Responses to poverty, inequality and marginalisation are at the heart of critical approaches to social work and ageing. However, the boundaries being drawn around gerontological social work in education and practice tend to focus on health and on professional issues of assessment and service delivery, with limited connections to either critical gerontology or structural social work. Analysing responses to poverty and late-life homelessness from a critical perspective can explain how these gaps emerged, and situate a more clearly articulated critical gerontological social work approach in research, education and practice.

Homelessness among older people is on the rise across international contexts such as the United States (US), Canada, Europe and Australia (Crane et al, 2005; Gaetz et al, 2016). Some estimates suggest that the numbers of older people who are homeless have grown by 20 per cent in the early 2000s (Crane and Joly, 2014). Although many factors contribute to this rise in late-life homelessness, many of the antecedents can be attributed to service provision, lifelong poverty and social crises such as trauma, family breakdown and mental health/substance challenges (Brown et al, 2016). Population ageing combined with concerns about growing inequalities between those ageing in poverty or disadvantage and those with more advantageous economic circumstances demands insights from critical social work approaches and active strategies for systematic change.

While there is a strong radical tradition in social work (see Fook, 1993; Leonard, 1997; Healy, 2000), and a related critical feminist focus on social care operating at the peripheries of social gerontology (see Sevenhuijsen, 2003; Baines, 2007; Armstrong and Braedley, 2013), these areas of research and scholarship have seldom been taken up directly in gerontological social work education and practice. Critical social work theories have evolved in child welfare, housing and immigration, but gerontological social work tends to be configured as a medically dominated and professionally defined field with little account for how systems of care and inequality shape the experiences of older people (see Hartford Program and Council for Social Work Education for a North American articulation of gerontological social work).

Introduction

This book has explored the extent to which the concepts of ‘precarity’ and ‘precariousness’ can provide new insights into the way in which inequalities and insecurities may be experienced across the life course. A dominant theme of the chapters has been the impact of various changes that have affected the lives of older people in the 21st century, these including the decline of the social or welfare state, the move to extend working life, the pressures faced by caregivers and the vulnerabilities of late old age. Of course, as many of the contributors suggest, not all older people are affected in the same way, with significant variations according to race, ethnicity, gender, social class and sexual orientation. But relatively few people are likely to escape the experience or feeling of insecurity at some point in later life, and for many these may become deeply rooted in everyday life.

As a general argument, then, and for different reasons, we think ideas associated with ‘precarity’ and ‘precariousness’ are valuable for students of ageing and policymakers to consider. First, they extend our understanding of the many sources and forms of insecurity that may affect the lives of older people. These have been illustrated in this book through, for example, discussions relating to migration (Kobayashi and Kahn), care work (Fine), cuts to health and social care (Polivka and Bao; Portacolone), and the influence of life course transitions in creating precarity and responses to it (Settersten). Second, later life may bring distinctive features in respect of changes to mental and physical health. As noted in many of the chapters, however, these are often best understood in terms of lives that, from childhood onwards, may face numerous threats to independence and security (see, for example, the chapters by Settersten and Grenier). Third, on an optimistic note, the idea of precarity may also be used to point the way to new forms of resistance developed by individual older people and by larger social groups (an aspect identified in the chapters by Katz and Phillipson). Thus, the debate about precariousness is not only about understanding new vulnerabilities but also about the emergence of collective organizations in response, both across and within generations (see later in this chapter).

Introduction

Over the last 15 years, frailty has emerged as one of the most powerful constructs in gerontology, geriatrics and health care delivery. Authors from biomedicine have highlighted the clinical importance of the concept (Fried et al, 2001; Rockwood et al, 1994; Rockwood and Mitnitski, 2007), with researchers in the social sciences calling attention to its powerful position in establishing the foundations for medical expertise and disciplining older bodies according to function and risk (Grenier, 2007; Katz, 2011; Pickard, 2014). The concept of frailty appears in countless calls from medical interest groups (Morley et al, 2013; Turner and Clegg, 2014), and is used to frame a number of international research priorities such as the Canadian Frailty Network, as well as national care priorities such as that of the National Health Service in the UK (Vernon, 2016; Young, 2014). The concept of frailty is also now central to service eligibility across a range of settings and international contexts, and has appeared in advocacy campaigns such as that of the charity AGE UK. Over time, the use of the concept of frailty has expanded across community and hospital settings, international policy, and local governments, with a growing basket of tools, measures and training to guide assessment and intervention.

The dominant portrayal and response to frailty is deeply rooted in biomedical knowledge, professional health expertise, and institutional or organizational practices such as hospital care, rehabilitation settings and home care. Yet, this view tends to mask that frailty is both experienced by older people (with the lens of frailty ever widening to the ‘pre-frail’), and is historically situated in a wider political context of neo-liberal priorities and managed care. Contemporary features such as population ageing, longevity and the neo-liberalization of care thus represent an important landscape against (and through) which frailty is experienced, and responses are configured and enacted. That is, the concept of frailty is not without meaning or context; it is a human experience, a representation of the need for care and a response (or multiple responses) to this need. The experiences that are often labelled and classified as ‘frail’ are thus both part of the human condition and deeply political.

Introduction

This book examines some of the challenges facing older people, given a context of rising life expectancy, cuts to the welfare state, and widening economic and social inequalities. Although cultural representations and policy discourses depict older people as a group healthier and more prosperous than ever, many older people experience ageing amid insecurities that emerge in later life or are carried forward as a consequence of earlier disadvantage. At the same time, responsibility is now placed upon individuals and/or their families to secure support for many of the vulnerabilities associated with old age. The purpose of this book is to examine the potential of a new approach to thinking about the risks facing older people, drawing on debates in the field of ‘precarity’ and ‘precariousness’.

This book examines precarity and ageing from a range of disciplinary backgrounds, critical perspectives and contexts. The collection of chapters develops a distinctive approach to understanding the changing cultural, economic and social circumstances that create precarity for different groups of older people. This book explores what insights the concept of precarity might bring to an understanding of ageing across the life course, especially in the context of the radical sociopolitical changes affecting the lives of older people. In doing so, it draws attention to altered forms of ageing, but also to changing social and cultural contexts, and to realities that challenge the assumption that older people will be protected by existing social programmes or whatever resources can be marshalled privately.

This chapter sets the foundation for the book, with an exploration of the concept of precarity and its relevance to the field of ageing. It establishes precarity as a lens, or a means, for drawing attention to insecurity and risk in later life. The chapter begins with a discussion of the concept of precarity and precariousness in fields such as geography and labour studies, and how the concept has been applied to ageing and late life. It then poses a series of questions to guide reflection and ground the debates pursued by authors, followed by a brief overview of the chapters ahead.