Hostname: page-component-7c8c6479df-94d59 Total loading time: 0 Render date: 2024-03-18T16:09:50.125Z Has data issue: false hasContentIssue false

Being Old, Old People and the Burdens of Burden

Published online by Cambridge University Press:  14 November 2008

Anthony M. Warnes
Affiliation:
Department of Geography and Age Concern Institute of Gerontology, King's College, University of London.

Abstract

Burden is today often applied to elderly people in two senses, for the fiscal load of income support and health and social care costs, and for notions and scales of care-giving effort and stress. It does not however convey straightforward meanings for its understanding is affected by two millenia of metaphorical and rhetorical usage. The use of burden tends to simplify relationships, whether between age-groups of a population or between a carer and an elderly person, and it communicates senses of a nuisance and an excessive charge. Portentous implications are invoked from biblical senses and derogatory overtones are strengthened by association, earlier this century, with racial stereotyping. An etymological survey reveals many sources of the word's versatility and rhetorical power. Important extensions of usage towards the two contemporary gerontological applications are then studied. A bibliometric examination of the surge in the word's social science use since the early 1980s is undertaken, and the paper concludes with a discussion of current usage as evidence of current attitudes towards, and constructions of, old age on the part of politicians and policy analysts.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

NOTES

1 The alternative spelling was in common use in both Britain and America until around the First World War, but the latest Concise Oxford has t as archaic. OED notes the continued usage of burthen in shipping. H. L. Mencken's The American Language (1936) records with disapproval that in Oxford the University Press Authors' and Printers' Dictionary changed burthen to burden in its seventh edition of 1933.

2 See also Skeat, Walter W., Etymological Dictionary of the English Language, Clarendon, Oxford, 18791892Google Scholar. The Concise Oxford Etymological Dictionary and Chambers Twentieth Century Dictionary provide accessible guides. OED's thoroughness is however unsurpassed: the exposition of to bear requires more than a dozen columns.

3 Vine, W. E., Unger, M. F. and White, W., An Expository Dictionary of Biblical Words, Thomas Nelson, Nashville, Tennessee, 1984, p. 227.Google Scholar

4 Grenshaw, J. L., Burden, . In Achtemeier, P.J. (ed.), Harper's Bible Dictionary, Harper & Row, San Francisco, 1985.Google Scholar The opinion that vs 34–40 are a midrash is ‘almost unanimous’ among scholars: Hyatt, J. P., Exegesis of Jeremiah. In Buttrick, G. A. (ed.), The Interpreter's Bible, vol. 5, Abingdon-Cokesbury, Nashville, Tennessee, 1956, p. 995.Google Scholar The ‘late scribe’ should be distinguished from Baruch, to whom Jeremiah twice dictated his prophecies. One of the most difficult biblical usages of massa' is in a passage about old age in Ecclesiastes 12:5, which in James is translated: ‘also when they shall be afraid of what is high, and fears shall be in the way … and the grasshopper shall be a burden, and desire shall fail: because man goeth to his long home, and the mourners go about the streets’. In NIV this is rendered, ‘when men are afraid of heights and of dangers in the streets … and the grasshopper drags himself along and desire no longer is stirred’. For comments on this passage see Minois, , Georges, , History of Old Age From Antiquity to Renaissance, Fayard, Paris, 1987Google Scholar; English trans. Polity, Cambridge, 1989, p. 36; and Blythe, Ronald, The View in Winter: Reflections on Old Age, Penguin, Harmondsworth, Middlesex, 1979, p. 20.Google Scholar The NIV prefers oracle for burden throughout the Jeremiah verses, and even prefers load at the first noun occurrence of the primary meaning (Exodus 23:5).

5 Hopper, S. R., Exposition on Jeremiah. In Buttrick G. A. (ed.), op. cit, p. 996Google Scholar; White, R. E. O., Indomitable Prophet: A Biographical Commentary on Jeremiah, Eedermans, Grand Rapids, Michigan, 1992, p. 110.Google Scholar The quotation continues in parenthesis: (Verses 34–40, RSV, NEB; the NIV substitutes “oracle” for “burden,” the Hebrew word bearing both meanings. But “oracle” confuses the passage – see vv. 33, 39 – and makes Jeremiah condemn his own practice [see chaps. 3, 5]; the punning ambiguity is probably deliberate.)

6 Holladay, W. L., Jeremiah: A Commentary on the Book of the Prophet, vol. 1, Fortress, Philadelphia, 1986, p. 648.Google Scholar See also McKane, W., Massa' in Jeremiah 23:3340.Google Scholar In Emerton, J. A. (ed.), Prophecy, Essays Presented to Georg Fohrer on His Sixty-Fifth Birthday, de Gruyter, Berlin, 1980, pp. 3554CrossRefGoogle Scholar; and Bright, J., Jeremiah: Introduction, Translation and Notes, Doubleday, Garden City, New York, 1965.Google Scholar Shorter notes are found in Douglas, J. N., New Bible Dictionary, Inter-Varsity, Leicester, 2nd edtn, 1982Google Scholar; and Hastings, J., Dictionary of the Bible, Scribners, New York, 1963.Google Scholar

7 Gehman, H. S., The ‘burden’ of the prophets. Jewish Quarterly Review, 31 (19401941), 107–21.CrossRefGoogle Scholar

8 Holladay, , op. cit, pp. 652–3.Google Scholar

9 White, , op. cit, p. 65.Google Scholar

10 Vine, et al. , op. cit, pp. 149–50.Google Scholar

11 The 1987 edition of the Britannia is best avoided. It confounds confusion in its discussion of the meaning of the burden of conviction, referring to who is responsible for securing a judgement, either the plaintiff in civil proceedings or the prosecutor in criminal proceedings. It adds with scant regard for the Napoleonic code or European social democracy, ‘since, according to socialist rules of civil procedure, thejudges themselves must search for the facts, it is dubious whether one can speak at all of a burden of proof under socialist law’ (Vol 26, 157).

12 This paragraph owes much to Baugh, Albert C. and Cable, Thomas, A History of the English Language, Routledge & Kegan Paul, London, 3rd edition, 1978Google Scholar; and Randolph, Quirk, The Use of English, Longman, London, second edition, 1968.Google Scholar A shorter, lively account is David, Crystal, The English Language, Penguin, London, 1988.Google Scholar

13 Minois, , op. cit., p. 36.Google Scholar

14 Minois, , op. cit, pp. 58 and 63.Google ScholarPlato, , The Republic, trans. D. Lee, Penguin, Harmondsworth, 1975, 1.330, p. 64Google Scholar; and Xenophon, , Anabasis and Memorabilia, trans. J. S. Watson, London, 1894, ch. VIII. 1, pp. 504–5.Google Scholar

15 Simone de, Beauvoir, La Vieillesse, Gallimard, Paris, 1970, (trans. O'Brian, Patrick, Old Age, Penguin, Harmondsworth, Middlesex, 1977).Google Scholar

16 Humphrey, Mill, Poems Occasioned by a Melancholy Vision, Blaickelocke, London, 1639Google Scholar; cited by Keith, Thomas, Age and authority in early modern England, Proceedings of the British Academy, 62 (1976), p. 245.Google Scholar

17 Williams, Rory, A Protestant Legacy: Attitudes to Death and Illness Among Older Aberdonians, Clarendon, Oxford, 1990, pp. 99 and 115.Google Scholar

18 Stout, G. D., Textual footnotes for Laurence Sterne, A Sentimental Journey Through France and Italy By Mr Yorick, University of California Press, Berkeley, 1967, p. 74.Google Scholar Stout indicates doubt about his reading of burden: Stout's incredulity or Sterne's illegibility? One day I will check the holograph, now in The British Museum. Approximately 380 words later, Sterne makes enigmatic use of the psychological extension of burden in the observations of a ‘peripatetic philosopher’ on nature: ‘It is there only (away from home) that she has provided him with the most suitable objects to partake of his happiness, and bear a part of that burden which in all countries and ages, has ever been too heavy for one pair of shoulders.’

19 Samuel, Johnson, A Journey to the Western Isles of Scotland. In Greene, Donald (ed.), Samuel Johnson, The Oxford Authors, Oxford University Press, Oxford, 1989, pp. 631–2.Google Scholar

20 Daniel, Rogers, Matrimoniall Honour, or the Mutuall Crowne and Comfort of Godly, Loyal and Chaste Marriage, London, 1642, p. 92Google Scholar; cited by Thomas, , op. cit., p. 239.Google Scholar Character as described in the Dictionary of National Biography, 49, 118.Google Scholar

21 Robert, Burton, The Anatomy Of Melancholy: What It Is With All The Kinds Causes Symptoms Prognostics% Several Cures Of It In Three Partitions With Their Several Sections Members & Subsections Philosophically Medicinally Historically Opened And Cut Up By DEMOCRITUS JUNIOR With A Satirical Preface Conducing To The Following Discourse, Henry Cripps, Oxford, 1621. (Chatto & Windus, London, 1927. p 61).Google Scholar

22 Barnes, Jonathan, Introduction to The Ethics of Aristotle: The Nichomachean Ethics, (trans. Thomson, J. A. K.), Penguin, Harmondsworth, Middlesex, 1976, p. 14.Google Scholar

23 Jonathan, Swift, Travels into Several Nations in the World. In Four Parts. By Lemuel Gulliver, 1726. (Doren C. Van, The Portable Swift, Viking, New York, 1948, pp. 427, 432 and 435).Google Scholar The assessment is Simone, de Beauvoir's, op. cit., p. 213Google Scholar; it was shared by Ronald, Blythe, ‘Swift's appaling tirade … the most hate-bearing statement on ageing that we possess’ (op. cit., p. 33).Google ScholarMinois, (op. cit., pp. 6062)Google Scholar demonstrates that Aristotle anticipated both Burton and Swift. See also Faulkner, Thomas M., and de Luce, Judith, A view from antiquity: Greece, Rome and the elderly. In Cole, Thomas R., Van, Tassel, David, D. and Kastenbaum, R. (eds), Handbook of the Humanities and Aging, Springer Publishing Company, New York, 1992, pp. 339.Google Scholar

24 Nokes, David, Jonathan, Swift: A Hypocrite ReversedM, Oxford University Press, Oxford, 1985, pp. 274–5.Google Scholar See also idem, Swift and the beggars, Essays in Criticism, 36, 1976, 218–35. Swift employed burden in its fiscal sense in A Proposal for the Universal Use of Irish Manufacture in Cloaths and Furniture of Houses Utterly Rejecting and Renouncing Everything that comes from England, Waters, London, 1720, reprinted in Davis, H. (ed.), Prose Works, volume 9, Blackwell, Oxford, 1948, p. 19Google Scholar: ‘That the revenues of the Post Office … should be remitted to London, clogged with that grievous Burthen of Exchange, and Pensions paid out of the Irish Revenues to English Favourites … a hardship put upon the POOR Kingdom of England’.

25 Nokes, , 1985, op. cit, pp. 266, 268–9Google Scholar; citing Samuel, Johnson, Lives of the Poets, 1781, (G. Hill, Oxford, 1905, iii, p. 45).Google Scholar

26 Nokes, , 1985, op. cit., p. 276.Google ScholarJonathan, Swift, Causes of the Wretched Condition of Ireland, reprinted in Prose Works, op. cit., p. 206.Google Scholar

27 Bunyan gave biblical citations in the text and in footnotes. He would have known that Jeremiah's final and ‘greatest contribution to religious thought’, the superiority of an individual rather than a collective (or the tribe's) covenant with God, was made when imprisoned at the age of around 60 years: ‘his prison-house became his Patmos’ (White, , op. cit. p. 116).Google Scholar

28 Demos, John, Old age in early New England. In Van, Tassel, David, D. (ed.), Aging, Death and the Completion of Being, University of Pennsylvania Press, Philadelphia, 1979, pp. 115–64.Google Scholar Citing Increase Mather (son of Richard Mather, an early Puritan emigrant from Lancashire, and father of Cotton Mather, also a Puritan minister). Increase Mather, , Two Discourses, B. Green, Boston, 1716, p. 105Google Scholar; Cotton, Mather, A Brief Essay on the Glory of Aged Piety, S. Kneeland and T. Green, Boston, 1726, p. 27Google Scholar; idem, Addresses to Old Men and Young Men and Little Children, R. Pierce, Boston, 1690, p. 37.

29 Cole, Thomas R., The ‘enlightened’ view of aging: Victorian morality in a new key. In Cole, T. R. and Gadow, S. A. (eds), What Does it Mean to Grow Old? Duke University Press, Durham, North Carolina, 1986, pp. 117–36Google Scholar; citing Nathaniel, Emmons, Piety: a peculiar ornament to the aged, in Works, Congregational Board of Publications, Boston, Massachusetts, 1842, iii, 501–2Google Scholar; and Joseph, Lathrop, The Infirmities and Comforts of Old Age, Springfield, Massachusetts, 1802.Google Scholar

30 See the commentary by Leavis, Q. D., Introduction. In George, Eliot, Silas Mamer: The Weaver of Raveloe, Penguin, Harmondsworth, Middlesex, 1967, p. 13.Google Scholar

31 Williams, , op. cit., chapter 9, Religion, pp. 280315. Quotations pp. 290 and 283.Google Scholar

32 Franklin, Benjamin, No Taxation Without Representation: Three Letters of 1754 to Governor William Shirley, reprinted in Writings, Library of America, New York, 1987, p. 403.Google Scholar

33 Morison, S. E.The Oxford History of the American People, Oxford University Press, New York, 1965, (Penguin-Mentor edition, vol. 1, New York, 1972, p. 251).Google ScholarOED does give as the third figurative sense of the noun, ‘An obligatory expense, whether due on private account or as a contribution to national funds; often with the additional notion of pressing heavily upon industry and restraining freedom of action’. Its earlier citations are from belles lettres: Andrew, Marvell, Correspondence, xxi of 1661Google Scholar, see Grosart, , Works, 18721975, II, p. 55Google Scholar: ‘In the matter of your two companyes, if they be of any charge or burthen to you, he is willing to indulge you’. The next from 1741 is an explicit reference to a community charge: Conyers, Middleton, Cicero, I.ii, p. 62Google Scholar: ‘Without any burthen on the Province’.

34 As recorded by Thomas, Jefferson in Autobiography 1743–90. With the Declaration of Independence, 1821. Reprinted in Writings, Library of America, New York, 1984, pp. 2426.Google Scholar

35 Booth, C. The Aged Poor in England and Wales, Macmillan, London, 1894, p. 11.Google Scholar The earliest OED verb citation is to Harriet Martineau's 1832 novel, Homes Abroad: ‘Without burthening the parish.’

36 Craigie, and Hulbert's, A Dictionary of American English (1938)Google Scholar gives only one distinctive American variant of the primary meaning, burthen car, for a railway freight wagon, with several citations from the 1830s and 1840s.

37 Jefferson, Thomas, Notes on the Stale of Virginia: Query XIV, The Administration of Justice and the Description of the Laws, 1781–82.Google Scholar Reprinted in Writings, op. cit., p. 259.

38 Carrington, C., Rudyard Kipling: His Life and Work, rev. 2nd edtn, Macmillan, London, 1978, pp. 319 and 326.Google Scholar

39 Morison, op. cit. vol. 3, p. 118, 122 and 337.Google ScholarCarrington, , op. cit., pp. 333 and 335.Google Scholar The author compares the swell of American opinion in 1898 with that produced in England a year later by the Boer rebellion in the Transvaal. The Spanish-American war began as one of liberation. The Treaty of Paris of 1900 granted The Philippines to the USA, but it held only Manila and to impose its rule continued the war until 1902. The assumption of an imperial role affronted 1776 constitutionalists. Mark Twain, then 60 years of age, wrote tracts in support of the Anti-Imperialist League including one he did not publish, The Stupendous Procession, a biting satire which comments of 3,200 Filipino fatalities, ‘The White Man's Burden has been sung. Who will sing the Brown Man's?’. See Zwick, J., Mark, Twain's Weapons of Satire: Anti-Imperialist Writings on the Philippine-American War, Syracuse University Press, Syracuse, New York, 1992, pp. xi–xlii and 53.Google Scholar At a New York dinner to welcome an English visitor, Twain's polished invective against imperialism ended on relations between the countries: ‘We have always been kin … now we are kin in sin, the harmony is complete, the blend is perfect, like Mr (Winston) Churchill himself. I have the honor to present him to you’ (ibid, 11).

40 Strongly divergent views on Kipling's advocacy of, faith in, and criticisms of British imperial rule in India and of his relationship to Cecil Rhodes continued decades afterwards. The following assessments are all instructive: Eliot, Thomas S., Preface. In A Choice of Kipling's Verse Made by T. S. Eliot, Faber & Faber, London, 1941Google Scholar; Dobrée, Bonamy, Rudyard Kipling: Realist and Fabulist, Oxford University Press, London, 1967Google Scholar; George, Orwell, Rudyard, Kipling. In Critical Essays, Seeker & Warburg, London, 1946Google Scholar, reprinted in Rutherford, A. (ed.), Kipling's Mind and Art, Oliver & Boyd, Edinburgh, 1964, pp. 7084Google Scholar; Annan, Noel, Kipling's place in the history of ideas, Victorian Studies, 3 (19591960)Google Scholar; reprinted in Rutherford, , op. cit., pp. 97125.Google Scholar An empathetic and informative school textbook is Moore, Katherine, Kipling and the White Man's Burden, Faber, London, 1968.Google Scholar

41 Orwell, , op. cit., pp. 7980.Google Scholar Of the other exemplified phrases, only ‘east of Suez’ and ‘the female of the species is deadlier than the male’ retain journalistic life. Remarkably one of Rudyard Kipling's last works ‘that nobody read’, The Gardener, a beautifully crafted moral fable published in 1926, closes with four stanzas entitled The Burden, the only so-titled imaginative work I have found. It is the final work in a late collection, Debits and Credits. In The Gardener, the burden refers to a child, a prophesy and (not to reveal the story) a psychological load; and despite Kipling's aversion to orthodox Christianity, the tale manifestly alludes to the Gospel of St. John. But the stanzas can also be read as self-reflective, and the appellation of burden to the fable could have been a craftsman's reminder to feckless word-smiths of the rich resonances of its age-old senses. See Dobré'e, , op. cit, pp. 45–6Google Scholar, and Wilson, Edmund, The Kipling that nobody read, Atlantic Monthly, 167 (1941), 201–14Google Scholar, reprinted in Rutherford, , op. cit., pp. 1769.Google Scholar Two novels with burden prominent in their titles (as yet unseen) and contemporaneous with Wmb are: Pryce, Richard, The Burden of a Woman, Innes, London, 1895Google Scholar; and Converse, Florence, The Burden of Christopher, Houghton Mifflin, Cambridge, Massachusetts, 1900.Google Scholar

42 The United States ended its military presence in the Philippines on November 24th, 1992, with a final withdrawal from the Subic Bay naval base.

43 Anon (by an average observer), The Burden of Proof: Some Aspects of Sir Redvers Buller's Work During His Recent Campaign in South Africa, Grant Richards, London, 1902Google Scholar; Horton, Isabelle, The Burden of the City, Revell, New York, 1904Google Scholar; Cobden, Club, The Burden of Armaments: A Plea for Retrenchment, Unwin, London, 1905Google Scholar; Durham, Mary E., The Burden of the Balkans, Arnold, London, 1905Google Scholar; US National Child Labour Commission, The Burden Bearers By Small Kodak, NCLC, New York, 1907Google Scholar; Dennis, J. T., translator, The Burden of Isis, Being the Laments of Isis and Nephthys, Translated from the Egyptian, Murray, London, 1910Google Scholar; Dole, C. F., The Burden of Poverty: What to Do, Huebsch, New York, 1912Google Scholar; International Free Trade League, The Burden of Protection: An International Repudiation of the Gospel of Artificial Scarcity, Westminster Press for the IFTL, London, 1912.Google Scholar

44 Wells, H. G., The New Machiavelli, Collins, London, 1911, I.iv and III.ii.2.Google Scholar

45 Theodore Roosevelt subsequently promoted and sanctioned several retrogressive measures which decreased the involvement of blacks in the Republican Party and in political offices, while Lodge was ‘virtually the last senatorial advocate of black enfranchisement through federal coercion’. His Federal Elections Bill of 1890 anticipated the Voting Rights Act of 1965. See Matthew, Holden, The White Man's Burden, Chandler, New York, 1973, pp. 52, 65 and 67.Google Scholar Another intriguing study, which further spreads the inter-racial rhetoric and with substantial gerontological implications is Hayes-Bautista, David E., Schink, Werner O. and Chapa, Jorgé, The Burden of Support: Young Latinos in an Aging Society, Stanford University Press, Stanford, California, 1988.Google Scholar This projects California's population and state budget to 2030, envisaging high public expenditure to support mainly white retired ‘baby-boomers’ when the tax base will rely substantially on a less well educated and paid Latino (Latin American origin) population. It advocates increased investment in the ‘human capital’ of the Latino population. For a critical response see Minkler, Meredith and Robertson, Ann, The ideology of ‘age/race wars’: deconstructing a social problem, Ageing & Society, 11(1) (1991) 122.CrossRefGoogle Scholar

46 Cuvillier, Rolande, The housewife: an unjustified financial burden on the community. Journal of Social Policy, 8(1) (1979), 126.CrossRefGoogle Scholar This argues that in societies with strong sex-role differentiation, subsidies to married couples are a community burden. The wife does the housework and raises the couple's standard of living. Housewives should therefore pay income tax and social security contributions on 50% of their husband's earnings, their‘earned income’, and husbands should pay the same taxes on their total income. On word-processor thesauruses, they encourage catachresis: mine lists 110 substitutes for burden including hamper, wound, deject, intimidate, overhead, tragedy, frustration and culpability (Calvin and Swift live!).

47 Victor, Christina R., Health and Health Care in Later Life, Open University Press, Milton Keynes, Buckinghamshire, 1991, p. i.Google Scholar

48 Titmuss, Richard M., Pensions systems and population change. Political Quarterly, 26(2) (1955)CrossRefGoogle Scholar, reprinted in idem, Essays on the Welfare State, 3rd edtn., Allen & Unwin, London, 1976; Wells, Nicholas and Freer, Charles (eds), The Ageing Population: Burden or Challenge, Macmillan, London, 1986Google ScholarPubMed; Thane, Patricia, Old age: burden or benefit? In Heather, Joshi (ed.), The Changing Population of Britain, Blackwell, Oxford, 1989, pp. 5671Google Scholar; Walker, Alan, The consequences of an ageing population for the social security system, Contemporary European Affairs, 2(1), (1989), 89102Google Scholar; idem, The economic burden of ageing and the prospect of intergenerational conflict, Ageing & Society, 10(4), (1990), 377–98.

49 Estes, Carroll L., Social security: the construction of a crisis. Milbank Quarterly, 61 (1983), 445–61Google ScholarPubMed; Binney, Elisabeth A. and Estes, C. L., The retreat of the state and the intergenerational war. International Journal of Human Sciences, 18(1) (1988), 8396Google ScholarPubMed; and Walker, 1990, op. cit.Google Scholar Examples of the papers attracting criticism are: Davis, Kingsley, Age relations and public policy in advanced industrial societies. Population and Development Review, 7(1) (1981), 118CrossRefGoogle Scholar; Preston, S. H., Children and the elderly in the United States, Scientific American, 251 (1981), 4449.CrossRefGoogle Scholar Walker lists several reports from the Council of Europe, the Organisation for Economic Cooperation and Development, the International Social Security Association and the International Labour Office. Recent examples with little more sociological realism include: Gillon, C., Ageing populations: spreading the costs. Journal of European Social Policy, 1(2) (1991), 107–28CrossRefGoogle Scholar; Preston, S. H., Himes, C. and Eggers, M., Demographic conditions responsible for population aging, Demography, 26 (1989). 691704.CrossRefGoogle ScholarPubMed

50 Preface, p. xxiii of Butler, Robert N., Oberlink, M. R. and Schechter, M. (eds), The Promise of Productive Aging: From Biology to Social Policy, Springer Publishing Company, New York, 1990.Google Scholar

51 Studies of productive ageing are presently enjoying considerable vogue. See Butler, Robert N. and Gleason, H. P. (eds), Productive Aging: Enhancing Vitality in Later Life, Springer Publishing Company, New York, 1985Google Scholar; Butler, Oberlink and Schechter, (eds), op. cit.Google Scholar,; Herzog, A., Regula, Kahn Robert L., Morgan, James N. and others. Age differences in productive activities, Journal of Gerontology, 44 (1989), pp. 81298138CrossRefGoogle ScholarPubMed; Herzog, A. R. and Morgan, J. N., Age and gender differences in the volue of productive activities: four different approaches, Research on Aging, 14(2) (1992), pp. 169–98CrossRefGoogle Scholar; Kahn, R. L., Productive behavior through the life course: an essay on the quality of life, Human Resource Management, 23 (1984), pp. 522.CrossRefGoogle ScholarPubMed In the USA, a Commonwealth Fund ‘Productive Aging Survey’ has established that three-quarters of old people are active in at least one of: employment, education and training to improve work skills, volunteering, helping children and grandchildren, and providing assistance to sick or disabled people, see Bass, S. A. and Caro, F. G., Productive contributions of old people (abstract), The Gerontologist, 32, special issue II (1992), 196–7.Google Scholar Findings of research on intergenerational relations and social support are synthesised in Bengston, V. L. and Cutler, N. E., Generations and intergenerational relations: perspectives on age groups and social change. In Binstock, R. H. and Shanas, E. (eds), Handbook of Aging and the Social Sciences, Von Nostrand Reinhold, New York, pp. 130–59Google Scholar; Bowling, Ann, Social support and social networks: their relationship to the successful and unsuccessful survival of elderly people in the community. Family Practice, 8(1) (1991), 6883.CrossRefGoogle Scholar

52 Smith, George Teeling, Measuring Health: A Practical Approach, Wiley, Chichester, 1983, p. 3. Author's emphasis.Google Scholar

53 Callahan, Daniel, Setting Limits: Medical Goals in an Aging Society, Simon & Schuster, New York, 1987Google Scholar; Idem, What Kind of Life: The Limits of Medical Progress, Simon & Schuster, New York, 1990.

54 Levinsky, Norman G., Age as a criterion for rationing health care, New England Journal of Medicine, 322 (1990), 1815CrossRefGoogle ScholarPubMed; Boyle, Joseph, Should age make a difference in health care entitlement? In Gormally, Luke (ed.), The Dependent Elderly: Autonomy, Justice and Quality of Care, Cambridge University Press, Cambridge, 1992, pp. 147–57CrossRefGoogle Scholar; Barry, Robert L. and Bradley, Gerard V. (eds), Set No Limits: A Rebuttal of Daniel Callahan's Proposal to Limit Health Care for the Elderly, University of Illinois Press, Urbana, Illinois, 1991Google Scholar; Binstock, Robert H. and Post, Stephen G. (eds), Too Old for Health Care? Controversies in Law, Economics and Ethics, Johns Hopkins University Press, Baltimore, 1991Google Scholar, in which see particularly: Moody, Harry R., Allocation, yes; age-based rationing, no! pp. 180203.Google Scholar

55 Moody, , op. cit., p. 180.Google Scholar

56 See Preface, Barry, and Bradley, , op. cit., pp. vii–ixGoogle Scholar, and Moody, , op. cit., p. 202.Google Scholar Moody does not comment specifically on Callahan's quantification of the ‘natural life’ at almost one-third less than the 115 years that some attain.

57 Callahan, , op. cit., p. 20.Google Scholar

58 Barry, Robert L., Mandatory, universal age-based rationing of scarce medical resources. In Barry and Bradley, op. cit., pp. 314.Google Scholar

59 Undocumented quotation from Kant by Louis, Wirth, On making values explicit. In Reiss, Albert J. (ed.), Louis Wirth: On Cities and Social Life. University of Chicago Press, Chicago, 1964, p. 159.Google Scholar See also in the same volume Wirth on: Ideas and ideals as sources of power in the modern world, pp. 146–61.

60 Moody, , op. cit., p. 182.Google Scholar

61 See for example Thomson, David, Workhouse to nursing home: residential care of elderly people in England since 1840, Ageing & Society, 3(1) (1983), 4370.CrossRefGoogle Scholar

62 Wing, S., Casper, M., Davis, W. et al. , Trends in the geographic inequality of cardiovascular disease mortality in the United States, 1962–82. Social Science and Medicine, 30 (1990), pp. 261266.CrossRefGoogle Scholar For a summary of recent UK late age mortality trends see Warnes, A. M., The Demography of Ageing in the United Kingdom of Great Britain and Northern Ireland, Committee for International Cooperation in National Research in Demography and the United Nations Institute on Ageing, Valletta, Malta, 1993, 102 pp.Google Scholar See also Chave, S. P. W., The origins and development of public health. In Holland, W. W., Detels, R. and Knox, G. (eds), Oxford Textbook of Public Health, Volume 1, History, Determinants, Scope and Strategies, Oxford University Press, Oxford, 1984.Google Scholar

63 Townsend, Peter, The structured dependency of the elderly: a creation of social policy in the twentieth century, Ageing & Society, 1(1) (1981), p. 6.CrossRefGoogle Scholar

64 Vitaliano, Peter P., Young, Heather M. and Russo, Joan, Burden: a review of measures used among caregivers of individuals with dementia. The Genntologist, 31(1) (1991), p. 67CrossRefGoogle ScholarPubMed; citing George, Linda K. and Gwyther, L. P., Caregiver well-being: a multidimensional examination of family caregivers of demented adults. The Gerontologist, 26 (1986), 253–59.CrossRefGoogle ScholarPubMed Two early and characteristic examples of the usage are Morycz, R. K., The exploration of senile dementia and family burden. Clinical Social Work, 8(1) (1980), 1627CrossRefGoogle Scholar; and Zarit, S.H. and Zarit, J. M.Relatives of the impaired elderly: correlates of feelings of burden. The Gerontologist, 20 (1980), 649–55.CrossRefGoogle ScholarPubMed A comprehensive listing of later articles is not attempted, but see: Montgomery, Rhoda J. V., Gonyea, J. G. and Hooyman, N. R., Caregiving and the experience of subjective and objective burden. Family Relations, 34 (1985), 1926CrossRefGoogle Scholar; Verbrugge, Lois, Role burdens and physical health outcome of women and men. Women and Health, II (1986), 4777CrossRefGoogle Scholar; Harper, Sarah and Lund, A., Wives, husbands and daughters caring for institutionalised and non-institutionalised dementia patients: toward a model of caregiver burden. International Journal of Aging and Human Development, 30(4) (1990), 241–62CrossRefGoogle Scholar; Each new issue of The Gerontologist and the Journal of Gerontology adds more. See also Anderson, R., The unremitting burden on carers, British Medical Journal, 294 (1987), 73.CrossRefGoogle ScholarPubMed

65 Maddox, George L., Long-term care policies in comparative perspective. Ageing & Society, 12(3) (1992), 355–68.CrossRefGoogle Scholar

66 Kitwood, Tom, The technical, the personal and the framing of dementia. Social Behaviour, 3 (1988), 161–80Google Scholar; Kitwood, T. and Bredin, Kathleen, Towards a theory of dementia care: personhood and well-being, Ageing & Society, 12(3) (1992), 269–87CrossRefGoogle ScholarPubMed; Kitwood, T., Towards a theory of dementia care: the inter-personal process, Ageing & Society, 13(1) (1993), 5168CrossRefGoogle Scholar; Gubrium, J., Old-Timer's and Alzheimers: The Descriptive Organisation of Senility, Jai, London, 1986.Google Scholar

67 Sinclair, Ian, Crosbie, D., O'Connor, P., Stainforth, L. and Vickery, A., Bridging Two Worlds: Social Work and the Elderly Living Alone, Avebury, Aldershot, Hampshire, 1988Google Scholar; Sinclair, Ian (ed.), Residential Care: The Research Reviewed, Her Majesty's Stationery Office, London, 1988.Google Scholar

68 Hinrichsen, G. A. and Hernandez, N. A., Time to abandon ‘caregiving’? A reply to Parmelee and Katz. The Gerontologist, 32(5) (1992), 582–3CrossRefGoogle ScholarPubMed; Parmelee, P. A. and Katz, I. R., ‘Caregiving’ to depressed older person: a relevant concept? The Gerontologist, 32(4) (1992), 436–7.CrossRefGoogle ScholarPubMed

69 One distributor of frozen foods describes itself as ‘The Caring Caterer’. Another uses the pleonastic slogan ‘We Care – Seriously’. Being intensively competitive, both promote products that minimize preparation time, staff inputs, freezer losses and price and I suspect that the nutritional quality and delectability of the foods are secondary considerations. To care however is not so perplexing and is in most usage transitive.

70 Quirk, , op. cit., p. 257.Google Scholar

71 Johnson, , Preface to the Dictionary, op. cit., Reprinted in Greene, op. cit., p. 324.Google Scholar