Introduction
Chronological age is often used as an administrative term and as a general means of categorisation, underpinned by certain assumptions about different age groups, especially older people. However, the use of chronological age as a self-evident cut-off point for ‘oldness’ has been criticised (Jolanki Reference Jolanki2009: 19–21), and more attention has begun to be paid to the actual characteristics and needs of each age group. Even though categorisations based solely on chronological age have diminished, the ‘new’ ways of defining older people may be equally simplifying and problematic, for example, because they still have different individual needs for care. Furthermore, whatever the means used for categorisation, talk about older people today is still apocalyptically laden – ageing is seen as a threat. The growth of the ageing population in many contemporary societies is seen as a ‘demographic apocalypse’: a burden, and an alarming problem that must be tackled in some way (Fealy et al. Reference Fealy, McNamara, Treacy and Lyons2012; Gee Reference Gee2002).
When talking about different population groups, we often use collective nouns and adjectives. It thereby often creates value-laden disparities between groups, and stereotypes of those that belong to such groups. By defining the characteristics of members of a certain group, we erect more or less insuperable boundaries between ‘us in the in-group’ and ‘them in the out-group’ (e.g. Hendricks Reference Hendricks2004). Through these fairly conventional ways of speaking, we gradually make general social constructions of different population groups. The focus of this paper is on the social constructions made of older people. The point of departure for the paper is that social constructions of older people are created and maintained through spoken and written language (Fealy et al. Reference Fealy, McNamara, Treacy and Lyons2012; Weicht Reference Weicht2013). The way we talk about older people most probably affects the way we treat those people, and also the way they see themselves (Hendricks Reference Hendricks2004).
Socially constructed images of older people have been studied fairly widely. Scholars have analysed different public and private arenas in which such social constructions are created. These include newspapers (Fealy et al. Reference Fealy, McNamara, Treacy and Lyons2012; Nilsson Reference Nilsson2008; Weicht Reference Weicht2013), magazines (Lumme-Sandt Reference Lumme-Sandt2011), advertisements (Carrigan and Szmigin Reference Carrigan and Szmigin2000), focus group discussions (Weicht Reference Weicht2013) and the talk of older people themselves (Bradley and Longino Reference Bradley and Longino2001; Jolanki, Jylhä and Hervonen Reference Jolanki, Jylhä and Hervonen2000). However, there are very few studies analysing the language used by political decision makers (although see Nilsson Reference Nilsson2008). The aim of this study is to examine the discursive constructions of older people by analysing the talk of members of parliament (MPs) during parliamentary discussions in Finland.
The discussions analysed here were part of the legislative process concerning the Act on Supporting the Functional Capacity of the Ageing Population and on Social and Healthcare Services for Older People, which came into force on 1 July 2013. The official aim of the Act is to ‘ensure that older people will obtain individual care services and care according to their needs on an equal basis throughout the country by means of quality social and healthcare services’ (Ministry of Social Affairs and Health 2012). Social constructions made of older people serve as a basis for the planning of such services (Weicht Reference Weicht2013). The language used by politicians creates social constructions of the ‘target population’ of such policy making (Schneider and Ingram Reference Schneider and Ingram1993), which in turn further defines the policies designed for that group (Carney Reference Carney2010). In addition, statements by policy makers are reported widely in the media, and hence the MPs are involved in the wider process of the construction of public understandings of older people. Thus decision makers' underlying understandings of older people are likely to influence profoundly the way services for older people are organised.
Older people and ageing in research and society
Research on public representations and social understandings of ageing has been widely conducted in the field of social gerontology. The findings suggest that ageing in general is understood and defined in a fairly ambivalent way, both in research literature and in practice. In general, discourses about older people as a group delineate them from the rest of society. Older people are commonly referred to as either a burden or an asset to society (Wiles and Jayasinha Reference Wiles and Jayasinha2013).
In studies focusing on public representations of older people and ageing, terms such as decline, disability, disease, frailty, incompetence, stagnation, vulnerability and victimhood (Fealy et al. Reference Fealy, McNamara, Treacy and Lyons2012; Nilsson Reference Nilsson2008) have been found fairly often in relation to ageing. Representations of active older people have also increased (Wiles and Jayasinha Reference Wiles and Jayasinha2013), but the spheres of activity at old age have been relatively restricted, mostly to physical activity (Weicht Reference Weicht2013), and are presented by way of contrast with passive and dependent old people. This kind of division, between the frail and declining, on the one hand, and the active and productive, on the other, can also be found in research discussions of different ageing categories, namely the ‘third age’ and the ‘fourth age’ (Baltes and Smith Reference Baltes and Smith2003). Older people are seen as being able to represent only one or the other of these two extremes, and the whole spectrum of activity is absent (Biggs Reference Biggs2001). Whether negative or positive, images of older people are almost always stereotypical.
Nilsson (Reference Nilsson2008) suggests that even when older people are described as active and productive, their activity is held back by ageist society. This is related to the concept of ‘structured dependency’ developed by Peter Townsend over 30 years ago (Townsend Reference Townsend1981): dependency is created by the boundaries, practices and norms of society and institutions, rather than by the characteristics and actual needs of older people themselves. Although the dependency generated in our social structures – e.g. retirement age, pension systems, institutional care, etc. – have been challenged since the 1980s, ‘structured dependency’ still exists in many different settings and forms (Carney Reference Carney2010; Gilleard and Higgs Reference Gilleard and Higgs1998). The predominant tone of the general discussion is that being active and independent as such is important and desirable, while conversely passivity and dependence are undesirable (Robertson Reference Robertson1997).
A fairly general observation from the studies is that older people are often represented as a homogenous group (Fealy et al. Reference Fealy, McNamara, Treacy and Lyons2012; Weicht Reference Weicht2013). This homogeneity is constructed by referring to older people with collective nouns and phrases and by creating stereotypes. Old people are also represented as genderless, and as a group whose age structure gives it a right to receive – or even an obligation to seek – care, indicating that all older people are seen as potential care recipients (Nilsson Reference Nilsson2008).
Older people are also discussed as a group of ‘others’ (Fealy et al. Reference Fealy, McNamara, Treacy and Lyons2012; Weicht Reference Weicht2013), singled out from mainstream society due to their age. This notion has been challenged with reference to the tendency to talk about older people as a responsibility of society. Nilsson (Reference Nilsson2008) suggests that taking care of older people that are frail and vulnerable is seen as the responsibility of society, thereby representing them not as social outsiders but as ‘our older people’. In this way language creates a group of people that are ‘others’ but are also included in ‘our’ society.
Material and methods
Data
The data for the study consist of official records from four plenary sessions in the Finnish parliament that were held in autumn 2012. These parliamentary sessions were related to the process of passing the Act on Supporting the Functional Capacity of the Ageing Population and on Social and Healthcare Services for Older People. The first session on 25 September was an interpellation debate (Minutes 85/2012), in which the opposition called upon the government to account for the funding of the upcoming legislation. The second session, on 14 November (Minutes 110/2012), was the preliminary debate on the Bill. The last two sessions were the first reading on 11 December (Minutes 126/2012) and the second reading on 17 December (Minutes 131/2012), during which parliament made its suggestions for additions, removals and amendments to the Bill. Altogether the data contained 282 speeches. The speakers (N=105) represented all parliamentary parties (N=8), divided fairly equally between the government parties (N=6) and the opposition (N=2). The Finnish parliament has a total of 200 MPs.
Method
We selected discourse analysis as the methodological approach for the study. Discourse analysis is a useful method to capture, uncover and increase the understanding of people's underlying perceptions. The basis of discourse analysis is that language is not a neutral tool of communication, but a means to construct social understandings of the issue in question (Potter and Hepburn Reference Potter, Hepburn, Holstein and Gubrium2008). Furthermore, discourse analysis enables us to identify the aspects of the issue that are emphasised, and the aspects that are hidden behind prevalent discourses.
It is often the case in discursive strategies that speakers define the situation of others. In this particular case, it is decision makers – the majority of whom belong to the group of young social achievers – who are defining the situation of older people. That is, younger people are looking at older people's situation from the outside (Weicht Reference Weicht2013). One MP aptly described the parliamentary discussion as a ‘conversation in which certain people discuss and certain people are the subject of the discussion’.
The main concern of our analysis was with the content of the MPs' talk about older people, and the expressions, metaphors and images they used in their talk. No particular framework for analysis was used, but the study of Jolanki, Jylhä and Hervonen (Reference Jolanki, Jylhä and Hervonen2000) acted as an example (see also Wetherell and Potter Reference Wetherell and Potter1992). The analysis began with several rounds of reading the data in order to make a preliminary assessment of it. During this preliminary reading, the authors also held discussions of the content and of tentative findings. After the preliminary reading phase and discussions, a more specific question was formulated: how do MPs talk about older people and ageing? This question directed the second phase of the analysis, that is, in-depth reading. In the course of in-depth reading, textual samples in which MPs referred to ageing and older peoples' characteristics were identified. These samples were reduced to core messages and similar messages were categorised under the same theme. These themes were then used as the basis of the grouping of the data. At this point the findings from similar studies (Fealy et al. Reference Fealy, McNamara, Treacy and Lyons2012; Nilsson Reference Nilsson2008; Weicht Reference Weicht2013) were used as source of inspiration. The result of this grouping was the identification of three dominant discourses.
Discursive context
The underlying assumption behind discourse analysis is that language has to be studied in its social context (Jolanki, Jylhä and Hervonen Reference Jolanki, Jylhä and Hervonen2000). Written and spoken language is socially constitutive and conditioned: discourses are shaped by the situation in which they are presented, and they also shape that situation (Wodak and Meyer Reference Wodak and Meyer2009: 5–6). Thus, when analysing discourses it is essential to highlight the context in which they are (re)produced. Before presenting the results, we will therefore offer a brief introduction to the Finnish welfare system, the rationale behind the Act, and the aims of the Act and of policy making for old people in general.
In Finland, municipalities are responsible for and autonomous in organising the wide range of social and health-care services for their residents. Because of the large number of municipalities (currently 320) and the scarcity of resources available for such services, variations in the scope and quality of care have become evident across the country. During the past few years, a number of claims have been made about disparities and neglect in the care of older people in particular. The improvement and assurance of old people's access to and quality of care has been an important policy priority in Finland for at least a decade. The central rationale for focusing on old people's care delivery is the increase in the aged population, as well the deteriorating economic situation.
The Finnish parliament has drawn up sets of strategic guidelines (in 2001, 2008 and 2013) to maintain and develop ‘good ageing and services for older people’. However, these guidelines have not been sufficient to regulate the care provided by municipalities, leading the government to pass the Act on Supporting the Functional Capacity of the Ageing Population and on Social and Healthcare Services for Older People, which came into force in summer 2013. The official aim of the Act is to ‘ensure that older people will obtain individual care services and care according to their needs on an equal basis throughout the country by means of quality social and healthcare services’. Among other things, the Act gives precedence to services provided at home, and stipulates that the service needs of older people must be evaluated within a minimum waiting time. Different options for care have to be discussed with the older people themselves (or with their relatives), and their views must be recorded in the service plan. It is recommended that services be provided within three months of the evaluation (Ministry of Social Affairs and Health 2012).
The aims and content of the Act are in line with previous policy aims stated, for example, in the National Framework for High-quality Services for Older People (Johansson Reference Johansson2010; Ministry of Social Affairs and Health 2008). This framework includes five main ethical principles to guide the delivery of long-term care, i.e. the rights to self-determination, equality, participation, individuality and security, all of which are also present in one way or another in the new Act. In addition, the Act is in accordance with previous national guidelines, in which the overriding aim is to avoid the use of institutional care, and to offer services at home for as long as possible. To achieve this aim, municipalities have been urged for example to offer regular home care, and to support informal care provided by family members. When care at home becomes insufficient, long-term care should be provided in community-based facilities rather than in more institutional settings such as residential homes. These objectives are compatible with other countries' policy aims (Joy and Fong Reference Joy and Fong2000).
Results
A dear child has many names
Within the parliamentary discussions, older people were named and referred to with collective nouns and phrases. The MPs referred to older people as ‘the aged’, ‘aged population’, ‘aged people’, ‘an aged person’, ‘the elderly’, ‘an old person’, ‘ageing’ and ‘those who are getting old’. Terms such as ‘senior citizens’, ‘the over-65s’, ‘the over-75s’, ‘grannies’, ‘granddads’ ‘the retired’ and ‘grown-ups’ were also used. Several MPs made a distinction between ‘the retired’ and ‘the elderly’ or ‘aged people’. Older people were also talked about with reference to their family members. Terms such as ‘our elderly parents’, ‘sick mother/father’, ‘the elderly in the family’ and ‘grandparents’ were used. One MP highlighted the difficulty of choosing the right term when speaking about older people. She mentioned the distinction used in the Bill, which referred to people aged 63+ as ‘the aged population’ and people aged 75+, with some exceptions, as ‘old persons’. However, chronological age markers were not widely used in the discussions, because before these debates took place in autumn 2012 it had already been decided that the legislation could and should not be restricted to people in certain age groups, but should apply to the ‘aged population with needs’ in general.
Old people as a homogenous group of others
While the MPs discussed older people in several different ways, the overlapping tendency was to talk about them as a homogenous group. In several speeches it was first stated that older people should not be treated as a homogenous group, but rather as people who, like ‘active folk’ or ‘the adult population’, have individual preferences concerning their own lives and care. However, it was also suggested that when older people cannot manage on their own ‘they need support from our service system’. These words placed older people outside the adult population, and designated them as a separate group of others.
Older people were often regarded as benefiting from health services or other health-promotion interventions in similar ways. In addition, and probably due to the content of the Bill, the MPs were fairly unanimous that all older people want to live at home. Home was considered to be ‘the best place to live’, and just ‘by offering the right and effective services old people are able to live at home as long as possible’. Furthermore, the needs and desires of all older people were presented as similar, and were reduced to things such as security, good food, contact with relatives and friends, physical activity, and hobbies that promote their health and wellbeing. Homogeneity was also constructed by talking about older people as a genderless and asexual mass of people.
Constructions of older people
We identified three main discourses about older people: ‘the dependent’, ‘the active’ and ‘the deserving’. All of these, however, included several nuances, which are presented below in more detail. Textual examples of each discourse are presented in Table 1.
Discourses and data extracts as examples
The dependent
The discussions focused largely on older people with needs for care, that is, with frailties, physical or cognitive problems, various ailments and other difficulties in their lives. The image of older people was fairly dramatic: e.g. they were described as ‘elderly people lying in their beds in wet nappies’, and as ‘the elderly that are transferred between different service providers’ or ‘cared for in an institution’. Older people were seen both explicitly and implicitly as dependent on others, and especially on services. There were four somewhat differing ways in which this dependency was constructed in the MPs' talk.
Firstly, older people were compared to children. This child-like form of dependency was constructed through talk in which MPs compared older people's situation in society to that of children, and welcomed the fact that finally ‘the old and helpless will be taken care of just as well as children are’. Older people were described as helpless and unable to take full responsibility for themselves.
Secondly, the dependency of older people was seen as the inevitable outcome of the process of ageing. This deterministic view of dependency was explicitly displayed in phrases such as ‘when problems occur’ and ‘when an elderly person is in need of care’. These were commonly used when the MPs were talking about older people's lifespan in general. Thus it was not a question of ‘if’ but of ‘when’ care is needed.
Thirdly, dependency on others was related to ‘a good life’ and ‘good ageing’. It was commonly said that it is ‘our responsibility to enable the elderly to have a good life’. It was stated that ‘the more active our older people are given the opportunity to be, the better their quality of life will become’. The implication in several instances of talk was that ‘despite their age, older people have to be given the opportunity to have influence over their own lives and the care they receive’. All in all it was implicitly stated that older people are not able to lead a ‘good life’ without help from their family, the service system or society in general.
Finally, while older people were seen in many ways as dependent on others, they were still regarded as autonomous persons. That is, they were seen as dependent but autonomous in regard to their own lives and the care they receive. This emerged in talk that stated that despite their need for care, older people should have ‘a right to have a say concerning the care they receive’. Thus, older people were not seen solely as passive objects of care: it was considered that older people should have autonomy, even though they were otherwise dependent on other people and the service system.
The active
Alongside and partly in contradiction with this dependency discourse, MPs often referred to the activity of older people. We identified three ways of talking about active older people.
Firstly, discourses of activity and dependency were somewhat overlapping. Older people were seen as active subjects in their care procedures and as active service users in general, which comes close to the talk about dependent but autonomous older people. However, in the activity discourse it was more specifically stated that people have to take an active role in their own care procedures. For example, it was said that an older person has a right to disagree with their care plan, and that their opinion is as important as that of the care staff. In addition, activity was sometimes constructed as conditional on the appropriate help of others. In this sense there was an overlap with the dependency discourse, in which older people were seen as dependent on others in order to have a good life.
Secondly, we identified phrases in which older people were considered as active and productive citizens. These statements constructed older people as valuable contributors to society, whether through informal care, voluntary work or otherwise active citizenship. Older people were referred to as ‘potential voters’, as ‘powerful players’ in society and as ‘the granddads and grannies that want to take care of themselves and are active citizens in our society’. In many instances of talk, older people were referred to as ‘grandparents that take care of their grandchildren’ and ‘a great resource for the voluntary sector’. There were also several statements concerning older people as informal carers that take care of their spouses.
Finally, there was something of an implication that active older people were exceptions from the mainstream. Such people were seen as active despite the odds, and were referred to as ‘the people that, despite their age, lead an active life’ or ‘people that, despite their age and care needs, must have a say on their care’. Furthermore, while older people were frequently constructed as active and committed citizens, such statements were presented as counter-arguments to the dependency discourse.
The deserving
MPs talked a lot about older people's right to receive services because they deserve them. This deservingness was presented in several ways. First, the implication in several instances was that because older people were the builders of today's society, and because they have raised their children and grandchildren and paid their taxes, it is ‘our duty to take care of them when they are in need of help’. In other words, it was seen that the effort and sacrifices that older people have made for society must somehow be compensated.
In some comments older people were seen as deserving care simply because they are old, with no requirement for any other qualifications. It was also stated, both explicitly and implicitly, that although older people are individuals with different preferences, they all still have important service needs. A few MPs suggested that all people at a certain age should be ‘called in for health checks’ because they are potentially in need of care, or at least of health-promotion interventions. On the other hand, older people were also seen as a group that ‘deserve the same rights as active folk’, despite their age. It was stated that ‘older people too must have a right to lead the kind of life they want’.
Discussion
Discourses are always positioned in a specific societal context, formulated about a specific topic and directed towards a specific audience with specific rules of speech (Jolanki Reference Jolanki2009). The context simultaneously both limits and enables the scope and ways of speaking. In this study, the data were drawn from a context in which politicians were talking about a long-awaited and desired Act, the rationale of which was to secure services for older people. Hence it is not surprising that the content of the discussion tended to construct older people as needy in relation to services. Even though representations of active and productive older people were common, they were used mostly for contrast with discourses of need and dependency, rather than as self-contained aspects of older age. That is, references to older people as active were not a normative way of speaking, unlike references to old people as dependent. Although the context frames the study in a certain way, it seems, however, that the discursive constructions of older people found in this study are also more universal in nature. The results are to a large extent in line with previous studies addressing the representations of older people in other contexts (Fealy et al. Reference Fealy, McNamara, Treacy and Lyons2012; Nilsson Reference Nilsson2008; Weicht Reference Weicht2013).
The most prominent discourse was that constructing older people as in need of care. This presented older people as either totally dependent or ‘dependent but autonomous’. Furthermore, it was taken for granted that everyone eventually reaches a phase of life at which the help of others, and especially of the formal service system, is needed. Some speakers understood this phase as beginning as early as retirement, while others saw it as more related to hospitalisation and the approach of death. All in all, older people were seen as both deterministically and homogenously dependent.
However, the ‘structured dependency’ said to be typical of both modern and post-modern society and to constitute passive citizens (Biggs Reference Biggs2001; Gilleard and Higgs Reference Gilleard and Higgs1998) was not on display in the MPs' talk: the notion of completely passive older people was to a large extent missing from the repertoire of discourses (Wiles and Jayasinha Reference Wiles and Jayasinha2013). Only the dependency discourse represented (to some extent) older people as objects of care – as people who are ‘taken care of’. However, this passivity was challenged by other discourses that described older people as subjects in their own care procedures, even though dependency on others was emphasised. Thus, structured dependency was undermined by ideas of older people as actively participating in their own care.
The image of older people as partners in their own care procedures can be linked to the increasing emphasis on consumerism in contemporary society (Gilleard and Higgs Reference Gilleard and Higgs1998). From this perspective, and also from that of previous studies (Anttonen and Häikiö Reference Anttonen and Häikiö2011; Häikiö, van Aerschot and Anttonen Reference Häikiö, van Aerschot and Anttonen2011; Rudman Reference Rudman2006), it is surprising that older people were not represented as consumers in the sense that they would be free to choose and pay for services on the market. In line with Gilleard and Higgs's (Reference Gilleard and Higgs1998) suggestion, the discourses of older people uncovered in this study tend towards the categorisation of older people as in the fourth age and as ‘powerless users’ of services, rather than placing them in the third age, when older people are considered ‘true consumers’ with real power to influence services.
At first glance the MPs' talk did not contain straightforward suggestions that older people are a burden on society. However, more in-depth analyses showed that the rationale, both implicit and explicit, behind the desire to keep older people active, self-sustaining and living at home was more or less economic. Active older people were said to be ‘assets for society’, but the underlying suggestion was that ‘as long as older people stay active they will live longer in their own homes, and thus stay out of expensive services’. Thus, for older people the activity discourse with its economic underpinning might contain a devastating message: in order to keep your dignity as a member of society, keep fit – otherwise you will become a burden.
Our results are partly in accordance with previous findings of the dichotomous construction of older people as either dependent or active (Biggs Reference Biggs2001; Wiles and Jayasinha Reference Wiles and Jayasinha2013). However, our results highlight the overlaps between these constructions. They also reveal that dependency is constructed as homogenous, while activity tends to be seen as a characteristic of the few. Some, though not all, older people are thus seen as homogenously individual. On the one hand, they are members of a homogenous group that shares particular characteristics, such as a certain level of dependency, certain desires, and the ability to benefit from services in a certain way. On the other hand, older people are seen as having individual needs and preferences concerning their own lives. Although our results break the dichotomous view of old people as either totally dependent and passive or extremely active, the picture of them still remains one-dimensional. There is an absence of recognition of the diversity among older people (Biggs Reference Biggs2001: 313). We found only one reference to older people with sexual needs, to differences between men and women, or to immigrants with special needs. However, because of the content of the Act, older people were referred to as spouses that should be enabled to continue to live with their partners if they are referred for institutional care.
The language used by policy makers creates social constructions of target populations, which in turn define the policies designed for those groups (Carney Reference Carney2010). That is, the planning of services is based on the social constructions made of older people (Weicht Reference Weicht2013). It is therefore worth considering what kind of service systems the representations of older people found in this study would promote. The considerations presented below are useful when planning the services in Finland but also elsewhere, as the nature of the discursive constructions found in this study seem to be more universal (compare Fealy et al. Reference Fealy, McNamara, Treacy and Lyons2012; Nilsson Reference Nilsson2008; Weicht Reference Weicht2013).
Firstly, it was implicit that services are intended for those older people who have earned them by contributing to society during their ‘active years’. This suggests that the value of old people arises from what they have achieved, not from who they are. They were referred to as parents, grandparents, voters, nation-builders, etc., not as ‘just’ humans with rights as such. Secondly, older people were seen as a relatively uniform ‘target population’ that should already be covered by the service system during the early stages of ageing. This group was regarded as having certain general characteristics that defined the services that should be provided and the way in which the older people themselves should benefit from them. Thirdly, despite the general understanding that older people have individual needs, these were still commonly elided in discussions. The needs and desires of older people were reduced to things such as living at home, security, good food, contact with relatives and friends, physical activity, and hobbies that promote their health and wellbeing.
For the planning of services, all of these approaches are problematic. The idea that services should somehow be earned can be interpreted as contravening the principles of universalism and equity that form the basis of most welfare states, especially in the Nordic countries: regardless of age, gender and place of residence, all residents should have an inherited right to sufficient services according to their needs. The discourse of ‘deservingness’ raises the question of older people who have not contributed to society in certain ways, such as by working, serving during the war or raising children. Deservingness is also problematic from the perspective of the appropriateness of services. If older people are seen as a group that deserves services just because they have been productive in their earlier life, we might end up providing services that are not actually appropriate to their needs. Furthermore, if older people's needs are reduced only to particular services, there is a danger that we will be stuck in a system that has been criticised already for producing only standardised sets of services, and that creates structured dependency. This would be in contradiction with current discussions of service tailoring and individual service planning (e.g. Tynkkynen et al. Reference Tynkkynen, Hakari, Koistinen, Lehto and Miettinen2012), which the Act discussed in this study – at least explicitly – is also said to represent.
