From androgyny to androgens: Re-sexing the aging body. In T. Calasanti and K. Slevin (eds), Age Matters: Realigning Feminist Thinking, 75–97. New York: Routledge. Martin. E. (1991) The egg and the sperm: how science has constructed a romance based on stereotypical male-female roles. Signs 16(3): 485–501. Maynard, M. (1999) What do older women want? In S. Walby (ed.), New Agendas for Women. London: Macmillan. Oakley, A. (1985) Sex, Gender and Society (rev. edn). London: Temple Smith. Aldershot: Gower. Potts, A., Grace, V. M., Vares, T. and Gavey, N. (2006) ‘Sex for life’? Men’s counter-stories on ‘erectile dysfunction,’ male sexuality and ageing. Sociology of Health & Illness 28(3): 306–29. Rowbotham, S. (1979) The trouble with ‘patriarchy’. New Statesman 98: 970–1. Ribeiro, O., Paúl, C. and Nogueira, C. (2007) Real men, real husbands: Caregiving and masculinities in later life. Journal of Aging Studies 21(4): 277–88. Scraton, S. and Holland. S. (2006) Grandfatherhood and leisure. Leisure Studies 25(2): 233–50. Seidman, S. (1997) Difference Troubles: Queering Social Theory and Sexual Politics. Cambridge: Cambridge University Press. Smith, D.E. (1990) The Conceptual Practices of Power: A Feminist Sociology of Knowledge. Boston: Northeastern University Press. Smith, J.A., Braunack-Mayer, A., Wittert, G. and Warin, M. (2007) ‘I’ve been independent for so damn long!’: Independence, masculinity and aging in a help seeking context. Journal of Aging Studies 21: 325–35. Sontag, S. (1972) The double standard of aging. The Saturday Review 23 September: 29–38. Spector-Mersel, G. (2006) Never-aging stories: Western hegemonic masculinity scripts. Journal of Gender Studies 15(1): 67–82. 208

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27 Anti-ageing and identities Barbara L. Marshall

There are two broadly contradictory images of ageing that circulate widely in contemporary Western societies. On the one hand are portrayals of age-associated physical decline, risk and impending dependency. Rife with warnings to individuals of the necessity of planning and self-care to mitigate the risks of ageing, these images often accompany—or illustrate—alarmist demographic pronouncements of a ‘tsunami of geezers that’s about to crash on our shores and suck the wealth of future generations out to sea’ (Wente, 2012). On the other hand, there are increasing portrayals of those ‘geezers’ as health-conscious, fit, sexy and adventurous consumers, who take good care of themselves and control a significant proportion of disposable income. This more optimistic vision of ageing posits a ‘new, anti-ageist, positive senior . . . who bridges middle age and old age without suffering from time-bound constraints of either’ (Katz and Marshall, 2003: 5). These alternative and conflicting ‘bipolar’ (McHugh, 2003) images of ageing shape the context through which many older people negotiate their social identities. This chapter reviews debates about the shifting bases for identity formation in mid- and late-life as these have been shaped by larger theoretical questions related to the cultural landscape of contemporary Western societies.These have framed new ways of thinking about ageing and age-based identities, as conventional chronological distinctions and life course identities have become blurred in relation to a host of social, demographic and cultural shifts. Against this backdrop, the chapter surveys work that has explored the cultural sites and resources for identity construction in mid- to late-life, especially those that highlight the increasingly embodied, individualistic and consumption-based anchors of identity in contemporary Western societies. The contemporary—and impossible—goal of ‘growing older without ageing’ (Katz, 2005) shapes a contradiction-laden discourse of anti-ageing in tension with anti-ageism—what might be termed ‘post-ageist ageism’.

Ageing identities and ‘late’ modernity A substantial body of theoretical literature has mapped out the contours of what has been called ‘late’ (Giddens, 1991), ‘second’ (Beck, 1992), ‘liquid’ (Bauman, 2000) or ‘post’ (Featherstone, 2007) modernity.While differing on the fine points, there is agreement that the traditional anchors of identity—including those linked to life course transitions—have eroded, giving way 210

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to a diversity of life courses and contexts for identity formation. Beck refers to this as the ‘deinstitutionalization of the life course’ where ‘the life course, like one’s lifestyle, should be regarded as less a question of fate and more a matter of individual responsibility’ (1992: 277). An emphasis on reflexivity and self-fashioning of identities is linked to the expansion of consumer culture and the general aestheticization of everyday life (Featherstone, 2007, Hennessy, 2000) and to a focus on ‘lifestyles’ that ‘give material form to a particular narrative of self-identity’ (Giddens, 1991: 81). Drawing on this theoretical oeuvre, Gilleard and Higgs’s Cultures of Ageing (2000) was instrumental in opening up questions of ageing and identity in late modern societies. Prodding social gerontology to move beyond its focus on themes of ‘loss and lack’ as shaping later life, it set the agenda for the emerging ‘cultural turn’ in social gerontology. This turn importantly located ageing in relation to those key theoretical tropes that were shaping research in other domains of contemporary social life—especially those exploring fragmentation, individualization, differentiation and reflexivity in the construction of self and identity. In doing so, they provided an important critique of biologically-foundationalist approaches that invoked the inevitability of physical ageing with their implicit assumption that ‘the very hardware resources to sustain, let alone fashion, an identity in later life will eventually give out’, thus blunting the capacity for individual agency in later life (2000: 40). The ‘deinstitutionalization’ of life courses means that those qualities identified as defining the late modern subject—reflexivity, agency, flexibility, mobility, responsibility, individuality—have now been extended to older adults, transforming the contexts and resources for later-life identities. New questions about the malleability of age-related identities have emerged as these become increasingly detached from chronological age (Katz, 2010, Öberg and Tornstam, 2001). This malleability is particularly evident in studies of the Third Age. Introduced by British historian Peter Laslett in 1987, the term ‘Third Age’ reflected economic and demographic shifts in wealthy Western nations, where a cohort of relatively healthy and financially secure older people were entering ‘the age of personal achievement and fulfillment’ (Laslett, 1987:135). Laslett’s concept of the Third Age had affinities with the category of the ‘young old’ previously posed by American gerontologist Bernice Neugarten (1974). Like Laslett, she identified the need for new terminology capable of capturing diversity in ageing, and acknowledging positive and productive ageing experiences and identities. The conceptual apparatus of the Third Age has been stimulating to cultural gerontology, informing a range of research on mid- and later-life activity, agency, representations and identities, and has prompted critical debates about inequality, social policy and commercialization. It has also been subject to critical commentary for the varying and sometimes contradictory ways in which it has been used (Carr and Komp, 2011). Gilleard and Higgs’s (2011a) elaboration of the Third Age as a ‘cultural field’ is a productive point of departure. On their account, the Third Age is not simply another name for a stage of life, a cohort or a generation; nor is it merely clever postmodern jargon that risks depoliticizing gerontology or masking real issues of inequality and need in later life, as some critiques have suggested (Holstein, 2011). Linked to, though not defined by, the ‘baby boomers’ whose ‘generational habitus’ has been shaped by expectations of consumption, individuality, self-expression and the erosion of traditional anchors of identity such as work and family, it is conceptualized as an arena of practice. Viewing the Third Age as a cultural field is not so much about focusing upon the chronological age of the participants or players as it is about mapping the social space within which they participate, the new logics that are driving such participation, and the new sets of possibilities that are realized within the field. (Gilleard and Higgs, 2011a: 36) 211

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A central ‘logic’ of this cultural space is its construction in opposition to ‘old’ age, with its connotations of impairment, social immobility and non-participation in autonomous, self-fashioning consumer lifestyles. Gilleard and Higgs conceptualize this agency-less Fourth Age as ‘a kind of social or cultural “black hole” that exercises a powerful gravitational pull upon the surrounding field of ageing’ (2010: 121–2). Third Age culture thus promotes the ‘liberation of ageing from old age’ (Gilleard and Higgs, 2005: 161)—in other words, it valorizes the ultimately impossible goal of ‘growing older without ageing’ (Katz, 2005:188). It is on these grounds that images of ‘positive’ Third Age identities and lifestyles purporting to be anti-ageist are viewed by critics as underpinning more subtle, yet equally compelling forms of anti-ageing (Holstein, 2011, Öberg and Tornstam, 2001). For example, McHugh (2003) finds in his study of the imagery of contemporary retirement communities clear evidence of ‘bipolar’ ageism—a dualism of negative/ positive images of ageing—which, as Cole (1992) notes, has existed for centuries—underpinning anti-ageing culture’s message of agelessness. As he summarizes it, ‘positive stereotypes centred on anti-ageing, agelessness and successful ageing stand in dialectic relation with enduring negative stereotypes of old age as dependence, decay and disease’ (McHugh, 2003: 180). Richards and colleagues (2011) note the difficulties of producing images that transcend this existing dualism of ‘heroes of ageing’ versus bodily decline, even when a project sets out with this intent. All of this suggests that there is no clear answer to the question ‘Anti-aging—are you for it or against it?’ as rhetorically posed by Cole and Thompson (2001–2).

Anti-ageism/anti-ageing and midlife identities Gullette (1997) has argued that the paradoxical effect of anti-ageing discourse is to shift anxiety about ageing forward, into midlife, which has become the ‘entry point’ into cultural decline narratives, and an increasingly critical phase for constructing ageing identities. This is exacerbated by an even further expansion of the ‘mature’ market—the long ‘midlife’ now imagined by marketers. Katz noted in 2005 that the ‘so-called “ageless” seniors market’ (190) was usually pegged at 55+; today there is evidence that those in their 40s are now included, as planning for one’s personal health and welfare in later life and the work of not becoming (or at least appearing or acting) old intensifies. The masthead of Canada’s Zoomer magazine, for example, hails those in their ‘40s, 50s, 60s, 70s, 80s and beyond’. The women’s magazine More, based in the USA, self-identifies as ‘a celebration of women over 40’. There is certainly some irony in the simultaneous extension of lifespans and earlier identification as ‘ageing’. As Mike Hepworth notes (1995: 177) the ‘accelerated age-consciousness’ that accompanies discourses of positive ageing permits ‘the fear of ageing into old age to predominate’. Hepworth and Featherstone’s Surviving Middle Age was important in carving out midlife as a critical cultural space, drawing attention to the role of popular media in generating new images of ageing and promoting the value of ‘looking good’ and ‘ageing slowly’ to a mass audience (1982: 69). Their analysis of Retirement Choice magazine identified a critical shift in the mid-1970’s when the magazine became commercial, changed its name to Choice, went from monochrome to glossy, and featured for the first time close-ups of celebrities on the cover—‘all of whom presented an anti-ageist image in the crucial areas of personal appearance and lifestyle’ (1995: 35). Blaikie (1999: 101) notes that many print magazines targeted at older adults have since shifted their approach to this ‘pro-active Third Age awareness’. Subsequent research on media products directed at the Third Age market has confirmed this, highlighting in particular the focus on appearance, activity and celebrity in the construction of ‘successful’—and aspirational—ageing identities (Kitch, 2003, Lumme-Sandt, 2011, Marshall and Rahman, 2014, Smirnova, 2012,Ylänne, 2012). As Twigg (2011: 1049) notes, this ‘aspirational dynamic is at the 212

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heart of consumption’, and underscores the importance of attention to broader cultural economies in understanding ageing experiences. Consistent with the individualization of lifestyles and aestheticization of everyday life in consumer capitalism, working on the body has emerged as a key aspect of fashioning the self in later life, particularly as ‘healthy ageing’ policies have been increasingly focused on prevention of age-related physical decline through various forms of lifestyle management, including exercise, diet and monitoring of ‘risk factors’ (Cardona, 2008, Moreira, 2010). Katz and Marshall (2004) argue that the emphasis on fitness is grounded in a biopolitical valorization of enablement and ‘functionality’, forging new ‘bio-identities’ ranked by lifestyle and health status, and linked to neo-liberal mandates of activity, responsibility, self-care and independence. Sexual fitness, incorporating the ‘re-sexing’ of ageing bodies (Marshall and Katz, 2002, 2006), is also a central aspect of body-focused anti-ageing projects, whether biomedical or cosmetic in nature. Doing age is, as much research has noted, complexly embodied (Calasanti, 2005, Hurd Clarke and Korotchenko, 2011, Gilleard and Higgs, 2013, Laz, 2003, Marshall and Katz, 2012, Tulle, 2003).The management of appearance figures centrally, encompassing a range of practices including hair colouring, dieting, working out, use of cosmetics, and a range of medical treatments aimed at masking, reversing or forestalling the signs of bodily ageing. These practices are often couched in the language of reducing the discord between external appearance and one’s ‘authentic’ younger, more vital identity—what Featherstone and Hepworth identified as the ‘mask of ageing’ (1991). Marketers eagerly capitalized on demographically expanding markets, pitching anti-ageing products as part of the modern mature consumer’s kitbag. While ‘rejuvenative interventions’ are still more commonly undertaken by white populations in affluent, multi-ethnic Western societies, recent research by Gilleard and Higgs (2013) suggests that this is changing as visible minorities also take up the ‘new somatic technologies of self-improvement that have flourished in second modernity’ (66). Twigg (2011, 2007) notes that the inclusion of self-realization and consumption in the remit of the social space of the Third Age makes fashion a potentially important site for the shaping of late-life identities. And while there is still a double standard observable in anti-ageing culture, with women particularly subject to scrutiny and pressure to retain a youthful appearance (Hurd Clarke, 2011, Richards et al., 2011), there is evidence that men, too, are feeling the pressure (Slevin, 2008, Spector-Mersel, 2006, Szymczak and Conrad, 2006, Ward and Holland, 2011).

Post-ageist ageism As noted earlier, the discourse and imagery of the ‘Third Age’ has been criticized for grounding new forms of ageism. Martha Holstein, for example, argues that the proliferation of images of ‘busy, apparently happy, fit-looking, even sexy older people’ reinforces rather than challenges ageism, by continuing to enforce a dichotomy between ‘good’ and ‘bad’ ageing (2011: 235). While Holstein is correct to identify the extent to which celebratory representations of the Third Age depend on continued vilification of the presumed dependency and decrepitude of the Fourth Age, this is more complex than simply old, ageist wine in new, Third Age bottles. Certainly the late modern reflexive project of the self is, in its contemporary representations, ageist, in that youthful standards continue to ground successful ageing identities. However, it is not just an unproblematic emulation of youth. As Lumme-Sandt suggests in her analysis of a Finnish magazine aimed at a 50+ market, ‘a sort of praise for the charisma of ageing’ can also be identified (2011: 50). Garnham’s (2013) analysis of older men and women engaging in anti-ageing cosmetic surgery suggests that for many participants it was understood as 213

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a ‘redesigning’ rather than a denial of ageing. A space is thus created for the development of contradiction-laden aspirational identities for ageing, where conventional (and traditionally stigmatized) signifiers of old age may be resignified. As Gilleard and Higgs (2011b: 138) summarize: ‘There now exists the opportunity to contrast the evident activity of aged social actors with the visible signs of their agedness—exemplified in such descriptions as gray panthers, silver surfers, wrinkly rockers and so forth’. Caution is warranted, however, in embracing an unbridled optimism towards the opening up of the life course to new forms of self-making in later life. As a number of critics have argued, the individuals posited by theories of reflexive modernity belie their class, race and gendered positioning (Adkins, 2002, McNay, 2000, Savage, 2000, Skeggs, 2004). Increased capacities for reflexivity and self-fashioning of identities are not evenly distributed—they are dependent on particular forms of economic, social and physical capital, inequalities of which may increase with age. No less than with other types of social relations, and usually compounding them, individuals are constrained by the social relations of age that continue to privilege youth (or the performance of youth) over age, and some forms of ageing over others (Calasanti, 2003). Furthermore, the very discourses of personal choice and self-improvement may, as feminist critiques have argued, be rife with regulative aspects and closely connected to neo-liberal political agendas (Gill and Scharff, 2011). Furthermore, the conceptual apparatus of ‘positive ageing’ has been charged with ethnocentrism and of being shot through with values specific to Western societies (Wray, 2003: 515). Even for those marginalized and generally excluded from the suggested practices of self-making, revised cultural standards of ‘successful aging reconstruct life courses in such a way as to set new expectations and create new ways of “failing” to meet them’ (Ranzjin, 2010). Finally, while the conflation of positive ageing with anti-ageing that underlies the remaking of later-life identities has the potential to become a global phenomenon, local contexts will always shape the ways that successful ageing is discussed, sold and practised (see for example Erol and Özbay, 2012, Wentzell, 2012). Drawing from analyses of post-feminism (Gill, 2007, Wearing, 2007), the term ‘post-ageist ageism’ perhaps captures the complex and contradictory ground on which new cultural identities of mid and later life are being shaped. Gill argues that a post-feminist sensibility is distinctive in that ‘feminist ideas are both articulated and repudiated, expressed and disavowed’ (2007: 163). In a similar fashion, post-ageist ageism embraces anti-ageist sentiments at the same time as old age is constructed as something to be resisted. Gill’s observations about women in post-feminist culture—on the one hand presented as ‘active, desiring social subjects’, but on the other hand ‘subject to a level of scrutiny and hostile surveillance that has no historical precedent’ (2007: 163)—might just as easily be made of older people in post-ageist cultures. Post-ageist ageism can only make sense in a culture where consumption and lifestyle choice frame age-based identities, and where ‘positive’ and ‘negative’ ageing identities are ‘socially constructed moral categories reflecting the prevailing social preference for individualised consumerism, voluntarism and decentralisation’ (Hepworth, 1995: 176).

Conclusion A growing body of literature suggests that social transformations related to risk, individualization, reflexivity and consumption are reflected in shifting social and cultural resources for the construction of ageing identities. However, ‘anti-ageing’ culture, which has reimagined the life course in non-chronological terms, has not so much released ageing individuals from restrictive identities as re-located them in a reconfigured landscape of continuing fitness, fashionableness, functionality and flexibility. Building on critiques of post-feminism, this emergent narrative of 214

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the continuing dualism of positive and negative images of aging is described as ‘post-ageist ageism’. The self-reliant, healthy, sexy, active ‘Third Ager’ is an important subject-position that has been at the centre of these narratives and—like all identities—is dynamic, situated and dependent on cultural resources. This chapter has not broached what is perhaps one of the more pressing questions—how do we internalize, in ways that may take up, refuse or modify them, these resources for identity formation in later life? As Gill (2008: 433) remarks, ‘we know almost nothing about how the social or cultural “gets inside” and transforms and reshapes our relationships to ourselves and others’. Mapping the cultural resources that frame identity construction is a useful exercise, but there is still much to learn about how anti-ageing culture reshapes identities from the inside-out, making its ideals feel like one’s own. Finally, while there is convincing evidence that contemporary consumer capitalism and neoliberal political agendas shape anti-ageing culture in such a way as to circumscribe the cultural resources available for fashioning late-life identities, it cannot be concluded that new, ‘positive’ ageing identities are produced simply through duping the masses.While anti-ageing culture and technologies cannot make good on their promise to transcend human ageing, neither are they masking some ‘authentic’ foundation for later-life identities. If agency is to be recognized in later life, and identity construction seen as a life-long process, then more complex and contradictory narratives must be acknowledged.

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Gill, Rosalind and Christina Scharff (2011) New Femininities: Postfeminism, Neoliberalism and Subjectivity. Basingstoke: Palgrave Macmillan. Gilleard, Chris and Paul Higgs (2013) Ageing, Corporeality and Embodiment. London: Anthem Press. ——— (2011a) ‘The Third Age as a Cultural Field’, in Dawn C. Carr and Kathrin Komp (eds), Gerontology in the Era of the Third Age. New York: Springer. ——— (2011b) ‘Ageing Abjection and Embodiment in the Fourth Age’, Journal of Aging Studies 25(1): 135–42. ——— (2010) ‘Aging without Agency: Theorizing the Fourth Age’, Aging & Mental Health, 14: 121–8. ——— (2005) Contexts of Aging: Class, Cohort and Community. Cambridge: Polity. ——— (2000) Cultures of Ageing: Self, Citizen and the Body. Harlow, UK: Prentice Hall.Gullette, Margaret Morganroth (1997) Declining to Decline: Cultural Combat and the Politics of the Midlife. Charlottesville: University Press of Virginia. Hennessy, Rosemary (2000) Profit and Pleasure: Sexual Identities in Late Capitalism. London: Routledge. Hepworth, Mike (1995) ‘Positive Ageing: What Is the Message?’ in Robin Bunton, Sarah Nettleton and Roger Burrows (eds), The Sociology of Health Promotion: Critical Analyses of Consumption, Lifestyle and Risk. London: Routledge. Hepworth, Mike and Mike Featherstone (1982) Surviving Middle Age. Oxford: Basil Blackwell. Holstein, Martha (2011) ‘Cultural Ideal, Ethics and Agelessness: A Critical Perspective’, in Dawn C. Carr and Kathrin Komp (eds), Gerontology in the Era of the Third Age. New York: Springer. Hurd Clarke, Laura (2011) Facing Age: Women Growing Older in Anti-Aging Culture. Lanham, MD: Rowman & Littlefield. Hurd Clarke, Laura and Alexandra Korotchenko (2011) ‘Aging and the Body: A Review’, Canadian Journal on Aging, 30: 495–510. Katz, Stephen (2010) ‘Measuring Age Beyond Chronological Age: Functions, Boundaries, Reflexivity’, in Gerontology Society of America Sixty-third Annual Scientific Meeting. New Orleans. ——— (2005) Cultural Aging: Life Course, Lifestyle and Senior Worlds. Peterborough: Broadview Press. Katz, Stephen, and Barbara L. Marshall (2004) ‘Is the Functional “Normal”? Aging, Sexuality and the Biomarking of Successful Living’, History of the Human Sciences, 17: 53–75. ——— (2003) ‘New Sex for Old: Lifestyle, Consumerism and the Ethics of Aging Well’, Journal of Aging Studies, 17: 3–16. Kitch, Carolyn (2003) ‘Selling the “Boomer Babes”: More, My Generation and the “New” Middle Age’, Journal of Magazine and New Media Research, 5: 1–11. Laslett, Peter (1987) ‘The Emergence of the Third Age’, Ageing and Society, 7: 133–60. Laz, Cheryl (2003) ‘Age Embodied’, Journal of Aging Studies, 17: 503–19. Lumme-Sandt, Kirsi (2011) ‘Images of Aging in a 50+ Magazine’, Journal of Aging Studies, 25: 45–51. Marshall, Barbara L. and Stephen Katz (2012) ‘The Embodied Life Course: Post-Agesim or the Re-Naturalization of Gender?’ Societies, 2: 222–34. ——— (2002) ‘ “Forever Functional”: Sexual Fitness and the Aging Male Body’, Body and Society, 8: 43–70. ——— (2006) ‘From Androgyny to Androgens: Re-Sexing the Aging Body’, in Toni Calasanti and Kathleen Slevin (eds), Age Matters. New York: Routledge. Marshall, Barbara L. and Momin Rahman (2014) ‘Celebrity Culture and the “Third Age” ’ International Journal of Cultural Studies, online first June 3, 2014. McHugh, Kevin E. (2003) ‘Three Faces of Ageism: Society, Image and Place’, Ageing and Society, 23: 165–85. McNay, Lois (2000) Gender and Agency: Reconfiguring the Subject in Feminist and Social Theory. Cambridge: Polity Press. Moreira, Tiago (2010) ‘Prologue: Preventing Alzheimer’s Disease: Health, Ageing and Justice’, in T. Mathar and Y. Jansen (eds), Health, Promotion and Prevention Programmes in Practice. Bielefeld: Transcript Verlag. Neugarten, Bernice L. (1974) ‘Age Groups in American Society and the Rise of the Young-Old’, Annals of the American Academy of Political and Social Science, 415: 187–98. Öberg, Peter and Lars Tornstam (2001) ‘Youthfulness and Fitness—Identity Ideals for All Ages?’ Journal of Aging Identity, 6: 15–29. Ranzjin, Rob (2010) ‘Active Ageing—Another Way to Oppress Marginalized and Disadvantaged Elders?: Aboriginal Elders as a Case Study’, Journal of Health Psychology, 15: 716–23. Richards, Naomi, Lorna Warren and Merryn Gott (2011) ‘The Challenge of Creating “Alternative” Images of Ageing: Lessons from a Project with Older Women’, Journal of Aging Studies, 26: 65–78. Savage, Mike (2000) Class Analysis and Social Transformation. Buckinghamm: Open University Press. Skeggs, Beverley (2004) Class, Self, Culture. London: Routledge. 216

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Slevin, Kathleen F. (2008) ‘Disciplining Bodies: The Aging Experiences of Older Heterosexual and Gay Men’, Generations, 32: 36–42. Smirnova, Michelle Hannah (2012) ‘A Will to Youth: The Woman’s Anti-Aging Elixir’, Social Science & Medicine, 75: 1236–43. Spector-Mersel, Gabriela (2006) ‘Never-Aging Stories: Western Hegemonic Masculinity Scripts’, Journal of Gender Studies, 15: 67–82. Szymczak, Julia E. and Peter Conrad (2006) ‘Medicalizing the Aging Male Body: Andropause and Baldness’, in Dana Rosenfeld and Christopher Faircloth (eds), Medicalized Masculinities. Philadelphia:Temple University Press. Tulle, Emmanuelle (2003) ‘Sense and Structure: Toward a Sociology of Old Bodies’, in Simon Biggs, Ariela Lowenstein and Jon Hendricks (eds), The Need for Theory: Critical Approaches to Social Gerontology. Amityville, NY: Baywood Publishing Co. Twigg, Julia (2011) ‘Adjusting the Cut: Fashion, the Body and Age on the UK High Street’, Ageing and Society, 32: 1030–54. ——— (2007) ‘Clothing, Age and the Body: A Critical Review’, Ageing and Society, 27: 285–305. Ward, Richard, and Caroline Holland (2011) ‘ “If I Look Old, I Will Be Treated Old”: Hair and Later-Life Image’, Ageing and Society, 31: 288–307. Wearing, Sadie (2007) ‘Subjects of Rejuvenation: Aging in Postfeminist Culture’, in Yvonne Tasker (ed.), Interrogating Postfeminism: Gender and the Politics of Popular Culture. Durham, NC: Duke University Press. Wente, Margaret (2012) ‘The War against the Young’, The Globe and Mail, February 2. Wentzell, Emily (2012) ‘Decreasing Erectile Function and Age-appropriate Masculinities in Mexico’, in A. Kampf, B. Marshall and A. Petersen (eds), Aging Men, Masculinities and Modern Medicine. London: Routledge. Wray, Sharon (2003) ‘Women Growing Older: Agency, Ethnicity and Culture’, Sociology, 37: 511–27. Ylänne,Virpi (2012) Representing Ageing: Images and Identities. Basingstoke: Palgrave Macmillan.

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‘Sex after 60: the myth about sexual desire disappearing is untrue’. ‘Sex after 60 is the last sexual taboo’. ‘Sex after 60 still creates a fuss’.These are examples of headlines from contemporary mass media and advertising addressing sex and sexuality in later life (På ålderns höst February 2012, Dagens Nyheter 29 September 2010, Veteranen.se 9 February 2009). In recent years there has been an increase in voices pointing to how sexuality is important throughout the entire life course, and that older people often wish to continue to be sexually active in later life. In mass media, advertising and popular culture as well as in scientific literature on ageing and sexuality, there are repeated assertions that sexuality continues to matter as we age and become old. Researchers often position their research on sexuality as a challenge to the stereotypes of non- or asexual later life (Scherrer 2009).The impetus to discuss the sex lives of older people can be understood as a discursive shift on later life sexuality; this shift is the focus of the chapter. Notions of ‘sexy seniors’, who are both willing and functioning, have partly replaced the stereotype of the ‘asexual oldie’.Yet, even though both old and new discourses influence how older men and women understand and experience their sexual selves, the question remains whether they accurately represent the many complex experiences of sex and sexuality among older men and women. Although there has been a great increase in discussions on sex and sexualities of older people, these discussions are by and large concerned with heterosexual sex and the experiences of older heterosexuals. Due to the heteronormative bias of research there is little knowledge of the sexual experiences of older lesbian, gay, bisexual and trans-identified persons. The handbook contains another chapter specifically on LGBT ageing, but this chapter concerns heterosexuality and heterosexual practices.

‘Asexual oldies’ The rise of a discourse that seeks to assert the sexualities of older adults should partly be understood as a reaction against a long-standing history that dissociates sexuality and later life: a persistent story about the ‘asexual oldies’. The strong links between reproduction and sexuality in Western Christian tradition and later in sexological literature have clearly contributed to the idea of sexuality as the domain of the young (Andersson 2009, Gott 2005). The disavowal of the ageing body as a non-desirable body has also been suggested as one of the reasons why 218

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older people have not been understood as sexual beings: in order to be sexual you need to be perceived as sexually desirable (Gott 2005).This has in particular cut off older women from sexuality, as women’s sexual desirability, more than men’s, is constructed in relation to physical looks and bodily attractiveness (Sontag 1972, Calasanti & Slevin 2001). Besides being overlooked and neglected, the sexualities of older people have also been a source of ridicule, reflected in humorous depictions of older people’s sexualities, for example, in jokes and birthday cards (Jones 2002). The construction of old age as asexual and undesirable can be seen as ageist, underpinning the disempowerment of older people vis-à-vis younger ones (Gott 2005, Hinchcliff & Gott 2008). The need to assert the sexuality of older adults, in mass media as well as in scientific literature, can consequently be understood as an attempt to reverse these negative images, replacing them with more positive and affirming images of later life sexuality. Current research on older people and sex repeatedly stresses the importance of working with negative and ageist attitudes concerning sexuality among older people, not least among health care staff ( Jones 2003). And this is where the ‘sexy seniors’ enter.

‘Sexy seniors’ Despite claims of later life sexuality being ‘the last taboo’ and something that ‘still creates a fuss’, portrayals of older people as sexually and romantically involved are gaining popular attention (Vares 2009). Today it is relatively easy to find examples of sexually interested and active older people in films, magazines and newspapers across various national contexts. One such example is a series of articles entitled ‘Desire and longing 50+’ from 2010 in the newspaper with the widest circulation in Sweden, Dagens Nyheter, in which older adults were interviewed about experiences of sexuality beyond midlife. In this series older women in particular were portrayed as desirous and desirable subjects, whose sex lives not only continued but in fact improved as they grew older, with respondents expressing such views as ‘I have never had sex as good as I do today’ (Elisabeth, 62) or ‘I have also discovered my own body and sex in a new way’ (Karin, 57). Recent quantitative research on the prevalence of sexual activity among older adults, such as US studies by Lindau et al. (2007) and Trompeter et al. (2012) and a Swedish study by Beckman et al. (2008) could also serve as contemporary examples of the sexually active older population.These studies report not only continued sexual activity among older adults but also greater sexual satisfaction, results that have gained significant media attention.These examples from media and science point to what researchers on sexuality and ageing have suggested is a cultural-scientific shift whereby later life sexuality is seen not only to exist but to be part of healthy and positive ageing (Marshall & Katz 2002, 2003, Gott 2005). The emphasis on the sexually active senior citizen can be linked to the introduction of the concept of successful ageing in gerontology, which has gained considerable purchase in consumerist discourse and policy-making (Katz 2001/2). Successful ageing was introduced as an alternative to decline discourses in which old age was primarily conceptualized in terms of illness and dependency, to foster images of healthy, active and independent retirees. The emphasis on staying active as an older adult has extended to the possibilities of staying sexually active (Calasanti & King 2005, Marshall & Katz 2003). However, what may at first sight seem to be positive and affirmative discourses that ‘liberate’ old people from the myths and stereotypes of asexuality can also be seen as imposing new norms, disciplining later life sexuality in particular ways (Sandberg 2011, Gott 2005, Marshall 2008, 2010, 2012, Marshall & Katz 2002, 2003, Calasanti & King 2005, Mamo & Fishman 2001). As shown in the extensive work by Barbara Marshall, sometimes with colleague Stephen Katz (Marshall 2008, 2010, 2012, Marshall & Katz 2002, 2003), ‘pharma-scripts’ formulated by 219

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biomedicine and pharmaceutical companies play a central role in defining later life sexuality. Sexual activities are thus narrowly conceptualized in relation to the function and or dysfunction of the male penis, and the possibilities of having penile-vaginal intercourse (also Potts et al. 2006). This has been critiqued for being ageist since it overlooks the realities of physical ageing, which for men may include impotence, and for women vaginal dryness and sensitivity. It promotes ideas of agelessness by reviving the erection with the aid of sexuo-pharmaceuticals. The focus on the older man’s sexual function could, moreover, be critiqued for shaping continued sexual activity in primarily masculinist, phallic and heteronormative terms, which largely overlooks the experiences of heterosexual women and older LGBT people (Loe 2004, Gott 2005). Overall, sexuality becomes part of a wider health imperative in later life, where remaining sexually active become a means to maintain oneself as a healthy, responsibly and successfully ageing (and gendered) subject (Katz 2000, Marshall 2008, 2012). Although it seems fair to claim that the discourse of asexual old age has for a long time been dominant, it seems questionable whether this is the case today. Instead ideas that sexuality is natural and that sexual desire does not cease with age are gaining prominence. Jones (2002: 125) discusses the rise in discourses about sexuality as a natural part of ageing as a ‘liberal storyline’ on ageing and sexuality, which seeks to claim that ‘of course older people have sex too’. She argues that although this storyline generally is positioned as a counter-narrative, it could be understood as a dominant discourse in some instances. As shown in Jones’ (2003) review of the scientific literature on older people and sex, assertions about negative attitudes towards later life sexuality are seldom backed up by empirical examples. Instead, asexual old age is primarily constructed as a ‘myth’ and a ‘misconception’, something to be repudiated (also Scherrer 2009). The work of Michel Foucault (1990 [1977]) suggests that this presentation of ‘asexual old age’ may function as a discursive apparatus. One of Foucault’s significant contributions to the theorizing of sexualities is his argument that sexuality emerges as an object of knowledge by being positioned as something that has been repressed, and which motivates us to speak out further on sexuality. Rather than being a natural and essential phenomenon, sexuality emerges as an object of knowledge through continuous articulations in discourse. Power operates according to Foucault not primarily through repression but through the regulation of how and where sexuality is spoken of. Paradoxically, discourses that appear to attempt to liberate sexuality benevolently from a perceived repression, and that promote the existence of ‘sexy seniors’, may in fact contribute to ‘the same disciplinary apparatus as the discourses of repression that they criticize’ (Marshall 2012: 341). In this, biomedicine and the anti-ageing industry, including the market for sexuo-pharmaceuticals, operate as regulatory regimes shaping male, but also increasingly female, ageing sexuality in terms of function and dysfunction.The emphasis on the erect penis within biomedicine and the pharmaceutical industry shapes ageing male bodies as phallic bodies, which should be hard and impenetrable, in contrast to the softness and permeability of the female body (Sandberg 2011). As such, the emergent discourse of sexuality as something that is lifelong reinforces narrowly gendered conceptions of ageing bodies. It does not account for older men’s experiences of the vulnerability and softness of the ageing body (Jackson 2001, Sandberg 2011), and it largely overlooks female ageing embodiment (Potts et al. 2003). Since discourses that assert the sexuality of older adults are heavily invested in understandings of sexuality as beneficial to health, people have little room to refuse or opt out of continued sexual activity in later life.Withdrawing from the responsibilities to maintain one’s health, including sexual health, becomes a process of opting out of a desirable citizenship altogether (Marshall 2012). As a result those who cannot or do not wish to continue sexual activity as they age run the risk of being pathologized and ‘othered’. As Scherrer (2009: 10) comments: ‘at the same 220

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time that this research [asserting later life sexuality], usefully, opens the door to thinking about aging sexualities it also (unintentionally) positions lack of sexuality in older adults as a negative characteristic’. The critique of the sexualization of old age in many ways parallels critiques by feminists of the sexualization of female bodies. While the increasing sexual agency of women can be understood as positive, feminists have cautioned against how this can sexualize women within a ‘profoundly heteronormative framework’ (Marshall 2012: 340 citing Gill 2008: 54). Feminist Germaine Greer (1992, cited in Meah et al. 2011) has, for example, argued that the desexualisation of the female ageing body may offer post-menopausal women a time of ‘serenity and power’, outside normative gendered embodiment. As Gott concisely puts it (2005: 22): ‘liberation from sexuality may be just that—liberating’. The shift from the asexual oldie stereotype, which contributed to the invisibility and neglect of sexual desire beyond midlife, to the sexy senior, where the sexualities of (some) older people are affirmed and sometimes even celebrated, can consequently be understood as problematic, in that it formulates sex and sexuality in very narrow terms. The new sexy senior discourse can, moreover, be criticized for ‘othering’ older people who cannot, or do not wish to, be sexually active. In order to move beyond these binary representations of later life sexuality, however, it is useful to turn to qualitative studies that seek to represent the voices of older people on their experiences of sex. These narratives propose ways of thinking about sexuality and sexual embodiment that go beyond discourses of asexual old age and the successfully ageing healthy sexy seniors. This may in turn contribute to more complex and nuanced understandings of sex and sexuality in later life, where sex becomes part of a wider spectrum of intimacy.

Cuddling, intimacy and touch The emergent discourses of ‘sexy seniors’ in mass media, advertising and quantitative gerontological and medical research consequently portray later life sexuality in rather narrow ways. The images that emerge from qualitative studies on later life sexuality, however, are significantly different. Although participants in qualitative studies often understood sexuality as continuing to be significant, as in quantitative work, the meanings they gave to it were often redefined, and less centred on coital sexual practices (Gott & Hinchcliff 2003, Potts et al. 2006, Hughes 2011, Vares et al. 2007, Sandberg 2011, 2013, Hurd Clarke 2006,Wentzell 2012).The majority of these studies, however, are from white Western contexts, which may suggest a certain bias. A recurring strand within qualitative studies is the impact and consequences of embodied ageing and changes in health on experiences of sexuality among the older participants. For example, in a UK study by Gott and Hinchcliff (2003), of men and women aged 50–92 years, some participants reflected on how intercourse could cause pain for their partner. Another Swedish study of men aged 67–87 suggested that issues such as stiff joints or back problems could be significant in how men experienced sexuality in later life (Sandberg 2011). However, rather than bringing an end to sexual practices and physical intimacy altogether, several studies suggest that bodily changes from ageing lead the older participants to reinvent the meaning of sex (Gott & Hinchcliff 2003, Hurd Clarke 2006,Vares et al. 2007, Potts et al. 2006, Hughes 2011, Sandberg 2011, Wentzell 2012). This could involve engaging in other sexual practices, such as oral sex, but also maintaining physical intimacy through cuddling or touch. Hinchcliff and Gott’s (2008) study argued that this was particularly the case for women; but other studies suggest that older men also found cuddling and touch to be central to their positive experiences of later life sexuality (Hughes 2011, Sandberg 2011, 2013). A 77-year-old interviewee in Sandberg’s study, 221

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for example, explained: ‘I’m more interested in touching and feeling and like that, now than [before]’. Touching enabled him to discover the whole of his body in a different way (Sandberg 2011, 2013). In several studies sexuality is described by interviewees as something wide and open. This was, for example, expressed by the interviewee Charles, aged 68, (Hughes 2011: 99), who had a 10-year relationship with a woman with whom he had never had intercourse: ‘well there is a sexual thing there in terms of cuddling or just in terms of how you relate to her because she is different from you. Sexuality covers such a wide . . .’. One can interpret these redefinitions of sex as adaptations and mere substitutes when intercourse was no longer possible. What these studies suggest, however, is that cuddling, touching and being close with a partner are valued in their own right, experienced as just as positive as having intercourse. For the women interviewed in the study by Vares and colleagues (2007), who were partners of men who used Viagra, erectile difficulties were experienced as positive because they extended the sexual repertoire, which led to greater sexual pleasure for the women. Similarly, the women aged 52–90 in Hurd Clarke’s (2006) study expressed positive surprise that cuddling and touching could give such profound satisfaction. These narratives around increased touching, cuddling and exploration of the body clearly suggests a ‘de-centering of the penis’ for some older people (Potts et al. 2006: 318), and sometimes even a de-centring of genitalia altogether. The studies involving older men suggest that some men still relied on their penises as central to their experiences of sexuality and sexual pleasure, and consequently experienced erectile difficulties as a hardship and a loss. However, in contrast to portrayals of impotence as a ‘fate worse than death’, which are found in mass media and popular culture (Sandberg 2011), several men in qualitative studies negotiated and challenged the significance of the erect penis for pleasurable sex (Potts et al. 2006, Sandberg 2011, Hughes 2011, Wentzell 2012). There are possibly significant cultural differences in this. Masculinity is understood differently, for example, in Sweden and Mexico: men in Sweden relate to discourses of gender equality; while those in Mexico emphasise machismo in which sexual prowess is central. Despite this, the results of Sandberg’s (2011) study of Swedish men and Wentzell’s (2012) of Mexican men were markedly similar. Both the older Mexican men and the older Swedish men understood declining erectile function and the slowing down of sexuality as one ages as a part of a normal life course narrative and rejected the use of sexuo-pharmaceuticals as unnecessary, ‘age-inappropriate’ and potentially harmful (Wentzell 2012: 129). The turn away from intercourse towards other sexual practices and a wider terrain of intimate physical or non-physical activities not only de-centred the significance of genitalia but was also experienced as a welcome disruption to the teleology of intercourse. Women interviewed in Hurd Clarke’s study (2006: 136) discussed how cuddling was ‘an enjoyable end in itself ’ and an 81-year-old woman spoke about how cuddling in her first marriage always led to sex, whereas the physical intimacy today did not have to lead to sex, something she appreciated.This resembles the experience of Jakob, aged 83, who said: ‘the desire is the same, and being together doesn’t have to end with or lead to intercourse. A lot of warmth can be given just by bodily contact really’ (Sandberg 2011). Sexuality earlier in life was narrated as more bound by expected outcomes, and this was for some also linked to the reproductive aspects of sex. The qualitative studies discussed above present narratives of later life sexuality in which sexuality expands and becomes redefined to include a wider spectrum of intimacy and touch. Narratives of intimacy and touch are not narratives of asexuality, since they are filled with pleasure and desire; nor are they entirely compatible with the discursive apparatus of the ‘sexy senior’, which produces sexuality in narrow terms of intercourse and reinforces gendered binaries where older men’s bodies are reinvented as phallic bodies. Evidence from qualitative studies suggests new

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ways of thinking about later life sexuality. Intimacy and touch exists on the borderlands of sexual and non-sexual, and as such they could propose more open and different ways of conceptualizing sexuality (cf. Sandberg 2011, 2013). As a result, highlighting qualitative work of later life sexuality is important as it provides more complex notions of sex and sexuality, notions that do not ‘other’ those who cannot or do not want to engage in intercourse or genital sexual practices.

Conclusion Despite repeated claims that later life sexuality is a ‘taboo’ and that the asexuality of old age is a ‘myth’ that lives on, there has probably never been as much discussion of the sexuality of older people as there is today. This chapter has outlined the ongoing discursive shift from the ‘asexual oldie’, where sexual desire and activity are understood to fade as people age, and eventually disappear altogether, to the ‘sexy senior’, a more liberal and affirmative discourse of later life sexuality. In both cultural and scientific representations, sexuality and an active sex life are increasingly understood as lifelong and part of a healthy and positive ageing. Nevertheless, discourses about sexy seniors are not necessarily liberating for all older adults. As critical researchers have pointed out, the pursuit of ‘liberation’ for older people’s sexuality has resulted in the emergence of the discursive apparatus of the sexy senior, formulated at the intersections of biomedical, consumerist and successful ageing discourses. This discursive apparatus shapes later life sexuality primarily as a matter of the male erection, heterosexual intercourse and the health imperative. It leaves little room for older people’s non-coital experiences of sexuality, or of sexuality as comprising positive and pleasurable activities in their own right, healthy or not. The new emphasis on sexuality as lifelong also risks ‘othering’ those who cannot be or do not wish to be sexually active as they age. Evidence from qualitative research on later life sexuality, however, opens up to a more complex picture, beyond the binary position of the asexual oldie and the sexy senior. In this research older participants do affirm the significance of sex and sexuality in later life. But they also point to how changes in the ageing bodies affect what sex is possible or desirable. Bodily changes, including declining erectile function and vaginal dryness, point older men and women towards other sexual practices. This often means great focus on cuddling and touch, de-centring the significance of men’s erections and of intercourse. The increasing emphasis on cuddling and touch among older men and women, however, did not imply that changes in sexuality in later life were experienced as uncomplicated. Qualitative research points to considerable ambivalence around later life sexuality, not least in relation to the uses or non-uses of Viagra or other sexuo-pharmaceuticals, which are often surrounded by mixed feelings in both older men and women (Potts et al. 2003, Loe 2004,Wentzell 2012, Agunbiade Ojo 2012). Later life sexuality is, moreover, negotiated in relation to local gender-specific cultural contexts. This was most evident in Agunbiade Ojo’s (2012) study on older Nigerian men living in polygynous marriages. This work calls for more studies on later life sexuality outside Western contexts. Neither the asexual oldie nor the sexy senior fully reflects the multifaceted experiences of later life sexuality. Thinking of later life sexuality through experiences of intimacy, cuddling and touch, however, as suggested by qualitative research, opens us up to new terminologies and ways of thinking sexuality. It argues for a language that acknowledges how sex and sexuality exist within a continuum of pleasures, desires and ambiguities. It requires a language that makes visible both strong urges and serene desires, that does not overlook or silence the experiences of sexuality that older people have, but avoids ‘othering’ those who do not wish to be sexual.

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Meah, A., Hockey, J. and Robinson,V. (2011) ‘ “I’m a sex kitten aren’t I . . .”: relocating agency and pleasure in older women’s narratives about sex’, Australian Feminist Studies, 26: 57–71. Nordgren, M. (2010) ‘Sex efter sextio är det sista sextabut [Sex after sixty is the last sexual taboo]’, Dagens Nyheter, 29 September. Available online at www.dn.se/insidan/sex-efter-sextio-ar-det-sista-sextabut/ (accessed 25 April 2014). På ålderns host (2012) ‘Sex efter sextio: Myten om att lusten försvinner stämmer inte [Sex after sixty: The myth about sexual desire disappearing is untrue]’, February. Potts, A., Gavey, N., Grace,V. and Vares, T. (2003) ‘The downside of Viagra: women’s experiences and concerns’, Sociology of Health & Illness, 25: 697–719. Potts, A., Grace,V.,Vares, T. and Gavey, N. (2006) ‘Sex for life?: men’s counter stories on “erectile dysfunction”, male sexuality and ageing’, Sociology of Health and Illness 28: 306–29. Sandberg, L. (2011). Getting intimate: a feminist analysis of old age, masculinity & sexuality (dissertation). Linköping: Linköpings Universitet. Sandberg, L. (2013) ‘  “Just feeling a naked body close to you”: men, sexuality and intimacy in later life’, Sexualities, 16: 261–82. Scherrer, K. (2009) ‘Images of sexuality and aging in gerontological literature’, Sexuality Research and Social Policy, 6: 4–12. Sontag, S. (1972) ‘The double standard of aging’, Saturday Review, 55: 29–38. Trompeter, S.E., Bettencourt, R. and Barrett-Connor, E. (2012) ‘Sexual activity and satisfaction in healthy community-dwelling older women’, The American Journal of Medicine, 125: 37–43. Vares, T. (2009) ‘Reading the “sexy oldie”: gender, age(ing) and embodiment’, Sexualities, 12: 503–23. Vares, T., Potts, A., Gavey, N. and Grace,V. (2007) ‘Reconceptualising cultural narratives of mature women’s sexuality in the Viagra era’, Journal of Ageing Studies, 21: 153–64. Wentzell, E. (2012) ‘Decreasing erectile function and age-appropriate masculinities in Mexico’, in Kampf, Marshall and Petersen (eds), Aging men, masculinities and modern medicine. London: Routledge, pp. 123–37.

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Non-heterosexual ageing has developed from an ‘unmentionable topic’ for academic study in the 1970s (Kimmel et al. 2006: 2), to a subject on which full-length books and special issues of journals have been published. The key to understanding non-heterosexual ageing is to interrogate the very meanings of sexual and gender identities. Research and theory that takes a biological approach to homosexuality focuses on why and how homosexual orientation develops ‘against the nature’ of reproduction. This differs radically from a socio-cultural approach that analyzes the historical and cultural contingencies of sexuality (Foucault 1978). This social constructionist approach ‘is about understanding the historical context which shapes the sexual’ (Weeks 2003: 18). Evidence from historical and anthropological research across times and cultures has revealed that same-sex sexual practices take a number of forms, and can be assigned very different meanings and hence be socially received very differently. Religious authorities, through defining sexual norms, and sexologists, through medicalizing sexuality, played crucial roles in the formation of a sexual hierarchy (Rubin 1984) that privileges heterosexuality as a dominant, all-pervading social category that is naturalized, universalized and absolved from scrutiny (Wilkinson and Kitzinger 1993: 3). This social organization of sexuality in turn influences the lived realities of non-heterosexual people (Plummer 2003), informally through social discourses and stereotypes, and formally through laws, policies and practice on an everyday basis. Sexual minorities, including but not limited to LGBT (Lesbian, Gay, Bisexual,Transgender) people, are as a result Othered, stigmatized, marginalized, excluded and persecuted.These social and cultural configurations influence how sexual desires are expressed through different behaviours, and whether and how sexual identities are formed. Such recognition of the socially constructed nature of sexual and gender identities implies that attempts to understand LGBT ageing need to take to heart the influences of the social and cultural environment. Life course approaches, which suggest that ‘no period of life can be understood in isolation from people’s prior experiences, as well as their aspirations for the future’ (Mortimer and Shanahan 2003: xi), are especially useful. It reminds us of the need to examine how formative experiences in older LGBT people’s earlier lives can contribute to a unique world view or frame of reference that remains powerful throughout their lives (Mannheim 1952: 298).

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When this current cohort of older gay men and lesbians were born, male homosexuality was criminalized in most parts of the world, and ‘homosexuality as a stigma was not only dominant, but exclusive’ (Rosenfeld 1999: 128).Take England for example: homosexuality in private between two consenting male adults over the age of 21 was decriminalized as recently as 1967, and the age of consent was equalized to 16 between heterosexual and gay men only in 1997. This social and historical backdrop means that many older gay men and lesbians learned from a very early age that they had to keep their sexual orientation secret. It is therefore not difficult to understand how 37 per cent of older gay men and lesbians in the UK reported that they had always hidden their sexual identity throughout their lives (Heaphy,Yip and Thompson 2004). Staying in the closet can lead to chronic stress and internalized homophobia, which has been shown to be related to lower self-esteem, relationship dissatisfaction, increased psychological distress, increased likelihood of depression and weaker ego strength (see reviews in Allen and Oleson 1999: 41, Mayfield 2001: 72). On the other hand, it has been found that the more open older gay men and lesbians were about their sexual orientation and the less time they spent before disclosing their sexual orientation, the more victimization, in particular physical victimization, they reported. Those who had been physically attacked reported lower self-esteem, more loneliness, poorer mental health and more suicide attempts than others (D’Augelli and Grossman 2001). That said, the current cohort of older gay men in England witnessed the Gay Liberation Front set up in London in 1970, Britain’s first gay pride march held in London in 1972, the opening of the London Lesbian and Gay switchboard in 1974, and the onset of the HIV/AIDS epidemic in the 1980s. In 2004 the Gender Recognition Act and Civil Partnership Act were enacted.The Equality Act 2010 has made it ‘illegal to discriminate on the grounds of sexual orientation when providing goods, facilities or services, in education, when selling or letting premises or when exercising public functions’. It thus seems entirely possible that older LGBT people of future cohorts will have faced very different social circumstances during their upbringing compared with the current cohort of older LGBT people. One speculation would be that they would be much more open about their sexuality than the current cohort. Therefore, to understand older LGBT people, or LGBT people more generally, it is imperative to identify the ‘identity cohort’ (Rosenfeld 1999) or ‘sexual generation’ (Plummer 2010) that they come from. Such a social constructionist approach also highlights the difficulty in defining older LGBT people. Identity categories are fluid and changeable, depending on time and culture. There are myriad social forces at work in shaping how individuals are defined and self-define themselves, and such decisions can be ‘pragmatic, related to concerns of situational advantage, political gain, and conceptual utility’ (Seidman 1994: 173). Queer Theory, which suggests the need to expand, transgress and even subvert any kind of identity category, argues that ‘older LGBT people’ as a category for analysis is itself a construct, and may be too restrictive, failing to include those individuals who choose not to label themselves along the socially defined binary imaginary of sexual orientation and gender.

Cultural representations and ageism Although representations of gay men and lesbians in the media have been increasing and becoming more diverse, the portrayals of gay and lesbian characters are still criticised for legitimizing and reinforcing, rather than challenging, heteronormativity (Shugart 2003).Younger Caucasian men and women who support the family logic are featured more prominently and positively, whereas older gay men and lesbians, alongside members of ethnic minorities, are generally

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absent in the mainstream media as well as gay media. Older lesbian women are particularly invisible due to the intersecting influences of ageism, homophobia and sexism (Kehoe 1986). There is a suggestion that because of alternative appearance norms and standards in the lesbian community, older lesbians may be less affected by bodily changes related to ageing, but the evidence is inconclusive (Clarke and Griffin 2008, Slevin 2010). Older gay men, like heterosexual women in general, are subject to the ‘male gaze’ because their sexual partners are men who put more focus on physical appearance. The gay culture’s focus on physique, fashion and personal grooming (Drummond 2006: 60) and the archetypal gay male body. which is ‘muscular, athletic, devoid of fat and hairless’ (Drummond 2010: 31), together set an ideal that is difficult to achieve and has adverse effects on many gay men’s body image (Levesque and Vichesky 2006). Such emphasis on youth is supported by an analysis of the age preferences of men and women of different sexual orientations when it comes to dating. Gay men are more likely than heterosexual men, heterosexual women and lesbians to state a preference for a younger partner (Hayes 1995). Research focusing only on gay men has repeatedly documented such a preference for younger partners (Heaphy 2007: 200, Kaufman and Chin Phua 2003). In one study of phone advertisements from men seeking men, it was found that almost seven times more gay men advertised for younger partners than for older ones (Bartholome, Tewksbury and Bruzzone 2000). Because of this emphasis on youth in the gay community, gay men face more pressure as they age than heterosexual men. They think of themselves and others as middle-aged and old earlier than heterosexual men, a phenomenon referred to as ‘accelerated ageing’ (Bennett and Thompson 1991: 66). It has been commented that older gay men are excluded from ‘a world in which being old equates to being unattractive and being attractive is a precondition for entry’ (Jones and Pugh 2005: 258). Some older gay men expressed that their wish to ‘locate a setting that was not dominated by younger men’ was difficult to realize (Christian and Keefe 1997: 69).

Lack of culturally appropriate care A growing strand of research focuses on how older LGBT people face ‘a number of forms of discrimination which may impact upon the provision of, access to and take up of health, social care and housing services’ (Addis et al. 2009). Because of their experience of growing up under strong sexual stigma, in particular facing prosecution, older LGBT people show mistrust towards ‘authorities’, including police and health care providers (Brotman, Ryan and Cormier 2003), and assume them to be homophobic until proven otherwise. As a result, while relocating into a care home is a stressful process for any person, older LGBT people face the added concerns of possibly being rejected or neglected by healthcare providers, particularly personal care assistants, on the ground of their sexual and gender identities; not being accepted and respected by other residents; and having to go back into the closet (Stein, Beckerman and Sherman 2010). Administration, care staff and residents of retirement care facilities were all perceived as potential sources of discrimination by older LGBT people (Johnson et al. 2005). It is not therefore surprising that many older LGBT people showed a preference for LGBT-specific care. More than half of those interviewed in a study in New Zealand preferred LGB-specific facilities, and such preferences were held regardless of educational attainment, annual income or gender (Nevill and Henrickson 2010: 589). Such support for LGBT-specific care was also found in the US (Stein, Beckerman and Sherman 2010, Johnson et al. 2005) and Australia (Hughes 2007). On the other hand, there is concern about whether such specific care facilities might bring about some form of ‘ghettoization’ (Stein, Beckerman and Sherman 2010). 228

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‘Families of choice’ and ‘new’ care cultures Older LGBT people transcend the normative framework of understanding how care is provided and received (King and Cronin 2010). Although non-heterosexual older people are less likely to receive informal care from their spouses and children than heterosexual people, they have been found to receive significant social support from their ‘families of choice’, which may consist of friends, former lovers, or members of a partner’s family (Weeks, Heaphy and Donovan 2001). These ‘chosen families’ carry with them special concern over mutual care, responsibility and commitment. In one study, more than one-third of older lesbian, gay and bisexual (LGB) people interviewed reported receiving care from people other than healthcare providers in the past 5 years and more than two-thirds provided care to other older LGB people. More than 75 per cent of those interviewed said they would be willing to provide care to LGB people in the future (Grossman, D’Augelli and Dragowski 2007). This shakes the prevalent understanding in Western societies that caregiving is typically a family activity undertaken by opposite-sex partners and adult children (Manthorpe 2003). It also challenges the assumption that a single individual is usually the primary caregiver. Instead, the term ‘networks of care’ seems more appropriate to describe older LGBT people’s support system (Hughes and Kentlyn 2011). It also leads to a more fundamental questioning of whether the heterosexual couple, and particularly the married, co-resident heterosexual couple with children, is still the unquestionable centre ground of Western societies, and whether it can be taken for granted as the basic site of care exchange in society. Roseneil and Budgeon (2004) have pointed out the importance of recognizing that care increasingly takes place beyond the ‘family’—between partners who are not living together ‘as family’, and within networks of friends. However, there seems to be a lag in policy thinking, which has failed to move beyond a focus on families and conjugal couples. Fiscal benefits, inheritance and other ‘next of kin’ rights remain difficult to access for networks of care surrounding older LGBT people, as well as those who do not fit within the ‘care norms’.

Bisexual and transgender ageing There are very few empirical studies on bisexual ageing. Most articles are speculative in nature, drawing on existing knowledge about bisexuality and envisaging the lives of bisexuals in later life. In that sense bisexual older people are even less recognized and more invisible than older lesbian and gay people. Bisexual people are subject to misunderstanding and stereotypes from the general public, as well as from the lesbian and gay community itself. The definition of bisexual older people can itself be problematic, as sexual desire, behaviour and identity may not overlap. Also, such desire, behaviour and identity are not stable and may change through the life ( Jones 2010). Transgender is an umbrella term, encompassing people who live in a variety of ways that vary from the socially expected gender performances, including people who either have a wish to undergo or have undergone male-to-female or female-to-male surgeries (transexuals); those who cross-dress (transvestites); and gender-queer people (who do not identify with any gender category at all). Transgender ageing, like bisexual ageing, remains under-researched. One of the reasons is that it is only now that the first generation of transsexual people living with the hormone surgeries that started in 1960s and 1970s, some of which were experimental in nature, is entering into old age. Applying the life course perspective described earlier in this chapter, the discrimination experienced by older transgender people in their earlier lives needs to be taken into account. Many transgender people have experienced major mental health problems prior to transitioning. Even 229

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after transition, support losses related to gender transition, including the support of parents, children, spouses, friends and colleagues are often reported.Verbal and financial abuse, sexual assault (including rape) and physical violence are events not uncommonly experienced by transgender people. Such life course experiences mean that some older transgender people may be at risk of poverty and a lack of health insurance coverage. The formation of social support networks may have been hampered (Finkenauer et al. 2012). There is a great shortage of care providers who are knowledgeable about transgender issues. Older transgender people can face discriminatory practices or ignorant health care providers, whom ‘patients with transgender concerns are usually required to educate’ (McMahon 2003).

Race, ethnicity and geographical location Intersectionality theory suggests that various socio-economic variables are interlocked (Crenshaw 1991). It is important to recognize how being old and self-identifying as LGBT intersects with social class, race, ethnicity, nationality, partnership status, living arrangements (living alone/, rural/urban), having children or not, HIV status and physical/mental health statuses, among other social variables. Here, race, ethnicity and geographical location are used as examples to illustrate how the differences among older LGBT people can be as marked as the similarities. Research on older LGBT people from black and ethnic minority (BME) communities is lacking, and the few studies that have been conducted are mostly on black older gay men and lesbians. It has been found in the US that black older gay men reported significantly higher levels of perceived racism than younger black gay men, and significantly higher levels of ­homonegativity than younger black gay men and white gay men (David and Knight 2008), suggesting that identity struggles and acceptance can be made even more difficult for BME older non-heterosexual people. Older LGBT people from BME communities can be trapped in a situation of not being able to call any community home. While racism is not uncommon in the gay community (Chan 1989), racial and ethnic communities that put a strong emphasis on family ideals and gender norms can also marginalize LGBT people. For example, a study of older African American lesbians and gay men in the US (Battle et al. 2013) revealed that they showed an aversion to LGBT labels because of the cultural connotations attached to the terms. They faced alienation in the African American community, in which they had to deliberately conceal their sexual identity. They expressed a need to find alternative communities away from their community of origin, yet they also faced racism in the gay community. In addition to such social isolation, racial discrimination throughout the life course can affect educational attainment and employment market participation, which may also mean that some older BME LGBT people are financially disadvantaged in later life, resulting in barriers to accessing health services. Most research about older LGBT people has been conducted in the UK, US, Australia and Canada, leaving older LGBT people’s lives in other parts of the world almost unknown. This reflects the way sexual rights have developed unevenly across the globe. In Iran and Afghanistan, for examples, male homosexuality is still punishable by death. Legislation against discrimination on the ground of sexual orientation is still being fiercely debated and resisted in many parts of the world. In many parts of the world, conducting research into older LGBT people, or LGBT people in general, still involves tremendous difficulties in terms of the stigma attached, funding and sampling. Also, as noted earlier, sexual identities are developed in specific cultural and historical contexts. It may be the case that older people from different cultures, despite sexual attraction towards the same sex or various gender performances, reject the labels of LGBT. 230

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Resilience and strengths While it is important to recognize the challenges older LGBT people face, they are not ‘victims’. It has been argued that LGBT people have learned to live with a stigmatized identity in their earlier lives. For example, in cases where they have come out, ‘confronting the reactions of family members or friends’ (Jones and Hill 2002: 23) and transphobia; having experienced negative life events (e.g. loss of custody of children, anti-gay violence); more chronic daily hassles such as hearing anti-gay jokes, always being on guard (Garnets and Kimmel 2003)—all these are likely to be stressful or even traumatic. This means that when LGBT people enter into old age, they may well have achieved ‘crisis competence’ (Friend 1980, Kimmel 1978) through ‘learning to manage an identity that was in disfavour almost everywhere’ (Berger 1982: 38). These ‘adapative coping talents’ (D’Augelli 1994) that have been developed may help them to better adapt to acquiring another, also often marginalized, status of being old. In addition, it has been suggested that more flexible gender roles throughout their lives mean that they can more easily face life transitions in later life.

Conclusion Applying life course approaches, this chapter highlights that LGBT ageing should be understood as a phenomenon contingent on cohort membership. Older LGBT people remain invisible and marginalized in cultural representations, and ageism within the LGBT community prevails, particularly among older gay men. There is also a lack of culturally appropriate care for older LGBT people. Through forming ‘families of choice’, older LGBT people exemplify the emergence of ‘new’ care cultures that are increasingly common among both heterosexual and non-heterosexual people but remain under-recognized by research, policy and practice. The experiences of older LGBT people from BME communities illustrate how cultural differences among older LGBT people may be as marked as the similarities they share. Older bisexual and transgender people’s experiences remain under-researched. The lives of older LGBT people outside the UK, US, Canada and Australia remain largely unresearched. Most research on older LGBT people has been based on convenience samples of white, relatively affluent, well-educated and physically and mentally healthy people, whereas working-class and ethnic minority members continue to be under-represented in almost all samples. The older LGBT people studied were also often recruited through LGBT groups or organizations, or venues in the gay scene. Although the volume of research into LGBT ageing has been increasing, more nuanced academic studies and public policy responses are needed in order to allow LGBT people to age well and have their sexual citizenship recognized.

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Bennett, K. C. and Thompson, N. L. (1991) ‘Accelerated aging and male homosexuality’, Journal of Homosexuality, 20, 65–76. Berger, R. M. (1982) Gay and Gray:The Older Homosexual Man, London: University of Illinois Press. Brotman, S., Ryan, B. and Cormier, R. (2003) ‘The health and social service needs of gay and lesbian elders and their families in Canada’, The Gerontologist, 43, 192–202. Chan, C. S. (1989) ‘Issues of identity development among Asian-American lesbians and gay men’, Journal of Counseling & Development, 68, 16–20. Christian, D. V. and Keefe, D. A. (1997) ‘Maturing gay men: A framework for social service assessment and intervention’, Journal of Gay & Lesbian Social Services, 6, 47–78. Clarke, L. H. and Griffin, M. (2008) ‘Visible and invisible ageing: Beauty work as a response to ageism’, Ageing and Society, 28(5), 653–74. Crenshaw, K. (1991) ‘Mapping the margins: Intersectionality, identity politics, and violence against women of color’, Stanford Law Review, 43, 1241–99. D’Augelli, A. R. (1994) ‘Lesbian and gay male development: Steps toward an analysis of lesbians’ and gay men’s lives’, in B. Grenne and G. M. Herek (eds), Lesbian and Gay Psychology:Theory, Research, and Clinical Implications, Newbury Park, CA: Sage. D’Augelli, A. R. and Grossman, A. H. (2001) ‘Disclosure of sexual orientation, victimization, and mental health among lesbian, gay, and bisexual older adults’, Journal of Interpersonal Violence, 16, 1008–27. David, S. and Knight, B. G. (2008) ‘Stress and coping among gay men: Age and ethnic differences’, Psychology and Aging, 23, 62–9. Drummond, M. (2006) ‘Ageing gay men’s bodies’, Gay and Lesbian Issues in Psychology Review, 2, 60–6. Drummond, M. (2010) ‘Younger and older gay men’s bodies’, Gay and Lesbian Issues in Psychology Review, 6, 31–41. Finkenauer, S., Sherratt, Marlow, J. and Brodey, A. (2012) ‘When injustice gets old: A systematic review of trans aging’, Journal of Gay & Lesbian Social Services, 24(4), 311–30. Foucault, M. (1978) The History of Sexuality, Harmondsworth: Penguin. Friend, R. A. (1980) ‘Gay aging’, Journal of Family and Economic Issues, 3, 231–48. Garnets, L. D. and Kimmel, D.C. (2003) Psychological Perspectives on Lesbian, Gay, and Bisexual Experiences, New York: Columbia University Press. Grossman, A. H., D’Augelli, A. R. and Dragowski, E. A. (2007) ‘Caregiving and care receiving among older lesbian, gay, and bisexual adults’, Journal of Gay & Lesbian Social Services, 18, 15–38. Hayes, A. (1995) ‘Age preferences for same- and opposite-sex partners’, The Journal of Social Psychology, 135, 125–33. Heaphy, B. (2007) ‘Sexualities, gender and ageing’, Current Sociology, 55, 193–210. Heaphy, B., Yip, A. K. T. and Thompson, D. (2004) ‘Ageing in a non-heterosexual context’, Ageing & Society, 24, 881–902. Hughes, M. (2007) ‘Older lesbians and gays accessing health and aged-care services’, Australian Social Work, 60, 197–209. Hughes, M. and Kentlyn, S. (2011) ‘Older LGBT people’s care networks and communities of practice: A brief note’, International Social Work, 54, 436–44. Johnson, M. J., Jackson, N. C., Arnette, J. K. and Koffman, S. D. (2005) ‘Gay and lesbian perceptions of discrimination in retirement care facilities’, Journal of Homosexuality, 49, 83–102. Jones, B. E. and Hill, M. J. (2002) Mental Health Issues in Lesbian, Gay, Bisexual and Transgender Communities, Washington, DC: American Psychiatric. Jones, J. and Pugh, S. (2005) ‘Ageing gay men’, Men and Masculinities, 7(3), 248–60. Jones, R. (2010) ‘Troubles with bisexuality in health and social care’, in R. Jones and R. Ward (eds), LGBT Issues: Looking beyond Categories, Edinburgh: Dunedin Academic Press. Kaufman, G. and Chin Phua,V. (2003) ‘Is ageism alive in date selection among men? Age requests among gay and straight men in internet personal ads’, The Journal of Men’s Studies, 11, 225–35. Kehoe, M. (1986) ‘Lesbians over 65’, Journal of Homosexuality, 12, 139–52. Kimmel, D. (1978) ‘Adult development and aging: A gay perspective’, Journal of Social Issues, 34, 113–30. Kimmel, D., Rose,T., Orel, N. and Greene, B. (2006) ‘Historical context for research on lesbian, gay, bisexual and transgender aging’, in D. Kimmel,T. Rose and D. Steven (eds), Lesbian, Gay, Bisexual, and Transgender Aging: Research and Clinical Perspectives, New York: Columbia University Press. King, A. and Cronin, A. (2010) ‘A queer kind of care: Some preliminary notes and observations’, in R. Jones and R.Ward (eds), LGBT Issues: Looking beyond Categories, Edinburgh: Dunedin Academic Press.

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Levesque, M. J. and Vichesky, D. R. (2006) ‘Raising the bar on the body beautiful: An analysis of the body image concerns of homosexual men’, Body Image, 3, 45–55. Mannheim, K. (1952) Essays on the Sociology of Knowledge, London: Routledge. Manthorpe, J. (2003) ‘Nearest and dearest? The neglect of lesbians in caring relationships’, British Journal of Social Work, 33, 753–68. Mayfield, W. (2001) ‘The development of an internalized homonegativity inventory for gay men’, Journal of Homosexuality, 41, 53–76. McMahon, E. (2003) ‘The older homosexual: Current concepts of lesbian, gay, bisexual, and transgender older Americans’, Clinics in Geriatric Medicine, 19(3), 587–93. Mortimer, J. T. and Shanahan, M. J. (2003) Handbook of the Life Course, New York: Springer. Neville, S. and Henrickson, M. (2010) ‘ “Lavender retirement”: A questionnaire survey of lesbian, gay and bisexual people’s accommodation plans for old age’, International Journal of Nursing Practice, 16, 586–94. Plummer, K. (2003) Intimate Citizenship: Private Decisions and Public Dialogues, Seattle: University of Washington Press. Plummer, K. (2010) ‘Generational sexualities, subterranean traditions, and the hauntings of the sexual world: Some preliminary remarks’, Symbolic Interaction, 33, 163–90. Roseneil, S. and Budgeon, S. (2004) ‘Cultures of intimacy and care beyond “the family”: Personal life and social change in the early twenty-first century’, Current Sociology, 52, 135–59. Rosenfeld, D. (1999) ‘Identity work among lesbian and gay elderly’, Journal of Aging Studies, 13, 121–44. Rubin, G. (1994) ‘Thinking sex: Notes for a radical theory of the politics of sexuality’, in H. Abelove, M. A. Barale and D. M. Halperin (eds), The Lesbian and Gay Studies Reader, New York: Routledge. Seidman, S. (1994) ‘Queer-ing sociology, sociologizing queer theory: An introduction’, Sociological Theory, 12, 166–77. Shugart, H. A. (2003) ‘Reinventing privilege: The new (gay) man in contemporary popular media’, Critical Studies in Media Communication, 20, 67–91. Slevin, K. (2010) ‘ “If I had lots of money . . . I’d have a body makeover”: Managing the aging body’, Social Forces, 88(3), 1003–20. Stein, G. L., Beckerman, N. L. and Sherman, P. A. (2010) ‘Lesbian and gay elders and long-term care: Identifying the unique psychosocial perspectives and challenges’, Journal of Gerontological Social Work, 53, 421–35. Weeks, J. (2003) Sexuality, London: Routledge. Weeks, J., Heaphy, B. and Donovan, C. (2001) Same Sex Intimacies: Families of Choice and Other Life Experiments, London: Routledge. Wilkinson, S. and Kitzinger, C. (1993) Heterosexuality: Feminism and Psychology Reader, London: Sage.

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30 Grandparenting Sara Arber and Virpi Timonen

Contemporary grandparenting is at the centre of family relationships, but grandparenting practices are very different today than 50 years ago, and differ greatly across cultural contexts. To fully understand grandparenting, it is valuable to adopt a comparative and temporal perspective, taking account of cultural norms in different societies and broader societal changes over time. Consequently, grandparenting practices and the meaning of being a grandparent vary greatly between societies and within the same cultural context over time (Arber and Timonen 2012). Grandparenting should be considered as an active and dynamic family practice, with grandparents and other family members exercising agency in constructing their relationships with one another. Although extensive research on ‘doing family’ has examined family practices among couples and their children (Morgan 2011), fewer studies consider family practices among extended family members. It is important to consider the everyday practices of grandparenting, and how these are negotiated across both the dyadic grandparent–grandchild relationship and the triad of grandparent–adult child–grandchild. Underlying the family practices of ‘doing’ grandparenting, it is essential to recognise that family relationships are dynamic and changing, as well as being shaped by material and structural realities that face individual family members and the family as a whole. Although these structural constraints often operate within the bounded household context, research on grandparenting brings into sharp relief how family relationships that transcend household boundaries are also influenced by structural constraints and cultural norms. Gender has not been highly visible in research on grandparenting. Much research on grandparent care for grandchildren implicitly assumes that the primary caregiver is the grandmother, with ‘grandparenting’ often a euphemism for ‘grandmothering’. Few studies have examined family practices associated with grandmother versus grandfather care in a nuanced way. For example, we know little about whether grandfathering practices largely support the grandmothers’ practices, with his involvement secondary to the grandmother’s (Tarrant’s [2012] research on grandfathering is one exception). How gendered grandparenting practices vary between cultural contexts remains a largely unexplored area, and presents a fruitful agenda for future research. This chapter firstly focuses on macro-social issues by considering how various societal changes impact on the nature of grandparents’ involvement in grandchildren’s lives (including grandchild care), demonstrating the interconnections between families, labour markets and state 234

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policies, as well as between the public and private spheres. Second, it considers cultural norms about grandparenting and the agency of grandparents, and how clashes between norms and agency may result in ambivalence. Finally, it emphasises how grandparenting is part of a complex web of negotiated family relationships, within which the grandchild may impact on the grandparent’s attitudes and practices. In all three areas (macro-social, cultural norms, negotiated relationships), it is important to consider differences between cultural contexts.

Societal changes and grandparenting Many societal and cultural changes shape the practices and norms of grandparenting. Demographic change has produced a rapid increase in longevity across the globe, which means that grandchildren will share a much longer period of life with their grandparents (Phillipson 2010). Within the increasing number of three-, four- or even five-generational families, there is the potential for grandchildren to establish longer-lasting relationships with their grandparents, which often now extend well into the grandchild’s adulthood. Declines in fertility have been rapid, especially in southern Europe, China and Asian societies, resulting in fewer grandchildren and the development of ‘bean pole’ families: families with several surviving generations, but few members in each generation (Bengtson and Harootyan 1994). Fewer grandchildren might mean that grandparents ‘invest’ more time and resources in their relationships with each grandchild, developing stronger emotional bonds. Social and cultural contexts shape the rationale for this investment and the forms that it takes. For instance, in China this investment may take the form of grandparents looking after grandchildren ‘left behind’ by their parents who are undertaking employment in geographically far-removed locations within the Chinese labour market (Baker and Silverstein 2012). Other key changes in families include changing patterns of marriage, divorce and cohabitation. Divorce, separation (including from non-marital unions) and lone parenthood are increasingly prevalent in both the grandparent and the parent (middle) generation, often resulting in the establishment of ‘reconstituted’ families. Divorce, separation and lone parenthood in the middle generation may increase the extent of support provided by some (particularly maternal) grandparents, while fracturing relationships with other (particularly paternal) grandparents (Timonen and Doyle 2012). Divorce, separation and re-partnering in the grandparent and/or parent generation may potentially result in one grandchild having eight or more (step)grandparents. The prevalence of divorce, separation and reconstituted families varies greatly between societies, being higher in the US, UK and northern Europe; very low in China and Asian countries; and at an intermediate level in the predominantly Catholic countries of southern Europe and Ireland.We consider the agency exercised by grandparents in contexts of divorce/separation later in this chapter.

Changing involvement in grandchild care In many cultural contexts, grandparents play a major role in grandchild care. This role is influenced by the increased labour force participation of women across societies, and societal policies regarding provision of childcare (when mothers are in paid work). Alongside increases in women’s employment, recent policy concerns internationally have emphasised the costs of the ‘ageing population’, leading to increases in retirement age and policy initiatives for employees to delay retirement and remain longer in the labour market. A key issue is therefore how grandparents’ participation in paid employment impacts on their ‘opportunity’ and willingness to act as grandchild carers. 235

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Contemporary grandparents are becoming central to supporting the increased employment of women, but in ways that vary according to the cultural and welfare policy context, demonstrating the interconnections between families, cultural norms, labour markets and state policies. Herlofson and Hagestad (2012) contrast differences in grandparents’ roles across European societies in respect of women’s increased labour participation. In northern European countries, welfare policies support the provision of childcare and care for elders, with policies also encouraging greater gender equality in the domestic division of labour. Here grandparents provide occasional support and ‘baby-sitting’ for their grandchildren, but rarely undertake daily childcare to enable daughters/-in-law to work.They provide a backup resource in temporary emergencies or times of need, and are characterised as ‘family savers’,‘complementing’ the provision of state-sponsored childcare services. In contrast, southern European welfare states provide very little childcare (or elder care), a situation that also reflects entrenched cultural attitudes and practices.This, together with marked gender-segregated roles in the domestic arena, has resulted in employed women turning to their mothers (the maternal grandmothers) for everyday childcare. A high proportion of grandparents in southern European countries provide daily childcare, characterised as ‘mother savers’. However, higher-earning women are better able to afford formal childcare, rather than relying on (and constraining the lives of ) their mothers/-in-law, leading to diverging cultures of grandparenting between higher and lower socio-economic status groups. The UK contrasts with the Nordic and southern European welfare regimes, and is profoundly class-divided. Lack of affordable childcare means that working-class parents in particular turn to grandparents for daily childcare (or a regular commitment of childcare on 2–3 days per week) (Dench and Ogg 2002). Wheelock and Jones (2002) demonstrate the heavy reliance of employed mothers on grandparent care and that some grandparents give up paid work to provide regular grandchild care. The UK Grandparents Plus report (Glaser et al. 2010) highlights the considerable involvement of grandparents in regular childcare in the UK and across Europe, arguing that policies should be in place to provide financial and other supports for grandparents in this role. Thus, it is important to consider the interdependence between formal and informal systems of child care and how these differ across cultural contexts. While the employment of foreign domestic workers might be a ‘solution’ to support mothers’ paid work for middle/higher income families in Singapore and Hong Kong (Ko 2012, Sun 2012), these women domestic workers themselves have in many cases left behind grandparents, parents, children or grandchildren in their native country, limiting their own family relationships. Grandparents perform the greatest childcare role where the middle generation is absent because of migration (as in China; Baker and Silverstein 2012), through HIV/AIDS (as in sub-Saharan Africa; Oduran and Oduran 2010) or because of inability to parent through mental health problems, drug or alcohol addiction (as in the US; Minkler 1999). Within such ‘skipped generation’ households, Baker and Silverstein (2012) show how the routes into ‘custodial grandparenting’ are very different in the US and China, leading to diverse consequences for the grandparents. In the US, custodial grandparents are disadvantaged on financial and health grounds prior to entry into custodial grandparenting, and their health and wellbeing then worsens, largely due to the accumulation of socio-economic disadvantages. In contrast, grandparents in rural China are advantaged in their health and financial assets prior to becoming custodial grandparents, and while in this role their health and wellbeing improves, both because of financial remittances from adult children and the psychological benefits of grandparenting. The practices of grandparenting are therefore not static, and should be seen as dynamically changing in concert with other societal and cultural changes. However, within any culture there

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are patterned diversities in grandparenting practices, associated with gender, family structure, material circumstances, ethnicity and geographical propinquity.

Geographical distance, migration and changing cultures of communication Societal norms influence the geographical propinquity of grandparents to their grandchildren. Kohli and colleagues (2008) report marked differences across Europe in rates of grandparents living near adult children, varying from about 30 per cent of people aged 50 and over living within 1 km of a child in Sweden and Denmark to over 70 per cent in Italy, Spain and Greece. Following retirement, grandparents may move to live closer to grandchildren (Glaser et al. 2010). Geographical proximity of grandparents and grandchildren is crucial in providing ‘opportunities’ for interaction and thereby influencing cultures of grandparent-grandchild interaction (Cherlin and Furstenberg 1992). Globalisation has resulted in major migratory flows between countries for paid employment (such as for domestic work), and rural to urban migration for employment within countries. Migratory flows potentially sever or militate against contact between grandchildren and grandparents (except where the grandparents become primary carers due to the parents’ migration). Societal changes associated with rapid developments in communications technology in both developed and developing countries may reduce the barriers of geographical distance. Apart from mobile telephones and email, grandparents and grandchildren may increasingly communicate within and between countries and continents through Skype calls and virtual connectivities such as Facebook. Through these, grandparenting relationships can be co-constructed, despite grandparents and grandchildren being divided by great geographical distances. Thus, new communication technologies may facilitate links between grandparents and grandchildren, for example opening new spaces for the performance of masculinities among grandfathers (Tarrant 2012), who may be more likely to communicate with their grandchildren through internet technologies. However, use of internet-based communication technologies is influenced by material and cultural resources that are more available or accessible to higher socio-economic groups, and in most countries, more prevalent among younger generations.

Cultural norms, grandparenting practices and ambivalence As well as practical help and support provided by grandparents (Bengtson and Roberts 1991, Mancini and Bliezner 1989), grandparents transmit knowledge and values to younger generations (Kennedy 1992) and provide a sense of family heritage and stability (Kornhaber 1996). Research has demonstrated grandparental influence on grandchildren’s core moral values (King 2003) and religious practices and orientation (Copen and Silverstein 2007, Bengtson et al. 2013). Transmitting cultural values and meanings is a key part of passing on the culture of a group or a society. However, ethnic groups may differ in the extent to which grandparents are expected to play a central role in these processes. Grandparenting practices related to transmission of cultural values may lead to inter-generational conflicts or be constrained by transnational migration. Grandparents are part of dynamic and changing networks of family relationships; how these dynamics, together with broader societal forces, shape the cultural norms and practices of grandparenting represents an exciting research agenda for cultural gerontologists. Cultural norms regarding the appropriate roles of, and behaviour towards, grandparents have changed over time and vary markedly between societies. Grandparenthood is often equated with ‘old age’ in the popular imagination, although grandparents range in age from their thirties 237

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to centenarians. Cultural norms may differ between ‘historical generations’ associated with particular ‘birth cohorts’ (Mannheim 1952), each generation having different historical experiences that shape their outlook and attitudes (Arber and Attias-Donfut 2000). Grandparents who have lived through different historical periods and societal contexts enter later life with varying attitudes and expectations that influence their perspectives on grandparenting. The image of the grandmother knitting in a rocking chair, or the old widow dressed in black, is now outdated in the western cultural context, where contemporary grandmothers are less constrained by cultural expectations of passivity. The ‘baby-boomers’ in North America and many European countries, born in the late 1940s and early 1950s, are entering later life with altered cultural values, as well as being healthier, wealthier and more oriented to leisure than earlier cohorts. We can therefore expect that this generation will practise grandparenting in very different ways to their parents. A key normative cultural change in contemporary western societies is the expectation that older people should be active and productive (Bowling 2003). Grandparents may subscribe to the cultural norm of ‘active ageing’ as exemplified by leading an active lifestyle and demonstrating agency over their activities. However, this contemporary cultural mandate to ‘active’ or ‘successful’ ageing may conflict with other cultural norms and expectations, such as to ‘be there’ (available to support and care) for grandchildren (May et al. 2012).Thus, the norm of ‘active ageing’ may conflict with expectations of the parent generation that grandparents will be available to care for grandchildren while the mothers work. Conflict between these two cultural norms may lead to growing tensions or ambivalence between the desires of the grandparent generation for ‘active ageing’ and the requirements of the middle generation for grandchild care, tensions that are likely to be more keenly felt by older women than men. Older people may experience ‘ambivalence’ (that is, both negative and positive sentiments) regarding their relationship with adult children (Luescher and Pillemer 1998). Ambivalence may also extend to the grandparenting role, reflected for instance in the expectation that grandparents adhere both to the ‘norm of non-interference’ (Troll and Bengtson 1979) and the ‘norm of obligation’ to provide support when required by the younger generations. In the UK, May et al. (2012) report the ubiquity of norms of grandparents to ‘be there’ for their grandchildren while also ‘not interfering’ with the middle generations’ parenting practices.They highlight how grandparents negotiate competing norms within their everyday practices of grandparenting.The norm of grandparents being a ‘good parent’ to their own adult children implies allowing them to be independent and thereby ‘not interfering’, but this can conflict with perceived responsibilities to their grandchildren. The clash of cultural norms may be greater in specific societal or material contexts, increasing the need for negotiations between competing understandings of different kin responsibilities, tensions and ambivalence. For example, the changes in Asian societies have been particularly rapid, resulting in a ‘profound generational gap regarding social norms, expectations and cultural practices’ (Izuhara 2010: 3). Ko (2012) highlights how a pronounced generational gap in cultural norms exists in Hong Kong, creating substantial ambivalence related to the conflict between the filial norms of piety towards grandparents and current norms that grandparents should provide extensive everyday support to their grandchildren. Ambivalence and how grandparents negotiate contradictions between cultural norms may be particularly poignant in cases of divorce, especially in contexts where divorce is less normative. Timonen and Doyle (2012) examine grandparenting following an adult child’s divorce in Ireland, illustrating grandparents’ key role in the process of reorganising relationships within families following divorce. Grandparents use agency to maintain (and sometimes to reduce) contact with their grandchildren, and actively renegotiate boundaries around the cultural expectations about their grandparenting practices. Timonen and Doyle argue that grandparental agency was 238

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primarily motivated by the wish to maintain their grandchild’s wellbeing and to bridge formally dissolved family relations in order to secure their own continued contact with grandchildren. However, grandparents’ own wellbeing was also the driving consideration in situations where agency was used to reduce grandchild involvement that was experienced as onerous or excessive. Far from the image of ‘invisible facilitators’, some grandparents emerged as active and determined actors who shaped the level and nature of their involvement in the post-separation family. However, Timonen and Doyle (2012) also point to considerable differences in grandparents’ ability to exercise agency, and the continuing cultural expectations on many grandparents (e.g. to provide grandchild care). Understanding variation in grandparental agency between different cultural contexts is an important task for future research.

A relational perspective and grandchildren’s agency Earlier research on grandparents emphasised the importance of grandparents as socialisation agents for grandchildren (Neugarten and Weinstein 1964), and portrayed a one-way influence of grandparents on grandchildren. Later work also emphasised the potentially mediating role of the middle generation in influencing grandparent-grandchild relationships (Robertson 1976). This ‘downward’ model has neglected consideration of upward flows of influence from the grandchild to the grandparent, and that older grandchildren may influence the nature of the grandparent–adult child relationship; all three generations should be considered in order to fully understand grandparent-grandchild relationships (Hagestad 1985). Grandparenting, by definition, involves a dyadic relationship with one or multiple grandchildren. Literature from the sociology of childhood over the last 20 years (James et al. 1998) has emphasised the active ways that children influence relationships with their parents and other adults. Cultural changes in norms regarding childhood, and the expectations of being a grandchild, will also influence the nature of grandparent-grandchild relationships. The voices of grandchildren have been surprisingly absent in research on grandparenting. Clearly each party will have differing perspectives on the nature of the grandparent-grandchild relationship, as well as varying degrees of influence on different aspects of this relationship. Research in the sociology of childhood has emphasised that children have agency over their relationships and has pioneered new methodologies for researching and hearing the voices of children (Greene and Hogan 2005), but has not yet had a major influence on approaches within research on grandparent-grandchild relationships. The practices of grandparenting can only be understood through a broader relational approach that ‘emphasises the individual’s place within a dynamic and continuous set of transactional processes’ (Hillcoat-Nallétamby and Phillips 2011: 212). Thus, grandparents must be seen within an interactional network that involves not only the grandparent and grandchild, but also the parent(s) and potentially other family members, embedded within a cultural context.Within a relational perspective all three generations may be seen as having agency over the nature of the relationships, which are also contoured by cultural norms of grandparenting that vary by gender, class and welfare state context.

Conclusion To understand grandparenting practices, we need to consider both the changing cultural scripts for older people as well as changing norms about children and childhood. While it is important to emphasise diversity and the agency of both parties in the dyadic relationship of grandparent and grandchild, as well as the agency of the parent (middle) generation, we need to be mindful 239

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of how cultural and societal changes intersect with material and socio-economic resources, which contribute to the everyday realities of grandparenting practices. Gender often remains insufficiently acknowledged in studies of grandparenting. For example, where an older married couple provide grandchild care, few studies analyse the gender divisions of grandchild care in terms of the relative roles of each grandparent. Future studies need to more explicitly tease out the gendered dimensions of grandparenting practices, including gender differences in emotional aspects of relationships with grandchildren. Much more research is needed on how grandparenting practices and norms vary by the intersections of gender, lineage and step-grandparenting, as well as class and ethnicity. In western countries, the increasing prevalence of divorce, re-partnering and step-families means that step-grandparenting is a more common experience, yet remains poorly understood. New patterns in family reciprocity, including within step-families and transnational families, need further study. Divorce and family reconstitution throw into sharp relief issues of how gender is implicated in grandparenting practices. We need to better understand the constraints and possibilities associated with grandfathering following divorce and widowhood, and how this contrasts with grandmothering by divorced/widowed women.The growth of same-sex families (Heaphy 2007) has not been matched by research on grandparenting in relation to same-sex couples within the parent (middle) generation or the grandparent generation (Oriel and Fruhauf 2012). It remains fundamental to consider how gender influences grandparenting in the contexts of divorce and family re-formation, as well as considering lesbian and gay parents/ grandparents, regarding the attitudes and practices of members of all three relevant generations. This chapter has discussed some of the newer contours of grandparenting in different societal and cultural contexts, emphasising the importance of examining how grandparenting is influenced by cultural norms and welfare policies, as well as global trends associated with demographic changes, migration and increases in women’s employment. The importance of examining the doing of grandparenting has been emphasised, together with the value of using a relational perspective to understand the negotiated and culturally embedded nature of grandparent–adult child–grandchild relationships and the agency of each party within these three-generational relationships. Key cross-cutting dimensions include the salience of gender, age (or generation), marital status and inequalities associated with class, cultural and material resources.

Acknowledgements Some of the ideas presented in this chapter are derived from and build on S. Arber and V. Timonen (eds) (2012) Contemporary Grandparenting: Changing Family Relationships in Global Contexts, Bristol: Policy Press.

References Arber S. and Attias-Donfut C. (eds) (2000) The Myth of Generational Conflict: The Family and State in Ageing Societies, London: Routledge. Arber S. and Timonen V. (eds) (2012) Contemporary Grandparenting: Changing Family Relationships in Global Contexts, Bristol: Policy Press. Baker L. and Silverstein S. (2012) ‘The well-being of grandparents caring for grandchildren in rural China and the United States’, in S. Arber and V. Timonen (eds), Contemporary Grandparenting: Changing Family Relationships in Global Contexts, Bristol: Policy Press. Bengtson, V., Putney, N. and Harris, S. (2013) Families and Faith: How Religion is Passed down across Generations, Oxford: Oxford University Press.

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Bengtson, V. and Harootyan, R.A. (1994) Intergenerational Linkages: Hidden Connections in American Society, New York: Springer. Bengtson,V.L. and Roberts, R.E. (1991) ‘Intergenerational solidarity in aging families: An example of formal theory construction’, Journal of Marriage and Family, 53(4): 856–70. Bowling, A. (2003) ‘The concepts of successful and positive ageing’, Family Practice, 10(4): 449–53. Cherlin, A.J. and Furstenberg, F.F. (1992) The New American Grandparent, Cambridge, MA: Harvard University Press. Copen, C. and Silverstein, M. (2007) ‘The transmission of religious beliefs across generations: Do grandparents matter?’ Journal of Comparative Family Studies, 38(5): 497–510. Dench, G. and Ogg, J. (2002) Grandparenting in Britain: A Baseline Study, London: Institute of Community Studies. Glaser, K., Montserrat, E.R., Waginger, U., Price, D., Stuchbury, R. and Tinker, A. (2010) Grandparenting in Europe, London: King’s College London and Grandparents Plus. Greene, S. and Hogan, D. (eds), (2005) Researching Children’s Experience.Approaches and Methods, London: Sage. Hagestad, G. (1985) ‘Continuity and connectedness’, in V.L. Bengtson and J.F Robertson (eds), Grandparenthood, Beverly Hills, CA: Sage. Heaphy, B. (2007) ‘Lesbian and gay families’, in G. Ritzer (ed.), Blackwell Encyclopedia of Sociology, Oxford: Blackwell. Herlofson K. and Hagestad G.O. (2012) ‘Transformations in the role of grandparents across welfare states’, in S. Arber and V. Timonen (eds), Contemporary Grandparenting: Changing Family Relationships in Global Contexts, Bristol: Policy Press. Hillcoat-Nallétamby, S. and Phillips, H. (2011) ‘Sociological ambivalence revisited’, Sociology, 45(2): 202–17. Izuhara, M. (ed.) (2010) Ageing and Intergenerational Relations: Family Reciprocity from a Global Perspective, Bristol: Policy Press. James, A., Jenks, C. and Prout, A. (1998) Theorizing Childhood, Cambridge: Polity Press. Kennedy, G. (1992) ‘Quality in grandparent/grandchild relationships’, International Journal of Aging and Human Development, 35(2): 83–98. King, V. (2003) ‘The legacy of a grandparent’s divorce: Consequences for ties between grandparents and grandchildren’, Journal of Marriage and Family, 65(1): 70–83. Ko, L.S.F. (2012) ‘Solidarity, ambivalence and multigenerational co-residence in Hong Kong’, in S. Arber and V. Timonen (eds), Contemporary Grandparenting: Changing Family Relationships in Global Contexts, Bristol: Policy Press. Kohli, M, Kunemund, H. and Vogel, C. (2008) ‘Shrinking families? Marital status, childlessness, and intergenerational relationships’, in A. Borsch-Supan (ed.), First Results from the Survey of Health, Ageing and Retirement in Europe (2004–2007), Mannheim: Mannheim Research Institute for the Economics of Ageing. Kornhaber, A. (1996) Contemporary Grandparenting, London: Sage. Luescher, K. and Pillemer, K. (1998) ‘Intergenerational ambivalence: A new approach to the study of parent-child relations in later life’, Journal of Marriage and Family, 60(2): 413–45. Mancini, J.A. and Bliezner, R. (1989) ‘Aging parents and adult children: Research themes in intergenerational relations’, Journal of Marriage and Family, 51(2): 275–90. Mannheim, K. (1952) ‘The problem of generations’, in K. Mannheim (ed.), Essays on the Sociology of Knowledge, London: Routledge and Kegan Paul. May, V., Mason J. and Clarke, L (2012) ‘Being there yet not interfering: The paradoxes of grandparenting’, in S. Arber and V. Timonen (eds), Contemporary Grandparenting: Changing Family Relationships in Global Contexts, Bristol: Policy Press. Minkler, M. (1999) ‘Intergenerational households headed by grandparents: Contexts, realities and implications for policy’, Journal of Aging Studies, 13(2): 199–218. Morgan, D.H.J. (2011) Rethinking Family Practices, Basingstoke, Hants: Palgrave Macmillan. Neugarten, B. and Weinstein, K. (1964) ‘The changing American grandparent’, Journal of Marriage and Family, 26(2): 199–204. Oduran, A. and Oduran, C. (2010) ‘Grandparents and HIV and AIDS in sub-Saharan Africa’, in M. Izuhara (ed.), Ageing and Intergenerational Relations: Family Reciprocity from a Global Perspective, Bristol: Policy Press. Oriel, N.A. and Fruhauf, C.A. (2012) ‘Lesbian, gay, bisexual and transgender grandparents’, in A. Goldberg and K.R. Allen (eds), LGBT Parent Families: Possibilities for New Research and Implications for Practice, New York: Springer.

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Phillipson, C. (2010) ‘Globalisation, global ageing and intergenerational change’, in M. Izuhara (ed.), Ageing and Intergenerational Relations: Family Reciprocity from a Global Perspective, Bristol: The Policy Press. Robertson, J. (1976) ‘Significance of grandparents’ perceptions of young adult grandchildren’, The Gerontologist, 16(2): 137–40. Sun, S.H.L. (2012) ‘Grandparenting in the context of care for grandchildren by foreign domestic workers’, in S. Arber and V. Timonen (eds), Contemporary Grandparenting: Changing Family Relationships in Global Contexts, Bristol: Policy Press. Tarrant, A. (2012) ‘Grandfathering: The construction of new identities and masculinities’, in S. Arber and V. Timonen (eds), Contemporary Grandparenting: Changing Family Relationships in Global Contexts, Bristol: Policy Press. Timonen, V. and Doyle, M. (2012) ‘Grandparental agency after adult children’s divorce’, in S. Arber and V. Timonen (eds), Contemporary Grandparenting: Changing Family Relationships in Global Contexts, Bristol: Policy Press. Troll, L. and Bengtson, L. (1979) ‘Generations in the family’, in W. Burr, R. Hill, F. Nye and I. Reiss (eds), Contemporary Theories about the Family, New York: The Free Press. Wheelock, J. and Jones, K. (2002) ‘ “Grandparents are the next best thing”: Informal childcare for working parents in urban Britain’, Journal of Social Policy, 31(3): 441–63.

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31 Widowhood and its cultural representations Anne Martin-Matthews

The word ‘widow’ comes from Sanskrit and means ‘empty’ (Caine, 1974). Since biblical times, accounts of the plight of the widowed have evoked powerful images of women at their most vulnerable and in greatest need. Throughout history, the widow has been a ‘cultural category, produced and shaped through popular culture, custom, and law’ (Bradbury, 2011: 390). While the ‘lusty widow trope’ was emphasised in comedies by Shakespeare’s contemporaries (Kehler, 2006: 21), other cultural representations have included ‘the Merry or inconsolable [widow]; the poor deserving widow; the black widow who had buried several husbands; the faithful widow wearing black until her own death’ (Bradbury, 2011: 390). The lens of culture is a powerful tool in explicating processes and practices of meanings in widowhood.This chapter explores cultural understandings and representations of how widowhood is experienced and is being changed by societal and cultural forces, and how it is understood and represented in research and in the wider cultural context.

Experiencing widowhood Widowhood is both a status and a process. It is the status of an individual who has not remarried following the death of his or her spouse (Martin-Matthews & Davidson, 2005). Widowhood is also a process of transition, progressing from the illness to the death of the spouse and related events involving burial and mourning, grieving, and reconstruction of one’s social world (Martin Matthews, 1991). It is also both sex-selective and age-related. In many developed countries, half of all marriages end with the death of the husband, but only one-fifth with the death of the wife. Widowhood has become a central concept in studies of older people, reflecting and influencing our thinking about old people in general, and old women in particular (Martin-Matthews, 1999). Over time, with increased standards of public health, hygiene and medical care, the average age at widowhood has increased steadily, so widowhood today is primarily associated with older women. But this is not universal. Most recent available data indicate that in developed countries, approximately 16 per cent of widowed women are younger than 60, compared to 34 per cent in Latin America, and 44 per cent in the countries of Africa (Alter Chen, 1995).

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While the incidence (number) of widowed people in the population is increasing, its prevalence (proportion of the population) is decreasing in many parts of the world. Its duration is also decreasing (Martin-Matthews, 2011). Widowhood traditionally was a predictable, ‘expectable’ and defining characteristic of women’s old age; but is less so today (Martin Matthews, 1987, 1991; Martin-Matthews, 1999; Martin-Matthews & Davidson, 2005). Societal trends such as increased prevalence of divorce and singlehood in later life impact the prevalence of widowhood. Medical advances (such as reduction in deaths from heart attack in men) also delay the onset of widowhood. But this is not a global phenomenon. The epidemic of HIV/AIDS, for example, has reduced the average age of widowhood for both men and women in many parts of Africa (Martin-Matthews, 2011). Nevertheless, the predominant trend of a steady increase in average age at widowhood and shorter duration of widowhood have, together, profoundly ‘transformed the intimate landscape for old people’ (Allen & Walker, 2006: 160).

Historical contexts ‘The lives of widows any place in the world, in the past, present, or future reflect [. . .] the inter­ weave of societal history and personal biography. The culture and social structure of a society at any period of time influence the whole pattern of a member’s existence’ (Lopata 1996: 211). Representations of widowhood in socio-historical context are inevitably tied to the culture of the times in terms of: rituals of grief, mourning and bereavement; laws and customs that frame marital, inheritance and property rights; and the role of women and the place of patriarchy in social and cultural context. In a wonderfully insightful and thorough analysis of the records pertaining to two cohorts of women widowed in Montreal, Canada during the second half of the nineteenth century, Bradbury (2011) links the narratives of the individual itineraries of their lives with analysis of the laws and customs that framed their rights as wives and widows and the political debates that changed them. Several aspects of widowhood stand out as particularly noteworthy in historical perspective: prohibitions against remarriage, forms of naming and address and clothing proscriptions. The prevailing discourse of early modern England encouraged widows to live as celibates and to epitomize piety (Kehler, 2006). Historically, very strict customs and rules restricted remarriage soon after widowhood, with remarriage within a year punished as adultery, representing ‘infidelity to her husband’s memory’ (Bradbury, 2011: 214).While such customs have largely disappeared, in countries such as India, prohibitions against a widowed woman remarrying persist, with severity of practices varying among castes (Reddy, 2004). Cultural practices of the nomenclature of widowhood, as recorded in legal registers and census documents, also reflect cultural proscriptions of patriarchal societies and women’s lack of autonomy, rights to property and possessions in their own right. Canadian historical records describe women as ‘Widow Pelton’, or the French, ‘Veuve Gamelin’ (Bradbury, 2011: 391). The Scottish reference to a widow as ‘relict of the late’ (male name) was also ubiquitous. Such naming conventions have been described as ‘embodied traces of their former husbands, whose identity persisted in their names’ (Bradbury, 2011: 384). Clothing conventions also represent culturally defined characteristics of widowhood. Prior to about the 1930s, a woman’s clothing immediately identified her status as a widow. This was especially true if she was a recent widow, but, for many, wearing her widowhood persisted throughout her lifetime. The distinctive garb was referred to as widow’s weeds, a ‘chrysalis of gloom’ (Bradbury, 2011: 205). Historians of material culture have contributed much to our understanding of the evolution of mourning fashions, functioning as ‘cultural shields’ locking ‘widows’ bodies into their husbands’ shadows for at least a year, while publicly announcing 244

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their mourning’ (Bradbury, 2011: 232). With the increasing secularization of society, elaborate mourning garb has largely disappeared in western societies. However, in parts of India and Africa today, widowhood is still accompanied by rituals involving dress and appearance. While these rituals have remained normative expectations of widowhood in some cultural contexts, widowhood for most of the twentieth century was a largely invisible status, without an institutionalized role, ‘only a pervasive identity [. . .] that enters, more or less intrusively, into the relationships of her various social roles’ (Lopata, 1996: 211)

International contexts There is an emergent research literature on widowhood in an international context (MartinMatthews, 2011, Martin-Matthews, Tong, Rosenthal & McDonald, 2013). These studies, typically focused on women’s experiences of widowhood (although not necessarily in later life), highlight the relationship between the characteristics of widowhood and the status of women in society.Variations from one society to another, and within societies, reflect social and cultural norms surrounding death, mourning, and remarriage. Almost 2 decades ago, Lopata (1996: 212) described how, in North American society in particular and western societies in general, At this time in history [. . .] in this society, being widowed is not as bad as it has been at other times and places. Being a widow in traditional, patriarchally encrusted India was not an enviable situation, especially with the prevailing myth that widows caused the death of their husbands. Lopata used the past tense in referring to atrocities against widows in many patriarchal societies, but, alas, rites that depersonalize, dehumanize, and violate widows’ rights to dignity persist (Okoye, 1995). In India, the wife’s place is with her husband, both in life and in death, and with his death, her life is one of misery (Mehta, 2002; Reddy, 2004). In the name of tradition, widows are often forced to marry an in-law, to preserve family control of their late husband’s property (Chi, 2010). In India, and in some African cultures, particularly Nigeria (Chukwu-Okoronkwo, 2012), and in Cameroon (Chi, 2010), women are immediately suspect, even following their husband’s natural death. In some African cultures, widows ‘prove’ their innocence only by lying with the dead body prior to interment, or drinking water washed out of the husband’s corpse (Chukwu-Okoronkwo, 2012). Such abhorrent practices, ‘enshrined in culture and tradition’, are typically spearheaded by other women, themselves ‘potential widows’. Adekunbi (2001, as cited in Chukwu-Okoronkwo, 2012) describes this as culture and society having ‘subtly warped their thinking and perception against themselves’. With widespread transnational migration, however, national cultures of widowhood may be reflected in global diasporas. In increasingly secularized societies, mourning rituals and bereavement have become largely deinstitutionalized, especially in most individualistic western societies, with expressions of grief typically restricted or denied (Bedikian, 2008). Among more collectivist societies, however, elaborate and intense rituals endure. Especially where widowhood represents a devalued status, cultural traditions of the home country may be reflected in immigrant widows’ continuing identification with the late spouse and conducting rituals (in dress, and in grave visitations) in their honour, to provide stability during emotional upheaval (Panagiotopolous et al., 2013). Migrants from more communal or collectivist cultures face additional challenges in negotiating their widowhood in individualistic societies that require a self-confidence and ability 245

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to utilize resources that may not be readily available (Lopata, 1996). The experiences of older immigrant Chinese widows in Canada illustrate how cultural proscriptions that inhibit grief and advocate silent acceptance of bereavement conflict with host country norms, isolating widows emotionally as they endeavour to become more independent over time (Martin-Matthews et al., 2013).

Complexities and intersectionalities: a focus on gender Widowhood is defined not only by cultural norms and values involving mourning and bereavement, but also by the way in which it intersects with age, gender, race, class and the status of women in society. While the gendered nature of widowhood is generally well researched and understood (Martin Matthews, 1991; Davidson, 2002; van den Hoonaard, 2010), it is within cultural systems of patriarchy that gender differences are most stridently, in Bradbury’s words, ‘produced and policed’. Historically, ‘neither custom, the church, law, nor gossip placed restraints on men’s widowhood and [. . .] remarriages as heavily as they did on women’s’, with widows remaining ‘publicly linked to their deceased husbands in myriad ways that were not true of men’ (Bradbury, 2011: 10). In some African cultures today, widowhood practices are still reserved for women and not for men (Chukwu-Okoronkwo, 2012). The belief that ‘the god that owns a woman is the husband that married her’ is held with conviction (Okagbue, 1997: 89). When understood in the context of life course and intersectionality, widowhood is shaped by, and itself shapes, social roles, relations and resources and life circumstances. Many older people experience widowhood against a backdrop of other age-related changes such as chronic illness, disability, and diminished physical and cognitive capacities (Lund, 1989, Chambers, 2005). It may coincide with retirement from the paid labour force, or the care of increasingly long-lived parents. Cultural understandings of one life transition and status such as widowhood must be contextualized by a recognition of the ‘composite nature and the timing of transitions’ and how they are enacted through socio-cultural, relational and personal processes (Grenier, 2012: 137).

New forms and cultures of widowhood Throughout most of history, the social category of widow has been a product of heterosexual marriage (Bradbury, 2011), and this is reflected in all cultural representations of widowhood. However, same-sex marriage is now permitted in at least a dozen countries, and in other sub-national jurisdictions. In these jurisdictions, legal benefits commonly associated with marriage have been extended to cohabiting same-sex couples, in some for a decade or more. Same-sex partner bereavement has long been experienced outside the conventions of traditional marriage. Such loss has not been recognized as widowhood, often with attendant legal and financial difficulties for bereaved partners (Whipple, 2006). While the understanding of widowhood following long-term same-sex unions remains limited (Bonanno, Moskowitz, Papa & Folkman, 2005; Whipple, 2006), there is literature on gay male bereavement. Same-sex partners (whether married or not) and unmarried heterosexual couples often experience a ‘disenfranchised grief ’, with ‘the death of a partner [. . .] complicated by the general denial by society of their right to grieve’ (Springer & Lease, 2000: 300).

Ways of knowing about widowhood Although there are historical accounts of cultural practices surrounding bereavement and mourning, and analyses of images of widowhood in folklore, drama and history (Bensel-Meyers 246

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1985), knowledge and understanding of widowhood owe much to the work of sociologist Helena Znaniecka Lopata (1973, 1996), the most influential and prolific of scholars of widowhood worldwide. With early studies of widowhood focused on role loss and role exit, the conceptual foundations of widowhood research have shifted considerably in recent years. In her final book, written 2 years after her own widowhood, Lopata herself noted the shift from ‘the dismal image [. . .] of the ever-limited, ever-suffering, ever-dependent widow’ to one that is now ‘more complicated and varied’ (1996: xiv). This is largely due to research informed by more symbolic interactionist, critical gerontology, feminist and life course perspectives (van den Hoonaard, Martin-Matthews and Davidson, 2013). Instead of approaching widowhood with a ‘problematizing’ lens, the focus now is on how widowhood intersects with age, class, gender (including understandings of masculinity), ethnicity, culture, religious affiliation and environment, and on socially structured practices regarding marital status (Connidis, 2010). A gendered lens on widowhood continues to advance understanding of women’s experiences, and remains an important focus, especially given the demography of widowhood. However, sociological and gerontological research concerning men’s ageing is both fragmented and under-theorized. Recognition of the gendered nature of widowhood foregrounds women’s experiences, while largely neglecting (both in academia and in public discourse) issues of older widowed men. The nature of masculinities, especially in later life and old age, require attention. Transnational understandings of widowhood will increasingly become priorities as the population ages worldwide and as international migration results in diasporas of widowed people ageing in ‘foreign’ lands. Ethnicity and culture mediate and define the experience of bereavement. Little is yet known about the experience of widowhood when migration, and forces of cultural assimilation, bring contrasting understandings (home country and host country) into co-existence, thus requiring negotiation. The lens of cultural gerontology promotes consideration of new methodologies to advance understanding of widowhood as a transition and as a status. Visual methods, literary and biographical analysis, media productions and social media all contribute to this new perspective. In socio-historical analyses, print cultures of relevant periods reflect how marriage, widowhood and death were represented culturally, legally and politically (Bradbury, 2011). Over the centuries, theatre has also been a prime vehicle for depictions of widows and widowhood. Widows are prominent in Shakespeare’s plays, with at least 31 featured among his characters (Kehler, 2006). Theatrical depictions of widowhood reflect popular culture and can be used to stimulate public discourse about societal norms and values (Feldman, Radermacher, Lorains & Haines, 2011, Feldman, Hopgood & Dickins, 2013).Theatre and film can also be used to achieve even more specific political goals, and to empower those with the devalued status of widow. Chukwu-Okoronkwo (2012) considers the potentials of film and theatre in the reorientation of Nigerian society away from dehumanizing widowhood practices, and profiles one such film, shown in Paris during celebrations of the fiftieth Anniversary of the Declaration of Human Rights, and which subsequently toured Nigeria, with accompanying panel discussions. While film may serve the political purpose of exposing the treatment of widows, film that deals more generically with widowhood, or portrays the experiences of people who have been widowed, is otherwise so ubiquitous that social media contain ‘spoiler alerts’ and ‘plot warnings’ to widowed people who do not wish to be caught off-guard and unexpectedly subjected to content that prompts painful memories and associations. Autobiographical accounts of widowhood have long circulated, and are often insightful depictions of the ‘ecstasy of love and the despair of grief ’ (Martin, 2013: R13). The experiences of widows Lynn Caine (1974) and Betty Jane Wylie (1988) informed this author’s book Widowhood in Later Life (1991), providing an eloquent complement to the words of the widowed 247

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people featured in it. Very widely publicized accounts of widowhood by highly prominent literary figures have recently become something of a genre. Autobiographical accounts of widowhood by the American advice columnist Dr Joyce Brothers (1992), and by Joan Didion (2007), Joyce Carol Oates (2011), John Bayley (1999, with the later movie adaptation of Elegy for Iris) and Julian Barnes (2013), have been given prominence in mainstream media reviews, framing them in terms of broad cultural understandings of widowhood. O’Gorman (1998) has observed that ‘public expressions of grief may be shrouded in embarrassment and deemed problematic, with continuous grieving thought to interfere with one’s daily routine’. However, a culture of personal disclosure and of memorialization has emerged since O’Gorman’s writing. While ‘continuous grieving’ may indeed be deemed problematic, public expressions of grief (especially following the death of public figures, or where death is considered ‘off time’ or tragic in some way), are now common.

The rise of social media An emerging feature of the new cultural landscape of widowhood is the rise of social media. Research for this chapter identified at least 215 blogs about widowhood; countless websites ‘created by widowed people for widowed people’; and online videos on topics such as the legal and financial vulnerabilities of same-sex unmarried partners facing widowhood and bereavement. Websites report ‘Camp Widow’ events, and annual gatherings organized by members of the ‘Widowed Village’. Such sites and activities are framed in terms of support, acceptance, consciousness of kind (‘other people who “get it” ’), empowerment and ‘fun’. Via social media, widows reach out to others ‘who have been there’ to dialogue and discuss, and, increasingly, to meet at conferences and conventions.While older women in particular have previously had access to a reference groups of widowed age peers, the nature of those interactions appears to be different from that on some widowhood websites. As before, they meet as strangers motivated to interact by their common bond of widowhood; however, through social media, the contact can begin with much more anonymity (for example, visiting websites and/ or reading blogs). It can also commence with, or graduate to, a highly public statement of one’s widowhood: creating a website, authoring a blog, filming an online video. These forms of social media involve connections well beyond one’s local community, and can then lead to online or in-person interaction. Thus, new media plays an ever prominent role in this modern culture of widowhood, sometimes leading to involvement in ‘widow’ meetings and conferences, and sustained interactions.

Conclusion This chapter highlights advances made over several decades in focusing the lens of widowhood research specifically on older widowed persons. Nearly 20 years ago, Lopata observed that ‘many current myths concerning widows are old age myths’ (1996: 212); this will increase in the future. By late old age, most older people, and women in particular, are widowed; thus, widowhood is still an expectable event in later life. However, the duration of widowhood in later life continues to shorten. Also, increasing prevalence of divorce and singlehood in later life reduces the prevalence of widowhood.Widowhood is far less prominent as a status defining much of old age than it used to be. The meaning of widowhood as a defining characteristic of most women’s later years will continue to evolve. It remains to be seen whether widowhood will continue to have utility as a category defining access to benefits and services in old age (as is true in countries such as Canada). 248

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Further cultural shifts may auger well for adaptation to widowhood, reducing oft-expressed sentiments of feeling left out of relationships with, and being a ‘fifth wheel’ among, ‘couple’ friends. Dramatic increases in the frequency of ‘going solo’ (Klinenberg, 2012) suggest a new world order for widowed people. In 1950, only 22 per cent of American adults were single, compared with more than 50 per cent today. People who live alone comprise 28 per cent of all US households. For newly ‘unattached’ widowed people, systematic exclusion from the predominance of coupledom may be less problematic than in decades past. Conceptual approaches informed by life course and critical and feminist perspectives have substantially advanced understanding of widowhood in later life. Combined with in-depth qualitative analyses, studies have focused on the narrative accounts of older widowed women and challenged the dominant public narrative of misery and decline, pointing instead to a complexity of experience that is rooted in personal biography and in female and male life course experiences, rather than in later life widowhood itself. The culture of scholarship has also changed to include prospective research designs, and comparisons with those who have not experienced the loss of their spouse, or who have experienced other kinds of loss. However, with the advent of the internet and other ‘social media’ opportunities in the first part of the twenty-first century, there is a perceptible shift once again, especially among particular communities of widowed persons.Thus, over a period of about 75 years, there has been a substantial cultural shift in public representations of widowhood. Historically, there was the public wearing of one’s widowhood, through clothing and appearance. After about the 1930s, widowhood became more invisible overall, especially in increasingly secularized and death-denying societies. More recently, the emergence of social media has enabled a declaration or even reifying of widowhood, especially among select communities of widowed persons—notably those younger and widowed ‘off-time’, or gays and lesbians who have experienced disenfranchised grief. New mechanisms for expression among widowed people and new pathways to understanding widowhood contribute substantially to recognition of the diversity and variability of experience.

Acknowledgement The author acknowledges the research assistance of Danielle Hachborn, School of Population and Public Health at the University of British Columbia, in the identification of background material for this article and in the structuring of the discussion.

References Allen, K.R. and Walker, A.J. (2006) ‘Aging and gender in families: A very grand opening’, in Calasanti, T.M. and Slevin, K.F. (eds), Age Matters: Realigning Feminist Thinking, New York: Routledge, Taylor & Francis Group, pp.155–74. Alter Chen, M. (1995) ‘Why Widowhood Matters’, in Women: Looking Beyond 2000, New York: United Nations. Barnes, J. (2013) Levels of Life, Toronto: Random House Canada. Bayley, J. (1999) Elegy for Iris, New York: Picador USA. Bedikian, S.A. (2008) ‘The death of mourning: from Victorian crepe to the little black dress’, Omega: Journal of Death and Dying, 57(1): 35. Bensel-Meyers, L.D. (1985) ‘A “figure cut in alabaster”:The paradoxical widow of renaissance drama’, PhD. dissertation, Department of English, University of Oregon, USA. Bonanno, G.A., Moskowitz, J.T., Papa, A. and Folkman, S. (2005) ‘Resilience to loss in bereaved spouses, bereaved parents, and bereaved gay men’, Journal of Personality and Social Psychology, 88(5): 827–43. Bradbury, B. (2011) Wife to Widow: Lives, Laws and Politics in Nineteenth-Century Montreal,Vancouver: UBC Press. 249

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Brothers, J. (1992) Widowed, New York: Ballantine Books, Random House. Caine, L. (1974) Widow, New York: William Morrow & Co. Chambers, P. (2005) Older Widows and the Life Course: Multiple Narratives of Hidden Lives, Aldershot: Ashgate. Chi, Y.L. (2010) ‘Widowhood rituals worsen pain of death’, The Media Project, September 24. Available online at http://themediaproject.org/article/widowhood-rituals-punish-cameroons-bereaved (accessed April 18, 2013). Chukwu-Okoronkwo, S.O. (2012) ‘The culture of widowhood practices in Africa: de-institutionalizing the plights of women through theatre’, in Opara, J.A., Biagini, A., Obagah, M.O.N., Motta, G., Nosike, A.N., Hidalgo, R.R.S., Anele, K.A. and Shahmohammadi, N (eds), International Congress on Social & Cultural Studies: Book of Proceedings, vol. 1, Spain: International Association for Teaching and Learning, pp. 208–14. Connidis, I.A. (2010) Family Ties and Aging (second edn), Thousand Oaks, CA: Pine Forge Press. Davidson, K. (2002) ‘Gender differences in new partnership choices and constraints for older widows and widowers’, Ageing International, 27(4): 43–60. Didion, J. (2007) The Year of Magical Thinking, New York: Knopf Doubleday Publishing Group. Feldman, S., Radermacher, H., Lorains, F. and Haines, T. (2011) ‘A research-based community theatre performance to promote ageing well: is it more than just a show?’ Educational Gerontology, 37(10): 885–98. Feldman, S., Hopgood, A. and Dickins, M. (2013) ‘Translating research findings into community based theatre: more than a dead man’s wife’, Journal of Aging Studies, 27(4): 476–86. Grenier, A. (2012) Transitions and the Lifecourse: Challenging the Constructions of ‘Growing Old’, Bristol: The Policy Press. Kehler, D.F. (2006) Shakespeare’s Widows of a Certain Age: Celibacy and Economics, MHRA Working Papers in the Humanities, 1: 17–30. Available online at www.mhra.org.uk/ojs/index.php/wph/article/viewFile /MHRAWPH2/41 (accessed April 11, 2013). Klinenberg, E. (2012) Going Solo: The Extraordinary Rise and Surprising Appeal of Living Alone, New York: Penguin Press. Lopata, H.Z. (1973) Widowhood in an American City, Cambridge, MA: Schenkman. Lopata, H.Z. (1996) Current Widowhood: Myths and Realities, Newbury Park, CA: Sage. Lund, D.A. (1989) Older Bereaved Spouses: Research with Practical Applications,Washington, DC:Taylor & Francis, Hemisphere Press. Martin, S. (2013) ‘A sense of the ending’, The Globe & Mail, Toronto, April 20: R13. Martin Matthews, A. (1987) ‘Widowhood as an expectable life event’, in Marshall,V.M. (ed.), Aging in Canada: Social Perspectives (second edn). Toronto: Fitzhenry and Whiteside, pp. 343–66. Martin Matthews, A. (1991) Widowhood in Later Life, Toronto: Butterworths, Harcourt Brace. Martin-Matthews, A. (1999) ‘Widowhood: dominant renditions, changing demography and variable meaning’, in Neysmith, S.M. (ed.), Critical Issues for Future Social Work Practice with Aging Persons, New York: Columbia University Press, pp. 27–44. Martin-Matthews, A. (2011) ‘Revisiting Widowhood in Later Life: changes in patterns and profiles, advances in research and understanding’, Canadian Journal on Aging, 30(3): 339–54. Martin-Matthews, A. and Davidson, K. (2005) ‘Widowhood and widowerhood’, in Birren, J.E. (ed.), The Encyclopedia of Gerontology (second edn), Oxford: Elsevier, pp. 669–74. Martin-Matthews A., Tong, C.E., Rosenthal, C.J. and McDonald, L. (2013) ‘Ethno-cultural diversity in the experience of widowhood in later life: Chinese widows in Canada’, Journal of Aging Studies, 27(4): 507–18. Mehta, B. (2002) Widows, Pariahs and Bayadères: India as a Spectacle, Cranbury, NJ: Associated University Presses. Oates, J.C. (2011) A Widow’s Story: A Memoir, New York: Ecco, HarperCollins Publishers. O’Gorman, S.M. (1998) ‘Death and dying in contemporary society: an evaluation of current attitudes and the rituals associated with death and dying and their relevance to recent understandings of health and healing’, Journal of Advanced Nursing, 27, 1127–35. Okagbue, O. (1997) ‘ “When the dead return”: play and seriousness in African masked performances’, South African Theatre Journal, 11(1), 89–108. Okoye, P.U. (1995) Widowhood: A National or Cultural Tragedy, Enugu: Nok Publishers. Panagiotopolous, G., Walker, R. and Luszcz, M. (2013) ‘A comparison of widowhood and well-being among older Greek- and British-Australian migrant women’, Journal of Aging Studies, 27(4): 519–28. Reddy, P.A. (2004) Problems of Widows in India, New Delhi: Sarup & Sons.

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Springer, C.A. and Lease, S.H. (2000) ‘The impact of multiple AIDS-related bereavement in the gay male population’, Journal of Counseling and Development, 78(3): 297–304. van den Hoonaard, D.K. (2010) By Himself: The Older Man’s Experience of Widowhood, Toronto: University of Toronto Press. van den Hoonaard, D.K., Martin-Matthews, A., and Davidson, K. (2013) ‘The legacy of Helena Znaniecka Lopata in widowhood research: enduring concepts, life lessons, new insights’, Journal of Aging Studies, 27(4): 457–63. Whipple,V. (2006) Lesbian Widows: Invisible Grief, New York: Harrington Park Press. Wylie, B.J. (1988) Beginnings: A Book for Widows, Toronto: McClelland and Stewart.

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32 Loneliness and isolation Christina Victor and Mary Pat Sullivan

In a speech about older people at the National Children and Adults Services (NCAS) conference on October 18, 2013, the British Health Secretary Jeremy Hunt highlighted the ‘problem of loneliness that in our busy lives we have utterly failed to confront as a society’ and stated that ‘it is a source of national shame that as many as 800,000 people in England are chronically lonely. . . . Some five million people say television is their main form of company’. His suggestion to solve the problem of loneliness in later life was to emulate the ‘respect’ and explicit inter-generational solidarity he stated is articulated within Asian countries and that ‘every lonely person has someone who could visit them and offer companionship’. These comments neatly encapsulate a common stereotype of old age and later life that is commonly articulated within contemporary western and northern European countries. Loneliness is perceived as a ‘normal part of ageing’ (Pettigrew and Roberts, 2008) and unique to later life; older people are perceived as lonely and isolated (Tan et al., 2004), and older people themselves have internalized these views held about them. For example, one-third of people aged 18–64 in the United States see loneliness as a problem of growing older (Pew Research Centre, 2009), while one-third of those aged 65+ in England believe that loneliness is part of ‘normal’ ageing and 50 per cent expect to get lonelier as they age (Victor, 2013). These views thereby suggest that there is little we can do to ‘prevent’ this experience, one that is both universal and homogeneous. Thus loneliness is seen as a major ‘social problem’ of old age, with older people depicted as lonely, isolated, neglected and socially excluded. These assumptions are exemplified by the quotation, from the Rowntree report on old age in Britain, that, ‘A distressing feature of old age is loneliness. All who have done welfare work among the old have found it the most common, if at the same time the most imponderable, of the ills from which the aged suffer’ (Rowntree, 1947: 52). Similar concerns are evident for a broad range of countries, as evidenced by studies of loneliness in old age that have been conducted in Australia, North America, Europe, China and Korea. This chapter provides a culturally situated critique of the theoretical and empirical conceptualizations of loneliness, and of how definitions and measures of loneliness facilitate (or inhibit) the revelation of the cultural context and heterogeneity and temporality of the experience that underpins cultural gerontology.

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What is loneliness? Theoretical or conceptual understandings of the phenomenon of loneliness are both complex and contested (Peplau and Perlman, 1982) and have historical links with a range of different social science perspectives, including the ideas of alienation articulated by Marx and of anomie by Durkheim. From a more individualistic perspective, clinical observations from the Freudian psychodynamic tradition were highly influential in generating early ideas about loneliness. In contemporary research, loneliness has been defined in a variety of ways, as both a personal and a social state with a variety of possible causes. It has been interpreted as the subjective counterpart to the objective measure of social isolation or as the antithesis of social support (Andersson, 1998); the perceived deprivation of social contact (Townsend, 1968; Wenger, 1984); the lack of people available or willing to share social and emotional experiences; a state in which an individual has the potential to interact with others but is not doing so; and a discrepancy between the actual and desired interaction with others. Given this variety of definitions, Peplau and Perlman (1982: 3) synthesize the concept of loneliness as consisting of three essential attributes: a subjective experience; a consequence of deficits in an individual’s social relationship; and an experience that is unpleasant and distressing. There is now a significant body of research articulating the negative health outcomes associated with loneliness, including: a mortality differential between lonely and non-lonely individuals of 50 per cent (Luo et al., 2012; Holt-Lunstad et al., 2010); elevated rates of dementia and depression (Wilson et al., 2007; Prieto-Flores et al., 2011); a range of negative health behaviours including smoking, excess alcohol consumption and lack of exercise (Hawkley et al., 2009; Lauder et al., 2006); three fold differential in general practitioner consultation rates between the lonely and non-lonely; and emergency hospital admission rates 30 per cent higher than non-lonely peers (Ellaway et al., 1999; Molloy et al., 2010). Such is the magnitude of the differentials in mortality between lonely and non-lonely people that loneliness has been characterized as ‘worse’ than smoking in terms of the strength of the association with negative health outcomes (Holt-Lunstad et al., 2010). Across these differing definitions there is some consensus as to the key components of loneliness, especially the essentially subjective nature of the experience and the resultant negative consequences. Most research problematizes the experience of loneliness. However, some scholars, especially those working from an existentialist perspective, contest this consensus with its conceptualization of loneliness as a ‘reflective’ state. Moustakas (1961) argued that loneliness is an essential part of the ‘human condition’ across the lifespan and is not, therefore, a problem but part of being human. Furthermore, he argued that loneliness is an opportunity for the individual to reflect on their situation, and offers the potential for self growth.Tillich (1963) suggested that loneliness provided the opportunity for an individual to encounter and build an understanding of themselves. He stated that loneliness is a necessary aspect of life, as people were fundamentally on their own in life’s most intimate moments such as death. Similarly, Mijuskovic (2012) maintains that it is the existence of loneliness that motivates us to engage with our social world through relationships with others and current forms of social engagement. There is limited empirical research that has examined loneliness from the existentialist perspective, and thus there are few data to support or refute these ideas. However, they do serve to raise questions concerning the way that loneliness has been consistently presented as a ‘problem’ of old age, with few studies challenging this orthodoxy.

Differentiating loneliness and isolation Weiss (1973) draws a conceptual distinction between emotional isolation—an ‘affective state’, resulting from the loss of an attachment figure (characteristically bereavement in later life)—and

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social isolation—the loss of (or reduction in) an accessible social network and/or recognized social role(s)—and speculates that the nature of these experiences may vary across the life course. Whilst it is not uncommon to see the terms loneliness and isolation used interchangeably, they are distinct concepts. Weiss’s concept of social loneliness is similar to the concept of ‘social isolation’ articulated by Townsend and Tunstall (1973), where the focus is on the amount and types of social contact, not the quality of the contacts. However, determining the point along a social contact continuum at which isolation starts is problematic. We also need to distinguish living alone, which is simply a description of individuals’ living arrangements, from ‘being alone’, which is the amount of time an individual spends alone. Living alone is frequently used as a proxy for assumptions about the social networks and social relationships of older people, and is seen as being universally and inevitably characterized by loneliness and isolation. One example of this is the ‘loneliness map’ of Britain (British Broadcasting Corporation, 2008). Using a range of variables including living alone, residential mobility and tenure, it reported that, as a society, the UK had become lonelier.

Approaches to studying loneliness Research focusing on loneliness in later life is predominantly quantitative in nature, with studies that aim to evaluate the extent of the problem and identify the groups most ‘vulnerable’ to experiencing loneliness, determining the key ‘risk factors’. Comparatively few studies have investigated how older people define and understand loneliness (Stanley et al., 2010). As the Rowntree report (1947: 52) puts it, ‘Loneliness is a complaint that is difficult to assess quantitatively’. Whilst this comment was made within the British context it applies much more widely and is important given the focus of cultural gerontology in revealing the heterogeneity and temporality underpinning the experience of ageing and later life. How do our ways of measuring loneliness enable us to reveal this variability? We can distinguish three key approaches to the measurement of loneliness. Self rating scales require the participant to rate their level of loneliness with the variation between measures as to reference period (last week or month) and response categories (always, often, sometimes and never). Such questions, widely used in Britain, Europe and Australasia, conceptualize loneliness as a one-dimensional concept that is implicitly based on a cognitive deficit model of loneliness. A key criticism of such measures is that that they will not elicit a ‘true’ response: they will generate only a ‘publicly acceptable’ response given the stigmatizing nature of loneliness (Victor et al., 2005). Furthermore, these questions presume that there is a universal understanding of the concept and experience of loneliness among older people, and that they are a homogeneous group. Given the diversity that characterizes the older population and the experience of later life in terms of age, generation, gender, class and ethnicity, this presumption is open to challenge and requires evaluation.We can then identify two distinct types of measurement scales: those that conceptualize loneliness as a multi-dimensional concept, such as the de Jong Gierveld (1987) measure based on the typology of Weiss, which includes social and emotional loneliness, and the uni-dimensional scales such as the University of California, Los Angeles (UCLA) loneliness scale (Russell, 1996). Each of these scales measure loneliness ‘indirectly’ by not asking explicitly about the experience, and were developed in Europe and the United States respectively. A key aim of cultural gerontology is to recognize comparisons across and within populations.Within the field of loneliness, comparison has been made across a range of countries within Europe (Stickley et al., 2013; Yang and Victor, 2011; Fokkema et al., 2012; de Jong Gierveld and van Tilburg, 2010); and between specific countries such as Canada and the Netherlands (van Tilburg et al., 2004) or the Netherlands and Britain (Scharf and de Jong Gierveld, 2008). The potential limitations of current measures as 254

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mechanisms for revealing heterogeneity within a specific population are again noteworthy here, and this may (or may not) apply when making comparisons between populations. To develop measures specific to particular cultural contexts such as China requires extensive testing and development, as illustrated by Leung and colleagues (2008) in their Chinese version of the De Jong scale. Such work is essential if we are to draw comparisons of loneliness systemically and robustly across different societies, reach appropriate conclusions from the findings, and develop sound theoretical and empirical evidence about the universality (or otherwise) of the experience of loneliness in later life. Research focusing on loneliness in later life has focused on quantitative studies that aim to evaluate the extent and nature of the experience. Comparatively few studies have investigated how older people define and understand loneliness, or explored how these may vary with gender, age, class and ethnicity, although there are some studies with specific populations such as the dying. Victor and colleagues (2009) in their qualitative study of 45 people aged 65+ in England reported that all of those who described loneliness did so in negative terms (‘I think loneliness would be the lack of human contact’), and the predominant narrative was around loss (‘Loneliness, it’s having someone, knowing that they’re there, knowing what they think, and then turning round, they’re not there’).There were no narratives suggesting loneliness as a potentially positive experience, or evidence that individuals felt that experiencing loneliness had enabled them to develop as individuals (or had the potential to do so): ‘I feel lonely, it’s a sense of loss’. This was very clearly linked to social contacts: ‘It’s not having someone to talk to that very minute you want to’. Of course, these findings may reflect the implicit understandings of the people interviewed of loneliness as a cultural script that was both a negative and stigmatizing and/or the limitations of the interview guide. Qualitative studies of loneliness tend to focus on this concept and future studies perhaps need to focus more explicitly on issues of solitude, aloneness and the potential positive aspects or potential of loneliness.

Who are the lonely? Researchers have also sought to examine key socio-demographic correlates of loneliness such as age, gender and ethnicity, and identify key risk factors. Such research has largely been (implicitly) informed by the humanitarian component of the ‘old age as a social problem’ perspective within a social epidemiological paradigm.The force driving much of this research has been the desire to develop appropriate screening procedures, calculation of risk scores and interventions to remediate, prevent or ‘cure’ loneliness. However, these approaches to loneliness are linear, relying on a model of antecedent and consequence explanations, giving rise to the notion that loneliness can be extinguished (Karnick, 2005), and this may explain, in part at least, our failure to develop robust and effective interventions. How does the extent and experience of loneliness vary between and within different populations? The cultural context of loneliness has been acknowledged, but has rarely been foregrounded in our analysis (Johnson and Mullins, 1987; Jylhä and Jokela, 1990). How do rates of loneliness vary within Europe? The reported rate of loneliness for older people (aged 65+) in a variety of European countries in 2011 ranged from 1 per cent (Finland) to 38 per cent (Ukraine) (Table 32.1). Countries with very high rates of loneliness, defined as 20 per cent or greater, were the Russian Federation (32 per cent), Greece (25 per cent), Croatia (24 per cent), Hungary (24 per cent), Lithuania (22 per cent), Poland (21 per cent) and Slovakia (24 per cent). In 2010, 5 per cent of those aged 65 and over in the United Kingdom reported that they were lonely, similar to the Netherlands, Switzerland, Estonia, Spain and Norway, where levels of loneliness were 5 per cent or less. Ireland, Slovenia, Sweden, France and Cyprus form an intermediate group 255

Christina Victor and Mary Pat Sullivan Table 32.1  Prevalence (%) of loneliness among those aged 65+ by country Country Belgium Switzerland Cyprus Germany Denmark Estonia Spain Finland France United Kingdom Greece Croatia Hungary Ireland Lithuania Netherlands Norway Poland Portugal Russian Federation Sweden Slovenia Slovakia Ukraine

% loneliness—2006

% loneliness—2010

10 7 18 8 4 16 13 8 19 11 N/A N/A 29 7 N/A 8 7 30 20 32 9 18 24 42

8 2 18 2 1 4 4 1 7 5 25 24 24 7 22 4 4 21 18 32 7 9 22 38

European Social Survey: authors’ analysis

(see Table 32.1). Can we identify common factors that unite the low/high prevalence groups? With the exception of Greece, all of the ‘high prevalence’ countries in both 2006 and 2010 were former eastern European/Soviet Union states. In part these variations reflect demography and the effect it has on established risk factors for loneliness, but also the expectations of growing old that are specific to these cultural contexts. In the case of Russia and the former Communist bloc, a profound decline in living standards (especially for older people) and the destruction of established norms and expectations of old age resulting from the collapse of the values of Soviet society are no doubt relevant (Yang and Victor, 2011; Fokkema et al., 2012; de Jong Gierveld and van Tilburg, 2010; Stickley et al., 2013). The importance of cultural expectations of old age underpins the well established north-south divide in loneliness across Europe.The lowest levels of loneliness are in countries with the highest percentage of older people living alone and a strongly individualistic culture, whereas the highest levels of loneliness are in the southern European countries, which are characterized by higher rates of co-residence across the generations and a more familist culture.This suggests that responses to questions about the experience of loneliness are mediated through the lens of the cultural expectations of later life for that population and cohort. For Germany, Estonia, Spain, France, the UK, Netherlands and Norway, rates of loneliness halved between 2006 and 2010, which demonstrates that at both individual and population

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levels loneliness is dynamic. It is beyond the scope of this chapter to examine the differentials in loneliness between countries and the changes in loneliness prevalence over time. However, these data do unambiguously demonstrate that loneliness, like many other aspects of ageing and later life, is both culturally and temporally situated and subject to change. How loneliness varies over time, from daily, through seasonal, to longer periods of time such as the life course, remains largely unexplored. Explorations of loneliness have predominantly focused on capturing prevalence rates at a single point in time. However, there is an emerging body of evidence that demonstrates that loneliness in later life varies over time. Longitudinal studies across Europe suggest that the majority of older people (50–70 per cent) are ‘never’ lonely; 10 per cent to 20 per cent are persistently or chronically lonely; 10 per cent to 15 per cent recover from loneliness; and a similar number experience increased loneliness (Dykstra et al., 2005; Victor and Bowling, 2012). Loneliness also has a neglected temporal element whereby it varies across the days of the week and time of day and, indeed, has a spatial and physical component (Bennett and Victor, 2012). These latter aspects of the variability of the experience of loneliness in later life remain largely unexplored. Within specific national contexts there is a range of evidence linking increased vulnerability to loneliness with increased age and being female and, to a much lesser degree, with ethnicity. Studies within individual countries such as the USA, Canada, Ireland and Australia have identified the increased rates of loneliness among the ‘oldest’ old (those aged 80+), women and members of minority communities. Some of these associations, especially with age and gender, are less robust when confounding factors such as widowhood and living arrangements are taken into account. Furthermore, the prevalence of loneliness shows variability with both age and gender between nation states. To illustrate this it is worth considering the prevalence of loneliness by age group in the United Kingdom and Russian Federation (see Table 32.2). There is a very strong age-related trend for reported loneliness in the Russian Federation, with rates increasing from 4 per cent to 5 per cent for those aged under 25 to 38 per cent for those aged 75+. For the United Kingdom we see a U-shaped distribution, with the highest rates of loneliness being among those in later life and early adulthood. Furthermore, focusing on the Russian Federation one can see that loneliness decreased between 2006 and 2010 for young adults but not for older people. A more detailed analysis is required to understand what has brought about these changes. However, these data clearly indicate that loneliness is culturally situated; that it varies over time in response to changes in the socio-cultural context; and that these changes may be differentially experienced Table 32.2  Prevalence of loneliness: United Kingdom and Russian Federation 2006