4 - Public policies on ageing and disability

Summary

Introduction

Public policies frame how societies provide care and support in practice, influence a sense of identity, and shape perceptions of what categories we belong to as individuals. They offer a window on how society conceives of disability for younger and older persons (Kahana and Kahana, 2017: 181). In this chapter, I engage with the separation of public policy frameworks on ageing and disability, and the consequences for older people, focusing on social care.

I first introduce how public policies traditionally underscore difference between people with different timings of disability onset. They can operate as if people are disabled or older, not both. This separately constructs ‘disability’ experienced at different points of the lifespan and makes for an anomalous picture when we consider experiences at the intersections of the two frameworks. The phenomenon of more people ageing with disability highlights the need for connection between the two frameworks. The issues discussed here form part of the rationale for this book's attempt to open more dialogue between scholarship on ageing and on disability, and form a backdrop to the findings of the empirical study discussed in Part II.

To approach public policies in an international context is to engage with a very broad set of issues. Identifying patterns in long-term care is more difficult than in other policy areas (Esping-Andersen, 1990; Glendinning, 2010), as they are often built on existing institutional arrangements. Hill (2006: 42) reminds us that the characteristics of policies require attention to ‘constitutional, institutional and cultural factors’, and to financing and delivery. In this chapter, I consider key aspects of public policies that are relevant to the arguments in this book, hoping to foster more engagement with the issues involved.

I first discuss disability prevalence linked to increased numbers of older people in populations, and introduce traditional approaches to policies on ageing and on disability. I consider consequences of the traditional separation between these two policy frameworks for people first experiencing disability with ageing and then for people ageing with disability. The chapter goes on to consider attempts to bridge the two fields in practice. I finish by suggesting lessons that can be drawn by those attempting to find a way forward in this area.

Background: disability prevalence

National and supranational estimates of disability prevalence represent one area where older people are usually counted within the category ‘disabled’.