PowellJasonL 2017 WhatIsAging RethinkingAgingFoucau

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May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law.
Chapter 1
INTRODUCTION – WHAT IS AGING?
Health, care and welfare have emerged as key vehicles used to legitimise
and position the identities that older people adopt in contemporary modernity.
Both contain continually changing technologies that function to mediate
relations between older people and the State. Medico-technical, victimisation
policies and care management discourses have been presented as adding
choice and reducing limitations associated with adult aging.
However, they also represent an increase in professional control that can
be exerted on lifestyles in older age and thus, the wider social meanings
associated with that part of the life-course. The books presents a theoretical
analysis based on a critical reading of the work of Michel Foucault. It
identifies the inter-relationship between managers and older people in terms of
power, surveillance and normalization. The book highlights how and why
older people are the subjects of legitimising professional gazes through the
dark side of modernity: being managed, being victims, being abused and
Copyright @ 2017. Nova Science Publishers, Inc.
existential questions of death. Before we interrogate this, we need to explore

the concept of aging.
WHAT IS AGING?
Ageing can be defined as bio-medical (biological, psychological)
and social (chronology, historical, cultural, legal, social and populational
definition). If we take the latter definition that impinges on trends of ‘ageing
populations’ there is no doubt that in many societies around the world older
people are a growing proportion of the global population. For example:
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 The US Census 2004 showed that 35 million US citizens were aged at

least 65;
 By 2030, 1 in 5 Americans will be 65 years or over;
 Worldwide, there were 131 million in that category in 1951 – but 420
million by 2000;
 Italy and Japan have the highest percentage of older people, with 28%
forecast;
 1 in 10 Japanese will be 85 or over by 2030;
 Powell (2006) argues that the demographic situation in the UK for the
population aged 65 and over is set to increase steadily (by one fifth
overall) between 1983 and 2021. However the largest rises are due to
the numbers aged 75 and over and 85 and over: 30 per cent and 98 per
cent respectively. By the end of this period women will outnumber
men in the 85 and over age group by around ‘2.5 to 1’;
 Despite such success in First World countries, it is developing
countries that have the highest rates of growth, for instance Singapore,
Malaysia, Colombia and Costa Rica will see elderly numbers triple.
The United Nations estimates that by the year 2025, the global population
of those over 60 years will double, from 542 million in 1995 to around 1.2
billion people, as Figure 1 shows (Krug, 2002:125).
Figure 1
1400
1200
1000
800
600
400
200
0
Males Females Total
1995 2025
Figure 1. Global population of those over 60 years over time.
All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law. Introduction – What Is Aging? 3
How has ageing been theorised alongside the various definitions

given above?
‘Gerontology’ is a broad discipline which encompasses psychological,
biological and social analyses of ageing (Longino and Powell, 2004). Since
the beginning of the twentieth century, the ‘bio-medical’ study of ageing
consisting of biological and psychological explanatory frameworks has
dominated the disciplinary development of gerontology. There are important
implications here for how ageing is viewed not just by bio-medical models of
ageing but for how society and the arrangement of political and economic
structures that create and sanction social policies grounded in such knowledge
bases (cf. Powell, 2001).
Such knowledge bases are focused on: one, ‘biological ageing’ which
refers to the internal and external physiological changes that take place
in the individual body; two, ‘psychological ageing’ is understood as the
developmental changes in mental functioning – emotional and cognitive
capacities. Bio-medical theories of ageing can be distinguished from social
construction of ageing: one, focusing on the bio-psychological constituent of
ageing; two, on how ageing has been socially constructed. One perspective is
driven from ‘within’ and privileges the expression from inner to outer worlds.
The other is much more concerned with the power of external structures that
shape individuality. In essence, this social constructionism poses the problem
from the perspective of an observer looking in, whilst bio-medical model takes
the stance of inside the individual looking out (Biggs, 1999).
Estes and Binney (1989) have used the expression ‘biomedicalization of
ageing’ which has two closely related narratives: one, the social construction
of ageing as a medical problem; two, ageist practices and policies growing out
of thinking of ageing as a medical problem. They suggest:
‘Equating old age with illness has encouraged society to think about
aging as pathological or abnormal. The undesirability of conditions labelled
as sickness or illness transfer to those who have these conditions, shaping the
attitudes of the persons themselves and those of others towards them. Sick
role expectations may result in such behaviors as social withdrawal, reduction
in activity, increased dependency and the loss of effectiveness and personal
control – all of which may result in the social control of the elderly through
medical definition, management and treatment.’ (Estes and Binney, 1989,
588)
Estes and Binney (1989) highlight how individual lives and physical and
mental capacities which were thought to be determined solely by biological
All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law. 4 Jason L. Powell
and psychological factors, are, in fact, heavily influenced by social

environments in which people live – yet bio-medicine is a powerful domain.
Bio-medical gerontology is a fundamental domain where medical
discourses on aging have become located and this is very powerful in
articulating ‘truths’ about aging (Estes and Binney, 1989). Similarly,
biomedical models of ageing have also been prone to what Harry R. Moody
(1998) refers to as an “amalgam of advocacy and science” in a neo-liberal
attempt to position individualized perceptions of ageing. Under the guise of
science and its perceived tenets of value-freedom, objectivity and precision
(Biggs, 1993), bio-medical gerontology has a cloth of legitimacy. However,
Powell and Phillipson (2004) ask a fundamental question: how has bio-
medical gerontology not only stabilized itself with a positivist discourse that
not reflects history but also the total preoccupation of science and the
‘problems’ of ageing?
The bio-medical model represents the contested terrain of decisions
reflecting both normative claims and technological possibilities. Bio-medicine
refers to medical techniques that privilege a biological and psychological
understanding of the human condition and rely upon ‘scientific assumptions’
that position attitudes to ageing in society for their existence and practice
(Powell and Biggs, 2000). As Arthur Frank (1991, 6) notes, the bio-medical
model occupies a privileged position in contemporary culture and society:
‘Bio-Medicine [occupies] a paramount place among those institutions

and practices by which the body is conceptualized, represented and
responded to. At present our capacity to experience the body directly, or
theorize it indirectly, is inextricably medicalized not sociologized.’
So scientific medicine is based on the biological and psychological

sciences. Some doctrines of the biomedical model more closely reflect the
basic sciences while others refer to the primary concern of medicine, namely
diseases located in the human body. Most important is that these beliefs hold
together, thereby reinforcing one another and forming a coherent orientation
toward the mind and body. Indeed, the mind-body dualism had become the
location of regimen and control for emergence of scientific in positivist
methodological search for objective ‘truth’ (Longino and Powell, 2004). The
end product of this process in western society is the “bio-medical model”. In
this sense, bio-medicine is based on the biological and psychological sciences.
Some doctrines of the biomedical model more closely reflect the basic
sciences while others refer to the primary concern of medicine, namely

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INTRODUCTION – WHAT IS AGING?

existential questions of death. Before we interrogate this, we need to explore

 The US Census 2004 showed that 35 million US citizens were aged at

Figure 1. Global population of those over 60 years over time.

How has ageing been theorised alongside the various definitions

and psychological factors, are, in fact, heavily influenced by social

‘Bio-Medicine [occupies] a paramount place among those institutions

So scientific medicine is based on the biological and psychological

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