We are the UK’s leading publisher of books on Ageing and Gerontology and our titles fill a clear gap in the current literature. The list interrogates the challenges of an ageing population, push forward knowledge and reframe perspectives.
Central to this are the international and comparative works in the Ageing in a Global Context series, published in association with the British Society of Gerontology, and the Longitudinal and Lifecourse Studies journal.
Ageing and Gerontology
Although the status and role of gerontological social work varies locally (Pajunen et al, 2009) and by country (see Chapter 5), it has commonly been regarded as a low-status area of practice with poor professional potential (Lymbery, 2005). Arguably, the low status afforded to gerontological social work and the older population it serves has contributed to its limited success in developing its identity and visibility as a distinct speciality. A tendency for social work to focus on meeting ‘care’ and ‘health’ needs in old age means that it has often occupied a more marginal space in its ability to fully respond to the diversity of ageing experience. The variable presence, visibility and purpose of gerontological social work has arguably been reinforced by managerialist approaches in public service and welfare policy. Increased pressure to reduce public sector funding is common in most developed countries (Pentaraki, 2018). The impact of austerity measures over the past decade has increased the strain on public service professionals, including social work. For example, in Greece and Spain, but echoed to varying degrees throughout Europe, the impact of cuts to health and other public sector organisations has exacerbated challenges for social workers coping with the implications of long waiting lists for services, rapid and inappropriate discharge from hospital, social work shortages and increased pressures on older people to cope alone with deteriorating and difficult circumstances or to rely on families, assuming the older person has one (Ioakimidis et al, 2014; Verde-Diego et al, 2018; Deusdad, 2020).
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).
Social work is a human rights-based profession. Advocating and upholding human rights is a core activity embedded in the international definition of social work (IFSW, 2014). In the context of supporting older people, this intersects with the United Nations (UN) Principles for Older Persons (United Nations, 1991), which sets out independence, participation, self-fulfilment and dignity as principles integral to supporting older people to fully participate in society. Missing from discourses both on ageing and on human rights is an understanding of sexual rights. The World Association for Sexual Health (WAS) (2014) identifies 16 sexual rights as ‘grounded in universal human rights’; however, social and cultural discourses compound the invisibility of older adults’ sexual rights and inhibit discussion about the sexual well-being of older adults in social work practice contexts.
A global transformation is taking place as the world’s population is rapidly ageing and, for the first time in history, most people can expect to live into their 60s and beyond. It is therefore understandable that one of the latest reports written by the Population Division of the United Nations’ Department of Economic and Social Affairs begins with the following statement: According to World Population Prospects 2019 (United Nations, 2019), by 2050, 1 in 6 people in the world will be over the age of 65, up from 1 in 11 in 2019. All societies in the world are in the midst of this longevity revolution – some are at its early stages and some are more advanced. But all will pass through this extraordinary transition, in which the chance of surviving to age 65 rises from less than 50 per cent – as was the case in Sweden in the 1890s – to more than 90 per cent at present in countries with the highest life expectancy. What is more, the proportion of adult life spent beyond age 65 increased from less than a fifth in the 1960s to a quarter or more in most developed countries today.
User involvement and critical gerontology are two key concepts and approaches for social work and related services with older people in the early 21st century. Yet, so far exploration of their interrelations seems to be at an early stage. For this reason, the aim of this chapter, to look more closely and critically at the role of user involvement in relation to critical gerontology in a European context, is likely to be both especially timely and productive. The praxis of user involvement is likely to be maximised through a critical gerontological lens and, in turn, critical gerontology is unlikely to fulfil its promise unless united with an in-depth understanding of the theory and practice of participation. The chapter will address user involvement in policy, practice, learning and research and conclude with a case study offering implications for practice.