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This chapter examines the impact of ageing societies on families based on empirical evidence from Europe, North America, and Australasia. It identifies three broad roles for families: as mechanisms for intergenerational support, intergenerational transfer, and intergenerational solidarity. It argues that more heterogeneous forms of family are emerging, with their own sets of roles and relationships influenced by demographic, social, and cultural changes.

This chapter assesses Peter's role as the founder in the UK of the sociology of ageing and his influence on the development of critical gerontology. It notes that the article published in the first issue of Ageing and Society in 1981 represented a systematic attempt to provide a new theoretical framework for the study of ageing. It notes that Peter sought to shift the debate from individual approaches to the social processes that led to the structured dependency of people in later life. It then goes on to consider three major issues for structured dependency theory and critical gerontology more generally: the transformation of retirement; the impact of privatisation and deregulation; and finally, the influence of globalisation. It makes a powerful case for a break with the past and for research and policy on older people to be central to wider debates within social policy, sociology and political science, in the overall.

This chapter aims to refocus the direction of environmental gerontology by examining the current policy context and ‘preparedness’ of nations to address the aspirations of an increasingly ageing society. It raises three key shortfalls in policy and practice and discusses the way forward, such as the need to better link environmental gerontological research with those who make policy, and to ensure that empirical and policy knowledge is disseminated to developing countries that are undergoing rapid urbanisation and growth in the ageing of their population. It has also suggested the idea of having a minimum standard for neighbourhoods, the need for a rethinking and different discourse around ageing and older people, and the need to invest in ageing.

This chapter reviews progress in critical gerontology from a British perspective. Drawing on an examination of the first 25 years of the journal Ageing and Society, together with a case study of the interaction between the members and officials of the Welsh Assembly and gerontological advisers, the chapter clarifies who the variety of interest groups now are in the gerontological enterprise; how gerontology has grown and expanded; and what the strengths and weaknesses of current research are. A number of important challenges for gerontology and gerontologists include the paucity of theoretical development in gerontology; the persistent tension for gerontologists about whether to commit to gerontology or to their base discipline or research field; and the often difficult relationship between research and policy formulation and the dominance of biomedical and problem-oriented perspectives.

It is an interest in ageing with explicit critical gerontological focus that provides a unique set of understandings about ageing and later life in the 21st century. This chapter describes critical perspectives on ageing societies. Close scholarly analysis of policies affecting the lives of older people offer challenges to gerontologists and ageing individuals. In addition to the life course orientation, other themes thread their way throughout this book. This chapter notes three particular themes and sets of commitments that stand out in all these explorations. First, all the contributors in the book are committed to illuminating and extending the critical gerontological approach conceptually, methodologically and practically. Second, they are all committed to the importance of research and to the full and proper involvement and participation of older people. Third, they demonstrate an engagement with the ‘passionate scholarship’ which, at heart, aims to bring about change.

Picking up the issues raised about critical gerontology in general, this chapter explores these issues from a North American vantage point: highlighting how anxiety about population ageing arises most prominently at times when the fate of future generations appears to be at risk. It draws on historical, environmental and philosophical arguments to show how a focus on justice between generations is ‘an idea that will not go away’ and how it can illuminate the policy choices faced by ageing societies during the 21st century. The wide-ranging historical review concludes by proposing a greater attention to the ‘late freedom’ of old age as a model for generativity and concern for the welfare of future generations around the world.

Chapter 1 draws out key paradoxes and puzzles in contemporary ageing-related discourses, with a view to identifying sensitising concepts that are important starting points in developing new theory. The central paradox of contemporary ageing societies is the paradox of turning the problem into the solution: reform proposals and exhortations for change are premised on the idea that ‘the problem’ (older people and the resultant ‘burden’) can and must also be ‘the solution’ (older people becoming more active and less dependent). ‘Turning the problem into the solution’ is the direction that more and more policy and practice towards older adults is taking as policy makers worry about ageing and turn to the resources of older adults (or, indeed, older adults themselves as a resource) in the hope that this will hold the ‘solution’ to the ‘problem’ of ageing. The chapter assembles some building blocks of a new theory of meso-level dynamics in ageing societies where particular sets of policy and marketing scripts are supposed to shape the lives of older people. The chapter introduced the idea that all economically developed countries with large older populations prescribe ‘model’ behaviours for older people, with the aim of alleviating the ‘burden’ of population ageing.

Inclusive housing allows individuals to take part fully in their preferred mode of life. This chapter discusses the concept of inclusive housing: what it means, what it implies, and what it demands. With a vision of the future where desirable design features in general housing include planned accessibility and sustainability, this chapter examines inclusive housing and its application to housing the ageing society as well as the issues relating to the aspects of material and social environments, resources, technologies, and issues around choice and self-determination.

Policy and public discourse promote new technology as a solution for reducing care needs and public expenditure and for improving the quality of life of older people. This chapter analyses and describes how telecare, exemplified by the use of GPS-based tracking technology in care for people with dementia, establishes a form of care at a distance, and what this implies for different actors in terms of new possibilities, challenges and limitations. It demonstrates that telecare affords valued positions, reciprocity and symmetry, but also that telecare comes with new ideals, demands and responsibilities. Whereas technology, in political rhetoric, represents new solutions especially for those with no family or social network, this chapter argues that technologies do not work in a vacuum nor by themselves but rely on a care collective and a well-defined arrangement and organisation for the distribution of tasks and responsibilities.

The introduction sets out the main aims of the book, highlighting the complex relationship between ageing, health and care. It provides an overview of the theoretical orientation of the book, setting out the challenge to contemporary policy priorities for ageing societies and the importance of an ethic of care for this challenge. It also provides an outline of the organisation of the book.

Preparing for an adequate support and care system and for health support workers to meet the needs of the elderly in an ageing world is an urgent issue. Japan has a population with the longest life expectancy. Previously family members took care of the elderly and the disabled. However, today care is more often provided by non-family members. As a result, the long-term care insurance system was implemented. Under the system, certain services are provided by qualified professional health care staff as defined in classic neo-Weberian terms. However, to realise an appropriate quality of life for the elderly and disabled, more services are often required. This results in additional services being performed by non-professional health support workers and home helpers, which raises concerns about low-waged female labour and the practice of health and medical care by unqualified persons. However, such personalised care helps bring about a higher quality of life for the elderly and disabled, especially since educational programmes are now being provided. In this chapter, the roles of qualified and non-qualified health support workers are examined and relevant issues and their solutions are explored in a Japanese and wider global context.

This final chapter reflects on the future of palliative care provision for non-cancer patients, in the light of the varied, challenging, and influential views expressed in the book. The question of how best to extend palliative care to non-cancer patients highlights a number of critical issues which have implications for hospice and palliative care in general, as well as for non-cancer palliative care in particular. These include changes in the age structure of industrialised countries which will impact on both the demand for palliative care and the availability of informal carers to provide care, and the growing heterogeneity in palliative care provision which raises questions about the fundamental values of hospice and palliative care.

This chapter highlights the need for partnership working, which has been a long-standing objective of health and social policy. For many years, the National Health Service (NHS) and local authorities have been attempting to deal with 'wicked issues'. Issues such as homelessness, disaffection of young people, and the ageing society that have complex multiple causes require joined-up approaches by the statutory and third sectors at national and local levels. In 2012, at the time when Public Health responsibilities were transferred from the NHS to local authorities, health and wellbeing boards (HWBs) were established in England. With few exceptions, HWBs punch below their weight and are not the powerful system leaders that were hoped for. Evidence of their value and impact is negligible, with poor-performance indicators, and the difficulties in overcoming deep-seated departmentalism and a silo approach prevalent in government and public services, leaving 'wicked issues' as deep-seated as ever.

The different models of welfare states are explored, drawing on the seminal work of Esping-Andersen. Next, we examine the challenges to welfare state systems arising from demographic change, new family formation patterns, immigration, and new trends in employment. Governments also struggle with the rising financial liabilities arising from pensions and healthcare. All of this has inspired liberalizing reforms across the OECD. To the political left, the European Union offered an unfulfilled opportunity for market reregulation. Reform measures in this domain are difficult to implement and often assume a piecemeal character. Yet demographic change in particular will force policymakers’ hands in years to come.