This book compares age-related policies and services for the ageing population between different countries and regions of the world. Adapting an outline by the UN the author explores the societal, economic and philosophical aspects and impacts of ageing, and makes the case for the importance of understanding and approaching the phenomenon of ageing from a number of different perspectives.
The book is divided into four parts entitled ‘social context of ageing’, ‘health, income and work in later life’, ‘care of older persons’ and ‘new behaviours, new demands and new challenges’. In part one there are three in depth, diverse chapters giving an overview of the main theoretical frameworks that have been developed to explain the phenomenon of ageing. There is a thorough exploration of factors that influence approaches to ageing, such as the demography of population ageing, the changing family and social context of ageing, the importance of social engagement for happy and healthy ageing, whether it is achieved through family networks or wider communities. Numerous graphs, pyramids and tables are provided to support the author’s theories, which are extremely helpful.
Part two is devoted to an exploration of health, income and work in later life and in my opinion is one of the book’s strengths. One of the more telling chapters is entitled ‘health in later life’. This chapter discusses the issues around the health status of the older population, including the possible significant increases in healthy life expectancy and the attendant compression of morbidity into shorter periods of time. Although the author refers to factors that might be working against the improvement of health in older age such as ‘the obesity epidemic in many developed and developing countries’ (p. 47), this has not been investigated in any detail. The chapter also explores ageism that is often inherent in health care insofar as older people are frequently assumed to be less deserving of medical care than younger patients, and it seems that this assumption is reflected in the treatments that are available to them.
The final two chapters in this part are excellent and deal first, with pensions and employment and providing security in old age and second, the issues around whether the ageing population poses a ‘demographic time bomb’.
I was particularly drawn to part three in which the author broaches the complex area of long-term care for older people, with a focus on outlining the differences and overlaps between informal and formal care, and the roles of public and private actors in providing and financing care. Using data from five case study countries (Sweden, Germany, Japan, UK and US), the author points out that these countries differ substantially in terms of the extent to which the responsibility for financing the cost of care is divided between individuals and the government. Given this information, the questions who gets care, how much and who pays become increasingly important for policy makers.
The final section considers what the ‘silver century’ might look like and concludes with a discussion of the ways in which societies strive a balance between cost and fairness considerations in their attempts to adapt to population ageing. There is an excellent discussion and a summary of the policies involved in extending working lives.
The book is well written and meets its aim of introducing and discussing both the theoretical and philosophical issues around ageing. The author succeeds in arguing that that whilst ageing is becoming increasingly widespread and global, the experience of ageing differs greatly between individuals, countries and regions of the world. The book will be of interest to students at undergraduate and postgraduate level, and general readers from a wide variety of backgrounds who wish to gain an understanding of the complex and highly topical subject of ageing.
