Ageing in Singapore

Service needs and the state

Peggy Teo, Kalyani Mehta, Leng Leng Thang, Angelique Chan

• Publisher: Routledge
• Year: 2006
• ISBN:
  9781134188543
• Edition: 1
• Topic: Política y relaciones internacionales
• Subtopic: Política

Older persons are often portrayed as social and financial burdens because pensions, health and social care have to withstand increasing old age dependency ratios. Due to a lack of access to representation or a lack of social and economic power, older people have found few opportunities to have their voices heard, making age an immensely political issue.

Written by an impressive team of authors, thisbook provides an in-depth analysis of the experience of ageing in Singapore examining key issues such as health, work, housing, family ties and care giving. It looks at how social categorization enters into everyday life to elucidate the multiple meanings of age and identity encountered in a rapidly changing economy and society.

Providing original critical discourse from Asian writers recording Asian voices, Ageing in Singapore will appeal to a wide readership and is an invaluable resource for policy makers, service practitioners and scholars working on Asian gerontology.

1 Introduction

Two decades ago, James Birren made a point that the study of ageing is ‘data rich but theory poor’ (Birren and Bengston 1988: ix). Twenty years on, many social gerontologists would agree that this research endeavour has seen changes for the better, but the restlessness continues. Rather than a problem, this characterization may be viewed as a healthy sign. The meaning and place of ageing in contemporary society, how much such meanings have influenced social policy and vice versa are best understood as evolving processes that vary by time and place. Understanding the contexts of these meanings for different groups and cohorts of older populations will make us more perceptive of their needs and will help to forward knowledge and outcomes to do with the demographic reality of ageing already happening in many parts of the world.

This book is thus an attempt to critically engage the experience of ageing in Singapore at a time when its population is growing old at an average rate of 3.6 per cent per annum (Ang and Lee 2000).¹ It argues that while biomedical understandings of physical ageing have always been (and continue to be) important to how policies to cope with older people are formulated, using social constructions of ageing offers valuable alternative insights that can be helpful (Estes et al. 2003; Laws 1995a; Phillipson 1998). By emphasizing the socially constructed features of the ageing experience – how social categories and forms of age enter into everyday life and how these are managed by various social groups – the ‘what’ and ‘why’ of contemporary ageing can be better understood. The focus will thus be on how the multiple meanings of age and identity exert an influence on (and are affected by) the politics of ageing; in fact, we even argue that ageing is as much, and even more, a political experience as it is a physical one.

Social constructs in revealing themselves as products of struggles in the unequal distribution of societal resources imply that there will be consequences for all social groups, no less older persons. Despite the fact that the state exerts such a strong influence on many aspects of life in Singapore, social constructions of groups have rarely been applied to understand how they are affected and how they negotiate the complex terrain of moral, legalistic and other restrictions to improve their respective quality of life. Besides this application of a more critical analysis of social gerontology in Singapore, we are also mindful that a great deal of research originates from the Anglo-American West. Asian ageing practices, for example, from Japan and South Korea in which adult children are expected to provide care for older persons, have been disregarded by Western-centric literature as impractical and irrelevant on the basis that Confucianism bears little cultural proximity; moreover, their own experiences tend toward global ageing trends (Liu and Kendig 2000; for an exception, see Doling et al. 2005). Of late, this Western orientation has been questioned as countries find that welfare entitlement as the basis of care policy for older persons in many parts of Europe is too costly and has been found not to meet the emotional needs of older persons. In addition, we also take into consideration Sibley’s (1998: 120) counsel that ‘research on inclusion/exclusion [needs to show] … an appreciation of other world-views’. In highlighting how older persons are marginalized in the Singapore situation, we acknowledge the importance of place-bound contextualizations in social constructions. The roles that older persons play in Singapore’s economy and in the family unit are different from the experience of the West and will help to illustrate another way in which inclusion/exclusion may be interpreted for this part of the world. In addition, having gone through rapid change in values and in the functioning of economy and society, Singapore’s care provision experience is analytically interesting as the country is receptive to models emanating from outside as much as it attempts to exemplify best practices derived from within. Both the welfare state of the UK and the market economy approach of care characteristic of the US have been explored by Singapore policy makers. This book illustrates some of the lessons we have learnt.

Critical perspectives on ageing

Since the 1980s, critical gerontology has undertaken to reconceptualize itself in order to be more effective in ‘decid[ing] on the questions it will ask, let alone answer’ (Gullette 2004: 105). It was generally felt that traditional gerontological theories and perspectives failed to address a ‘crisis in social ageing’ (Phillipson 1998: 1). By this, Phillipson meant the rapid changes in the way production was carried out (becoming more trans-border in configuration than before) and subsequently, issues to do with related topics such as employment, retirement, problems over pensions and the funding of older people’s needs. In addition, an overall increase in awareness of such issues in Europe, North America and elsewhere fuelled imminent concern as the debates and discussions proliferated. Rapid globalization (Giddens 1990; Held et al. 2000) had compressed time and space and revolutionalized the manner in which capital accumulation would be achieved. The new world order supported by capitalist industrialization had and continues to have significant implications for older people. In the first instance, it valorizes the young as productive while fundamentally weakening the value of accumulated life experience as a marker of social status (Laws 1995a). In addition, consumption in the globalized context is characterized by complexity and differentiation wherein many markets catering to a diverse range of lifestyles and practices exist side-by-side with ‘unproductive’ old age (Featherstone and Wernick 1995). Without oversimplifying youth and old age (as with other binaries such as male and female or black and white), globalization put on the map not one but plural forms of identity amongst older people, leading to analyses where criss-crosses are made between age and gender, ethnicity, nationality and able-ness.

Taken together, these shifts serve to recast the discussions on ageing. Disengagement theory, activity theory, modernization theory and the exchange theory of ageing were the first generation of ageing theories to be discarded because empirical findings were ‘simply not sufficient to support [their] claims’ (Bengston et al. 1997: S76). Amongst these traditional theories, disengagement was the most popular. As older people ‘adjusted’ their ‘activities’ for ‘life satisfaction’, it came across that such acts were almost ‘organic/natural’. A key argument of disengagement theory is the withdrawal of older persons because ‘ego energy’ declines with age (Phillipson 1998: 16). Individuals become more self-preoccupied and less and less responsive to the environment around. As a theory that provided a social dimension to ageing, it stimulated complementary or alternative theories such as modernization, exchange, age stratification and life course theories (for a fuller discussion, refer to Bengston and Schaie 1999; Estes and Associates 2001). For their critiques, however, this type of research only served to create more intolerance and repression of older persons because they helped to legitimate older persons as redundant and a burden to society.

As the social problems and conditions faced by older people came to the forefront, one of the radical research approaches which took root in Western discourse was the Marxist-influenced political economy school (Estes 1979). Political economists pointed out that right-wing sympathizers were responsible for attacking the allocation of funds to older people, significantly changing perceptions of this group as having a rightful place in society. As Walker (1981) and Laws (1995a) argued, citizenship rights came to be linked to productivity and performance which were in turn linked to the biomedical model of ageing. With age comes disease and ill health that will be financially problematic, not to mention the strain on caregivers. Radical political economists argued that ageing is viewed as a socially constructed status and that dependency is the ‘consequence of the forced exclusion of older people from work [such that] the experience of poverty, institutionalization, and restricted domestic and community roles’ are socially divisive creations meant to isolate older people from mainstream society (Townsend 1981 cited in Phillipson 1998: 18). The state as a strong supporter of capitalism is intrinsically involved in these negative associations as it is responsible for the allocation of funds and the mediation of various social groups within a political border.

Where there are foreboding structures such as state and society, political economy tends to assume that older persons passively accept their lot. This, argues Giddens (1984) and Thrift (1983), is overly-deterministic which is a major criticism against the political economy school. In relating to each other within society, recent research (e.g. Leonard and Nichols 1994; Teo and Mehta 2001) shows that people do construct and navigate their life paths in an active manner. As such, we can conceive of individuals as agents capable of acting with information and discernment, even within constrained social structures. In short, agency credits players with abilities to negotiate their positions relative to each other and in response to structural conditions.

The radical approach in social gerontology also yielded another thoughtprovoking and fruitful research direction – the work of feminists. Besides the operation of the labour market in discriminating against women, gender constructions also play a role in the ‘double jeopardy’ of older women (Arber and Ginn 1995). As Barbara Macdonald reflects in her book Look Me in the Eye: Old Women, Aging and Ageism (Macdonald and Rich 1984), society perceives her not just as a woman but an old woman. Feminists point out that besides workplaces and home, gender inequalities are pervasive in many other aspects of life, e.g. leisure (Pritchard and Morgan 2000; Teo 1997a; Wearing and Wearing 1996). Gender-sensitive gerontological research declares that ‘gender is not a property of individuals but a socially prescribed relationship, a process, and a social construction’ (Hare-Mustin and Marecek 2001: 101). Masculine and feminine ways of being in the world and relating to others are socially conditioned (Arber and Ginn 1995; Calasanti 1999; Moen 2001), imbricated with socially constructed power relationships, many of which are institutionalized. This inequality of power relations weaves into the very fabric of all social networks, generational as well as intergenerational ones, such that there is a need to discuss openly its consequences for older women.

From the gerontological research conducted up to the 1980s, one shortcoming that is apparent is the attentiveness paid to scales of analysis. The political economy approach would, for instance, be considered macro-scale while exchange theory would be micro-scale and disengagement theory straddles micro–macro (Bengston et al. 1997). While this concern has been useful, pigeon-holing analytic methods short-circuits research because academics become side-tracked into essentialist/purist paths that do not concur with the real world situation. The ageing experience occurs relationally across all scales – it is a micro-level individual experience that is also mediated by social others as well as ‘structures’. The nexus of the three scales was thought to reside in the subjective analysis of ageing: Moody’s (1988) work was classically ‘biographical’, emphasizing ageing as an existential experience and employing the humanistic approach to study the subjective. The turnaround to the subjective came about because of disillusionment with the quantitative revolution. Positivist research that had anchored much of social gerontology was due for a counterbalance in ways of thinking and this came in the form of the reinsertion of the subjective. This augurs well for critical social gerontology because qualitative research helps give voice to individuals (Gubrium 1993) and empowers the older individual to do ‘ordinary’ theorizing (Gubrium and Wallace 1990: 147).² Their narratives of ageing have much to offer because they are both relational and reflexive at the same time – we learn about how individuals experience old age in addition to how ageing is constructed.

Qualitative work also opened other doors, namely cultural gerontology. As part of post-structuralism discourse, the cultural turn stated that although contextual factors continue to be the main limiting factor to behaviour, structures are not only economic in nature (as Marx would have it). Culture and social power are the other structures that play important roles as well. Since places are indeed different and diverse, a grand theory like structuralism which uses only capitalism as an explanatory tool is limiting. Post-structuralists include Foucault (1991) and Soja (1988) who argue that power is everywhere. They view power as a relationship rather than an entity and emphasize that one’s place/position within a network of relations is fluid, forming a ‘complex strategical situation’ consisting of ‘multiple and mobile fields of force relations’ that are never completely stable (Foucault 1978: 93–102; emphasis added). This constructionist viewpoint is persuasive as it is neither meta nor reductionist in temperament. More important is its appreciation of the recursive relationship between culture, structure and agency which moves it away from the unidirectional causality implied in economics as the ‘base-superstructure’ propounded by political economists (Estes et al. 2003: 21). Variously known as moral economy, the emphasis is on:

cultural practices and their relation to power. Its constant goal is to expose power relations and examine how these relationships influence and shape cultural practices; [it seeks] to analyse the social and political context within which (culture) manifests itself … and is committed to … a radical line of political action.

(Sardar and Van Loon 1997: 8–9)

According to Phillipson (1998), subjectivity may be good but it can also be so open-ended that it will never have any of the intended outcomes suggested above. While there is a need not to reify structures of social domination (whether economic, cultural or social), emancipating the older person to a new form of social order significantly different from status quo remains an ambivalent concept. Exactly what emancipates is elusive as it can vary from individual to individual and even if the collective cultural grouping is used, can there really be a common standard and agenda? Emancipation is a lofty goal but emancipate to what remains for the most part open. While the outcome remains elusive, addressing cultural politics nonetheless gave an additional critical edge to ageing studies because it is both ‘contemporary as well as historical; theoretically informed yet grounded in empirical work; sympathetic to other conceptions of [how research should be conducted] … and [is] concerned with a range of cultures and with the cultural politics that this implies’ (Jackson 1989: 8: original emphasis).

Finally, postcolonialism is a critical discourse that merits discussion in this book. Postcolonialism upholds heterogeneity of identity and meanings in ageing since its foundation was laid by the cultural turn in social sciences. As an attempt to move away from Western-centric research, the purpose of postcolonial research is to (re)constitute the world in more discursive terms and thus reclaim epistemological space from the West. Postcolonialism does not assume that Western discourse immobilizes; rather by critical analysis, it aims to ‘articulate the silences of the native by liberating the suppressed in discourse’ (Yahya cited in Alatas 1995: 131). As Yeoh (2003: 369) argues, postcolonialism is not a ‘totalizing or monolithic discourse representing one-half of any simple West/non-West bifurcation of the world, but in fact a highly mobile, contestatory and still developing arena where opportunities for insight may be gained at multiple sites’. By refocusing, it is hoped that research (and policy frameworks) will not carry a Western-centred loci in its imaginings. In social gerontology, Harper’s (1992) work on China, Katz and Monk (1993) featuring Sudan, Caribbean and Colombia among others, Chow (2001) on Hong Kong SAR, Phillips (2000) on the Asia Pacific region, Bengston et al. (2000), Jones Finer (2005) and Liu and Kendig (2000) comparing East–West differences and many other indigenous writers are examples of alternate discourses (Chan et al. 2002; Chen 2003; Choi 1996; Li 1997; Mehta 1997a; 1997b; 1997c; Ogawa 2005; Omar 2000; Thang 2001; Teo et al. 2003a; 2003b).

Policy and critical gerontology

Current critical gerontology shows a maturing because the discourses make special attempt to move away from the essentialist tendencies of traditional social gerontology. Rather than mega-theories/narratives such as espoused to some extent in the original political economy approach, current critical gerontology recognizes diversity and difference across societies. Paradigm shifts in social science and the rise of social theorizing have helped to refocus research in ageing on dialectical relationships between structures and agency. According to Estes et al. (2003), since theory is interpretive, so is policy. Since neither theory nor policy is neutral, balancing power relations between structures (e.g. state and society) and the agent (e.g. older person) becomes an important research agenda that will elucidate the practice of ageing. As they point out, the question really is, who can press their views into wider consciousness and thus shape outcomes for older persons?

Speaking of policy, ideology comes to mind when structures such as governments allocate funds. Ideology is dominant in social constructions of older persons and as Estes (1979: 4) argues, ‘ideologies … as belief systems … hold major implications for power relations, for in enforcing certain definitions of the situation, they have the power to compel certain types of action while limiting others’. Gramsci’s (1971) ideas on ideological hegemony are helpful as he argues that the imposition of dominant social relations can meet with resistance of an overt or latent kind from agency. More insightful, however, is his explanation that ideology can be communicated and can win over individuals such that hegemony can occur without the use of force. In the neoliberal context of contemporary societies (Singapore included), Fischer and Poland (1998) assert that community policing is not at all coercive, interventionist or visible. Instead, discipline and regulation are unspectacular but nevertheless, persistent and penetrating. Formal processes emanating from the state take a back stage while self-regulatory civil and individual mechanisms come forward in the governance of resources. Using knowledge and raising issues related to risk and responsibility, individuals and communities can be moved to act independently or as a group to manage and reduce harm to society at large. Unlike the obvious actions of governments, self-regulation amongst ‘responsibilized’ subjects (Fischer and Poland 1998: 188) assumes ideological significance because this new interpretation of regulation is more progressive, involving voluntary action and not just state legislation alone. Private, civil and commercial institutions and agencies form the non-state segment for action. Rallying non-governmental organizations (NGOs) into its ambit of influence gives more power to the state and helps to further legitimize its decisions with regard to the allocation of resources. For older people, this is a worthy route of investigation because there are many voluntary organizations which have come into existence, seemingly with good intentions, but may in the end obfuscate rather than clarify power relations.

Whether tensions exist, the evaluation of social policy pertaining to work, retirement income, health, and other social service benefits and entitlements remains a central question in critical gerontology as it tries to show that age does matter and not only to those who are older but to everyone at large. Social policy is to be understood as time and place specific because it represents outcomes of social strugg...