Precarity in late life: rethinking dementia as a ‘frailed’ old age

May combine two claims.

Current fourth-age discourses conflict with person-centred and selfhood approaches, reinforcing the idea that people with dementia have less agency and that their lives are marginal and less valued.

“Yet, current discourses of the 'fourth' age run counter to these ideas, reinforcing the view that people with dementia have less agency, with the implication that their lives are both marginal to society and less valued.”

May combine two claims.

Health research commonly frames dementia as disease or frailty as a risk indicator, while socio-cultural approaches often employ fourth-age discourse grounded in late-life frailties and impairments.

“Where health research tends to focus on dementia as a disease or 'frailty' as an indicator of risk, socio-cultural perspectives lean toward use of a discourse of the 'fourth' age or the discussion of a 'fourth age space' that is grounded in ideas about the 'frailties' and impairments of late life (Pickard 2014, Lloyd 2015).”

• cites Pickard 2014Not checked yet

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• cites Lloyd 2015Not checked yet

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May combine two claims.

The fourth age acts as a major discursive and symbolic line separating health from impairment, marking nearness to death and the expectation that later life means decline and disablement.

“Whether in practice settings, or the larger socio-cultural sphere, the 'fourth age' is an important discursive and symbolic marker of the boundaries between health and impairment, the proximity to death, and by extension, the expectations of late life as a period of disablement and decline (Grenier 2012).”

• cites Grenier 2012Not checked yet

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Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

Precarity can expose a deeper problem: when dementia is seen as a frail old age, it may be read as a failed old age.

“Within this frame, precarity can help to draw attention to a deeper problem whereby notions of dementia as a 'frailed' old age risk being read and interpreted as a 'failed' old age.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

Precarity constitutes a new kind of ageing, especially as people move toward the oldest ages.

“We argue that 'precarity' represents 'new ageing'-in particular as one progresses to the upper extremes of the life course.”

Classified as probably not a substantial claim.

Precarity moves fourth-age debates away from age or stage categories toward acknowledging shared vulnerability and a duty of care.

“Drawing on understandings of 'precarity', we shift debates on the 'fourth age' away from ageor stage-based thinking, into a recognition of shared vulnerability and a responsibility for care.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

Frailty and dementia are more adequately grasped when placed within emerging insecurities that shape the life course.

“This paper analyses the extent to which frailty and dementia are better understood in the context of new forms of insecurity affecting the life course.”

Probably not a substantial claim: may not pass S4 (based).

Physical and mental frailties are frequently employed to define the line between health and illness in later life and to guide how people are treated.

“the 'frailties' of the body and mind are often used to mark the boundaries of health and illness in late life, and shape responses accordingly.”

May combine two claims.

Medicalising dementia has raised its public standing and attention, helping preserve its status as a distinct disease.

“However, the medicalization of dementia has also raised the status and public attention afforded dementia, sustaining its position as a distinct disease.”

May combine two claims.

When few care choices exist, fourth age constructs activated in the current political context can limit agency and reinforce the idea that agency is limited in the fourth age.

“With few available care 'choices', constructs of the 'fourth age' which become activated in the current political context, can serve to limit agency as well as reinforce notions that agency is limited in the 'fourth age'.”

Classified as probably not a substantial claim.

Ethics-of-care perspectives imply that because vulnerability is inherent in human life, care must be given and received in varied ways across the life course.

“These would suggest that to the extent that vulnerability is inherent in the human condition, this necessitates the giving and receiving of care in different ways throughout the life course.”

May combine two claims.

Care conditions shape precarity and highlight human interconnectedness.

“Conditions of care shape precarity and underline human inter-relatedness, as can be seen in the accounts of families and carers of people with dementia, who describe a sense of abandonment.”

• AssumptionRests on an assumption: Families and carers of people with dementia report a sense of abandonment.

Classified as probably not a substantial claim.

Precarity treats responding to vulnerability in late life as a moral and ethical imperative.

“Precarity emphasizes the importance of responding to vulnerability in late life as a moral and ethical imperative.”

Probably not a substantial claim: may not pass S2 (checkable).

Precarity clarifies how the fourth age is constructed as separate from youth and adulthood and devalued because of impairment and dependency costs.

“Using precarity to understand late life explicates the construction of the 'fourth age' as a location that is distinguished from youth and adulthood, and devalued as a result of impairment and the associated costs of dependency, whether financial or in terms of care/need.”

Classified as probably not a substantial claim.

In citizenship models grounded in an ethics of care, conflicts of interest are recognized and discussed through processes that include weaker voices.

“In models of citizenship based on the ethics of care, conflicts of interests are recognised and discussed through processes that ensure that weaker voices are included.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Precarity brings out risks and disparities throughout the life course and in later life, showing why fixations on age and stage in third- and fourth-age ideas should be abandoned.

“Precarity draws attention to the risks and inequalities across the life course and into late life, underscoring the importance of unburdening ourselves from the age-and stage-based fixations that are implicit in notions of the 'third' and 'fourth' age.”

May combine two claims.

Chronological age categories, including third and fourth age, and societal responses to them, produce and maintain inequalities, many stemming from current care decisions and priorities.

“Chronological ageor any proxy of chronological age such as the third and 'fourth age'and the ways in which we respond to these categories, create and sustain inequalities, many of which are a result of contemporary decisions and priorities about care.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Precarity provides a basis for understanding circumstances at different life-course points and for examining care processes and experiences of living with impairment.

“Rooted in the idea of instability and enhanced vulnerability, precarity provides a basis for understanding the particular circumstances that prevail at different points in the life course.It also provides a foundation from which to more closely consider the processes of care and experiences of living with impairment.”

Probably not a substantial claim: may not pass S2 (checkable).

Combining a critical analysis of precarity with an inclusive notion of citizenship can recognize and respond to the needs of older people with dementia.

“A critical analysis drawing on precarity, when combined with an inclusive notion of citizenship, holds the potential to recognize and respond to the needs of older people with dementia.”

Classified as probably not a substantial claim.

Butler holds that a response to precarity should begin with acknowledging fragility and limitation.

“According to Butler (2010), the response to precarity should develop from an acknowledgement of fragility and limitation.”

• cites Butler (2010)Not checked yet

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Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

For particular groups that have experienced life-course disadvantages, precarity rather than activity and success is becoming the new model for late life.

“This leads us to suggest (and fear) that it is 'precarity' rather than 'activity' and 'success', that for particular groups whom have experienced life course disadvantages, is becoming the new model for late life.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

Pairing precarity analysis with inclusive citizenship and shared responsibility to vulnerability can co-create understandings that alter late-life understandings and care structures and can alleviate rather than sustain suffering.

“Only from this point, can we co-create understandings that have the potential to alter current understandings of late life, structures and relations of care, and attempt to alleviate rather than sustain the suffering that may exist in late life.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Precarity also makes visible shared vulnerability, the desire for control, and the inability or lack of political will to address dependency, interdependence, and human suffering.

“Second, it renders visible, a shared vulnerability, as well as the desire for control, and the inability, or the lack of political will to address dependency, interdependence and human suffering.”

Classified as probably not a substantial claim. May combine two claims.

In the current context, placing people with dementia in a devalued fourth age can become a precondition for poorly resourced services and can threaten care responses for older people in that category.

“In a contemporary context, the relegation of people with dementia to a devalued category of the 'fourth age' can all too quickly become a prerequisite for poorly resourced services and threaten responses to care for older people in the 'fourth age'.”

May combine two claims.

Devaluing people because of cognitive impairment can reinforce precarity and divert attention from the experience of living with dementia and from care practices.

“In the context of this discussion, the devaluing of subjects by means of their cognitive impairment, can serve to reinforce precarity, and deflect attention from both the experiences of living with dementia, and the practices of providing care.”

Probably not a substantial claim: may not pass S2 (checkable).

Late life is distinctive for precarity because physical and cognitive impairment gains a new dimension through dependence and finitude.

“What makes late life unique with regards to precarity is how the realities of physical and cognitive impairment in late life take on a new dimension as a result of dependence and the finitude that late life represents.”

Probably not a substantial claim: may not pass S2 (checkable).

Linking precarity analysis with an inclusive citizenship challenges responses to older people with physical and cognitive impairments.

“One response is to link the analysis of precarity with an inclusive form of citizenship that challenges the responses to older people with physical and cognitive impairments.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Care is a political issue that should be moved from private to public debate, not only about cost and organization but about responding to need and supporting human flourishing.

“Care is a political issue that should be brought out of the private and into the public, and debated, not only in terms of cost and organization, but the potential to respond to need and support human flourishing.”

Probably not a substantial claim: may not pass S2 (checkable).

Recognizing precarity and the inherent risks of late life could provide a moral and ethical basis for reconfiguring care.

“Recognizing precarity and the inherent risks of late life could, however, form the basis for reconfiguring care from a moral and ethical standpoint (see also Gawande 2015).”

• cites Gawande 2015Not checked yet

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Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

A framework able to respond to precarity in late life must attend both to shared vulnerabilities and to unequal experiences of those conditions.

“A framework that is capable of responding to precarity in late life requires attention to both shared vulnerabilities, and the unequal experiences of such conditions.”

Classified as probably not a substantial claim. May combine two claims.

Butler's thought seriously challenges existing fourth-age discourses, arguing that responses to late life should begin from fragility and limitation rather than deny or distance them, and that such conditions must be cultivated.

“Here, Butler's (2009, with Athanasiou 2013) thinking presents a serious challenge to existing discourses of the 'fourth age', outlining both that our response to late life should develop from an acknowledgement of fragility and limitation, and not a denial or distinction from it, and that such conditions will not naturally emerge, but need to be fostered.”

• cites Butler 2009Not checked yet

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• cites Athanasiou 2013Not checked yet

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Probably not a substantial claim: may not pass S2 (checkable).

Precarity reveals that the need for care in late life arises where devalued positions meet individualized expectations and discourses of burden.

“What precarity brings to light is how the need for care takes place in a context where the implications of devalued positions in late life meet up with individualized expectations and discourses of burden.”

Probably not a substantial claim: may not pass S2 (checkable).

Precarity makes visible how current understandings, including the fourth age as failed late life, conceal universal suffering, structures of inequality, and processes of precarity.

“It does so by rendering visible how current understandings, including those of the 'fourth age' as a 'failed' late life mask universal suffering, structures of inequality, and processes of precarity.”

Probably not a substantial claim: may not pass S2 (checkable).

Shifting focus to shared vulnerability, acceptance of life and death limits, and shared political responsibility can detach dementia and impairment from a frailed and failed late life and provide a foundation for new care relationships.

“Shifting the focus from constructs that reinforce the negative valuations of age, to a recognized shared vulnerability, acceptance of the limitations of life and death, and shared political responsibility can help to unhinge dementia and impairment from a 'frailed' and 'failed' late life into a foundation from which to develop new types of care relationships.”

Probably not a substantial claim: may not pass S2 (checkable).

Cosmopolitan citizenship can serve as a bridge from the analysis of precarity in late life to pathways for enacting change.

“In this sense, cosmopolitan citizenship can provide a crucial bridge from our analysis of precarity in late life into pathways for enacting change.”

Classified as probably not a substantial claim.

The conflict between late-life care needs and both success-based positive views and cost-containment politics causes the greatest concern for physical and cognitive impairment.

“It is precisely how the need for care in late life conflicts with the 'positive' views espoused in success-based models, and against a politics of cost containment, that cause the greatest concern with regards to physical and cognitive impairment.”

May combine two claims.

Butler's account of precarity illuminates ageing politics, where older people may face unequal material access and weakened social networks, making them vulnerable to neglect, abuse, or violence.

“Her interpretations of precarity shed light on the politics of ageing, whereby older people can suffer from 'unequal access to material goods, and diminished social networks, resulting in a potential vulnerability to neglect, abuse and violence'.”

• cites Butler 2009Not checked yet

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Classified as probably not a substantial claim.

Precarity contributes by moving thought away from individualized age- or stage-based success frameworks that position dementia as a frailed old age.

“Precarity brings makes two contributions to the discussion: first, it moves thinking away from the dominance of individualised age-or stagebased frameworks that are rooted in success, and by consequence, position dementia as a 'frailed old age'.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Dementia is a site where fourth age constructs reinforce negative valuations of dependence as a problem and sustain notions of living with dementia as lacking agency and potential.

“Yet, it is a site where constructs of the 'fourth age' reinforce negative valuations of dependence as a problem and sustain notions of living with dementiaor other end of life stage conditions-as void of agency and potential.”

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

Precarity draws attention to how vulnerability is constructed and conditioned, and to the unequal distribution of even the right to a long life through differential mortality between privileged and disadvantaged groups.

“Precarity calls attention to the construction and conditions of vulnerability, including how even the right to a long life is unequally distributed, through for example, differential mortality rates of privileged and disadvantaged groups.”