In The Shadow of an Ageing Pimp, Crook and Paedophile

HOW CHARLES DICKENS PORTRAYED OLDER CHARACTERS IN OLIVER TWIST [ PART ONE] 

WHETHER  it was Fagin's age or ethnicity which so obsessed Dickens, the now very successful young author, there can be very little doubt that in the words of commentator S.Gill's introduction to the Oxford World Classic series Oliver Twist (1999) " the presentation of Fagin has a kind of concentrated ferocity"

Yet of all the words written since 1837-39 about Dickens's intention, very little has focussed on Fagin's age and his portrayal as "a very old, shrivelled Jew" with a "villainous and repulsive face...obscured by a quantity of matted hair." The debate since the book's publication has been about whether Dickens was anti-Semitic but very little about whether he was also gerontophobic. Edgar Johnson (1951)  in his dated contribution to this "Jewish question" concludes that he was not. The question however remains to this day despite the millions of words written about Dickens before and since. My interest here is to explore Fagin in the context of his portrayal of older characters in Oliver Twist asking the questions Johnson asked but related to old age and older people. "Does Dickens draw on other derogatory" pictures of older adults in his writing, and not favourable ones? "Do his utterances elsewhere imply an ill opinion" of older people as a group"? 

It is worth mentioning that 'Fagin is referenced 257 times in the first 38 chapters - as " the Jew" whereas the race and religion of Bill Sikes, goes unremarked' ( Independent 07.10.2005). Dickens's response to the criticism at the time was seen by many as defensive and naive. 

There's little doubt that despite Dickens's later deletion of the specific term "Jew" when referencing characters, the physical repulsiveness can be viewed in the context of both anti-semitisms, and old-age gerontophobia and hence literary gerontology. Quoting the Independent again:

               " Read how Dickens introduces the villian- standing before a fire, fork in hand,with a villainess and repulsive face , matted red hair. Red hair was worn by the devil in medieval mystery plays. Dickens several times refers to Fagin as "the merry old gentleman," an ancient euphenism for the devil, as is the phrase Bill Sikes uses when he says Fagin looks as if he has come straight from "the old'un without any father at all betwixt you" "

 Older adults are often portrayed in literature, especially Victorian, as corrupting the innocents and purity of children. The conflating of both Fagin's Jewishness and old age as portrayed is a powerful narrative but it is binary. What I am reaching for in this series of Blogs is to gauge, as best I can whether Dickens's view and attitude to age and ageing through his characterization tell us something about the early/mid and late Victorian mindset regarding the concept of later life, age construction, the emergence of Midlife ( with thanks to Kay Heath) and the medicalization of old age.  

  

                           Charles Dickens was only in his early/mid-twenties when writing Oliver                                Twist. How did his childhood and adolescence affect his view on older                                    adults and hence his characterization? 

                        

 The picture that emerges of not just Fagin, but other portrayals such as Anny, Bumble, Fang, Kags, Mrs Mann, and the "old crone" Martha and Sally, all arguably negative narratives of old age. But to answer the second of Johnson's questions there are characters which can be considered "positive" ( howbeit seen today as stereotypical) such as Mrs Bayton, Bedwin, the Brownlows, Grimwig, Mrs Maylie and as we shall see many others out of some 69 characters in the book! That said, they could all be seen as living in the very long shadow of Fagin.

We need to re-engage with this young author, flush with the success of Pickwick, newly married and increasingly financially secure as he writes what will be a second successful series and book.  Critic and scholar G.K. Chesterton said much later that Oliver Twist " was "by far the most depressing of all his books [and in] in some ways the most irritating.." George Gissing writing after Dickens's death in 1870 reminds us that it was a significant step in social and political history and the importance of not losing sight of [its] historic point of view. Nevertheless, Gissing also thought it "immature" with little "coherency in the structure of the thing; the plotting is utterly without ingenuity, the mysteries so artificial" - with fans like Gissing...! Gill however concludes that despite such observations  the book "remains for all its weaknesses, the most compelling of Dickens's early novels." It is probably not necessary here to outline the plot as readers will know doubt to be familiar with the essential elements and characters, even though through the sometimes distorted lense of Lionel Bart, Ron Moody, Alec Guinness and Harry Seacombe than having actually read the book. Perhaps being unfairly said, we are reminded that Oliver Twist's portrayal as a passive, innocent, naive, and good-natured child is set alongside the evil, scheming, manipulative and despicable characters of Fagin and Sikes. Monks, (who in fact was a young adult), vicious and scheming with Fagin to ruin the reputation of Oliver. Mr Bumble the Beadle, was simply a cowardly bully abusing his position of power, but more of him later and his wife (nee Corney) who is described as "hypocritical, callous and materialistic." Add to this cast of despicable characters is Mrs Man ( "an elderly female") who physically and mentally abuses the children in her care whom she farms out!

In May 1837 Charles Dickens had completed the first four instalments of Oliver Twist when he suspended writing. The tragic and sudden death of his 17-year-old sister-in-law, Mary Hogarth who lived with the Dickens family had a lifelong impact on Dickens as both a person and an author. 

To Be Continued......

PART TWO will explore the Childhood, Adolescence and Young Adulthood of Charles Dickens, the early influencers and influences and how this shaped the minor and major older characters in Oliver Twist. 

 

 

 

PRESERVE ME FROM CAMPAIGNS AND AWARENESS DAYS

I have long been ambivalent about international or national days given to raising awareness, be they be focussed on or about older adults, LGBTQ+, racism, human rights, (dis)Ability, mental health and a host of other causes. That is not to say I am against a focus on all these issues - if that be the right word- but I wonder just how effective they are post the Day! 

Many years ago I was involved with a number of national age and ageing focussed charities together with civic sectors (local and central government) - some might argue industry- still am- alongside the Department of Work and Pensions (DWP) in developing our response to the United Nations Older Peoples Day ( 1st October each year). The debate we had was about how best to portray people over 50 years of age in terms of celebration and/or the issues and challenges facing this particular demographic. We decided to focus on celebration and positive active ageing ( whatever that means), accompanied by illustrations of older adults "doing wonderful" things whilst reflecting, as some would argue as an afterthought on those living in poverty, long-term debilitating health conditions, poor housing etc.

 

Were we successful? Did we influence and change attitudes and challenge the myths and the stereotyping of older adults? Did we strike the balance we sought? I would argue, not at all. 

In the two-part blog, I published recently.  I drew attention to Shereen Daniels's book which sought to dismantle systemic racism in the workplace.). I reflected on my belief that slogans, many campaigns, awareness-raising initiatives and the like are more often than not, simply publicity stunts of the organisations engaged in a particular issue or cause. The blog I referred to, explored Daniels's challenges and insights in the context of the Co-operative Sector and in discussing with a colleague he forwarded a link to the 2017 article written by two academic journalists headed "Stop Raising Awareness Already" 

Fundamentally Ann Christiano and Annie Neimand argue that too many campaigns and awareness-raising initiatives including Special Days may have the laudable aim of communicating their message to a wider audience as possible. Frequently they fail to understand the risks. They build their publicity or events and slogans on false assumptions and presumptions of both their target audience and their messaging. Sometimes this includes the very people on whom their cause is focused.  

The authors believe "that people who are simply given information are unlikely to change their beliefs or behaviour"  and what needs to occur is moving beyond just raising awareness. The goal(s) of a campaign or even Day is " to get people to change how they feel, think, or act and create long-lasting change." For me, 24 hours, or even a week or a month of awareness raising just doesn't cut it. Nor does securing some TV celebrity off a popular soap or inane reality show ( select your own - I make no further comment) or God forbid, a waning or discredited celebrity or public figure who tailgates on a particular cause to increase or rehabilitate their public image or reputation! Too many organisations and so-called "worthy causes" see the Day as a means of simply increasing donations. 

SO HOW DO CAMPAIGNS FAIL?

Returning to Christiano and Neimand they rightly make the point that awareness-raising can " be a critical step in creating an environment where change is possible" and can on occasion influence national political attention to an issue citing Black Lives Matter or Transgender Rights. I am reminded that campaigning playwrights or documentaries can have a powerful impact - for good or ill. The seminal "Cathy Come Home"  and homelessness spring to mind. However, the authors argue that awareness has to be linked to strategically explore " a larger effort to drive social change." In this regard they are uncompromising and evidence base that not only can campaigns ( and here I would add Days) fall short and waste resources when only about raising awareness but "actually do more harm than good"

Before exploring the risks I return to the issue of false assumptions and damaging presumptions that stereotype individuals and communities. No more is that prevalent than in the fields of, for example, refugees, Aid, compassionate ageism, social care, race and ethnicity, LGBT+,  loneliness, safeguarding, community development, and climate change. How we think about these and much else will determine our responses, the language and narrative we use, the images marketed and our messaging. The harm is done to individuals, communities, and even countries is incalculable. Undoubtedly some of this will be unconscious, even at a corporate level, and hence the need to at least become conscious of personal and political bias reflecting on the assumptions we make and the presumptions we hold.

Four risks are identified: 

• Lead to no action: Using shock or humour which can dilute the message even if the campaign is seen at one level as highly successful in terms of attracting audience attention and even media coverage.  
• Reaches the wrong audience: An audience that in fact has no sympathy with the cause/issue being profiled. In addition, those who are already convinced and engaged with the subject or issue or need. An example would be Human Rights, Refugees, Older Adults and loneliness (let's not forget the John Lewis Christmas advert Man on the Moon)!: Mental health, Travellers,  
•  Creates harm: This can be linked to the wrong audience. Campaigns need to understand and be sensitive to how an audience might perceive the message. This often occurs when marketing experts are let loose with an issue of which they have very little knowledge but think they do! I recall many years ago taking the NSPCC to task for their Full Stop Campaign. At one level it was highly successful if judged by the number of people ( especially celebrities) who wore their little green badges. It was a false assumption that child abuse can be eliminated, it can't. Constantly referring to delayed hospital discharge as "bed blocking" leads to blaming older adults for bed shortages rather than resourcing hospitals, social care and indeed systemic issues of poor management. The point to be made is that campaigns can do little to address the context and the context is everything. We can so easily normalize issues and reduce or prevent effective responses that deal with the context. The authors raise the "gulf between scholarship (and academic research) that could help practitioners avoid harm, reduce risk, or increase the effectiveness of their efforts and practice is common and wide"  
• Generates a backlash: Beware partisan politics within Campaigns whereby an issue can directly lead to increasing controversy. The examples used are Teenage and Later Life sex, Vaccine takeup. Here the media can and do feed off a range of issues to increase their own profile, sell newspapers, and can totally undermine a campaign.   

 

IT'S ALL ABOUT COMMUNICATION, TARGETTING, MESSAGING AND USING THE RIGHT MESSENGER 

This may seem blindly obvious but even multi-million corporate businesses can get it wrong. Ask Walkers Crisps and their "Walkers Wave" campaign; Pepsi suggesting that protesters give the police a can of Pepsi and the suggestion that " if protesters were kinder and gave police a drink, there would be no need for social justice demonstrations" or campaigns; and Amazon's promotion of their show The Man in the High Castle was generally seen as "irresponsible and offensive to WW11 and holocaust and their families" 

Having explored the risks Christiano and Neimand highlight four elements that are important to avoid backlash, harm, and inaction. Firstly to target the audience as narrowly as possible. We often think that a campaign or raising awareness needs to reach as many people as possible. Wrong! Targeting a single individual can be far more effective if there is clarity over the goal and a defined strategy. Secondly, whether an individual or an audience of millions requires a compelling message that resonates, that is also a call to action and does not alienate the very person/people whose attitudes and behaviour one is seeking to change. Thirdly a campaign or awareness-raising day needs to have a clear understanding of what will be different and finally use the right messenger ( oh how many have got this wrong by thinking that a celebrity, any "celebrity" will do? - I'll leave it there but here's a clue!)

  

                                           [ Appeared on the TV show "I'm a Celebrity Get Me Out of Here"

                                            coming 3rd in a public vote (2023)]

I suppose I'm arguing that all organisations, be they civic, civil, or retail think seriously about sacrificing their credibility, their brand, and their resourcing on any campaign or awareness-raising event on the altar of false assumptions and presumptions about their audience. 

 DOES SYSTEMIC RACISM EXIST WITHIN CO-OPERATIVES? [PART TWO]

LEADERSHIP 

" Progressive Leaders for today and  the  future commit to seeing how the social construct is used to isolate, disadvantage and make power inaccessible to Black People,"  writes Daniels and continues " They are alert to unequal outcomes and work to dismantle systemic racism within their organisations and areas of influence"

Where are the anti-racist progressive leaders within UK Co-operatives?  I can easily identify them within my primary profession of Social Work and Care but a bit more challenging in the Co-operative. That said the likes of Radical Routes, Mondo and the Co-operative College are beacons within the sector and I readily acknowledge the Co-operative Group itself partnering with Waitrose back in 2020 with an anti-racist campaign. But we should not confuse Leadership with organising an event, a training programme or a campaign.

Daniels helpfully defines the key characteristics that distinguish the Leaders:

1. Humility: Creating safe spaces in the workplace 

2. Moral Courage: Being firm in the face of discomfort and opposition

3. Tenacity: The ability to persist with a course of action even if there is no immediate payoff or reward

Now here's the rub. Despite the laudable Cooperative campaigns and events, that is what they are. Anti-racism is not part of the DNA of Cooperative businesses. Ticking a box, producing a policy or having a discussion with Human Resources just does not cut it! It is not an event, it is an ongoing and monitored process underpinned and founded on "humility, moral courage and tenacity"

Here are Five Questions that Daniels suggests workplaces ask regularly

1. How far does this decision alleviate or worsen inequality?

2. If we do X, what is the impact on Y?

3. Who are the consistent winners and losers here?

4. What other pattern or trend we should watch for?

5. How far are we doing what is comfortable v's what is right?

I am wondering how many policy reports were agreed upon by Co-operative Boards or its "governing" body/Circle that asked these questions or indeed included specific reference to asking and answering "Difficult Questions"? 

Recently I read Phil Wang's "memoir" "Side Splitter "  writing about his experience of what it means to be torn between two continents, specifically about race, empire and colonialism. Putting aside the comedy ( he is a professional comedian) he, as an author, is sharp, and insightful and his chapter on Race dealing with labels stresses his preference for the terms "White" and "Non-White." The language we use is dealt with in some detail by Daniels and it is that which I now turn.

DEFINING MEANING

Many of the terms we use are binary, so for example, "majority" and "minority" are opposites which are value driven indicating a particular status " the first having a higher value than the other and given more status". In addition, the very word "diverse" is "an othering word, an identity of difference construct to produce standards of normality and superiority ...we are all diverse!"  

We need to reflect on the terms and words we use and whether they make us comfortable. Language changes, and increasingly we are more comfortable using the word "Black" There is, however, something uncomfortable with the term "people of colour" and whilst BAME has been normalized it is deeply offensive and should, says Daniels be 'deleted from existence. Rather than listing her 50-plus words and phrases, she emphasises, and this is the key message in our Cooperative context, that we must use language as a device (tool) to "dismantle racism" in our workplaces. I note in passing that  "BIPOC" [Black, Indigenous, and other People Of Colour] is used by some Candian Worker Co-operatives seeking to promote racially diverse and inclusive Co-operatives.   

Our words, speech, writing, images, and symbols which we believe are truths and best practices need to be understood in their cultural context. Daniels writes about "Corporate Regimes of Truth" which requires a total deconstruction of corporate/organisational communication to understand what they are! Here is her checklist( which again I have adapted)

• SocialConventions - the genesis of our words
• Why we are uncomfortable with certain words/labels/terms?
• Why do we take a particular action or use this particular knowledge?
• Whose interests does this knowledge/policy/action serve?
• Who benefits from what we say?
• How and why do they benefit?  

 

My message to the Cooperative Commonwealth is to Reflect, Reflect and Reflect some more; be informed about the changing use of language and benchmark against the three traits that distinguish leaders ( Part One). 

STARTING FROM WHERE WE STAND

" Exploiting diversity and employing more Black people does not show either yourself or your organisation to be anti-racist. It does not enable inclusion. And it doesn't mean you don't have a problem with systemic racism"  ( Shereen Daniels)

Are Worker or Multi-Stakeholder Co-operatives anti-racist?  If the answer is "YES" my response is "Prove it". The starting point is, put simply, by using Daniels's R.A.C.E four-factor Model referenced in Part One. It is a pretty straightforward guide if our Co-operative is up for it. If on the other hand, we think we are anti-racist without evidence.... remember it's not about a campaign, a poster or even an event, then arguably systemic racism exists in your workplace!

Again using Daniels as our guide she explains that there are four levels of her Racial Equality Maturity Model starting with the issue of Compliance ( legal and institutional); an intent to be Inclusive and establishing a Strategic focus with a specific Commitment and lastly Public and Private. The Reflective Questions mentioned earlier in this blog give the framework which could be a useful starting point for any Cooperative business or service interested and willing to explore (audit) where they are starting from. Her approach is both empowering and sensitive to the challenges this journey entails and helpfully points out the steps, key pitfalls and stresses, concluding "it ain't easy"!

I am mindful that readers and especially my co-operative colleagues might be finding this blog too biased, and negative and fails to tell the story of those Co-operatives meeting the challenges, asking uncomfortable Questions and demonstrating the very qualities of anti-racist leadership. If that is the case then I have failed to reflect on the empowerment and practical nature of "The Anti-Racist Organisation."  Let me, therefore leave this section with two quotes. The first is Cheryl Samuels, Deputy Director of Workforce Transformation, NHS England:

"This is an honest, thought-provoking book that takes you on a journey of discomfort that leaves you reflecting on your personal and professional relationship with race and racism" 

The second is Dr Jane Brearly, Founder and CEO, of Intent Health Ltd:

" This book weighed heavily on me, as it should. It's unapologetic, enlightening, and yet practical. If you are truly interested in becoming an anti-racist organisation, you won't just read this once, but will refer back to it again and again"

SO DOES SYSTEMIC RACISM EXIST WITHIN COOPS?

Your call! 

Mine?  YES, THEY CAN AND ARE and it is time to explode the myth that they can't.

  

DOES SYSTEMIC RACISM EXIST WITHIN CO-OPERATIVES ? [ PART ONE]

 

Recently Miles Dadfield, Co-op News digital editor asked in a posting that the co-operative "sector talks the talk on social justice, but how does it work in practice?" He explored Joan S Meyers publication " Working Democracies: Managing Inequality in Worker Co-operatives (2022 ). In essence, Meyers concluded from her detailed study of two North Californian worker co-operatives "that worker co-operatives can resist the naturalization of inequality" but acknowledged that they "face questions around equality, ownership, power and identity"

Miles rightly pointed out that worker-led models are "touted as a counter force" to large private Corporate bodies and increasingly becoming worthy of profiling in the mainstream press. Returning to Meyers, Miles was absolutely right to highlight her discovery that "almost all of the members of both Co-operatives shared similar levels of personal and family education, family wealth and occupational prestige, and 'class cultures'". My question is, when looking at the Co-operative sector itself here in the UK, does systemic racism exist? 

My starting point is why, according to Kate Whittle, Convener of the recently formed Solifund Cooperative Anti-Racism Group (CAR) there are so few members of minoritized groups to be found throughout the sector including worker co-operatives when there were significant numbers of Black and Asian co-operative workers and development workers back in the 1980s? Even the very terms and labels we use, including "people of colour" or BAME raise important questions about how we think about racism.

I have, since becoming a member of CAR, thought a great deal about my use of terms, my assumptions and presumptions and especially about my personal and professional relationship with race and racism.

The Anti-Racist Organisation: Dismantling Systemic Racism in the Workplace

This subheading is the title of a recently published book by Shereen Daniels, Chair of the African Diaspora Economic Inclusion Foundation and Managing Director of HR Rewired. I read it in the context of Cooperative businesses and services and found the blurb's claim that it is "an unflinching and practical take on the modern-day impact of systemic racism in the working world pulls no punches" was no hype. It has had a profound effect on me as I reflect on the Cooperative sector. 

The focus of these reflections helps me to develop a suitable narrative for exploring and discussing Racism within the Co-operatives and especially Worker Coops, including multi-stakeholder Co-operatives in which I have been involved for several years. My presumption is that we are not immune from racism in practice or behaviour and can be informed by this book. The challenges in my view must be seen in the context of the very International Values and Principles underpinning Co-operatives.

Daniels's aim is to develop awareness, ask difficult questions,  how " tokenism became the answer" and "move beyond conversations". In addition, she explains where anti-racist leadership starts in terms of defining meaning, starting from where we stand and argues for a four Factor Model which is specific. 

1. Recognise the Problem    

2. Analyse the Impact

3. Commit to Action

4. Empower for Change

It is a book that, in the words of Daniels does not " pander to whiteness or seeks to make the subject palatable for decision-makers. It isn't one that gently cajoles leaders into action..creating a smooth path, risk-free to racial equity." 

 Racism is a " system that divides, even those of us who share the same ethnicity ( Head down - get on with it)"! "Racism...Not Diversity, Not Inclusion, Not Belonging".

I take the liberty of inserting the word "Coop" in place of "workplace" to a narrative that is taken directly from page X1V

• Coops who create environments that mirror the unequal, inequitable aspects of society is inhumane
• Coops that ignore the lived experience of colleagues because they are a minority is inhumane
• Coops having systems and policies in place that reward behaviour that excludes people because of their skin colour is inhumane 

We need to ask ourselves whether Co-operatives here in the UK is too white and too homogeneous? Over the years of attending Co-operative events and Conferences, including annual Congresses, the members are mainly white and indeed regardless of gender, the same. 

 

Co-Creation - Co-operation?

Daniels stresses when discussing co-creation, that rather than telling people what to do we need to develop a foundation that helps us to explore and ask better Questions. The Cooperative movement and commonwealth are founded on its Values and Seven Principles of Cooperation. Some argue that this is our very ethical basis and indeed brand eg #The Co-operative Way.

For readers unfamiliar with those Values and Principles and maybe thinking that a Co-operative is nothing more than "Carrots and Coffins" put simply these are our Values:

• Honesty
• Openness

• Equality
• Responsibility
• Solidarity
• Community

Co-operatives are owned and controlled by their members. It exists to serve them. Membership is open and voluntary for those willing to take the responsibility that comes with it. Co-operative leaders or developers seek to protect these Values and are guided by the Principles of:

1. Membership: Members own, control and benefit

2. Democracy: Every member has one vote and an equal say, no matter how much money they put in. 

3. Finance: Members pool their resources and together they democratically control capital and decide what to do with its profits

4. Independence: Co-operatives are not beholden to anybody, whether investors, government or other organisations. It is an independent business and/or service owned and controlled by its members

5. Education: A co-operative provides its members and staff with the training needed to run a high-performing business and educate the wider public about co-ops

6. Co-operation: A co-operative aims to work with other co-operatives to support the wider sector

7. Community: As well as benefiting its members, a cooperative works in a way that benefits society or the environment. Here I would add to address social injustice and exclusion.

It should again be emphasised that these do not, in and of themselves, protect a Cooperative business (or even the Movement itself at a national level), from being or becoming a racist organisation. Certainly, the notion that all our hundreds of thousand UK members are anti-racist is nonsense. We need to ask ourselves, individually and collectively how best we can we lay the foundation for asking "uncomfortable Questions" in the context of our ethical business and narrative? Daniels is helpful.

• Defining what our vision looks like
• How honest are we with ourselves and the Team(s) we lead about the anti-racist journey?
• How committed are we to move beyond "low hanging fruit" and instead prioritise and invest in programmes that make a difference for those with the most impact?
• How willing are we to confront systemic racism and discrimination within our organisation and wider ecosystems?
• How comfortable are we to prioritise colleagues, suppliers, partners, members and external stakeholders who don't look like us? 

[Adapted directly from Shereen Daniels ppxxi]

It must be emphasised that Daniels's book is about leaders, especially white leaders! 

Raising Awareness

We need to understand the Coop data available (or not)  with regard to black members, workers and those with managerial responsibility. Does even Sociocratic decision-making address racism and get close to asking "uncomfortable questions? In addition, what is the evidence of Tokenism"?

Daniels's professional background is in Human Resources and readily points out that there is a gap with regard to HR/Organisational Board level approaches. She concludes that "suddenly promoting or hiring black people are not the answer. There is more to it than that". There are so often approaches which do not mention how the organisation their black workers or customers are thinking and feeling. She continues......

No mention of what it is like to live, work, and play in a society that accepts racial inequalities and inequities.

Little recognition of the inherent power and privilege afforded to "leaders" who could objectively debate and discuss a course of action according to convenience, comfort, ease and affordability

[ Part two of this blog will look at Anti -Racist Leadership within Worker and Multi-Stakeholder Co-operatives and Define Meaning using Daniels's as our guide] 

 COMING SOON:

An analysis of  Shereen Daniels's book " The Anti-Racist Organisation - Dismantling Systemic Racism in the Workplace" and what the Co-operative Sector can learn from it. My forthcoming blog challenges the sector to stop talking the talk and actually take racism seriously. 

 

TIME OUT ON LABELLING OLDER ADULTS AS FRAIL?

A PROPOSITION:

Labels and terms change over time, especially those used within the health and social care fields of professional practice and especially assessment. 

Here's a list:

• Catastrophic schizophrenia
• Feeble-minded
• "Homexulatity" as a disease
• Male/Female/Other Hysteria
• Identity disorder
• Idiot
• Imbecile
• Lunatic
• Vapours

It is interesting that many social workers and care workers in the past banded these terms about, particularly at meetings and in their case notes. This reminds me, of when I started my social work career back in the late sixties and well into the eighties we talked about those with whom we were working, as a Case!

The time has come to consider that the term Frail or Frailty be added to the list of obsolete terms and labels.

Frailty is classified as the medical condition of reduced function and health in older adults and hence patients are classified as Frail. Inactivity, poor nutrition, social isolation ( and God help me Loneliness) and multiple medications are among the predisposing factors and the symptoms that are deemed to warrant the term are:

• Falls
• Immobility
• Delirium
• Incontinence
• Side effects of medication 

 10 REASONS TO BE DOUBTFUL?

1. Frailty is associated with and feeds stereotypical images (mindsets) of clinicians and their teams who tailor their care to enable to help the individual to manage their "frailty"
2. It 'others' older adults and increases the stereotyping of them (me!)
3. Frailty is not binary. It is seen as a heterogeneous identity
4. The term does not capture the multifaceted concept of the so-called five Frailty syndromes
5. The degree of Frailty Indexes do not do justice to the variety  and complexities of the syndromes and thus the interaction between them
6.  There is a lack of clarity about the socio-economic determinants of functioning
7. There exist a (mis)balance between assets and deficits as determined by the Frailty Indexes
8. Coping with physical /psychological deterioration depends on resilience/ environmental and numerous other factors
9. Chronological age is too restrictive a factor to predict health status
10. The notion of frailty is in the eye of the professional beholder, not necessarily the individual labelled as such.

CHANGING THE NARRATIVE 

Not disputing the existence of the "conditions" that lead to the concept and labelling of Frail or Frailty applied to individuals or a whole section of an older demographic but the very term(s) exclude:

• Precarious conditions and the political context of Care
• The lifestyles of an older adult and their life course experiences and their perception of them/it 
• The issue of unmet need and the impact of reduced services ( eg Covid) and lack of access
• The terms are not attuned to the experiences of vulnerability and existential vulnerability

SO WHAT AM I SAYING?

To me, the term Frail and Frailty need to reflect and be underpinned by the notion of preciousness - the determinants of those conditions that constitute the label and thus the social conditions/environment and political systems which increase vulnerability.

The following quote says it all:

" The lens of precarity renders visible the extent to which frailty operates as a taken-for-granted practice based on an acceptance of individual and biomedical/functional interpretations.

It confronts how assessments are of frailty are constructed with the sole purpose of discriminating between needs and targeting service responses" *

 The label "Frailty" - like the term senility should become obsolete, it fails to acknowledge the moral imperative and ethical position with regard to care and later life. It fails to respond to and confront social justice. It is absolutely time to call it out! 

* See Liesbeth De Donder et al. Critical Reflections on the Blindsides of frailty in Later Life ( Journal of Ageing Studies. June 2019. pp 66-73

Ananda Grenier, Chris Phillipson & Richard A Settersten. Precarity and Ageing: Understanding Security and Risk in Later Life Policy Press ( 2020)