Ageing and the Crisis in Health and Social Care: Global and National Perspectives (Ageing in a Global Context)

Developing a trilayer analysis of global, national and individual perspectives, this book examines ageing and the health and social care crisis. It begins with an examination of how broad structural and discursive trends, such as neoliberalism and globalisation, have influenced the financing and provision of health and social care for older people in Western countries including Germany, Sweden and the UK. It then goes onto discuss the impact that privatisation, ‘choice’ and competition has had on service provision, including how declining social protections have impacted upon employment practices. Three UK case studies (active ageing, pre-emergency, and end of life care) provide insight into individual’s (both older people and health care workers) experiences of navigating the risky, fragmented and complex health and social care system. Then the UK’s response to the COVID-19 pandemic is compared with Sweden and Germany’s, and the UK government’s intended solutions to the health and social care crisis is discussed. Finally, the book ends by showcasing examples of innovative care solutions that have been trialled in the UK, and what broader cultural and political changes are necessary to provide a more sustainable and dignified health and social care system for older people. Front Cover Ageing and the Crisis in Health and Social Care: Global and National Perspectives Copyright information Table of contents Acknowledgments Series information 1 Introduction Contextualising care Setting the scene Key takeaways Outline of the book 2 Discourse, capital, intersectionality and precarity Introduction Neoliberal health and social care policy discourse: a Foucauldian analysis Governmentality and biopolitics Biomedical theorisation of ageing Social-gerontological theories of ageing Successful/active ageing theory Bourdieusian theory applied to ageing Intersections of age, gender, disability and ethnicity Theorising precarity and ageing Conclusion 3 Globalisation, neoliberalism and welfare state models: a comparative analysis Introduction Globalisation and neoliberalism The origins of neoliberalism Welfare state models and their political underpinnings The UK welfare state system: a neoliberal/Anglo-Saxon archetype Competition, ‘choice’ and consumerism The Swedish welfare state: a social-democratic/Scandinavian archetype The Swedish health and social care system The German welfare state: a corporatist/Continental European archetype The German health and social care system Conclusion 4 Failing health and social care in the UK: austerity, neoliberal ideology and precarity Introduction Austerity policies The Health and Social Care Act 2012 The Care Act 2014 Impact of austerity and neoliberal reform on service provision Failure of residential adult social care organisations The failure of Southern Cross Four Seasons Changes to the domiciliary (‘home care’) sector Precarious adult social care workers Precarious health care workers The ‘dementia tax’ and the 2017 election Brexit and Boris Conclusion 5 Public health, emergency settings and end of life care Introduction Case Study 1: Preventing decline – active ageing and public health Responses to images of active older people Importance of representations of ageing in public health information Case Study 2: older people falling and being attended to by paramedics Precarity of older people in emergency care Older people’s choice and sense of being a burden Signposting in a fractured system Precarity and making choices with older people in stressful, fragmented systems Case Study 3: negotiating end of life and advocating for the dying Discussing death Inadequate information: fragmented IT systems Lack of time and resources for sensitivity Patchy and inconsistent community end of life care services Advocating for the dying End of life postcode lottery Conclusion 6 The COVID-19 health and social care challenge Introduction The impact of COVID-19 on the UK Minority ethnic and working-class communities Men and health and social care workers Do older lives matter? Deaths of people over 80 and older people in residential settings Unsafe hospital discharge Denial of medical treatment Blanket ‘Do Not Resuscitate’ orders Negligence and the second wave Neoliberalism, intergenerational conflict and ‘new ageism’ Comparative contemporary analysis of Sweden’s and Germany’s handling of COVID-19 Sweden: herd immunity Germany: protect, track and trace The COVID-19–Brexit nexus Conservative policy post-COVID-19 and Brexit Improving integration or increasing privatisation? Conclusion 7 Innovative solutions and cultural change Innovative, alternative health and social care models Homeshare: intergenerational support Therapeutic nursing homes Age-friendly cities: alternative public health Relational/asset-based approaches Key issues of cultural change Quality, holistic and reciprocal relationships Care ethics and precarious interdependence A Moonshot feminist approach to health and social care Appendices Appendix 1: Methodology for Case Study 1 Appendix 2: Research team and methodology for Case Study 2 Methodology for paramedic participant data Methodology for patient participant data Research team Ethics approval Funding Appendix 3: Example of a healthy ageing leaflet: Chichester District Council (no date) HeartSmart Walks: Walk for your Hearts sake, Chichester District Council: Chichester References Index Back Cover Front Cover -- Ageing And The Crisis In Health And Social Care: Global And National Perspectives -- Copyright Information -- Table Of Contents -- Acknowledgments -- Series Information -- 1 Introduction -- Contextualising Care -- Setting The Scene -- Key Takeaways -- Outline Of The Book -- 2 Discourse, Capital, Intersectionality And Precarity -- Introduction -- Neoliberal Health And Social Care Policy Discourse: A Foucauldian Analysis -- Governmentality And Biopolitics -- Biomedical Theorisation Of Ageing -- Social-gerontological Theories Of Ageing -- Successful/active Ageing Theory Bourdieusian Theory Applied To Ageing -- Intersections Of Age, Gender, Disability And Ethnicity -- Theorising Precarity And Ageing -- Conclusion -- 3 Globalisation, Neoliberalism And Welfare State Models: A Comparative Analysis -- Introduction -- Globalisation And Neoliberalism -- The Origins Of Neoliberalism -- Welfare State Models And Their Political Underpinnings -- The Uk Welfare State System: A Neoliberal/anglo-saxon Archetype -- Competition, 'choice' And Consumerism -- The Swedish Welfare State: A Social-democratic/scandinavian Archetype -- The Swedish Health And Social Care System The German Welfare State: A Corporatist/continental European Archetype -- The German Health And Social Care System -- Conclusion -- 4 Failing Health And Social Care In The Uk: Austerity, Neoliberal Ideology And Precarity -- Introduction -- Austerity Policies -- The Health And Social Care Act 2012 -- The Care Act 2014 -- Impact Of Austerity And Neoliberal Reform On Service Provision -- Failure Of Residential Adult Social Care Organisations -- The Failure Of Southern Cross -- Four Seasons -- Changes To The Domiciliary ('home Care') Sector -- Precarious Adult Social Care Workers Precarious Health Care Workers -- The 'dementia Tax' And The 2017 Election -- Brexit And Boris -- Conclusion -- 5 Public Health, Emergency Settings And End Of Life Care -- Introduction -- Case Study 1: Preventing Decline -- Active Ageing And Public Health -- Responses To Images Of Active Older People -- Importance Of Representations Of Ageing In Public Health Information -- Case Study 2: Older People Falling And Being Attended To By Paramedics -- Precarity Of Older People In Emergency Care -- Older People's Choice And Sense Of Being A Burden -- Signposting In A Fractured System Precarity And Making Choices With Older People In Stressful, Fragmented Systems -- Case Study 3: Negotiating End Of Life And Advocating For The Dying -- Discussing Death -- Inadequate Information: Fragmented It Systems -- Lack Of Time And Resources For Sensitivity -- Patchy And Inconsistent Community End Of Life Care Services -- Advocating For The Dying -- End Of Life Postcode Lottery -- Conclusion -- 6 The Covid-19 Health And Social Care Challenge -- Introduction -- The Impact Of Covid-19 On The Uk -- Minority Ethnic And Working-class Communities -- Men And Health And Social Care Workers Bethany Simmonds. Do Older Lives Matter? Deaths Of People Over 80 And Older People In Residential Settings. Electronic Reproduction. Baltimore, Md Available Via World Wide Web. "Neoliberal political discourses have normalised the belief in northern European countries that individuals are responsible for their health and wellbeing, regardless of social class, gender or ethnic background. Drawing on examples from Germany, Sweden and the UK, Simmonds critically examines how the neoliberalisation and marketisation of health and social care have created an adverse environment for older people, who lack social and cultural capital to access the care they need. This crucial analysis scrutinises provision for ageing populations at individual, national and global levels. Challenging current political and social policy approaches, this rigorous text discusses innovative solutions to contemporary challenges in a complex care system."--Page 4 of cover

Neoliberal political discourses have normalised the belief in northern European countries that individuals are responsible for their health and wellbeing, regardless of social class, gender or ethnic background. Drawing on examples from Germany, Sweden and the UK, Simmonds critically examines how the neoliberalisation and marketisation of health and social care have created an adverse environment for older people, who lack social and cultural capital to access the care they need. This crucial analysis scrutinises provision for ageing populations on an individual, national and global level. Challenging current political and social policy approaches, this rigorous text discusses innovative solutions to contemporary challenges in a complex care system.

Current and future provision of health and social care for older people is explored in this timely study. It draws on examples from the Germany, Sweden and the UK to measure the impact of trends including neoliberalisation and marketisation and it considers new solutions to contemporary challenges in a complex care system.