You Are Too Old to Drive Dear: Elderspeak and Ageism in an Ageing Society
Sik Hung Ng
Victoria University Press, $8.95,
ISBN 0 864732813
Beyond Good Intentions: Support Work with Older People
Anne Opie
Institute of Policy Studies, Victoria University of Wellington, $30.00,
ISBN 0908935986
100 Years Young ‑ How to Live to a Ripe Old Age in Spite of Your Doctor
Gary Courtenay with Sue Waiter and K J Smith
Auckland Institute of Technology Press, $29.95,
ISBN 0958333459
Surviving Retirement ‑ Protecting the Rights of Older Adults
Jacques Vannoort
GP Publications, $39.95,
ISBN 1869561163
Ageing is Attitude
Anne Gluckman and Mary Tagg
Tandem, $24.95, ISBN 0 908884575
Living Well in Retirement
Noel Whittaker and Roger Moses
Hodder Moa Beckett, $34.95,
ISBN 1869581547
Old age is a condition of fear as much as a state of physical decline. A few of today’s elderly may be affluent enough to keep themselves in comfortable happiness and well supplied with the services they need, but most are beset by fears, anxieties and health problems that do not diminish owing to the nature of the times and the policies of successive governments.
You can see this in the literature aimed at the aged. The extent and complexity of their concerns is so dismaying that it is difficult for a reviewer to remain cheerful let alone maintain any pretensions to objectivity.
Ever since the Labour government in 1984 ratted on the working class and its elderly faithful by abandoning its traditional welfare philosophy, the thrust of successive government policies has been to cut back on state expenditure by a combination of privatisation, making users pay and reducing the quality and availability of services.
Whittaker and Moses in their guide to Living Well in Retirement provide a summary of the byzantine ramifications of superannuation and point out that the object of government policy is to make voluntary coverage attractive while offering as little in tax concessions and handouts as possible.
I suspect that this strategy owes something to a desire by governments to help their corporate friends and backers (as well as the army of speculators and projectors hanging on their coattails) to make more profits by keeping taxes down. Thus, a more aggressive economy and a lean, mean state are supposed to propel us into a dream of economic growth and prosperity.
This may turn out to be a cruel deception. Economic growth is just as likely to lead to chaos as to the hypothetical delights of burgeoning capitalism. Take a look at Japan. Have a think about the frightening problems of China. And contemplate the disorders in Russia as an example of what happens when speculators, profiteers and gangsters triumph over weak, demoralised government. We may fancy we can dodge some of the ugly features of economic development by staying small and green, but don’t be too sure. Foreign ownership and overseas markets determine the outlines of major policy in New Zealand and, in a conflict of interests, will triumph over benevolent intentions and idealistic hopes.
As far as many of the elderly are concerned, a direct consequence of post‑1984 government policies is that the state has been transformed from a guardian of public interest and a custodian of people’s wellbeing into a pinchpenny and unprincipled trader from whom one would certainly not want to buy a secondhand car, let alone health insurance or any other kind of security. This has not always been the case. Back in the dreaming time in 1938, when Labour brought in its revolutionary social security scheme, its election policy boasted that the Social Security Act would remove:
that paralysing fear of want and distress that has never been far from the mind of our average responsible citizen when he contemplates how he will fare when age, sickness, accident
or unemployment prevent him from earning a living, how he will meet the bills for doctors and hospitals, how his wife and children will be placed if he meets a premature death. In
place of the fear of want and of debt there will be security founded on the strongest institution of the nation ‑ the wealth of the whole community.
To accompany this alarming manifesto, Mick Savage, the Labour Prime Minister, mailed a reassuring personal letter to “fellow citizens” in which he declared: “I’ll never let you down or try to keep you down”. As a populist stunt this went over big. (Though it wouldn’t work today. The government PR team would be laughed out of town.) Savage was a tedious, moralising wowser given to pseudo‑christian homilies padded out with sentimental claptrap, yet he gave the impression of believing what he said. But who, today, would credit anything a politician says, especially about unemployment, superannuation, health services and welfare?
The damage to the political culture brought about by the demolition of the public service and the decline of the welfare system means that citizens have been forced to reconstruct themselves. From being trustful, co‑operative clients of the welfare state they have had to become bush lawyers and beady‑eyed accountants in their apprehensive dealings with welfare, superannuation and medical services.
But not all are able to manage this transformation. Even to figure out what one’s rights might be in some adversarial situation is far from easy, the more so since the outbreak of a new virus called “elder abuse” that the robber state has nurtured.
Jacques Vannoort in his ominous Surviving Retirement defines this as “the misuse of power in a relationship with an older person which is based on trust”. The abuse can be crudely physical or it may take the form of neglect, deprivation of assistance, negligence or emotional, psychological and psycho‑social threats of violence that can result in stress, fear and emotional disturbance.
Some elderly people think the state’s resort to means testing, asset stripping and differential taxation by means of superannuation surcharges are varieties of the abuse virus that are morally objectionable, if not illegal.
Vannoort draws attention to other areas, especially in the field of health. He suggests it is time for a charter of rights to protect helpless people. But this won’t come about unless the aged discover some new messiah and form themselves into an organised political group with effective electoral muscle.
Cunningly, the major political parties tried to liberate themselves from the tyranny of the elderly by fabricating an accord that freezes superannuation payouts in their existing unfair and inadequate condition. How well this will withstand the factions, plots and leverages of the coming MMP regime remains to be seen. Elderly voters are an increasingly attractive target for nervous politicians. Could MMP even result in the emergence of an angry Struldburg constituency in response to the increasing longevity of the population? Or will governments contrive to weasel out of their fiscal responsibilities by abolishing the concept of retirement altogether, and with it the need for superannuation? What is to stop some future cabinet from arguing that if people were to be kept at work longer, they could be left to finance their own health, education and retirement needs, leaving any casualties and unemployables to be grudgingly sustained by a minimal publicly funded safety net? The progressive raising of the superannuation age to 65 is an exploratory step in this direction.
Another way of thinking about the aged is to see them as stereotypes. Sik Hung Ng writes perceptively about the stereotypes of impairment and decline which have been imposed on older people, particularly the notion that they are a burden on the government. This raises questions about the psychology of survival. Those who are physically immobile and possibly suffering from senile dementia are likely to be dependent on help from informal family caregivers. They may resent the negative stereotypes of “ageism” and the patronising, demeaning forms of what Ng describes as “elderspeak”.
Such situations can produce a great deal of stress, not only for victims but for caregivers and social workers. Anne Opie’s Beyond Good Intentions is an important book. It evaluates the effectiveness of supportive social work services for caregivers and notes that the emotional demands on them can be very high. This is because the elderly disabled are likely to be chronically ill and in many cases suffering from dementia. The needs and rights of these patients can be easily overlooked. Opie bases her findings on a pioneering, three‑year research project with the workers engaged in this field. She calls for the development of a national dementia strategy by the government and recognition of the major social and economic contribution being made by caregivers who are becoming more important as the population ages and who play “a critical but marginalised role in the health system”.
Opie observes that caregivers need effective support from social workers and that this should involve far more than giving advice about physical needs and organising help for them. It should include a lot of psychological functions like helping caregivers deal with grief and the emotional issues within the family that arise from dementia. She also comments on the changing political environment of the health system and the effect of organisational upheavals. This reinforces criticism contained in a recent National Advisory Committee on Core Health and Disability Services report entitled Care for Older People in New Zealand. It finds that some services have suffered because of repeated restructurings and the accompanying fragmentation of responsibility. It also notes that central leadership is lacking and that there are no national health service goals for older people or comprehensive plans for the future.
So take care! It would seem that the disabled elderly are at the bottom of the health service barrel. Either by design or by administrative incompetence, they have been packed into back bedrooms and left to languish there with initial assistance from the state. Their neglect is consistent with the laissez‑faire economic doctrines that regulate government policymaking. If the aged want health care, let them buy it for themselves on the open market of health providers.
From pondering about what it would be like to end up helplessly in the hands of caregivers, many of whom are likely to be elderly women themselves beset by emotional tensions and anxieties, I was attracted to Courtenay, Walter and Smith’s 100 Years Young.
“This is more like it,” I thought. Away with all this doom and gloom. Down with ageism! Stave‑off old Mr Grim with eternal, faustian youthfulness.” The subtitle “How to live to a ripe old age in spite of your doctor” was irresistible. At first, I was a little dismayed by the threatening chapter headings. Alzheimer’s, arthritis, cancer, cardiovascular disease, depression, etc, seemed like a familiar catalogue of disaster. Then I found that Courtenay et al were into preventive medicine.
The idea is to strengthen the body’s immune system by proper diet, exercise and the use of natural remedies. Much of their advice seems excellent commonsense and worth taking very seriously. An appendix of extended reading and the addresses of health bookstores and suppliers of organically grown food completes a useful compendium of information. The authors also point to the importance of stress reduction and the need to learn the game of life by remembering “the child within” and discovering things to do that are forward-looking and interesting
This advice fits in neatly with media stereotypes of the happy couple in their retirement home or mortgage‑free property, busily managing their finances with the help of friendly banks, insurance companies and investment consultants. These paragons of homely dedication to investment wisdom are successful enough to be able to blow some of their wealth on occasional foreign travel with the help of equally friendly airlines and travel agents. How does one get into this utopia of amiable affluence?
Whittaker and Moses in their tempting Living Well in Retirement expound their “fundamental wealth‑building principles” beginning with “the miracle of compound interest” and progressing to advice on investment, managed funds, income tax minimalisation, trusts, insurance and superannuation. They then suggest that moving to a retirement village usually turns out to be an exciting and fulfilling experience.
Setting aside the objection that not everyone wants to relocate to an elderly ghetto, the trouble with their programme of personal enrichment (like the advice on preventive health) is that it is not much use unless it is set in train early in life, preferably in one’s big‑spending, heedless twenties or thirties.
Another shortcoming is that according to an Age Concern survey, 45% of our pensioners subsist on a personal annual income of less than $12,000 and, not surprisingly, some 60% of them have difficulty meeting their living expenses. No retirement villages, holidays in Tuscany or affluent lifestyles for them.
They face a penance of never‑ending money and health worries as victims of the complex old age‑health‑superannuation labyrinth we have imprisoned them in. The nineteenth-century doctrine of responsibility which is peddled by the political right has it that poverty is the fault of the poor because they have chosen this particular pathway in life. But investment advice, as a corrective for self‑imposed poverty or other shortcomings, is useless in their case because the poor and the handicapped have no capital and little prospect of acquiring any under an economic regime of job insecurity, rising costs and oppressive taxation. They are stuck in a poverty trap. Telling them to enrich themselves by saving, investing and speculating is like recommending a person with no legs to try cross-country running for a cure.
Rich and poor alike also have to withstand stress, anxiety and depression which can contribute stealthily to illness and physical deterioration. In their discussion of depression, Courtenay et al point out that laughter is a great antidote and propose television comedy as a suitable therapy.
I suspect that heavy exposure to the doldrums of television in New Zealand would be more likely to lead us all deeper into despair. What passes for comedy and light entertainment might keep a not very gifted 6‑year‑old amused for a while, but the violent morbidity of much of the rest can hardly be beneficial to the psychological wellbeing of the sick, the anxious, the frail and the aged. The best treatment for one’s depression is probably to disconnect television altogether and spend the licence fee on book purchases. Failing that, any programming that offers a light diet of eros and romantic adventure should be seized upon as a desirable distraction. Would more of “Love Boat”, “Late Night” and cheery documentaries about the secret life of plants or the nocturnal adventures of the blue‑tailed Tasmanian bandicoot (with correspondingly less of Arnold Schwarzenegger, Sylvester Stallone, Clint Eastwood and other apostles of violence and mayhem) help tranquilise us into amiable, fun‑loving angels instead of the disturbed beasts that we are, shuffling mournfully toward our melancholy final solutions?
The literature of ageing in New Zealand is deficient because it ignores some of the actual problems of the elderly, especially those who are poor and disadvantaged. Somebody should write a survival handbook called Down and Out in New Zealand on how to get money out of welfare, how to get to the head of hospital queues, how to construct convincing hard luck stories, exploit charity, scrounge for food; how to put together budget meals of rice, beans and vegetables, how to obtain free firewood, legal advice, reading matter and lodgings; how to locate the best thrift stores, how to work cash deals on the underground market instead of paying GST and how to keep out of the hands of usurers and lethal fast food outlets.
A society that deliberately arranges for the unemployment of an unskilled, inadequately educated underclass and lets its elderly languish in poverty is morally corrupt. Its incumbents can hardly be blamed for trying to rip off the system whenever they get the chance, or for resorting to burglary, theft and other forms of criminality that follow the example of the fraudulent state. Nor is it praiseworthy that the New Zealand state damages its citizens by encouraging gambling, tolerating the excessive consumption of liquor and fast foods and doing very little to dissuade many foolish consumers from smoking and drinking themselves to death.
The single biggest public health reform that an enlightened state could accomplish would be to require the compulsory attendance at instructional courses on diet and physical exercise as a prerequisite for the payment of pensions, health and welfare benefits, but it would probably take a fascist regime to enforce it. Things could come to such a desperate pass, but meantime, for most of us, growing old is a marathon in morbid endurance, unless you have been conditioned early on to laugh at adversity or to enjoy the exquisite torments of suffering and victimhood.
The affluent can always amuse themselves with the share market, private hospitals, travel and gambling. The poor have got alcohol, tobacco, keno, interminable melodramas of television, disputes with welfare and the crowded waiting rooms of the wreckage of the public hospital system.
However, for booklovers there are more libraries and volumes than they can hope to get through in a lifetime. Walking (so far) doesn’t cost anything, though it grows more dangerous as government fails to keep order in the streets. And over‑70s can ride free on ski lifts, though this is not much of a concession to the bed‑bound.
Yet immobility has advantages. Once, during a stay in Taumarunui hospital, I mugged up a huge dollop of Old English, although I now realise this was a foolish waste of time and I would have been better to have tackled Maori (which was being spoken all around me) or German or both. Nevertheless, if you are immobile you have a priceless opportunity to engage in some solid reading. You might even manage to escape into the enchanted forests of metaphor where more creative ways of seeing yourself abound. With the acquisition of a good radio receiver you can also surf the airwaves to extend your horizons still further.
Aged, arthritic fingers tend to impose limitations on instrumental performance, though I remember walking home late one night in Christchurch and seeing an old lady in the front room of a family house having a wonderful time at the keyboard of a silent piano, However, the possibilities for extended music listening are now considerable with the aid of cassette tapes, CD players and radio. Or you could try another language? Say Maori. Listen to Maori radio. Find out what is going on in that mysterious undergrowth. Or have a go at French or German. Try to scrape up a reading knowledge so that your worldview can expand.
Reading New Zealand books about the problems of ageing can lead to salutary perspectives about one’s future self and dark thoughts about the hazards of survival. There is little excuse for ignorance. Quite apart from the works surveyed here, public libraries and bookstores these days are well stocked with titles about nutrition, diet, exercise, natural medicine and drugs. If you can afford the expense it is also prudent to locate a reliable GP who can offer conventional wisdom on such matters, as well as keeping an eye on your physical health.
If you seek a more spiritual view of ageing from a religious perspective, the Methodist‑Presbyterian public questions committee in 1984 published a brief monograph entitled Ageism that discusses religious values and looks at various forms of discrimination on the grounds of age. Most libraries also have collections of works on the behavioural aspects of ageing. One of them, Old Age by Simone de Beauvoir is a classic of “passionate sociology”.
To survive in old age one should do more than read a few books. One needs to construct a cave with at least two exits and get on with as much activity as one can. The immobile are in the worst plight. But for those who have been lucky enough to retain their mental capacities there are always the consolations of imagination and fantasy, exploitable through the resources of art, music and popular culture. Daydreaming is an enormously useful accomplishment to cultivate. It ought to be part of the social studies syllabus at school as equipment for the life of unemployment to which a substantial part of the low‑skilled labour force is destined.
The advent of virtual reality technology is another promising field to explore. It could enable even the most literal minded and disabled of us to scoot off to whatever pastures of the mind we are capable of exploiting, either as whimsical travellers, or as the child within, re‑indulging the follies, dreams and passions of turbulent youth. The accidents of infirmity, the miracles of technology and the machinations of government policymakers aside, one thing predominates in the ecology of survival and resounds throughout its literature ‑ busyness of some sort is all.
Les Cleveland is a retired political scientist.