Towards Critical Intersections of Ageing, Housing and Well-Being

ABSTRACT

Across the life course, far-reaching socio-demographic and health related transformations are influencing the meaning of home in the UK. The collection presented in this Special Issue of Home Futures critically interjects into the ‘where and when’ of dwelling during the process of ageing with key concepts explored within this introductory article. It argues that, change is seen through the disruption of conventional ideas of ageing ‘at home’, traditional understandings of ‘the older person’ and its corollary social imaginaries, alongside the relationship between care practices and homes. Many of these shifts are being addressed through a range of emerging housing (and collaborative) alternatives. The article concludes by considering how discussions in this special issue disclose the home, from a range of social and material angles, as a diverse process and experience of meaning making over time, deeply entangled with health and well-being, disrupting traditional understandings of ‘place making’ in later life.

KEYWORDS:

• ageing
• housing
• well-being
• home futures
• care
• design
• lifecourse

TRANSFORMATIONS OF AGEING AND MEANINGS OF THE HOMES

This Special Issue on Home Futures critically interjects into the ‘where and when’ of dwelling during the process of ageing. It is grounded on an understanding of home as a complex topic: a social, physical and emotional environment replete with meaning that can be supportive of personal identity, senses of security and future during the ageing process, while also being filled with unsettling and alienating potential during times of change or uncertainty (Blunt and Varley 2004; Rowles and Chowdhury 2005; Milligan 2009; Peace 2015). Demographic change, which has included a significant decline in mortality among older age groups, disrupts conventional ideas of ageing in place in one’s own home. Some older people may be living for several decades after retirement, and, depending on their health and the availability of support, may have to recreate ‘home’ within supportive housing and institutional environments of care (Cutchin 2013; Oswald and Wahl 2013; Golant 2015).

Demographic change has also greatly disrupted conventional understandings of ‘the older person’. The idea of the bifurcation of later life into a third age and a fourth age is now a common place of the social gerontological literature (Laslett 1989). Those in the third age are more commonly couples - long term or separated, divorced, and remarried - as well as singles, many of whom may deny the ageing process (ONS 2013, 2017; Rees Jones and Hyde 2008). While the oldest old are currently living well into their eighties, nineties and, increasingly, hundreds, many may do so in ill health, leading to a loss of personal agency and increasing vulnerability at the end of life ( Lloyd 2015; Victor 2010; see also Visser, this issue ). Indeed, this sense of loss of agency and increasing vulnerability among the older old is not merely a problem for those of the fourth age and the environments of care in which the frail elderly often live (See Higgs in this Issue; Gilleard and Higgs 2010; Grenier et al. 2017; Higgs and Gilleard 2015 ). It is itself a ‘dreaded social imaginary’ (Gilleard and Higgs 2010; Higgs and Gilleard 2015, 2016) which casts its shadow over the cultural field of the third age ‘baby boomers’ ( Gilleard and Higgs 2000, 2013 ), even as they remain active, possibly still working, and fully enmeshed in consumer society. A key element of this social imaginary of the fourth age is the fear of dementia (impacting one in six people over the age of eighty years [Alzheimer’s Society 2019]), which also has objective implications for the arrangement and configuration of homes for those who face cognitive impairment (Grenier et al. 2017).

Around the world these socio-demographic and health related transformations are accompanied by unprecedented social, economic and political pressures that, in turn, impact homes and the care that takes place within them (See Gopinath et al. and Kallitsis et al. in this Issue). In this context, residential spaces are increasingly public objects of policy attention and interventions. For many years now in the UK (Means 1997) and throughout much of the industrialised world (Plath 2009) encouraging people to remain in their own homes has been the centerpiece of social care policy that promotes independence. This was grounded on a vision of home as mitigator of the isolation and loneliness associated with significant physical and mental health risks in older age. That home is the best place in which to age is also overlaid with pervasive cultural imaginaries. On the one hand, the beatific narrative of family as ‘container for emotion and care’ (Biggs 2018); and, on the other, the horrific imaginary of the care home as dreaded last resort and key feature of the fourth age as social construct (Higgs and Gilleard 2015). When asked where they wish to live, older people will tend to say ‘within their own homes, for as long as possible’ (Peace et al. 2011) recognising issues of attachment that supports self-identity, as well as reflecting fears of institutionalized living (O’Bryant 1983; Bartlam et al. 2013).

Even so, within the context of ever declining levels of state support for older people in their own homes (Humphries et al. 2016; AgeUK 2017), traditionally understood ways of doing home (and family and care) are evolving. Home adaptation is begininng to be discussed (Adams and Hodges 2018). And, in direct contradiction to the ‘staying at home’ tendencies highlighted here, downsizing policies intending to free-up normatively understood ‘family’ homes and to release individual capital for older people’s health and care needs are encouraged. This is leading to a range of experiences related to the intersections of futures, homes and ageing that impact on wellbeing - with wellbeing understood here as a subjective sense of health, care and meaning in later life (Barac and Park 2009; Best and Porteus 2012; Liddle et al. 2013; Yates 2016; Gregory et al. 2017).

For some, what has been called ‘option recognition’ – a complex identification of the balance between personal needs and housing environment as one ages (Peace et al. 2011) – may lead to a change of dwelling, including various forms of housing with care (Evans 2009; Best and Porteus 2017; Park and Porteus 2018). Studies from the USA have found that ‘residential normalcy’, or a new meaning of home, may be re-discovered in these novel living spaces (Golant 2015). Nevertheless, despite these purported options, the on-going shortage of new build housing alternatives and increasing housing unaffordability in the UK does not facilitate choice for those with varied financial resources, even though some local authorities are addressing the issue (Local Government Association 2017; Boughton 2018; Hammond et al. 2018).

AGEING OTHERWISE IN ALTERNATIVE HOME FUTURES

Demographic and societal changes, as well as crises contexts, are shifting the ways in which home-making, familial relationships and age are practiced and felt. These are core changes to our individual and collective futures that demand transformations in how we think about home innovations in later life. Here, however, lies the ever present danger that such purported transformations end up reifying the rigid social norms and traditional practices that ageing bodies and relationships in older age actually challenge.

Collaborative housing in older age, one notable example of which – the Older Women’s Co-housing Network - we have been privileged to study, points the way to forms of living and ageing otherwise that have the potential to challenge traditional maxims of ‘staying at home’ (Fernández Arrigoitia 2017; Fernández Arrigoitia and Scanlon 2018, 2015; Fernández Arrigoitia and West forthcoming). Other such citizen-led innovations in social and material design are emerging and challenging mainstream ways of living alone in one’s home (Jarvis 2014). They provide alternatives to traditional housing development practices and the normative family assumptions upon which these are based (Brenton 2013; Glass and Vander Plaats 2013; Labit 2015). While still niche, senior co-housing is increasingly grabbing the attention and imagination of citizens who recognise a need for change. Such modes of mutually supportive living may enhance individual and collective well-being, generating new meanings to ‘ageing in place’. They can point the way to smoother transitions between the third and fourth age in later life that may involve partnership between older residents, children, family, friends and formal carers to support degrees of end of life care in cohousing although this has seldom been tested (see Peace forthcoming). They may also generate new understandings and ways of being in the third age, which eschew societal expectations of ageless ageing (Fernández Arrigoitia and West, forthcoming).

Socially-driven innovations to complex contexts of insecurity, isolation and loneliness in older age may come to provide an antidote to the common repertoire of mainstream solutions that have, so far, done little to bring the kind of answers necessary to appropriately sustain home life, and all its caring infrastrucutres, in later life. The changing nature of home is a life course issue with financial and social resource implications that are public and well as private (see Jupp et al. 2019) and needs to be recognised by all so that older people are able to value the positives of homeliness without undue concern over institutionalisation. However, given the social and cultural capital necessary to form these intentional communities within existing temporal, socio-spatial and financial constraints across much of the Western world, they may also generate new forms of exclusion, even in spite of avowed intentions to be inclusive (Ruiu 2014; Sanguinetti 2015). Recent emerging research on community and collaborative forms of housing is considering how best-practices that have enabled affordability, accessibility and social and environmental sustainability can be brought to bear in UK policy circles and practices (LaFond and Tsvetkova 2017; Heath et al. 2018; Mullins and Moore 2018). The mixed-tenure OWCH example is also promising in this regard (Fernández Arrigoitia and West, forthcoming). Further research on these emerging alternatives will no doubt address these questions, but such hope for the future should not blind us to the ways in which the more here-and-now, everyday meanings of home are made, and will need to be re-made, in the context of demographic change and the social imaginaries it ushers in.

ADDRESSING HOME FUTURES

This Special Issue seeks to address the changing meaning of home in the context of demographic change through the framework of ‘home futures’ – a phrase that is not just about where we will live but with what social imaginaries, arrangements and supports. Home encompasses material, social and emotional configurations, while Futures indicates the range of immediate and long-term temporalities to which the home, and its inhabitants, orient themselves. The distinct future-oriented developments that homes are being subjected to span a range of spatial scales and cultural practices (see Pilkey et al. 2017; Sixsmith et al. 2014; Scicluna 2017 for LGBTQ experiences). The critical theoretical and empirical questions these raise are beginning to be explored.

Theoretically, within the field of environmental gerontology, person-environment congruence has been examined through the relationship between belonging and agency (Oswald and Wahl 2005); while multi-disciplinary research concerning the development of dementia-friendly settings present a context for theoretical examination (Orpwood et al. 2017). For those staying in their own home, living alone or with a partner, additional support is likely to come from adult children or through home care. But the relationship between all parties to informal and formal home care is still under-researched (see Twigg 2000; Humphries et al. 2016). Once again, the route to home care is very dependent on financial resources. Home carers may come into the home at various points of the day and can also offer live-in care and night care. Issues of time and space, here, are coterminous.

The ability to receive or provide care in older age is also increasingly tied to the alarming growth in housing insecurity, itself a result of inequality, austerity, deregulation and privatization (UNHRC 2019). Some critical sociological and geographical studies of dwelling are looking beyond the more typical political economy framework of housing to focus instead on its everyday use value and lived dimensions (Amin 2014; Lancione 2019). This approach includes looking at homes through the spatial and temporal lenses of ‘making’ and ‘unmaking’ (Baxter and Brickell 2014), and stretches to practices of older people in transnational migration contexts (Walsh and Nare 2016; Sampaio, King, and Walsh 2018). In the UK, the undoing of homes in older age have been especially linked to crushing austerity policies which are known to disproportionately affect vulnerable groups like pensioners (Lloyd and Phillipson 2017; Alston 2018; Lloyd 2018; Human Rights Watch 2019; Jupp et al. 2019). This precarious reality, where responsibilities of social care in older age are being devolved from the State to predominantly female citizens, has generated what some have called a ‘crisis of humanity’ (Skeggs 2017; Jupp et al. 2019) - with neglect designed into the system of health and care of older people. The evident and growing inattention to the infrastructures of care necessary for supporting life at older age calls for a renewed focus on non-paternalist forms of social and housing care that speak directly to older people’s needs—whatever their home environment may be.

Spanning a range of disiplinary backgrounds and empirical contexts, the articles that follow (versions of which were first presented in two organised sessions in the 2017 RGS-IBG Conference in London) underscore the impacts of the privatisation of care and the reduction of public financial support on homes and their dwellers. In their approaches to how socio-material home environments intersect with the variegated experience of ageing, they share a concern for the way in which care by self, others or institutions takes place; i.e., about how care happens ‘at home’ or ‘with the home’ in older age. Gopinath, Peace and Holland, for example, consider how caring for a partner with dementia at their long-term home impacts the meaning of intimate domestic space and relations. How partnerships are experienced in relationship to ageing and the home has barely been explored, and their review of the literature reveals that alternative social, material and spatial arrangements have the potential to satisfy individual and collective household interests over time.

With a similar focus on the experience of family caregivers (not just partners) of people with dementia, Kallitsis, Soilemezi and Elliott offer a socio-spatial analysis of the uses of domestic space. While the role of architectural design in creating dementia-friendly spaces has long been recognized, design principles have been developed largely with institutional care environments in mind rather than the more unpredictable environments of home, or the experience of the carer (for two recent ethnographic exceptions, see: Pink et al. 2017 and Park et al. 2016). Kallitsis and co-authors identify compact layout, spatial flexibility and the wider neighborhood networks as three key themes that should be critically incorporated into the future design of what are currently highly constraining home environments that disable the possibility of quality care for self and other.

Beyond ‘conventional’ housing fabric, issues of design can also draw our attention to how care is currently being reconfigured through new and emerging arrangements of home and performances of age—a topic that Paul Higg’s afterword on ‘Homes in the context of the third and fourth ages’ also attends to. These include, but are not limited to, evolving home care technologies (for example telecare or telehealth) and new practices in home design, such as age- or dementia-friendly design, and the proliferation of ‘smart home’ technology. These have all been encouraged in policy for some time, but, for a number of reasons have not achieved the scale of diffusion hoped for, in part because of a lack of shared understanding among the various stakeholders. Their potential to fix ‘the crisis’ in older adult care nevertheless stalks the policy scene (see Schillmeier and Domenech 2010; Thygesen and Moser 2010), and it is important to explore what the persistent projection of this potential in policy discourse does to understandings of needs and care in relation to housing and the home, health and wellbeing in later life (Fernández Arrigoitia, West, and Scanlon 2018). In the context of growing isolation in older age and austerity described before, as well as to the transformation of what old age means, what possibilities of a future home life can these dis-embodied systems enable and block? Is the future here, inevitably, an individualist one where surveillance becomes a different aspect of institutionalisation? Smart homes, for instance, are bound to utopian ideals of automatic health responses, but do little to address the lack of human interlocutors within those technocratic systems, which often act as inexact surrogate deliverers of care. In such cases, the role that place and home play in sustaining (or otherwise) meaningful relationships is poorly understood (Milligan and Mort 2011).

Moreover, the role home plays to temporal understandings of the self from the perspective of older people is also lacking. Visser’s article intervenes in this latter sense by dwelling on the minutiae of one older woman’s daily home-making practices and her attachment to gardening, to record how home happens as older age gets longer and prospects of death – while imminent – are not as close as once imagined (see also Milligan and Bingley 2015). Running through this entire edition is an underlying ethical question about what forms of human and non-human care should take place as the meaning of home and ageing evolves over time.

The collection of articles discloses the home as a diverse process and experience of meaning making over time, deeply entangled with health and well-being, that can disrupt traditional understandings of age and ‘place making’ in older age. They demonstrate the need for alternative or expanded versions of meanings of home where, if home continues to be rigid in the way it is imagined, but also physically shaped and reconstituted over time, then it does little by way of expanding our social imaginary and practices. If it is expanded as a concept to embrace embodied changes, as we emphatically argue it should, it may also continue to support self-identity and more humane relations of care throughout the lifecourse.

Additional information

Notes on contributors

Melissa Fernández Arrigoitia

MELISSA FERNÁNDEZ ARRIGOITIA IS A LECTURER IN URBAN FUTURES AT LANCASTER UNIVERSITÝS SOCIOLOGY DEPARMENT. HER RESEARCH FOCUSES ON THE PRODUCTION AND DESTRUCTION OF ALTERNATIVE AND SOCIAL HOMES IN TIMES OF MULTIPLE CRISES, WITH PARTICULAR INTEREST ON ACTIVIST AND COHOUSING INITIATIVES. [email protected]

Karen West

KAREN WESTIS A PROFESSOR OF SOCIAL POLICY AND SOCIAL GERONTOLOGY AT THE UNIVERSITY OF BRISTOL AND A SENIOR RESEARCH FELLOW OF THE NATIONAL INSTITUE FOR HEALTH RESEACH SCHOOL FOR SOCIAL CARE RESEARCH. HER RESEARCH LOOKS AT ALTERNATIVE CONCEPTS OF LATER LIFE LIVING, CARE AND SUPPORT AND CRITICAL UNDERSTANDINGS OF POLICY IN RELATION TO AGEING AND THE OLDER PERSON. [email protected]

Sheila Peace

SHEILA PEACEIS EMERITUS PROFESSOR OF SOCIAL GERONTOLOGY AT THE OPEN UNIVERSITY. SHE HAS A LONG HISTORY OF RESEARCH IN ENVIRONMENTAL GERONTOLOGY CONCERNING HOUSING, CARE AND COMMUNITY INTEGRATION. [email protected]