Life course

Access to social ties and health after retirement age: the issue of inequalities

June 30, 2021 10:45
June 30, 2021 12:15

Marie Baeriswyl and Michel Oris (Centre for the Interdisciplinary Study of Gerontology and Vulnerability, Swiss National Centre of Competences in Research LIVES, University of Geneva)


Barbara Masotti (Centre of Competence on Ageing, University of Applied Sciences and Arts of Southern Switzerland) and Michel Oris (CIGEV, IDESO, NCCR Lives, University of Geneva)

Valérie Hugentobler, Aline Veyre, Melissa Ischer, Ophélie Guerdat (Haute école de travail social et de la santé Lausanne (HETSL) HES-SO)

Charlotte Renda (Department of Sociology, Bielefeld University)

Iuna Dones, Ruxandra Oana Ciobanu & Marie Baeriswyl (Institute of Demography and Socioeconomics, University of Geneva; Centre for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva; Swiss National Centre of Competences in Research LIVES)

The COVID pandemic has led to contradictory social expectations about older adults (in particular people aged 65 and over). Indeed, in the past decades, the encouragement of an active aging as an important component of individual and collective well-being has become crucial in scientific and political discourses on aging, promoting a positive image of older age. However, not only the health crisis has suddenly limited the social participation of older adults, but the crisis has also made from their vulnerability a central issue: their frailty was (and remain) at the heart of the strategies dealing with the pandemic and was made highly visible in the media. At the individual level, this situation revealed a heterogenous population. Two extremes characterize this diversity: on the one side, there are older adults being in excellent health, who during the pandemic were in fear that they could not participate in social life anymore and expressed openly their disagreement with the stigma of their age group as vulnerable population; on the other side, other older adults experienced the pandemic in fear of the disease, accepting the imposed social isolation whether they liked it or not.

Retired people have been affected to a lesser extent by the economic vulnerabilities linked to health crisis. However, the issue of inequalities is still crucial in this population, between the variety of realities they live. Indeed, social participation and relationships, as well as health and care, are significant resources during the life course that are not equally distributed in terms of socioeconomic position, gender, age or ethnicity. The risks of isolation, disease or lack of access to care do not affect all social categories in the same way.

This session aims to discuss the living conditions after retirement age addressing in particular the issue of the inequalities of access to health, formal and informal care, social participation or relationships. Contributions that address the complex links between health and social integration in the perspective of inequalities are particularly welcome, likewise contributions addressing the intersectionality of the various forms of social stratification (gender, age, ethnicity, socioeconomic position). By this, we want to gain insight into the heterogeneity characterizing the population of older adults and the possible unequal mechanisms that shape this diversity. We also want to question processes of accumulated disadvantages across the life course that can lead to highly vulnerable and precarious situations in older age.

Keywords: Older adults, Health, Social relationships, Inequalities, Life course

Care-receiving trajectories during old age. A follow up study of the use and non-use of formal homecare

Barbara Masotti (Centre of Competence on Ageing, University of Applied Sciences and Arts of Southern Switzerland) and Michel Oris (CIGEV, IDESO, NCCR Lives, University of Geneva)

This communication analyses the use and non-use of formal care among older adults living at home in Switzerland. More specifically, we study care-receiving trajectories by considering the many types of existing professional services. Their access, together with the support of the informal network (family, friends and neighbors), allow people to stay at home as much as possible when with age, frailty becomes an issue. However, only few studies focus on the evolution of home care receipt among older adults, on trajectories. Cross-sectional studies are still predominant, while longitudinal ones use specific research designs, and often start from different definitions of home care. Most of them look at the interplay between non-use, use of formal care, use of informal care, or use of both (formal and informal care) (Bravell et al., 2008; Geerlings et al., 2005; Geerts & Van den Bosch, 2012; Kjær & Siren, 2019; Steinbeisser et al., 2018).

Our study is based on a sample of 629 community-dwelling people aged 65 and over having participated to a cohort survey, “Vivre Leben Vivere” (Oris et al., 2016), during a 6-year timeframe. In 2011/2012 and in 2016 participants self-reported their use of professional services such as basic and personal care, household assistance as well as services like meals-on-wheels and transportation. This data is analyzed firstly to identify and describe home care use trajectories (i.e. stable non-users, new users, former users and stable users). We then aim at identify factors predicting the arrival of home-care during this timeframe (the new users case) by using Andersen’s Behavioural Model of Health Services Use (Andersen, 1968). This model considers need factors (functional impairment, health events), predisposing factors (sex, age, education, age) and enabling factors (income, social network, type of care regime in place). We also study the interruption of care (the former users case).

Analyses take into account the various types of help (care, domestic help, others services) and focus on the social inequalities in home care access. 

Keywords: Home care utilization, Older adults, Longitudinal analysis, Trajectories  

Andersen, R. M. (1968). A Behavioral Model of Families’ Use of Health Services. Center  for Health Administration Studies, University of Chicago.

Bravell, M. E., Berg, S., & Malmberg, B. (2008). Health, functional capacity, formal care, and survival in the oldest old: A longitudinal study. Archives of Gerontology and Geriatrics, 46(1), 1–14.

Geerlings, S. W., Margriet Pot, A., Twisk, J. W. R., & Deeg, D. J. H. (2005). Predicting transitions in the use of informal and professional care by older adults. Ageing and Society, 25(1), 111–130.

Geerts, J., & Van den Bosch, K. (2012). Transitions in formal and informal care utilisation amongst older Europeans: The impact of national contexts. European Journal of Ageing, 9(1), 27–37.

Kjær, A. A., & Siren, A. (2019). Formal and informal care: Trajectories of home care use among Danish older adults. Ageing & Society, 1–24.

Oris, M., Guichard, E., Nicolet, M., Rainer, G., Tholomier, A., Monnot, C., Fagot, D., & Joye, D. (2016). Representation of vulnerability and the elderly. A Total Survey Error perspective on the VLV survey. In M. Oris, C. Joye, & M. Ernst-Stähli (A c. Di), Surveying Human Vulnerabilities across the Life Course,. Springer.

Steinbeisser, K., Grill, E., Holle, R., Peters, A., & Seidl, H. (2018). Determinants for utilization and transitions of long-term care in adults 65+ in Germany: Results from the longitudinal KORA-Age study. BMC Geriatrics, 18(1), 172.

Le balisage des parcours de retraite des personnes en situation de handicap

Valérie Hugentobler, Aline Veyre, Melissa Ischer, Ophélie Guerdat (Haute école de travail social et de la santé Lausanne (HETSL) HES-SO)

Dans le cadre de cette contribution, nous nous proposons d’aborder le phénomène de vieillissement des personnes vivant, à l’âge adulte, dans des institutions socio ou médico- éducatives. Depuis une trentaine d’années, on constate une importante augmentation de l’espérance de vie de cette population. Cet allongement soulève de nombreuses questions notamment en ce qui concerne les prestations offertes, l’organisation des dispositifs ou encore les modalités d’accompagnement. La littérature nationale et internationale montre que les parcours individuels des personnes en situation de handicap sont fortement balisés, tout au long de la vie, par les dispositifs institutionnels et par les politiques sociales. L’ensemble de ces éléments est susceptible de générer ou d’accroitre les inégalités en termes de ressources, d’accès aux prestations et impacte la participation sociale des personnes concernées. Si certaines politiques cantonales et institutionnelles sont élaborées spécifiquement pour réfléchir l’accompagnement des personnes en situation de handicap vieillissantes, de fortes disparités existent, avec d’importantes inégalités concernant, par exemple, le choix du lieu de vie, le type d’accompagnement professionnel et socio-sanitaire, la possibilité de maintenir et de développer des liens sociaux ou encore de participer à des activités adaptées et qui font sens pour les personnes concernées. Le « passage à la retraite » – qu’il s’agira encore de définir pour un sous-groupe particulier de personnes vieillissantes – et la manière dont il est cadré par les politiques sociales et les pratiques institutionnelles, est susceptible de provoquer des ruptures, des bifurcations dans les parcours de vieillissement, ou au contraire de favoriser des formes de continuité. 

Les premiers résultats d’une recherche actuellement en cours seront présentés. Un des objectifs de l’étude vise à mettre en évidence l’impact des politiques sociales sur les conditions de vie de certains groupes sociaux. Plus spécifiquement, il sera question de traiter du lien entre les dimensions individuelles et structurelles des problèmes. Les questions suivantes seront abordées : comment l’accompagnement de cette population spécifique est-il pensé par les politiques publiques? Comment ces réponses structurent-elles le(s) parcours de vieillissement(s) des individus ? Afin d’y répondre, une analyse documentaire des bases légales et les lignes directrices établies dans six cantons romands (Fribourg, Genève, Jura, Neuchâtel, Vaud et Valais) sera réalisée, ainsi que des entretiens semi-directifs avec les responsables cantonaux en charge des questions liées à l’accompagnement et l’hébergement des personnes en situation de handicap. 

L’analyse s’ancrera dans une perspective intersectionnelle afin de mettre en évidence la manière dont les logiques de l’âgisme s’ajoutent à celles du capacitisme et viennent ainsi conditionner et structurer le parcours de vie des personnes en situation de handicap vieillissantes. L’accent sera mis sur l’impact des politiques publiques et sur la philosophie qui sous-tend les dispositifs déployés; comment les moyens alloués aux institutions sociales en charge de cet accompagnement varient et si ces variations ont une incidence sur les pratiques professionnelles, sur la définition des concepts d’accompagnement élaborés et, par conséquent, sur les conditions de vie et les opportunités des résident·e·s.

Keywords:  vieillissement, handicap, retraite, accompagnement, capacitisme 

Sacrificing Futures, Sacrificing Lives – Generation Differentiation and Social Integration in the Corona Pandemic

Charlotte Renda (Department of Sociology, Bielefeld University)

One eye-catching aspect of the Corona-Pandemic is that age is a risk and the number of deaths among those infected rises tremendously regarding those above the age of 80. This notion brought with it new kinds of asymmetries and challenges for social integration. The construction of what might be referred to as a Corona-specific conflict of generations is an example of what Hirschauer called „Pandemic Human Categorization/Differentiation“ (Pandemische Humandifferenzierung). At the centre of the idea of “Pandemic Human Categorization” lies the question of how social categories are constructed and homogenized or pluralised, how boundaries are drawn and communities built, how they are brought into opposition to each other or put side by side. During the first lockdown in Germany, Italy, and other European Countries a discourse started that weighed up protection of the old against the strain inflicted upon the life of the young, claiming that to sacrifice the (tendentially) few years still to come in the life of the old is but little compared to the chances missed by the young people now and the resulting impairment of their future development. As Wolfgang Schäuble, President of the German Bundestag, said: In a way, the young are at greater risk, because for the old the natural end of life is rather near anyway. The mere protection of life should not be the ultimate goal that outweighs all. 

In the meanwhile, the discourse has shifted to questions of solidarity: sacrifices we all have to make for each other and the most vulnerable among us. In what way do the ideas of sacrifice (and the ensuing inequalities for some), of vulnerability and protection re-arrange social categories, and to what societal consequence? How does the construction of futures and chances intersect with categories of age? 

I argue that in the Corona pandemic, “future” becomes to mean something very different in regard to the old and the young. Longevity on the one hand side and exploration of possibilities, development, movement on the other which also implies that seclusion is a valid way of protection for one group and a hinderance and source of structural inequality for the other. All the processes of (intersecting, dissolving and evolving) categorizations carry with them implications for power relations and have consequence for (political) considerations on which inequalities carry weight, what people decide to “do” with the virus and who the blame shifts to. The aim of the paper is to reconstruct how a generational divide and/or social integration across generations are discursively brought into being and shaped.

Keywords: Generational conflict, Social categorization processes, Discourse, Construction of futures  

(Im)mobilities and life satisfaction in times of COVID-19: The case of older persons in Switzerland

Iuna Dones, Ruxandra Oana Ciobanu & Marie Baeriswyl (Institute of Demography and Socioeconomics, University of Geneva; Centre for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva; Swiss National Centre of Competences in Research LIVES)

The COVID-19 pandemic and the confinement associated to it have reduced physical mobility and have led to changes in everyday forms of alternative mobilities throughout the world. Physical movement and social contact have been shown to be correlated to subjective well-being and life satisfaction. In this paper we are interested in knowing how, during a sanitary crisis that engendered restricted physical mobilities and social contact, alternative types of mobilities relate to life satisfaction. To do so, we build on the new mobilities paradigm to operationalize imaginative, communicative and virtual mobilities as phone and digital communication, looking at photos and out of the window, and visiting museums and travel destinations through the use of the Internet. We hypothesize that frequent engagement in communicative, imaginative, and virtual mobility practices correlates to higher levels of life satisfaction. The paper draws on an original survey on the impact of the COVID-19 pandemic on the situation of persons aged 65 and over in Switzerland. The survey was conducted online and 787 respondents participated between April 18 and May 19, in part corresponding to the period of partial confinement in Switzerland, which recommended limited mobility. Results show that frequent engagement in communicative mobilities are related to higher life satisfaction, while imaginative mobilities only partially relate to life satisfaction, and virtual mobilities have no correlation to life satisfaction.

Keywords: COVID-19; older persons; life satisfaction; subjective well-being; virtual mobilities; imaginative mobilities; communicative mobilities