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The Structured Dependency of the Elderly: A Creation of Social Policy in the Twentieth Century*

Published online by Cambridge University Press:  14 November 2008

Peter Townsend
Affiliation:
Professor of Sociology, Department of Sociology, University of Essex, Wivenhoe Park, Colchester, Essex.
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Abstract

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If we are to develop better methods of integrating elderly people into society then above all we need a better sociology of the ageing and the aged. In this paper I wish to put forward the thesis that the dependency of the elderly in the twentieth century is being manufactured socially and that its severity is unnecessary. The process can therefore be revised or at least modified. Certain major influences, which will be discussed below, are steadily deepening, or widening that dependency. There is the imposition, and acceptance, of earlier retirement; the legitimation of low income; the denial of rights to self-determination in institutions; and the construction of community services for recipients assumed to be predominantly passive.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1981

References

NOTES

1 It is not easy to trace the origins of such a theme and explain why I now choose to attach such importance to it. The choice arises from work I have done with colleagues and alone and from the work of others. The dependency created by institutions is documented in my book The Last Refuge, London, Routledge, 1962Google Scholar; and the dependencies of retirement and poverty in The Family Life of Old People, London, Routledge, 1957 (summarily)Google Scholar, in later publications and, most recently in Poverty in the United Kingdom, Harmondsworth, Penguin Books, 1979Google Scholar. With Ethel Shanas, Dorothy Wedderburn and others I participated in a wide-ranging cross-national study of the elderly in Denmark, Britain and the United States, the chief conclusion of which was to call attention to the ‘dual’ relationship of the elderly to industrial society. Many of their problems, we stated, ‘arise as the consequence of formal actions on the part of mass society that confirm their separate retired status’ … They comprise ‘a special category in society…a potential or embryonic class accommodated uneasily in the present class structure’. There was a ‘balance between the integrative impulses of informal primary relationships and the segregative relationships of formal industrial society’… (Shanas, et al. , Old People in Three Industrial Societies, London, Routledge, 1968, pp. 425–6Google Scholar). I also tried to bring some strands together within the concept of the ‘structured dependency’ of the elderly in recent papers (‘The Changing Status of the Elderly in Industrial Society’, Bologna, 1977Google Scholar; ‘The Care of the Elderly in Britain and Japan’, 1978Google Scholar; ‘Structured Dependency in Old Age’, unpublished paper to Research Officers of Social Services Departments, 03 1978Google Scholar). I gained much from the work in the 1960s of Yonina Talmon and C. C. Harris in relation to the development of this theme and latterly from the work of Anne-Marie Guillemard (for example, La Retraite, Une Mort Sociale and La Viellesse et l'Etat) and Alan Walker (particularly his paper on the creation of dependency in old age, 1980). I am glad to acknowledge with gratitude the help of Alan Walker and Malcolm Johnson in revising this paper (first presented to the annual meeting of the Canadian Association of Gerontology, Saskatoon, Saskatchewan, 18 October 1980).

2 Donahue, W., and Tibbitts, C., The New Frontiers of Ageing, Ann Arbor, University of Michigan Press, 1957.Google Scholar

3 Tibbitts, C., Handbook of Social Gerontology, Chicago, University of Chicago Press, 1960.Google Scholar

4 Atchley, R., and Seltzer, M., The Sociology of Ageing: Selected Readings, Belmont, California, Wadsworth, 1976Google Scholar. And see also Stearns, P. N., Old Age in European Society, London, Groom Helm, 1977Google Scholar; and Clark, R. L., and Spengler, J. J., The Economics of Individual and Population Ageing, Cambridge, Cambridge University Press, 1980.CrossRefGoogle Scholar

5 Townsend, P., ‘The Care of the Elderly in Britain and Japan: the Relative Effectiveness of Community Care and Residential Services for the Elderly’, Paper given to the Japanese National Committee of the International Council on Social Welfare, 04, 1978Google Scholar, published in Japanese, Tokyo, 1979 (English version in mimeograph).

6 Cumming, E. and Henry, W. E., Growing Old, New York, Basic Books, 1961.Google Scholar

7 Cumming, E., ‘Further Thoughts on the Theory of Disengagement’, International Social Science Journal, XV, 3, 1963.Google Scholar

8 Talmon, Y., ‘Dimensions of Disengagement. Ageing in Collective Settlements’, paper given at research seminar on social gerontology, Markaryd, Sweden, 1963.Google Scholar

9 Talmon, Y., ‘Ageing in Israel, A Planned Society’, American Journal of Sociology, Vol. LXVII, No. 3, 1961.Google Scholar

10 Talmon, Y., Family and Community in the Kibbutz, Cambridge, Mass., Harvard University Press, 1972.Google Scholar

11 See, for example, Hendricks, J., and Hendricks, C. D., Ageing in Mass Society, Cambridge, Mass., Winthrop, 1977.Google Scholar

12 Shanas, E. et al. , Old People in Three Industrial Societies, London, Routledge, 1968.Google Scholar

13 Goffman, E., Asylums: Essays on the Social Situation of Mental Patients and Other Inmates, Garden City, N.Y., Doubleday Anchor, 1961.Google Scholar

14 Rothman, D., The Discovery of the Asylum, Boston, Little, Brown and Co., 1971, p. xix.Google Scholar

15 Henry, J., Culture Against Man, New York, Random House, 1965Google Scholar. Roth, J. A., and Eddy, E. M., Rehabilitation for the Unwanted, New York, Atherton, 1967.Google Scholar

16 Scull, A., Decarceration, Englewood Cliffs, New Jersey, Prentice-Hall, 1977.Google Scholar

17 Townsend, P., The Last Refuge, London, Routledge and Kegan Paul, 1962.Google Scholar

18 Thompson, E. P., The Making of the English Working Class, London, Victor Gollancz, 1963, p. 295.Google Scholar

19 Johnson, M. L., ‘Relations and Relationships’, Block 1, Unit 4 of the Post-experience Courses Unit, Course, An Ageing Population, Milton Keynes, The Open University Press, 1979.Google Scholar

20 Thomson, D., Provision for the Elderly in England 1830–1908, University of Cambridge, Ph.D., 1981.Google Scholar

21 Frobel, F., Heinricks, J. and Kreye, O., The New International Division of Labour, Cambridge University Press, 1980.Google Scholar

22 Shanas, E. et al. , Old People in Three Industrial Societies, London, Routledge, 1968.Google Scholar

23 Parker, S., Older Workers and Retirement, OPCS Social Survey Division, London, HMSO, 1980.Google Scholar

24 Townsend, P., Poverty in the United Kingdom, Harmondsworth, Middlesex, Penguin Books, 1979. See especially Chapter 19.Google Scholar

25 Ministry of Pensions and National Insurance, The Financial and Other Circumstances of Retirement Pensioners, London, HMSO, 1966.Google Scholar

26 DHSS, ‘The DHSS Perspective’, in Barnes, J. and Connelly, N., Social Care Research, London, Bedford Square Press, 1978.Google Scholar

27 Townsend, P., Poverty in the United Kingdom, op. cit., Chapter 7.Google Scholar

28 Wedderburn, D., ‘The Financial Resources of Older People’, in Shanas, E., et al., op. cit.Google Scholar

29 Townsend, P., Poverty in the United Kingdom, op. cit., Chapter 20.Google Scholar

30 Shanas, et al. , op. cit., Chapters 5 and 14.Google Scholar

31 Morgan, J. S., ‘Social Welfare Services in Canada’, in Oliver, M., (ed.), Social Purpose for Canada, Toronto, University of Toronto Press, 1961.Google Scholar

32 Thomson, D., op. cit.Google Scholar

33 DHSS, Conference on the Elderly; Background Paper, 26 07, 1977.Google Scholar

34 Kidd, C. B., ‘Misplacement of the elderly in hospital’, British Medical Journal, 2, 1962.CrossRefGoogle ScholarPubMed

35 Mezey, A. G., Hodkinson, H. M. and Evans, G. J., ‘The elderly in the wrong unit’, British Medical Journal, 3, 1968.CrossRefGoogle ScholarPubMed

36 Carstairs, V., and Morrison, M., The Elderly in Residential Care, Scottish Health Service Studies, No. 19, 1971.Google Scholar

37 Townsend, P., ‘The Needs of the Elderly and Planning of Hospitals’, in Canvin, R. W. and Pearson, N. G., Needs of the Elderly for Health and Welfare Services, University of Exeter, 1972.Google Scholar

38 Wilkin, D., Mashiah, T. and Jolley, D. J., ‘Changes in behavioural characteristics of elderly populations of local authority homes and long-stay hospital wards, 1976–7’, British Medical Journal, 2, 1978.CrossRefGoogle ScholarPubMed

39 Wilkin, D. and Jolley, D. J., Behavioural Problems Among Old People in Geriatric Wards, Psychogeriatric Wards and Residential Homes, 1976–1978. Research Section, Research Report No. 1, 1979.Google Scholar

40 Townsend, P., The Last Refuge, London, Routledge, 1962Google Scholar; ‘The Needs of the Elderly and the Planning of Hospitals’, op. cit.

41 Townsend, P., ‘The Needs of the Elderly, and the Planning of Hospitals’, op. cit., pp. 53–4.Google Scholar

42 Bebbington, A. C., ‘The Elderly at Home Survey: Changes in the Provision of Damiciliary Social Services to the Elderly Over Fourten Years’ (mimeo), University of Kent, 1978Google Scholar. Bebbington, A. C., ‘Scaling Indices of Disablement’, British Journal of Preventive and Social Medicine, 31, 1977Google ScholarPubMed. Munnichs, J. M. A. and van den Heuval, W. J. A., Dependency and Interdependency in Old Age, The Hague, Martinus Nijhof, 1976CrossRefGoogle Scholar. Harris, A. I., with Cox, E. and Smith, C. R. W., Handicapped and Impaired in Great Britain, OPCS, London, HMSO, 1971.Google Scholar

43 Townsend, P., The Last Refuge, London, Routledge, 1962Google Scholar. And see also Townsend, P., ‘The Needs of the Elderly and the Planning of Hospitals’, op. cit., p. 54.Google Scholar

44 Carstairs, V. and Morrison, M., op. cit., p. 74.Google Scholar

45 Department of Health and Social Security, The Census of Residential Accommodation, 1970. Volume I: Residential Accommodation for the Elderly and the Younger Physically Handicapped, London, HMSO, 1975, p. 44.Google Scholar

46 Carstairs, V. and Morrison, M., op. cit.Google Scholar

47 Shreeve, M., ‘A Survey of People Admitted to Old Peoples’ Homes and on the Waiting List over a three-month period’, Internal Report, Warwickshire Social Services Department, 1973.Google Scholar

48 Kimbell, A. and Townsend, J., Residents in Elderly Persons Homes, Cheshire County Council Social Services Department, 04 1974Google Scholar.

48a Townsend, J. and Kimbell, A., ‘Caring regimes in elderly persons' homes’, Health and Social Service Journal, 11 10 1975.Google Scholar

49 East Sussex County Council Social Services Department, Key Issue 1: The Elderly: Main Report on the findings, 1975.Google Scholar

50 Smith, R. G. and Lowther, C. P., ‘Follow-up study of two hundred admissions to a residential home’, Age and Ageing, 5, 3, 1976.CrossRefGoogle ScholarPubMed

51 Whitfield, J. and Symonds, J., Alternatives to Residential Provision for the Elderly, Essex County Council Social Services Department, 1976.Google Scholar

52 Townsend, P., The Failure to House Britains' Aged, London, Help the Aged, 1976.Google Scholar

53 Hare, E. J., Three Score Years and Then?: A Study of Practical Alternatives to Residential Care, Norfolk County Council, 1977.Google Scholar

54 Plank, D., Caring for the elderly: report of a study of various means of caring for dependent elderly people in eight London Boroughs, Research Memorandum, Greater London Council, 1978.Google Scholar

55 Oldfield, J. J. and Whitbread, A. W., At Home or in a Home? Warwickshire Social Services Department, 04 1978.Google ScholarPubMed

56 DHSS, Social Work Service, London Region, Residential Care for the Elderly in London, 01 1979.Google Scholar

57 Clarke, M., Hughes, A. D., Dodd, K. J., Palmer, R. L., Brondon, S., Holden, A. M. and Pearce, D., ‘The elderly in residential care: patterns of disability’, Health Trends, 11, 1979.Google Scholar

58 Booth, T., ‘Measuring Dependency’, Community Care, 31 01 1980, pp. 1518.Google Scholar

59 Bond, J., ‘Dependency and The Elderly: Problems of Conceptualisation and Measurement’, in Munnichs, J. M. A. and Van den Heuvel, W. J. A., Dependency or Interdependence in Old Age, The Hague, Nijhoff, 1976.Google Scholar

60 Bosanquet, N., A Future for Old Age, London, Temple Smith, 1978.Google Scholar

61 Brearley, C. P., Residential Work with the Elderly, Routledge, 1977.Google Scholar

62 Brocklehurst, J. C. and Shergold, M., ‘What Happens when Geriatric Patients Leave Hospital?’, The Lancet, 23 11 1968.CrossRefGoogle ScholarPubMed

63 Exton-Smith, A. and Grimley Evans, J., Care of the Elderly: Meeting Challenges of Dependency, London, Academic Press, 1977.Google Scholar

64 Harris, A. I., Social Welfare for the Elderly, Government Social Survey, Vol. 1, London, HMSO, 1968.Google Scholar

65 Isaacs, B., Livingstone, M. and Neville, Y., Survival of the Unfittest: A Study of Geriatric Patients in Glasgow, London, Routledge, 1972.Google Scholar

66 McLauchlin, S., Report of a Survey of Dependency Levels in Elderly People in Residential Homes and Hospital Accommodation on Tameside, Unpublished, 1979.Google Scholar

67 Sumner, T. G. and Smith, R., Planning Local Authority Services for the Elderly, London, Allen and Unwin, 1969.Google Scholar

68 Census, 1971, Non-Private Households, London, HMSO, 1975, p. 124.Google Scholar

69 Johnson, M. L., op, cit.Google Scholar

70 Townsend, P. and Wedderburn, D., The Aged in the Welfare State, London, Bell, 1965.Google Scholar

71 Townsend, P., ‘The Needs of the Elderly and the Planning of Hospitals’, op. cit.Google Scholar

72 Goffman, E., op. cit.Google Scholar

73 Reports of the Committee of Inquiry into Allegations of Ill-Treatment of Patients and other Irregularities at the Ely Hospital, Cardiff, Cmnd. 3975, London, HMSO, 1969.Google Scholar

74 Robb, B., Sans Everything: A Case to Answer, London, Nelson, 1968.Google Scholar

75 Findings and Recommendations Following Enquiries into Allegations Concerning the Care of Elderly Patients in Certain Hospitals, Cmnd. 3687, London, HMSO, 1968.Google Scholar

76 DHSS, The Census of Residential Accommodation, 1970, op. cit., p. 93.Google Scholar

77 Meacher, M., Taken for a Ride, London, Longmans, 1972.Google Scholar

78 Pasker, P., Thomas, J. P. R. and Ashley, J. S. A., ‘The elderly mentally ill – whose responsibility?’, British Medical Journal, 3, 1976.Google Scholar

79 Peterson, M., Confusion More Confounded – A Study of Separatism in a Home for the Elderly, Department of Sociology, University of Essex, 1976.Google Scholar

80 Wilkin, D. and Jolley, D. J., ‘Mental and physical impairment in the elderly in hospital and residential care’, Nursing Times, 74, 29 and 30, 1978.Google ScholarPubMed

81 Burrage, M. and Phillips, D. (eds), Nine Old People's Homes in a London Borough, London School of Economics, 1973.Google Scholar

82 Clarke, M. et al. , ‘The Elderly in Residential Care: Patterns of Disability’, Health Trends Vol. II, No. i, 02 1979.Google Scholar

83 Davies, B. P. and Knapp, M. R. J., Old People's Homes and the Production of Welfare, London, Routledge and Kegan Paul, (in press) 1980.Google Scholar

84 Fiske Lowenthal, M., Lives in Distress, New York, Basic Books, 1964.Google Scholar

85 Fiske Lowenthal, M., ‘Social Isolation and Mental Illness in Old Age’, American Sociological Review, 1963.Google Scholar

86 Isaacs, B. et al. , Studies of Illness and Death in the Elderly in Glasgow, Scottish Health Service Studies No. 17, Scottish Home and Health Department, Edinburgh, 1971.Google Scholar

87 Jelf, P., ‘A Survey of the Population of the Social Services' Department's Homes for the Elderly as at 9 March 1976’, Clearing House for Local Authority Social Services Research No. 6, 1976.Google Scholar

88 King, R. D., Raynes, N. V. and Tizard, J., Patterns of Residential Care, London, Routledge and Kegan Paul, 1971.Google Scholar

89 Lipman, A. R. and Slater, R., ‘Homes for old people – towards a positive environment’, Gerontologist, 17, 1977.CrossRefGoogle Scholar

90 Lowther, C. P. and MacLeod, H. M., ‘Admissions to welfare home’, Health Bulletin, 32, 1, 1974.Google ScholarPubMed

91 Ministry of Health, Residential Accommodation for Elderly People, London, HMSO, 1966.Google Scholar

92 Peace, S. M., Hall, J. F. and Hamblin, G. R., ‘The Quality of Life of the elderly in residential care’, mimeo, Survey Research Unit, The Polytechnic of North London, 1979.Google Scholar

93 Personal Social Services Council, Residential Care Reviewed, London, 1977.Google Scholar

94 Rees, A. M., Old People and the Social Services: A Study in Sunderland, Department of Social Administration, University of Southampton, 1972.Google Scholar

95 Shiphorst, B., ‘Some Aspects of Residential Care’, Social Work Service, No. 10, 07 1976.Google Scholar

96 Spasoff, R. A., Kraus, A. S., Beattie, E. J., Holden, D. E. W., Lawson, J. S., Rosenburg, M. and Woodcock, G. M., A longitudinal study of elderly residents of long-stay institutions, Gerontologist, 18, 1978.CrossRefGoogle ScholarPubMed

97 Townsend, P., The Last Refuge, op. cit.Google Scholar

98 Meacher, M., op. cit.Google Scholar

99 Peterson, M., op. cit.Google Scholar

100 Henry, J., op. cit.Google Scholar

101 Roth, J. A. and Eddy, E. M., op. cit.Google Scholar

102 Tobin, S. S. and Lieberman, M. A., Last Home for the Aged, New York, Jossey-Bass, 1976.Google Scholar

103 Scull, A., op. cit.Google Scholar

104 Bolling Manard, B., Woehle, R. E. and Heilman, J. M., Better Homes for the Old, Lexington, Mass., Lexington Books, 1977, pp. xiv, 31, 135.Google Scholar

105 See also Bolling Manard, B., Kart, C. S., Van Giles, D. W. L., Old Age Institutions, Lexington, Mass., Lexington Books, 1975.Google Scholar

106 Carstairs, V. and Morrison, M., op. cit., p. 40.Google Scholar

107 Based on Census, 1971, Non-Private Households, op. cit.

108 Abrams, M., Beyond Three Score and Ten, Age Concern, London, 1st Report, 1978, 2nd Report, 1980.Google Scholar

109 Booth, T., ‘Finding Alternatives to Residential Care – The Problem of Innovation in the Personal Social Services’, Local Government Studies, 07 1978.CrossRefGoogle Scholar

110 Hunt, A., The Elderly at Home. A Study of people – aged 65 and over living in the community in England in 7976, Office of Population Censuses and Surveys, Social Survey Division, London, HMSO, 1978.Google Scholar

111 Davies, B. and Knapp, M., ‘Hotel and Dependency Costs of Residents in Old Peoples' Homes’, Journal of Social Policy, 01 1978.CrossRefGoogle Scholar

112 Economist Intelligence Unit, Care with Dignity, National Fund for Research into Crippling Diseases, 1973.Google Scholar

113 Wager, R., Care of the Elderly, London, Institute of Municipal Treasurers and Accountants, 1972.Google Scholar

114 Moroney, R. M., The Family and the State, London, Longmans, 1976.Google Scholar

115 More complex conclusions were reached in work supervised by L. J. Opit. See, for example, Opit, L. J. and Shaw, S. M., ‘Care of the Elderly Sick at Home: Whose Responsibility is it?The Lancet, 20 11 1976CrossRefGoogle Scholar; and Opit, L. J., ‘Domiciliary Care for the Elderly Sick’, British Medical Journal, 1 01 1977.CrossRefGoogle ScholarPubMed