Photo: Family exercising outdoors from Age Positive image library at Ageing Better UK

We live in times of heightened societal fears of ageing. Ageing is seen as both a process and a state that we must vigilantly monitor and slow down, however, we cannot avoid it. Youthfulness, and its perceived vigour, are to be maintained. In everyday life we are confronted with youthful images, reminders of the need to look young, with an almost moral judgement focussed on maintaining the correct patterns of consumption to hold onto youth. Old age has increasingly become associated with perceived physical and cognitive decline, deplete of pleasure, enjoyment and feeling. These attitudes contribute to the continued stigmatisation of ageing and ageing related conditions including multi-morbidities and cognitive impairment, further adding to social anxieties. This sits paradoxically with societal pressure to live long lives, to eat well, to exercise, to avoid health risks, in order to one day reach the oldest age possible. The aim to live as long a life possible sits against the inevitability that doing so also requires growing old, to reach old age. Despite all efforts to slow and or evade the process, ageing is inevitable.

The fears of ageing and the possibility of increased risk of multi-morbidities and cognitive impairment are understandable and there is hope that improved knowledge about life style changes and choices will improve health and cognition in later life for many. However, knowledge of risk reduction and treatment do little to help with multi-morbidities and or cognitive impairment, (or those who will live with them). Risk reduction does little to tackle the socio-economic factors that shape access to and experiences of health and social care services, especially for those at risk of poverty who cannot access or afford the lifestyle choices associated with maintaining physical and cognitive function in later life.  In addition, prevention does little to address the structural factors that contribute to societal fears of ageing.

An area where these worries are perhaps most overlooked (but are in fact incredibly pronounced) are for those currently ageing within ethnic minority communities, and this brings its own particular fears, especially around being forced to move into a care home. For example, they may have fears that the people who racially abused you, bullied you at school when you were young, or ostracised you at work are ageing in sync with you. They could potentially be in the same care home as you, or worse, caring for you. Being an ethnic minority in an institution where you are vulnerable, separated from your community and cannot speak for yourself, is a daunting prospect.

Addressing social anxiety about ageing requires going beyond providing risk reduction advice to delay physical and cognitive decline, on to things like the need to consider how to address the wider structural factors such as access to health and social care services and social isolation.

Pricilla Alderson’s recent piece “Politics, Economics and the Sociology of health and illness” rightly questions the lack of sociological focus on the privatisation of the NHS. This is thought to be evident in recent governments’ policies that have led to a gradual decline in health and social care services which seemingly lays the grounds for a two-tier public and private health system. However, it may be worth seeing this as long-standing scholarly tendency to neglect scrutinising subsequent governments and political party policies on health and social care. From Tony Blair to Teresa May, most loudly (and hollowly) through Boris Johnson, briefly through Liz Truss and now the Sunak Government, successive governments have made grand promises about bringing about change and improving health and social care. However, to date, none have delivered.

Later this year there will be a general election in the UK, and much will made of the need to improve health and social care in manifestos of parties of all stripes, but I fear there will be little scholarly, including sociological, debate about what those really mean in real terms for social care services particularly for older people should look like. We will come out post-election and years to come, still talking about the need to “fix” the social care problem. The debate about improving social care for older people should be started now and sustained through to successive governments to ensure a better long-term solution.

There are spaces that provide hope. In my research I collaborate with charities and community organisations who, with minimal resources, provide remarkable services for older people. They can make a very real difference in the lives of older people by providing services such as art workshops, day trips, arrange social visits and help with shopping appointments etc among others. All these add pleasure, fun and value to ageing and living well in old age.

In conclusion, there is need for sociological inquiry that simultaneously analyses future governments policies while challenging the current health and social care status quo. This should focus on a continued interrogation of the socio-political processes that shape the design and delivery of social care not in the short term but for the long term. Doing so would go a long way to address, in part, the structural causes of societal anxieties of ageing- namely poor health and social care services. while also improving the wellbeing and care of older people.