Covid-19: Reframing Ageing

Anne Fuchs, Desmond O’Neill, Mary Cosgrove, and Julia Langbein // Report on the Interdisciplinary Webinar, University College Dublin, 12 June 2020

Introduction

The Covid-19 crisis gave rise to stories of sickness and resilience, unemployment and solidarity, death and hope.  But from among these stories, the discourse on older people has been among the most controversial and troubling.[i] Measures designed to protect older people from infection also severely restricted freedom and mobility over an extended period of time, causing problems of mental and physical health. In many countries older people were sectioned off from the rest of society, regardless of differing needs and abilities. The contribution of this cohort to society as a whole was eclipsed in favor of a discourse focused on collective vulnerability. A striking feature was its non-dialogic nature: older people were an object of public discourse rather than participants in the debate.

Our webinar Covid-19: Reframing Ageing[ii] attempted to rise above sector debates by asking:

  • What biases has Covid-19 revealed in public discourse and political rhetoric?
  • Is the widespread policy of “protecting” a particular group by means of chronological age a necessary defense against a virus with highly age-sensitive impacts, or a disturbing reframing of older people in society?
  • Is the language used to identify particular cohorts of the population appropriate? Is it consistent with a normative discrimination that typically frames (and writes off) people in this age-group as “elderly”?
  • What can governments, policy-makers, and wider society learn from this situation?

Four panels discussed these issues from interdisciplinary perspectives, straddling gerontology, sociology, gender studies, history, art practice, and literary studies.

Panel One: Ailbhe Smyth’s “View from the Interior”

Ailbhe Smyth, a lifelong women’s rights advocate and LGBT campaigner in Ireland who had spent 93 days in isolation, opened the webinar with her talk “Unseen, Unheard, Untouched: A View from the Interior.” Smyth probed the lack of human contact in the lives of those who had to spend the Covid-19 crisis in self-isolation: “virtual touch is the ultimate oxymoron, leaving me with ineffable longing, an ache, a need.”

Government and public health rhetoric admonished those in self-isolation: its “severely monitory” language peppered with modal instructions cowed people into acquiescence, even though the curtailment of freedom of movement had no basis in law. In Ireland this found symbolic expression in the patronizing notion of“cocooning.”

Public bodies, government, and media represented older people as frail, vulnerable, and dependent with little regard for variations in their lives and circumstances. Lack of consultation compounded the problem: NPHET (the National Health Emergency Team) had no members aged over 70 or representatives of advocacy for older people. In Ireland (as elsewhere) more than 60% of deaths occurred in nursing home settings. Although the most vulnerable group in society, their needs were overlooked or ignored. As Smyth described, “Living behind closed doors, they were unseen, unheard, untouched—and too many died as a consequence.”

Panel Two: Ageism and the Characterization of Older People

The first respondent, Thomas Scharf (Professor of Social Gerontology, Newcastle University), argued that we are seeing a resurgence of ageism as Robert Butler defined it 50 years ago[iii]: the complex, negative construction of old age at the individual and societal levels.[iv] In the UK, 90% of the over 63,000 excess deaths were among people aged 65+, with over 20,000 deaths in care homes, raising fundamental questions about why older people’s lives don’t appear to matter. Gerontologists are concerned by the speed and extent to which ageist language has re-emerged. The UK government and media representations of age and older people shape and perpetuate negative attitudes and stereotypes of ageing.[v]

In the UK, public messaging emphasized that science was guiding government through the pandemic, but there were no geriatricians or gerontologists on the scientific advisory group. The Covid-19 crisis revealed the extraordinary lack of gerontological literacy within government. Blanket use of chronological age reinforced negative associations of old age with vulnerability, ill health, disability, and proximity to death. An independent public inquiry should explore widespread institutionalized forms of ageism.

Paul Higgs (Professor of Sociology of Ageing, University College London) described another bifurcation: the separation of the so-called “Third Age” and “Fourth Age” (or the “old” and the “oldest old.”)[vi] While the Third Age cohort was seen as continuous with the rest of the population, the rights of older people in nursing homes were violated. This cultural division reflects the re-emergence of generational conflict within society, also evident in attitudes to herd immunity, a disastrous policy which would accelerate the deaths of older people.

The panel discussion focused on the language of “vulnerability,” which is often used to limit the agency of older people under the pretext of protection. Yet people are vulnerable in all kinds of ways at different points in the life-course. Women living with violent partners during the pandemic were vulnerable to emotional, physical, and psychological abuse.[vii] Vulnerability should be understood as a reality of the human condition and dissociated from blanket application to old age.

Panel Three: Generational Conflict and the Normative Life Course

Susan Pickard (Professor of Sociology, University of Liverpool) focused on “Age War discourse.”[viii] While Covid-19 did not create this discourse, the crisis made it pervasive in UK media, spreading simplistic and conflict-based interpretations. It characterizes the entire political spectrum, serving élite interests by avoiding more problematic class war discourses and appealing to the Left’s vision of youth as the engine of progressive politics.

The Third Age—which today corresponds to the “boomer” generations—has been blamed for climate change and capitalist excess, but this recrimination mischaracterizes the economic realities of Third Age life: one-sixth of all pensioners live in poverty. The Fourth Age (loosely, pre-boomers or those over 75) is discussed solely in terms of healthcare and welfare cost. Pickard quoted the former editor of The Daily Telegraph Max Hastings, who described older people as “monumentally selfish” and a “dead weight upon the health system.”[ix]  Pickard noted that the lack of value given to women’s lives exacerbates systemic ageism. Death in care homes is not only a genocide but a female genocide, given that over 70% of care home residents in the UK and Europe are women.

Andrew King (Professor of Sociology, University of Surrey) reflected on how Covid-19 revealed embedded “chrononormativity” in contemporary British and western culture. Chrononormativity is the use of time to organize individual human bodies toward maximum productivity.”[x]  A chrononormative culture accepts that chronological age is the single marker that defines the identity of older people, rather than complex social and cultural factors. It characterizes over-70s as an unproductive cohort in need of confinement. Chrononormativity is also based on the heterosexual life course, erasing experiences of older LGBT people and those without children. [xi]

Desmond O’Neill (Professor of Medical Gerontology, Trinity College Dublin) focused on the degradation of academic responses and responsibilities during the crisis.  For example, the Irish Department of Health developed ethical frameworks for care during the pandemic that did not meet the usual scholarly standards. These guidelines lacked transparency about authorship and consultation, as well as adequate bibliographic reference to bioethical research and scholarship.[xii] In anticipation of Covid-19-related capacity crises, the Irish government proposed prioritizing medical treatment in hospitals based on the criterion of “life years saved,” potentially excluding older people from life-saving treatment.[xiii] Gerontologists, philosophers of ethics, and humanities scholars should critique the assumptions underlying such guidelines.[xiv] O’Neill concluded by asking: “Are we at an #OlderLivesMatter moment where we can promote the longevity dividend?”

The ensuing discussion explored the intersection between Black Lives Matter and the fight for fair and dignified treatment for older people. The BLM movement reclaimed vulnerability as an urgent signpost for the violence to which black bodies are subject. Dana Walrath and Ailbhe Smyth pointed to the intersection of racism and ageism through systemic, particularly economic, factors: the struggles for black lives and older lives are linked through a logic of capitalism that renders some lives disposable.

Panel Four: Humanities Approaches to Ageing and a Focus on Care

In the final panel, speakers offered humanities-centered and international perspectives on how Austria, the Netherlands, and the USA have contended with the pandemic, emphasizing the importance of humanities research.

Ulla Kriebernegg (Associate Professor of American Studies, University of Graz) focused on cultural, media, and literary representations of ageing. Noting how Covid-19 functions as a magnifying glass for existing social problems, she addressed the theme of care, in particular the new visibility of the overlooked figure of the caregiver.[xv]  In Austria, carers are usually underpaid and underappreciated women from Eastern Europe. Many had to work in six-week shifts punctuated by two weeks of self-financed quarantine. Gender-biased media representations tended to represent caregivers as women “naturally inclined” to give care.[xvi]

Kriebernegg echoed prior panelists in highlighting the danger of representing care homes as places of “gothic” horror. Such cultural framing of this Fourth Age location resonates with a commonly held view of old age as a burden. However, many good long-term care homes strive to rewrite the last chapter of life positively.[xvii]

Kriebernegg echoed Pickard’s observations about Covid-19’s aggravation of generational conflict, citing Margaret Atwood’s story “Torching the Dusties” which tells the tale of younger people torching nursing homes full of expensive “parasites.”[xviii]

Rina Knoeff (Associate Professor of History, University of Groningen) described the approach taken in the Netherlands to protecting care home residents as a violation of human rights. What policy makers missed was that older people fear a lonely death more than death itself.

Society could learn much from pre-modern medicine with its careful consideration of emotional needs and social wellbeing. For example, approaches to ageing in the eighteenth century focused on cheerfulness, comfort, and a tranquil mind in older age.[xix] This is an area where humanities scholars and cultural gerontologists can offer expert advice to governments and policy-makers. However, the team in charge of the Dutch response to the pandemic, as in the UK and Ireland, did not include such scholars, whose work might help resist negative and cynical “decline” narratives of old age.

The last speaker, Dana Walrath (artist, anthropologist, and author of Aliceheimer’s: Alzheimer’s through the Looking Glass,[xx] USA), argued for the urgency of reframing ageing as a global human right in light of the murder of George Floyd in Minneapolis in May 2020, as systemic racism and ageism are deeply connected. Walrath spoke of the privilege of her mother Alice’s death in a care home.  Although she had arrived in the US as the “brown” daughter of refugees of genocide, she died a “white” privileged death surrounded by family and excellent staff.

Walrath’s talk also chimed with Kniebernegg and Knoeff’s emphasis on the potential of humanities research to improve our approach to ageing, thinking beyond bio-medicine, technological fixes, and bodies as one-dimensional sites of sickness.

Conclusion

Several important themes emerged from Covid-19: Reframing Ageing:

  1. Older people must be included in the conversations that shape their care and treatment.  Further, “old age” is not merely a medical condition but a varied and complex phase of the life course, and research and professional expertise from a range of fields, including gerontology, sociology, psychology, and the humanities should be called on to guide policy.
  2. There is a lexical crisis around old age that hampers transparent discourse on the subject among experts and the general public alike.  Scholars from gerontological, sociological, and humanities disciplines should unite to push for an educational campaign—beginning with the publication of a critical glossary—around the language of old age, to encourage nuance and diversity and to discourage patronizing blanket terms like “elderly.”
  3. While it is commonplace in contemporary academic and public discourse to speak of “intersectionality”[xxi]—that is, the systemic interconnection of identity-shaping factors (e.g. race, class, dis/ability)—age is often excluded from this nexus. We will not address ageism and its tragic consequences without making age an essential part of conversations about, for example, economic imperatives and class identity, racial discrimination and privilege, and sexuality and gender identity.

Author bios:

Anne Fuchs is Professor of German Studies and Director of the Humanities Institute Dublin. She is PI of the Wellcome Trust funded project Framing Ageing. Her latest book is Precarious Times: Temporality and History in Modern German Culture (Cornell UP, 2019).

Prof Desmond (Des) O’Neill is a consultant geriatrician, Professor of Medical Gerontology and Co-Chair of Medical and Health Humanities at Trinity College Dublin. He is also chair of the Humanities, Arts and Cultural Gerontology Advisory Panel of the Gerontological Society of America.

Mary Cosgrove is Professor in German at Trinity College Dublin. She is the author of Born under Auschwitz: Melancholy Traditions in Postwar German Literature (Choice Recommended title, Camden House, 2014). 

Julia Langbein is a Postdoctoral Research Fellow at Trinity College Dublin, where she is researching the visual culture of old age in nineteenth-century France.  Her book Laugh Lines: Painting and Caricature in Nineteenth-Century France is forthcoming (Bloomsbury Academic, 2021). 

Image source: Dana Walrath


[i] Sarah Fraser, Martine Lagacé, Bienvenu Bongué, Ndatté Ndeye, Jessica Guyot, Lauren Bechard, Linda Garcia, Vanessa Taler, CCNA Social Inclusion and Stigma Working Group, Stéphane Adam, Marie Beaulieu, Caroline D Bergeron, Valérian Boudjemadi, Donatienne Desmette, Anna Rosa Donizzetti, Sophie Éthier, Suzanne Garon, Margaret Gillis, Mélanie Levasseur, Monique Lortie-lussier, Patrik Marier, Annie Robitaille, Kim Sawchuk, Constance Lafontaine, Francine Tougas, “Ageism and COVID-19: what does our society’s response say about us?” Age and Ageing 49/5 (September 2020): 692–695.  M. Schrage-Frueh, T. Tracy, “Happy In? Ageing and Ageism in the Age of Coronavirus and Cocooning,” Moore Institute, NUI Galway, 23 April 2020, https://mooreinstitute.ie/2020/04/23/happy-in-ageing-and-ageism-in-the-age-of-coronavirus-and-cocooning/.

[ii] This webinar is part of the Wellcome Trust funded research collaborative project Framing Ageing. See: https://framingageing.ucd.ie. We would like to thank the Wellcome Trust for their generous funding.

[iii] Robert N. Butler, “Age-ism: Another Form of Bigotry,” The Gerontologist 9/4, Part 1 (1969): 243–246; Robert N. Butler, “Ageism,” Generations 29/3 (2005): 84–86. See also: Margaret Morganroth Gullette, Agewise: Fighting the New Ageism in America (Chicago: University of Chicago Press, 2011); John Macnicol, Age Discrimination (Cambridge: Cambridge University Press, 2009); Erdman B. Palmore, Laurence Branch, and Diana K. Harris, eds., Encyclopedia of Ageism (Binghamton, NY: Haworth Press, 2005).

[iv]L. Ayalon, L. and C. Tesch-Römer, “Taking a closer look at ageism: Self- and other-directed ageist attitudes and discrimination,” European Journal of Ageing 14/1 (2017): 1-4.

[v] On recent stereotyping around old age, see Hannah J. Swift H and Ben Steeden, “Exploring representations of old age and ageing” (London: Centre for Ageing Better, 2020). See:  https://www.ageing-better.org.uk/sites/default/files/2020-03/Exploring-representations-of-old-age.pdf (accessed 8 June 2020).

[vi] On this issue see Paul Higgs and Chris Gilleard, Rethinking Old Age: Theorising the Fourth Age (Basingstoke: Palgrave, 2015).

[vii] On vulnerability see Judith Butler, Precarious Life: The Powers of Mourning and Violence (London: Verso, 2006); Catriona Mackenzie, Wendy Rogers, Susan Dodds, eds., Vulnerability: New Essays in Ethics and Feminist Philosophy (Oxford: Oxford University Press, 2013).

[viii] Susan Pickard, “Age war as the new class war? Contemporary representations of intergenerational inequity” Journal of Social Policy 48/2 (2019): 369-386.

[ix] Max Hastings, “My oldie generation is privileged and selfish” The Times, 24 March 2020.

[x] Elizabeth Freeman, Time binds: Queer temporalities, queer histories (Durham, NC: Duke University Press, 2010).

[xi] On this issue see Andrew King, Older LGBT People: Minding the Knowledge Gaps (London: Routledge, 2019), and Andrew King, Kathryn Almack, eds., Intersections of Ageing, Gender and Sexualities (Bristol: Policy Press, 2019).

[xii] Government of Ireland Department of Health, Ethical considerations relating to long-term residential care facilities (Dublin: 4 June, 2020). https://www.gov.ie/en/publication/37ef1-ethical-considerations-relating-to-long-term-residential-care-facilities/

[xiii] Government of Ireland Department of Health. Ethical framework for decision-making in a pandemic (Dublin: 27 March, 2020). https://www.gov.ie/en/publication/dbf3fb-ethical-framework-for-decision-making-in-a-pandemic/

[xiv] Desmond O’Neill, “Covid-19: clinicians need continuing professional development in ethics,” BMJ 370, m2793(2020).

[xv] See Kathleen Woodward, “A Public Secret: Assisted Living, Caregivers, Globalization,” International Journal of Ageing and Later Life 7/2 (2012): 17-51.

[xvi] See Kathleen Woodward, ed., Figuring Age: Women, Bodies, Generations (Bloomington and Indianapolis: Indiana University Press, 1999); Susan Pickard, Age, Gender and Sexuality through the Life Course: The Girl in Time (London: Routledge, 2018)

[xvii] This research is led by Prof. Sally Chivers. See the open-access publication: https://library.oapen.org/handle/20.500.12657/30552. See also Sally Chivers, Ulla Kriebernegg, eds., Care Home Stories: Aging, Kriebernegg, Ulla. Disability and Long-Term Residential Care (Bielefeld: Transcript, 2017).

[xviii] See Ulla Kriebernegg, “‘Time to go. Fast not slow’: geronticide and the burden narrative of old age in Margaret Atwood’s ‘Torching the Dusties,’” European Journal of English Studies 22 (2018): 46-58.

[xix] See J. Kennaway and H. Knoeff, eds., Lifestyle and Medicine in the Enlightenment: The Six Non Naturals in the Long Eighteenth Century (London: Routledge, 2020).

[xx] Dana Walrath, Aliceheimer’s: Alzheimer’s Through the Looking Glass (Pennsylvania: The Pennsylvania State University Press, 2013).

[xxi] See Kimberlé W. Crenshaw, On Intersectionality: Essential Writings (New York, NY: Columbia University Press, 2017).

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