Paper short abstract:

Care workers in Japan, already facing poor conditions, burnout, and high turnover, will be experiencing huge shortages in the coming years. This paper examines the lives of precarious workers, most vulnerable to fatigue and other kinds of invisible suffering, who are shaping Japan's eldercare.

Paper long abstract:

By 2025, the worker shortage in Japan's eldercare services will top 300K. Care services proliferate, but worker shortages and rationalized administrative technologies aimed at organising the flow of older bodies through these services result in a simultaneous withering of the moral and affective force of care as a guiding principle. Precarious employment of care workers generates a logic of everyday, small acts of neglect or abuse, foreclosing on a carer's capacity to pay attention to the other's suffering. At the same time, the carer's job demands a careful accounting of bodies and vital signs, an affective labor of tenderness. Using interviews and observations in formal care settings, I show how Japanese carers tread a fine line between violence and vulnerability, acting as both agents of an uncaring system and as heartfelt companions to older people. They are often highly conscious of, even haunted by the emotional demands on this work, using idioms like "solitary confinement," "kidnapping," and "hostage," which implicate their own moral failings in delivering care. They also stake out other kinds of moral claims based on feelings of intimacy with the cared for when many families appear unwilling or unable to care. I examine how the subjectivity of care workers in Japan can shed light on the consequences of poor carer support in a rapidly ageing world.

Paper short abstract:

This paper problematizes the notion of ageing and dying ‘at home’. It will offer ethnographic examples from the UK and shows some of the challenges that older people living alone face. Older people’s perspectives are often not incorporated in policy yet are essential in creating more adequate practices.

Paper long abstract:

In the UK the home is often conceptualized as the most preferred place of death(Gomes et al. 2013) with little understanding of the actual implications of older people ageing and dying at home. Neither is there sufficient understanding of what 'home' means to people in later life. Dying at home has been theorised as being part of a 'good death' (Seale & van der Geest 2004) whereas dying alone is considered a 'bad death'(Seale 2004).

This paper will problematize the current emphasis on ageing and dying 'at home'. As the majority of older people are living alone in their own dwellings this poses real questions to what extent older people feel 'at home' in these places in present time, and how they anticipate their future within these dwellings. Furthermore it poses questions on the types of care and social contact that is available for older people ageing in place.

This paper will draw on ongoing ethnographic fieldwork conducted in the South West of England amongst older people living alone. Older people's perspectives on ageing and dying in their own dwellings or on 'ageing in place' are often not incorporated in policy yet are essential in creating more adequate end-of-life care practices.

Paper short abstract:

Care arrangements between grandparents and grandchildren in northwest Tanzania alter over time as grandchildren come of age and grandparents slowly age into advanced old age. The difficulty of reconciling the needs of young adults with care for frail grandparents, contributes to the precarity of old age care.

Paper long abstract:

In Northwest Tanzania grandparents have been raising orphaned grandchildren for the past three decades. Whereas growing up with grandchildren is normal in Kagera region, the relations between grandparents and grandchildren have been subtly reshaped by the AIDS epidemic. As yet unexplored is how practices of (grand)parenting alter over time, in different life phases of the grandchild and of the ageing grandparent. What is expected in terms of relational care of both grandparents and grandchildren changes as young children age into adolescents and young adults).In this paper I focus on the generation of orphaned grandchildren that came to live with their grandparents before the introduction of antiretroviral therapy (ART) in 2004 and came of age in recent years. Now in their late teens and early twenties they are confronted with their elderly grandparents needing physical care and attendance. In advanced old age, grandparents expect their young adult grandchildren to provide old age care, replacing their lost children. Although intimacy and affection are very strong between grandparents and grandchildren it is difficult to reconcile young adult's need to start a life with care for frail grandparents. Using cases of grandparents and grandchildren that I have been following since 2002, I show how both elderly grandparents and their young adult grandchildren navigate the rapidly changing landscape of care in northwest Tanzania, a landscape that not only changed due to HIV/AIDS and ART but also due to the introduction of a social pension system in 2004.

Paper short abstract:

Becoming old and diabetic in Tanzania means a chronification of progressive insecurity and an entangled control and management of cure and (self-)care on household and community level. ‘Kinning’ social relations – including diabetes-induced biosociality – become increasingly meaningful.

Paper long abstract:

Rapid demographic and epidemiological transition in Tanzania leads to two major dynamics: a substantial ageing of the Tanzanian society, and a considerable increase of non-communicable diseases (NCDs). This paper examines cases of elderly people in coastal Tanzania who grow old with diabetes in rural and urban environments. 'Becoming old and diabetic' is not only about intricate therapeutic itineraries and promising resorts of curative hope, but also about newly emerging flows of diabetes knowledge, control and management. They constitute a 'diabetic mapping' of health and illness, which is intrinsically centered on the household and its members. Sophisticated technologies such as insulin injections and glucose inhibiting medication, professional biomedical knowledge, for instance, about metabolic disorders through health education in a diabetes clinic, tight control (e.g. daily tests of blood sugar level), trendy global concepts of 'active ageing'/'healthy ageing' referring to a substantial, self-responsible change of lifestyle (e.g. doing physical exercise, going on a diet), and changes in care arrangement (for example leading to new 'carescapes' including kin/non-kin caregivers, health professionals, lay advisers, mobile phone assistance, medication-based selfcare) meet the older Tanzanian diabetics' risks of physical disability, economic hardship, social marginalization, and emotional despair. To provide answers for the overall question 'How does an elderly person deal with diabetes and its care in coastal Tanzania?' we focus on households with older diabetics, which represent a place where a progressive chronic illness, an ageing body and mind, different social dimensions, and these new flows converge - and where major care is provided.