Introduction
Environmental gerontologists who are concerned with researching the context of adult human experience and behaviour in later life regard person/environment (P–E) interaction as pivotal to ageing well. Consequently, Chapter 1 opens with the actor and their stage – the separate characteristics of older people and their environment based on lives in Western developed countries. By discussing these separately, they are then brought together to recognise interaction between them in everyday experiences. Finally, we move beyond this individualised interaction within specific contexts, recognising that P–E also must be addressed at a collective level. This has implications both in terms of levels of interaction and the methodology by which the evidence base and research methods, particularly participatory studies, are supported.
Under the heading of Person (P), attention is paid to the boundaries of ageing, in other words how an older person is defined in this text. Consideration is given to ‘successful’ or ‘active’ ageing and proposed definitions of ‘third’ and ‘fourth’ ages. Such definitions are grounded in a heterogeneity that sees each individual as uniquely gendered and ethnically, sexually and culturally distinct. Late life experience is built on an understanding of the self that takes a wider life course perspective. All these characteristics have implications for P–E interaction, and awareness of this diversity is necessary before underlying theoretical perspectives are addressed in Chapter 2. Environment (E) then comes to the fore, with the central concerns being space, place and materiality. The underlying relationship between space and place as social, economic, psychological and cultural is unpacked before public and private domains are examined. The issue of materiality is then considered through both material and immaterial worlds, leading to personal experiences of the attachment to place. This discussion captures both global and local contexts.
The chapter ends by bringing the two main components centre stage to discuss their interface – how an older person and their particular spatial environment come together through everyday living. Behaviour is examined at a local or ‘micro-’ level and yet by using a biopsychosocial approach, a person’s well-being subject to varied concerns relating to their physical and cognitive health is experienced wherever they are. These are embodied
Person (P)
Labelling later life
The word ‘active’ refers to continuing participation in social, economic, cultural, spiritual and civic affairs, not just the ability to be physically active or to participate in the labour force. Older people who retire from work and those who are ill or live with disabilities can remain active contributors to their families, peers, communities and nations. Active ageing aims to extend healthy life expectancy and quality of life for all people as they age including those who are frail, disabled and in need of care. (WHO, 2002, p 12)
This comment defines ‘active’ as living in an enabling world where people in later life feel empowered to participate, if that is their wish, and to have the resource and social capital within communities (see Putnam, 2000) to make that choice. The resources needed for those living with long-term health conditions or growing cognitive impairment is acknowledged in later World Health Organization (WHO) reports, in which the concept of healthy ageing is recognised (WHO, 2015a, 2015b, 2017a).
Recent critiques of the concept of successful ageing have revealed its complex and contradictory nature. While this positive approach is based within a neoliberal tradition that supports individualisation within consumer societies, it neglects to understand the social inequality faced by those experiencing poverty and discrimination (see Katz and Casalanti, 2015; Rubinstein and de Meideros, 2015). This critique is relevant to the question posed here: how are ageing and later life defined within a discussion of the environments of ageing? To explore this further, we engage with the sociological debate from developed nations where extended life expectancy
The starting point is the market for retirement housing provided by the independent/commercial sector within the UK, an income-rich, consumer-oriented country, where advertising can be aimed at those aged 55 and over. Here is an anonymised example:
Set on Beechwood Avenue in Notown, Heresville is nestled in a seemingly rural location within 0.8 miles of a station for trains to the city for theatres, galleries and shops. These are shared ownership luxury apartments at their best for those aged 55 and over who aren’t seeking to buy outright.
Family and carers may come and visit, and younger family are of course welcome.
Such advertising targets specific groups, commonly couples or singles who have retired from paid employment with financial assets, and may aim to provide a ‘home for life’ – which could be 30–40 years. This situates particular people within an environment where their stage of life is based not only on chronological time but also on generational, cohort, socio-economic, heterosexual and ethnic differences within an extremely heterogeneous population. While advertisements may be aimed at those who are aged 55 and over, in the main new residents are commonly in their late 70s (Park and Porteus, 2018, p 28). Darton et al’s (2012) comparison of those living in extra-care housing (ECH) and care homes shows how over 65 per cent of those living in ECH are women, with nearly 60 per cent widowed, divorced or separated, compared with 73 per cent of care home residents being in those categories. These forms of communal living are predominantly a women’s world, a point that is returned to in later chapters concerning the meaning of home. As this age-related community ages in place, they experience blurred boundaries between their ages and needs – an issue that is picked up in Chapter 7.
Before returning to the environments in which people age, the issue of age labelling should be discussed. This is where divisions are made between those identified as baby boomers or third agers, often equated, or fourth agers; this is visualised stereotypically in Figure 1.1 and from a life course perspective in Figure 1.2. These divisions are simple and allied to other stereotypes – the young old and the old/oldest old, and statistical divisions between those who are 65 and over or 85 and over. This rhetoric is commonplace, and the typology needs to be considered alongside a global policy framework that emphasises successful and healthy ageing within all societies, as outlined
The expression baby boomers is a socially constructed term that is given in many developed nations to birth cohorts born during the post-Second World War period of population expansion (Phillipson, 2007b). This has temporal variation internationally: for example, in the US and Australia it refers to people born in 1946–64 (Biggs et al, 2007), while two ‘waves’ are noted in the UK – the first 1945–55 and the second 1956–64, reflecting different peaks in the birth rate (Phillipson et al, 2008).
Drawing on the work of Laslett (1989, 1996) concerning the third age, Gilleard and Higgs consider how demographic, socio-economic and cultural change since the Second World War has led some to a lifestyle that is personally agentic and fulfilling after retirement from paid employment (Gilleard and Higgs, 2002). They comment that ‘The baby boom generation broke the mould of the modern lifecourse’ (2002, p 376). This group is seen to underpin the third age, a part of the consumer society that embraces new technology, and people with ‘greater education, income, social and material security and free time in and out of work’ (p 377). This position has also been noted in the US and other Western developed countries (Katz, 2005; Jones et al, 2008).
The positive lifestyle noted for baby boomers has not been the experience of all, and there are cultural, gendered, generational and locational (health,
Although it can be seen that some of the boomer generation may have a higher standard of living than their parents, there is a diversity of experience. Of value to the discussion of environments and ageing, even though it relates to a UK-based study, is Phillipson et al’s (2008) comment on how first-wave boomers continued to nurture the development of the nuclear family, their lifestyle influenced by ‘first, the surge in popularity of marriage during and immediately after the second world war, this providing the basis for high levels of domestic consumption (Sandbrook, 2005); second, the steady growth of owner-occupation during the 1950s and 1960s; third, the rapid growth of suburban living’ (2008, p 9). The influence of this housing history is seen in Chapters 5 and 6.
After this discussion of a third age, we focus on the fourth age, although recognising the dangers of compartmentalising people in these ways where a tension may exist at all ages between a loss-deficit model of ageing and a more positive approach. Again Gilleard and Higgs (2010, 2011, 2013; Higgs and Gilleard, 2015) are authors who address the ‘cultural field’ of the former and the ‘social imaginary’ of the latter, contrasting lives with social agency and lives that experience personal dependency through increased disability. This brings us to the lives of those experiencing deep old age and those caring for them, where attitudes underpinning a social imaginary take us to different levels of explanation.
I find the following definition truly negative: ‘the fourth age can be better understood as representative of a feared “state of becoming”, an ascribed
I would argue that the labels of the third and fourth age mark a fluid boundary within the life course rather than something more inflexible that exists in the thoughts of some academics and policy makers. Figure 1.2 aims to capture the ways in which older individuals, although living with vulnerability that may lead to frailty, may be recognised as successful individuals and in their own way active. So, while there is always an element of truth in ideas surrounding the fourth age, it should never be seen as just a period of frailty, vulnerability, ill health and dependence.
Lloyd (2015) highlights the importance of enabling self-identity at times when being agentic may become less possible and have to be delegated to others within interdependent relationships (Leece and Peace, 2009; Lloyd et al, 2014). The context in which one lives becomes crucial here in terms of facilitating levels of personal and delegated autonomy (Collopy, 1988). At a time of life when cognitive impairment is increasing, we should seek new ways to exploit the interaction between environment and ageing, building on ways of maintaining the self through person- and relationship-centred care and dementia-friendly environments. Indeed, Grenier et al (2017) take the incidence and experience of cognitive impairment in advanced old age
The typology of ageing discussed here influences the ways in which people are identified in particular situations and settings, how older people perceive themselves and how they interact with others.
Understanding the person
Variations in personal experience, competence or ability over time change depending on life’s gains and losses, and these are influenced by gender, ethnicity, socio-economic status, education and culture (Dannefer, 2003a). In later life, competency is often related to health, well-being and subsequent behaviour, reflected in the earlier labelling of the third and fourth ages. In Figure 1.3, these aspects are brought together with social factors to indicate the set of issues that contribute to the personal.
(see Dannefer and Settersten, 2010, pp 12–19)
enable appreciation of social change over time, eg the coming of computerisation;
provide recognition of diversity, inequality and variability among older people through biography embedded within social structure;
foreground ‘linked lives’ – how life is ‘shaped by the needs, circumstances and choices of others’; and
allow understanding of age-stratification through institutions such as education, employment or retirement; and how segregating older people from participation is being challenged during recent times of de-institutionalisation and individualisation.
These issues underpin the approach known as Cumulative Advantage and Disadvantage, in which experience across time contributes to expectations and inequalities (Dannefer and Uhlenberg, 1999; Dannefer, 2003a, 2003b).
Other authors contribute additional views. For example, there is seminal and ongoing work by developmental and lifespan psychologists who are considering universal and individual internalisation and adaptation to continuity and change over the lifetime (e.g. Erikson, 1982; Erikson et al, 1986; Baltes and Baltes, 1990). Grenier (2012) critiques current models of the life course and develops the subject of transitions to question successful ageing in relation to the fourth age. The important perspective of Rubinstein and de Medeiros (2004), who review the relationship between ecology and the self, also needs to be considered: they identify the importance of self, cultural and personal meaning and embodiment; this analysis is considered in Chapter 2.
Within this wider perspective, we can continue to contextualise the older person, unpacking the social to consider the where, why and how of everyday lives.
Social issues
Social issues that underpin people’s living environments are discussed here through a consideration of family change, living arrangements, financial circumstances and housing tenure. As a brief examination of complex topics, it draws on texts from a number of international edited collections (Johnson et al, 2005; Dannefer and Phillipson, 2010; Twigg and Martin, 2015a). Where statistics are presented they focus on the UK or England.
Parallel to population ageing, marked changes [have] occurred in families: in timing of family transitions; in family structures; in patterns of family formation and dissolution; ensuing diversification of families and household forms. (Lowenstein, 2005, p 403)
Over the past century, while heterosexual marriage remains central to family formation, family structure has changed through early and late parenthood, childlessness, increasing rates of divorce, separation, remarriage and singlehood, and a greater number of civil partnerships and arrangements where people have a relationship but live apart for some or all of the time (see Bildgardt and Oberg, 2019). Acknowledging how these changes affect those retiring from paid employment in their mid- to late 60s, particularly in Western developed countries, an increase in all forms of coupledom, including co-habiting and lesbian, gay, bisexual, transgender and queer (LGBTQ) partners, is noted (Tomassini et al, 2004; Lowenstein and Katz, 2010; King et al, 2020). Gender differences also vary in relation to marital status, and in countries where divorce/separation has increased, remarriage may be more common for men than for women, although same-sex partnerships and caregiving roles are also acknowledged (Calasanti, 2020). Basic statistics concerning marital status and household composition for the UK are given in Research summary 1.1.
Social characteristics of older people in the UK
At the time of writing, available demographic data is based on the 2011 census, with more recent reports based on population estimates and projections given by the Office of National Statistics (ONS) (e.g. ONS, 2018a). Data from the 2021 census will be published by ONS in 2022/23.
Data (000s) (%) for those aged |
65–74 |
75–84 |
85+ |
|
2014 |
6,195 (9.6%) |
3,708 (5.7%) |
1,503 (2.3%) |
|
2021 |
6,791 (10%) |
4,284 (6.3%) |
1,717 (2.5%) |
|
2041 |
7,996 (11%) |
6,549 (9.0%) |
3,247 (4.5%) |
|
Source: Laing (2018), Table 1.7
For England and Wales, the 2011 census also showed that for those aged 65 and over:
57 per cent (5.3 million) were married or in a civil partnership;
29 per cent (2.7 million) were widowed or the surviving partner from a civil partnership;
8.7 per cent (798,000) were divorced or formerly in a civil partnership now dissolved;
5.5 per cent (509,000) were single (never married or in a civil partnership).
(Source: ONS, 2013)
More recent analysis shows that in 2019 marriage or civil partnership is the most common form of marital status for just over 50 per cent of all adults aged 16 and over in England and Wales. This is slowly declining over time for all ages except those aged 70 and over, where, particularly for older women, they are more likely to be married or divorced in 2019 than a decade earlier, and less likely to be widowed (ONS, 2020a).
While there is a greater incidence of older couples, ONS data also shows that in 2019 of an estimated 12.4 million people aged 65 and over living in England and Wales, 32 per cent were living alone, 65 per cent of whom were women (ONS, 2020b).
Living alone is more commonly the situation of the oldest old in the UK, where data also shows that nearly 15 per cent of those aged over 85 live in care home environments (Laing, 2018).
Tomassini et al (2004) also consider the impact of family change on demography and culture within policy contexts that concern housing, health and social care. They indicate the degree to which childlessness varies between cohorts, impacting on intergenerational co-residence and the degree of social support across generations. In addition, financial resources and higher levels of education can lead to greater residential independence (Glaser and Tomassini, 2000). In making comparisons between (a) north-western Europe and the US and (b) central and southern Europe, they identify the individualistic culture of the former and the family culture of the latter, showing some association between on the one hand independent living and less frequent family contact, and on the other greater co-living and proximity to kin (Tomassini et al, 2004).
Informal family care, though diverse, is also a key part of enabling older people to age in place. In reporting on the EUROFAMCARE project, which drew on data from national surveys in five countries (Germany, Greece, Italy, Poland, Sweden, UK), Lowenstein and Katz (2010) state
In contrast, Aboderin (2004, 2016), with particular focus on sub-Saharan Africa, comments both on diversity between nations and a lack of knowledge concerning ageing within the developing countries of the Global South. In considering variation in family support between generations, she shows how households are experiencing degrees of continuity and change (Aboderin, 2005). Family ties may still be strong, with many older people living with younger kin in two or more generation households, but levels of support – emotional, economic, personal – may vary. For younger generations, labour migration can result in living at a distance from the family home, and paid employment for women is becoming more common for those who are part of the same community. Consequently, family support, while common, is changing – leading to greater ambiguity regarding filial obligation at times of increasing economic austerity, while grandparents are providing more child support for grandchildren (Gangopadhyay, 2017). These changes are presenting similar patterns of intergenerational assistance to those seen in more developed nations.
Financial security
There is considerable diversity in people’s material resources in older age, and this is central to where and how people live. As this quote from the WHO’s report on ageing and health shows, inequality and levels of poverty exist in the developed world and for the oldest old: ‘The prevalence of poverty among older people compared with that in the general population varies significantly across the world. In Europe, one in every five older persons has an income below the poverty line, with people older than 80 years being the most severely affected’ (WHO, 2015a, p 162).
In later life, financial security draws on four main sources: earnings, pensions, social transfers/benefits and assets. Earnings are a major resource for many who either go on working or are encouraged to work beyond retirement age or to learn new skills and maintain an employment base. Pensions are of crucial importance to most, whether occupational, private or state, with non-contributory old age pensions long established in developed
Despite this diverse income base, the patriarchal employment infrastructure across nations means that certain groups, particularly women, are more at risk of financial insecurity. Inequalities are seen for
women, who are more likely to be poorer than men;
older women, with fewer pension rights gained through working life;
older women, who are more likely to be poorer than men of the same age;
older people living with grandchildren in developing countries; those who are living alone, often widowed older women, are at risk of poverty – rates exceed 40 per cent in Australia, Ireland, Japan, Mexico, Republic of Korea and the US (see WHO, 2015a, p 162).
Given this background to material resources, differences exist across the older population in the UK. Data from the Department of Work and Pensions (DWP) show that younger pensioners have higher incomes than those aged 75 and over (DWP, 2015; Independent Age, 2016). As of October 2021, the state pension age has risen to 66 for both men and women, and while people are receiving various levels of state pension, at the time of writing the weekly state pension was £179.60 per week for those who have paid 35 years of National Insurance contributions.
While pensioner couples are more likely to have other income sources, including private pensions and assets, 2.1 million or 18 per cent of pensioners in the UK live in poverty, having income 60 per cent lower than the median household income after housing costs (Francis-Devine, 2021). In relation to older people and living environments, this is said to particularly affect those from minority ethnic groups, private renters, social renters and those living in areas with higher levels of deprivation (Joseph Rowntree Foundation, 2021). These financial issues have a direct effect on housing tenure, living arrangements and accommodation, with an associated impact on accessibility. In the UK, the housing infrastructure is long established, complex and grounded in different forms of housing type. Issues of housing adequacy are discussed in Chapter 5.
The changing nature of intergenerational living, family support and care across generations, together with the continuing increase in the oldest old, are principal factors that can influence living arrangements in later life. Levels of inequality have been noted. In relation to particular environments of ageing, the growing incidence of cognitive impairment through dementia continues to impact on long-term care. We turn now to Environment.
In the following sections, conceptual issues of space, place and materiality, critical themes for ageing, are discussed. They affect the relationship between person and environment. In Figure 1.4, the range of situations covered by the term ‘environment’ is indicated, and ageing in place, staying put, age segregation and age integration are important concepts.
Space and place
Andrews et al (2013) argue that many disciplines have contributed to what is seen as the ‘spatial turn’, highlighting how the early work of geographers Golant (1972) and Rowles (1978) introduced this perspective to social gerontology in order to better understand the daily lives of people in later life. Here a broader disciplinary base is used to discuss the spatial turn that contributes to environmental gerontology and geographical gerontology.
What begins as undifferentiated space becomes place as we get to know it better and endow it with value. Architects talk about the spatial qualities of place; they can equally well speak of the locational (place) qualities of space. The ideas of ‘space’ and ‘place’ require each other for definition. From the security and stability of place we are aware of the openness, freedom, and threat of space, and vice versa. Furthermore, if we think of space as that which allows movement, then place is pause; each pause in movement makes it possible for location to be transformed into place. (Tuan, 1977, p 6)
What is understood in the abstract may be transformed ideologically into something that displays different levels of power, with consequences for value and meaning. The work of Henri Lefebvre developed the idea of social space, in which urban and rural environments are discussed in terms of the context of everyday life, the social relations of production and lived space – which can be alienating. His early work pursued issues of social class rather than other issues of diversity (see 1991).
Urban sociologists and human geographers are pivotal in these debates. For example, both David Harvey and Doreen Massey have discussed the social construction of place. Harvey’s view (1973, 1996) is concerned with the political economy of place under capitalism and issues of social justice (Harvey, 2000), where a threat to particular places (e.g. disappearance of employment) reinforces the personal need for a sense of place, drawing on Harvey’s work on the importance of ‘place-as-dwelling’ (1973) and the value of the geographical imagination (Castree, 2007, 2011).
there are those who are simply on the receiving end of time-space compression. The pensioner in a bed-sit in any inner city in the country, eating British working-class style fish and chips from a Chinese take-away, watching a US film on a Japanese television, and not daring to go out after dark. And anyway the public transport’s been cut… There is in other words a highly complex differentiation. There are differences in the degree of movement and communication, but also in the degree of control and of initiation. The ways in which people are placed within ‘time-space compression’ are highly complicated and extremely varied. (Massey, 1993 in Cresswell, 2004, pp 65–6)
She goes on to rethink the terms ‘sense of place’, ‘locality’ and ‘regionality’, arguing for the importance of ubiquitous social relations that give places multiple identities and histories that are relational. She was a founding advocate of relationality, discussed in Chapter 2, providing a different response to a sense of place where globalisation may provoke anxiety or reactionary responses, is inward looking, nationalistic, has values boundaries and is defined predominantly through the global economy. There are parallels here to issues regarding the spatiality of ageing raised in later chapters (see Peace, 2015; Boccagni, 2017). In later work, Massey (2005) gives a comprehensive account of her understanding of space in relation to regionality, globalisation, identity and diversity, She develops the concept of time-spaces, indicating how they are inseparable from the establishment of ongoing power inequalities that influence the meaning of space at a specific time.
Power relations have been examined spatially in relation to gender differences and other aspects of diversity, showing how issues of control and human agency are central to experience and that the environment can present barriers to participation (Rose, 1993; Imrie, 1996; Bondi, 1998; McDowell, 1999). In the field of ageing and later life, Laws (1994, 1995) was an exception, with early conceptual work showing how space and place are central to the development of social identity in later life at both individual and collective levels. She argued that in relation to age there are ‘several dimensions of spatiality – accessibility, mobility, motility, spatial scale and spatial segregation – which are involved in the mutual constitution of places and identities’ (Laws, 1997, p 93). Each of these issues can be used to examine both the environmental and structural barriers that may prevent an older person from being integrated and connected with the wider community.
More recently, authors from health, social and cultural geography have addressed different levels of spatial scale in relation to the lives of older people (Andrews and Phillips, 2005; Andrews et al, 2013, 2018). At one extreme, population ageing can be defined through issues of health and well-being, with mortality rates being used to consider policy developments for health
place as a process – a part of social relations with family life or caring relationships;
place as ongoing negotiation – moves, adaptations, changes made;
contested places – between different people caring in different places;
place expressing power relations – staff versus residents, gender issues in caring roles;
places as simultaneously symbolic, social, physical – such as a care home;
places as interrelated – home in neighbourhood, in town, in county, in nation.
These spatially defined issues embrace individual, social, economic and political processes (Blakemore, 1999), and Andrews et al (2013) comment that ‘from a humanistic perspective, in many ways the idea of social space has brought abstract space “to life” in gerontology’ (p 1344). This geographic literature contributes to the interdisciplinarity of understanding environments of ageing, which is returned to in Chapter 2.
Over time, different disciplines have considered human agency at similar or varied levels of spatial scale. In 1951, the psychologist Kurt Lewin discussed human interaction within a ‘lifespace’ that involved the ‘psychological space’ in which the P–E interaction takes place. Psychosocial aspects of personal behaviour in natural or built environments and social settings has been the concern of environmental psychology since the 1960s (see founders Proshanksy, 1976; 1978, Proshanksy et al, 1983; Canter, 1977, 2008, 2012; Scott and Canter, 1997). We return to place theory in Chapter 2. These are different perspectives for discussing what has been defined by some as the reduced life space of people as they grow older, with changes over the life course (Pastalan and Carson, 1970; Verbrugge et al, 1994; Johnson et al, 2020).
The meaning of ‘place’ in social gerontology takes us back to Tuan’s quote, where it is defined as ‘the locational (place) qualities of space’. Here, the definitions vary culturally from the nation in which one lives or moves to, from and within; to places that are specific and known to an individual or
Public and private
In terms of space – ‘public’ may be explained in the language of communal, civic, free, open and unrestricted but it can also be owned independently, a consumerized space such as in markets, shopping malls, […]; spaces that have become both regulated and open to surveillance (Madanipour, 1999, 2003). Public space may be known or unknown territory; somewhere that people find easy to travel through following familiar routes and ‘short cuts’; or unfamiliar – which may be disorienting, leading to a sense of insecurity, or stimulating, leading to new experience. In contrast ‘private’ may be recognized in the language of individualized, familial, domestic, concealed, privileged, restricted, elite, intimate and may also be known or unknown; defined widely or only open to a limited group such as the domestic home or the consulting rooms of the doctor’s surgery in contrast with the waiting rooms. Historically, this duality of public/private has been linked to social constructions of gender so that there are stereotypical associations of public with masculine and work, and private with feminine and home (Arendt, 1958; McDowell, 1999). In more recent decades changing lifestyles, particularly in relation to employment, have come to challenge these assumptions (Bondi, 1998). (Peace, 2013, p 30)
Various authors conceptualise space, behaviour and everyday living through different disciplines. For example, early research by British architectural scholars Hillier and Hanson (1984) demonstrates how space features, in the form and function of buildings, through spatial configuration, relates to issues of access, reach and depth that impacts on behaviour and the use of buildings. These issues are central to Percival’s (2002) discussion of the use of domestic space across the daily lives of older people. This enables the concept of progressive privacy within settings that is seen to different
The conceptual work of two eminent sociologists, Erving Goffman and Pierre Bourdieu, also contributes to this discussion. First, the so-called presentation of self foregrounds how a person’s identity can be conveyed through different ways of being. Here, symbolic interactionist Erving Goffman’s use of the dramatic analogy of performance in front and back regions relates to how public and private are recognised (Goffman, 1959). In a study of environment and identity in later life, the current author and colleagues referred to Goffman’s work as follows:
He makes this comment in relation to the ‘front regions’: ‘The performance of an individual in the front regions may be seen as an effort to give the appearance that his activity in the region maintains and embodies certain standards’ (1959, p. 110). … In contrast ‘back regions’ allow the person to ‘relax’; ‘… he can drop his front, forgo speaking his lines, and step out of character’ (Goffman, 1959, p 115). (Peace et al, 2006, p 87)
This analogy was used to consider behavioural difference for older people living in various locations and housing types, for example when discussing how the liminal space from the front or back door to the street or garden enables semi-public or semi-private activity. Goffman’s concern with how behaviour is contextualised continued in his seminal study of mental health facilities, Asylums (1961), where his analysis of institutionalisation paralleled that of Barton (1959) and Kleemeier (1961) – and contributed to a literature of dysfunction (Jack, 1998) discussed in Chapter 8.
More recently, the work of Bourdieu (1977, 1998) and the concept of habitus has become an important tool for research, providing an overarching
Materiality
My interest in the meaning of home and the place in which people live introduces a third feature of environments of ageing – materiality. While Katz gives a broad definition, ‘a term to identify the various places, technologies, things, rhythms, designs, mobilities and environments in which our experience of ageing is grounded and observable’ (2019, p 1), we focus here on the relationship between personal identity and place attachment. Associations with place are not only social, but also embedded in Western developed countries through the consumption of material objects (Jones, et al, 2008) – furniture, equipment, artefacts, artworks, structures – that may convey particular significance and agency in later life (see Rubinstein, 1987; Rowles et al, 2004; Sherman and Dacher, 2005). In the spheres of art, craft and design, materiality may centre on the material itself across all mediums – from metals to media – with diverse skills incorporating the technological that produce artefacts with emotional, pleasurable and functional engagement.
In this text, there is a focus on materiality primarily through housing design, the importance of possessions and the development of equipment seen by some as assistive. The domestic dwelling has architecturally designed spaces for daily living activities – cooking, eating, sleeping and so on – labelled as kitchen, living room, bedroom or cultural equivalents. Yet people’s use of space within the home adapts to meet their needs: it has multiple functions and meanings. We work at the kitchen table, yet if cooking is a pleasure then this space may have special meaning; access to technology enables media to stream in all rooms for all ages; the exercise bike sits in the living room and the sofa bed can change the room’s function from gym to sleeping
The dwelling accommodates objects and artefacts that make settings comfortable, enabling and meaningful. In this area of material culture, it is not surprising that ‘new materialism’ is more concerned with a philosophical approach to how humans engage or absorb materials so that they are socialised through them and they become symbols of ourselves (Csikszentmihalyi and Rochberg-Halton, 1981; Miller, 2008, 2010). For the anthropologist Miller (2005), materiality in terms of an artefact can be tangible and simply defined, yet mask the complex interaction with sense of self (Bachelard, 1958; Miller, 2001). In talking about ‘objects’ he says: ‘The less we are aware of them, the more powerfully they can determine our expectations by setting the scene and ensuring normative behaviour, without being open to challenge. They determine what takes place to the extent that we are unconscious of their capacity to do so’ (2005, p 5). There are echoes here of psychologists Lawton and Nahemow’s (1973) environmental docility hypothesis regarding P–E fit and adaptation regarding comfort and proactivity, discussed further in Chapter 2. Both perspectives contribute to understanding the meaning of home.
Through this discussion of person and environment as separate entities, the way they meet is eluded to through meanings, attitudes to and behaviour within space and place. To conclude, I bring P–E together within the daily lives of older people through a health perspective.
The reality of the everyday
Health, behaviour and environment
The biopsychosocial interface between a person and their environment is the focus of this final section. The aim here is to consider how behavioural patterns that relate to biological ageing lead to a relationship with environment through a human ecology approach that sits alongside the social model of health. This approach is similar to that of Robert Kleemeier, a founder of environmental gerontology who provides an early account of how bodily change with age can relate to dwelling conditions concerning such issues as lighting, heating and noise (Kleemeier, 1959). This is part of the ongoing debate in gerontology that has been seen more recently in the cross-national
Here, the association between housing and health could consider poor sleep or incontinence (Meadows et al, 2008; Venn and Arber, 2011; Bichard et al, 2012); instead, we focus briefly on dementia, which covers a range of cognitive impairment, sensory loss and mobility problems, conditions discussed in more detail later. While treatment or therapy may improve health conditions, prevention is not the focus of this section, although environmental adaptation both indoors and outdoors is considered in Chapters 5 and 9.
Cognitive change and dementia
Dementia is a global health concern (WHO, 2020a, 2015a, 2015b) that includes a number of conditions, with the most common being Alzheimer’s disease and vascular dementia. It currently affects at least 50 million people across the world, with nearly 10 million new cases every year. There is currently no cure or modifying treatment. Over 800,500 people are living with dementia in the UK (NHS, 2020a; Public Health England, 2020), and while it is not an inevitable feature of ageing it is a leading cause of death in the UK. Women form a majority by almost 2:1 among this group.
Many people associate some memory loss, forgetfulness, misplacing things and ‘absent-mindedness’ as part of growing older, and some become anxious about developing a form of dementia (Whitbourne and Whitbourne, 2014, p 107), even if commonly this is not the case. Yet the experience of living with a form of dementia from early to late stage will see short-term memory loss gradually deepen, impacting on familiarity with people, place, time and space, which can alter personality and may be associated with wandering and agitation (Oruly, 2010). Depending on severity, a cognitive impairment may prevent people from carrying out normal daily activities or maintaining social relationships. However, while some comment that people with dementia may experience a ‘shrinking world’ (Duggan et al, 2008, p 191), more recent research is beginning to show the importance of person in place for maintaining social health as people with dementia engage with their local environment (Ward et al, 2018). This is discussed further in chapter 9.
The majority of people experiencing cognitive change and developing dementia live in the community in general needs housing, and access everyday services in buildings that are not specifically designed to meet their needs. This is an area that should be developed in terms of retrofitting
Sensory loss and mobility
In later life, sensory loss and changes to mobility can also combine to affect the ability to carry out activities at home or in the wider community. In the UK, approximately 2 million people are said to be living with sight loss, the majority of them older people, and there is a definite association with advanced age – older women and people from minority ethnic groups in particular having problems with certain conditions (RNIB, 2016), such as age-related macular degeneration, glaucoma, cataracts and diabetic retinopathy.
These conditions can have a particular impact when engaging with the wider community or carrying out activities within the home. Some people find going out without personal support a problem, and research shows how vision loss can lead to multiple disadvantages – including prevalence of falls, social isolation, depression and reduced emotional well-being (Wahl et al, 1999; Zimdars et al, 2012; Dhital et al, 2010; McManus and Lord, 2012; Peace et al, 2016, 2019). For a person with sensory loss, their circumstances may be compounded by, or compound, their mobility, and bringing these issues together indicates the importance of an environment that facilitates health-producing behaviour. In the home, adaptation through the use of stairlifts and walk-in showers may prevent falls, while walking outdoors in an environment where the danger of falling is at a minimum creates a feeling of security and safety. The inclusivity of initiatives to make the environment more age-friendly continues to be tested. For example, planning developments such as shared spaces where cars and pedestrians use the same road level leads to the loss of the pavement edge, which is of value to those who are vision impaired. Such planning should be labelled of ableist bias (Ward et al, 2018).
Person–environment interactions
In these two examples of the association of personal health and behaviour, it can be seen that the environmental context can be both enabling and disabling. We return to this form of interaction throughout the text, especially
Conclusions
By ending this chapter with a discussion that focuses on biopsychosocial issues, the aim is to show that the relationship between person and environment is contextual. Figure 1.5 brings these three elements together, indicating how interactions are continuous, operating within different levels of spatial environment and personal experience. For everyone, individual circumstances affect behaviour, and where and how agency is developed and maintained impacts on feelings about self and association with others. Wider circumstances change over time, with environmental change being important for the consideration of ageing and later life. To develop this view, we need to revisit the theoretical perspectives that underpin environmental gerontology, to begin to judge whether the proposed spatial scales can be addressed through current thinking or need further development.
