The Elderly

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THE ELDERLY

David G. Troyansky

At the turn of the twenty-first century, as European states tinker with the social security systems their populations have come to treasure, "the elderly" present a variety of faces. Naming them poses a problem. The word "elderly," like "the aged," carries with it an odor of condescension, fragility, and passivity. "Elders" implies wisdom, "seniors" a certain activity and privilege in the marketplace, "older people" a category that avoids categories. Distinctions between the "young old" and "old old," or "third age" and "fourth age," register the impact of demographic, medical, socioeconomic, political, and cultural changes as well as the separation of retirement from old age. Such diversity of names and categories, which exists in other European languages as well as English, reflects cultural choices but also social historical changes. People live longer in our present "age-transformed" populations (Peter Laslett's phrase), claiming entitlements, consuming medicines, and forming new social, cultural, and political groups.

Social historians have sought to understand these transformations and have shared their labors with historical demographers, cultural historians, and political economists. Their concerns have included demographic aging, family and household structures, work and retirement experiences, state support systems, medicalization and institutionalization, cultural representations, and popular attitudes. Those concerns are best addressed through their own chronologies, approaches, and examples. At the most general level, however, the literature on old age and the elderly can be divided between social and cultural history.

SOCIAL AND CULTURAL APPROACHES

The general tensions between social and cultural history are visible in the literature on the history of old age and the aged. As Paul Johnson has explained, social historians who made the elderly a subject of historical interest favored such themes as participation, well-being, and status, and addressed them in studies of employment, political activity, property ownership, health, and the transmission of household authority. The earliest efforts tended to follow an already creaky "modernization" scheme. For some, the modern world rendered the elderly marginal. For others, it was premodern society that had no use for them and modernity that invented them as a group.

Such simple choices proved unsatisfactory. The history of old age would not be contained in a one-directional master narrative of either progress or decline. Social historians have examined the age structure of limited populations, the shape of peasant households, entries to and exits from hospitals, age consciousness in official records, and the development of social policies concerning old age and retirement. But no overarching model has emerged.

Cultural history provided a possible solution. European culture has long examined the ages of life. Religious, philosophical, and scientific texts provided prescriptions for aging well, often connected with related themes of vanity, honor, and preparation for death. Religious retreat and humanist retirement to the study were among the recommended options for the fortunate minority, but there was no formal marker of entry into a new lifestage. Literary and artistic materials offered descriptions of experience but tended to repeat traditional tropes and images among representations of the elderly. Cultural historians recognized the predominance of certain images, from the ridiculous, lascivious graybeard or crone to the dignified wise man or woman.

These images have changed with successive periods of cultural history. The Protestant Reformation and the growth of the early modern state have been associated with the rise of patriarchy. The Enlightenment has been associated with a softening of the image of the patriarch and a process of de-Christianization that focused new attention on the last years of earthly existence and harmony between old and young. Nineteenth-century middle-class culture further developed eighteenth-century sentimentality, announcing the great era of grandparenthood, and also produced a powerful image of the indigent elderly. In all those periods, one found nostalgic evocation of a time in the past when elders were respected.

Cultural historians paid attention to representations of the ages of life, often in the form of a ladder or series of steps ascending by decade to fifty and descending to one hundred. Such images hardly conformed to typical human experience; they are best read as allegorical renderings of the life course that urged adherence to prescribed roles and attention to the omnipresence of death. In the sixteenth and seventeenth centuries, flames of hell beneath the steps warned of the punishment for straying. In the eighteenth, the images turned secular. Other sources suggest a very old tradition of seeing sixty, sixty-five, or seventy as the threshold of old age. Some historians have asked when people began to see each other as old, placing the emphasis on physical appearance, and some suggest menopause as a female threshold. Institutions such as hospitals and hospices often settled on sixty or seventy, but labor and environmental conditions more commonly placed the beginning of old age closer to fifty. Still, the elderly have been identified more in terms of physical and mental condition, household authority, and cultural status than numerical age. Awareness of chronological age mattered little to most premodern Europeans.

The greatest contribution of cultural history was to make clear that old age has meant many different things in different historical settings. It might have to do with authority and its loss. It might come with the marriage of children. It might bring honor or ridicule. It was already an object of study. More people in the contemporary world can experience it, and although cultural historians found much to examine in the early modern period, some social historians and historical demographers insist on the unprecedented nature of modern demographic aging.

DEMOGRAPHIC AGING AND INCREASING LIFE EXPECTANCY: TWO PROCESSES

Recognition of demographic aging lay behind some of the growth in historical literature on aging and the aged. Some historians have considered the aging of populations on a par with the demographic transition that has traditionally been described simply as a decline in mortality and fertility. It was the fertility decline, principally in the nineteenth and twentieth centuries, that resulted in demographic aging: an increased percentage of people over the age of, say, sixty or sixty-five within a population. Thus the age pyramid was broadened at the top, the eventual result of narrowing at the bottom. Even the post–World War II baby boom failed to reverse a process that has had a lasting impact on Europe and much of the world. Peter Laslett has demonstrated that there is no going back. The "fresh map of life" for the majority of Europeans includes a long period (the "third age," as the French named it) from retirement to the time of sickness, decline, and death.

In early modern European countries, between 7 and 10 percent of the population was over the age of sixty. France reached 12 percent by the last quarter of the nineteenth century. Sweden reached that level in 1910, when England and Germany still had just under 8 percent. England attained 12 percent in 1931, Germany in 1937. Experiencing the demographic aging that transformed Europe in the second half of the twentieth century, England had 16 percent over the age of sixty in the 1950s and 17 percent by the 1980s. These figures were significantly higher for women, lower for men (table 1). Socioeconomic differences were apparent, as they had been in the early modern period as well.

Local economic differences render "national" figures in the earlier period misleading. Thus eighteenth- and nineteenth-century cities receiving large numbers of young immigrants had relatively few elderly (sometimes under 4 percent), while depressed rural areas experiencing out-migration might for a time reach as high as 20 percent. The early modern elderly often had a small female majority, but that gender gap grew to be very significant in the modern and contemporary periods.

The female role in demographic aging (a merely perceived role if fertility decline is not only women's responsibility) and the fact that female life expectancy has exceeded male life expectancy led some early demographers to blame women for what they saw as a symptom of national weakness. In this way, demographic aging has been given political and cultural meaning, symbolizing national decline. Beginning in the 1920s, the work of French demographer Alfred Sauvy expressed that common conservative fear and provided a very influential model for social scientific thinking about aging. It need not have been that way. Aging could have been seen as a sign of progress in the battle against disease and premature death. Whether survivors of disease constitute a healthy population is another matter that has been debated. James Riley's discussion of "insult accumulation" dares to make projections about unhealthy survivors among elders in the future, but most historians of aging have avoided the alarmist language of Sauvy.

Declining mortality had some impact on the aging of populations, particularly in the more contemporary period, but its more important result was increasing average life expectancy. In general that meant more children reached adulthood. Only in the most recent period has mortality among older people fallen significantly. But even in the early modern era, some periods were clearly healthier than others, and socioeconomic standing almost always had an impact on survival into old age. The wealthy and privileged were therefore overrepresented in the elderly population.

Historical studies of life expectancy have mostly provided figures for life expectancy at birth. In England, whose population history has been most thoroughly studied, life expectancy at birth was around thirty-five from the sixteenth through the mid-nineteenth century. Progress was apparent in the late nineteenth century and dramatic in the twentieth. European women reached a life expectancy of 50 in the 1910s, 57 in 1930, 71.5 in 1960, 74.1 in 1970, and 77.5 in 1985, when men lagged farther behind at 70.6 (table 2).

Historians of the elderly have discovered the advantage of studying life expectancy in youth and adulthood, thus eliminating infant and child mortality. It is clear that once they survived childhood, reaching middle age was common for early modern young people. In France from the 1740s to the 1820s, the probability of a twenty-year-old's reaching age 60 went from 41.9 percent for men and 43 percent for women to 59 percent and 58.1 percent. But socioeconomic differences were crucial. In seventeenth-century Geneva, those probabilities for men and women can be divided into three classes. At the highest social class, the probability was 51.7 percent for men and 52.1 percent for women; in the middling classes, 38.8 percent and 40.5 percent; in the lower classes, 31.9 percent and 33.9 percent. Thus European elites had an experience of what their cultures considered old age long before the transformation of entire populations and the generalization of retirement.

Placing the emphasis on the contemporary period, Peter Laslett has created a "third age indicator," a measure of the moment when at least half of a country's male population can expect to survive from twenty-five to seventy. Patrice Bourdelais, criticizing demographers' arbitrary choice of a threshold of old age, opted for a moving threshold based upon probabilities of living five years between the ages of sixty and seventy-five and upon the chances of living another ten years. He recognized that chronological age does not correspond simply to "biological age," that a sixty-year-old person in the twentieth-century was not the equivalent of a sixty-year-old person two centuries earlier. His approach, lowering the age of entry into old age while moving back in time, resulted in the claim that old age was almost as common in the early nineteenth century as in the twentieth. In effect, he was telling demographers to tone down their alarm.

Even before the big transitions, within the context of the old demographic regime, situations have varied. Relatively small demographic alterations and migration resulting from regional economic developments may have contributed to social stresses. And we find life expectancy after childhood that is surprisingly long. Old people, in short, were visible in all historical times. They are mentioned in high cultural sources referring to continued political and administrative activity or the awarding of honorary posts, legal sources regarding exemption from military or state service, and notarial archives for premortem transmission of property. In some historical settings before the great transitions, peculiar household structures influenced the nature of the aging process. In Renaissance Florence, for example, husbands were on average thirteen years older than their wives. But even elsewhere, old men might have young children, especially as widowers remarried much more frequently than widows.

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FAMILY AND HOUSEHOLD STRUCTURES

The elderly were not the primary concern of the early family historians, who tended to emphasize childhood and marriage. But eventually it became apparent that family history was a possible approach to the elderly. Just as historians found a predominantly nuclear family model in northwestern Europe and a variety of extended forms to the east and south, so they have described a range from independent elders to older persons living within more complex households. As they turned from static descriptions of households at particular moments to more developmental life course approaches, they found more complicated and gradual transitions from one generation to another.

Some parts of Europe were characterized by coresidence between adult generations, and local custom indicated whether the younger resident was an older or younger child, a boy or girl. Inheritance customs and laws, whether demanding division of property or permitting a favored heir to hold the patrimony together, played a major role in determining the residence pattern. In southwestern France, for example, the oldest child, regardless of sex, was the heir, and patterns varied dramatically from one microregion of Europe to another. Rudolf Andorka found great "generational depth" in the household system of four Hungarian villages in the eighteenth and nineteenth centuries. Households there went through stages and changed shape, as children matured, left, and sometimes returned, but three generations coresided in the vast majority of households containing aged individuals. This may have been a cultural choice, but it may also have been the result of land shortage or the lack of charitable institutions.

By contrast, independent households remained the norm for the elderly in much of western Europe. In some cases, that may have meant abandonment and neglect, but most scholars have assumed that elders living on their own, then as now, did so by choice. And independent households did not preclude assistance from relatives, particularly at moments of emergency. Such assistance, moreover, may have continued to flow from elders to their children and other kin. We should not assume that the elders were necessarily poorer than their adult children. But widows and infirm widowers who did not manage to remarry might be in a difficult position. Even in England, in situations of need or where property was involved, the elderly might join or be joined by adult offspring in a stage of what David Kertzer calls a nuclear reincorporation model.

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For knowledge about the elderly without property and without children, the best historical sources concern charitable institutions. In England the destitute elderly were supported partly by the poor-law system and partly by relatives. One kind of support might complement the other. Lynn Botelho has found a significant percentage of seventeenth-century elderly receiving assistance in two small villages of Suffolk, but discovered that the amounts provided were considerably less than for the younger poor. She also found that one community was more generous than the other, probably because it was wealthier, but possibly because of greater religious motivation. Continental Europeans dealt with the poverty of the elderly in a variety of ways. Catholic charity was often based upon the activities of confraternities. German assistance to the aged tended to be local, while some French institutions were supported by the monarchy. Sherri Klassen has looked at urban elderly women in eighteenth-century France and found a variety of ways in which neighbors and coworkers met the impoverished elderly's minimal needs.

Culture undoubtedly played some role in determining patterns of residence, but structures varied according to the local economy. Thus, separating family from work history is artificial. Families were work-units, and the modern tendency to separate interest and sentiment is an obstacle to understanding the past. Within generally prescribed patterns of residence and inheritance, families worked out labor responsibilities and expectations for succession. Sharecropping households in southern Europe often joined together generations and kin. Feudal landlords sometimes forced transmission of limited authority from a less productive older generation to the next. In a very different spirit, some northern European elders chose retirement at their children's expense.

WORK AND RETIREMENT EXPERIENCES

Preindustrial populations were overwhelmingly rural, and transmission of property usually took place gradually. But there were exceptions. Thus it is possible to speak of peasant "retirement." At a time when the "empty nest" was not yet a common experience—in recent times property tends to flow from the very old to the fairly old or to skip a generation—transmission of authority and individual retirement primarily involved aged parents and young adults. In many parts of Europe, the "old person's portion," room, field, or bench, was commonplace. Notarized maintenance provisions have led historians to speculate about the need for such assurances. Did the stipulation that adult children owed so much firewood or food indicate the absolute need for such provisions? Would children have neglected the elderly if not legally bound to care for them? Or did it simply set forth sensible guidelines? Whether they were effective or even needed, such legal agreements continued to be drawn up in rural areas into the nineteenth and early twentieth centuries. Eventually, rural exodus and changes in occupation rendered them less important. So did the rise of private and public pensions. Over the long term, individual arrangements were replaced or accompanied by transfer payments involving large bureaucracies that may well have shifted the locus of intergenerational tension from individual families to entire societies. One consequence may have been greater intergenerational solidarity within families, but that is hard to know.

Artisanal experience was occasionally comparable to peasant experience in terms of transmission of the patrimony. Tools and shops replaced tools and fields in notarized settlements. Workers' own organizations sometimes addressed issues of dependency. Provident funds, mutual aid or friendly societies, and savings banks had early origins, but they were more concerned with meeting short-term emergencies such as temporary disabilities and burial costs than with a long-lasting old age, which became more important in the nineteenth century. Such organizations always favored men over women.

With demographic aging, workers often tried to hold onto their jobs or shift to less burdensome tasks. Adaptation to new tasks indicates a traditional approach that continued even into the era of industrialization. It has been suggested that elderly industrial workers were not a problem because aging workers tended to move into other occupations. The notion of career was not yet fully formed, especially among proletarians. Thus old age pensions for industrial workers often struck those workers as deferred payments they would never see.

Workforce participation was high for the elderly in the nineteenth century, higher perhaps than in preindustrial Europe. In such circumstances, retirement came only with disability or a downturn in the economy. It was not a condition to be sought. Participation of the elderly in the workforce fell dramatically in the twentieth century. In England, for example, 73.6 percent of males aged 65 and older were defined as "economically active" in 1881; that figure fell to 56.9 percent in 1911, 31.1 percent in 1951, and 8.7 percent in 1991. It was not a consistent decline, as wartime demand temporarily reversed the trend, and interwar rates of labor force participation remained exceptionally high in France, but in general (and especially in the second half of the century) healthier elderly, physically capable of working longer, retired. Historians have debated the degree to which this was a matter of choice. They have also debated the role of business and of the state in the spread of retirement. Were systems of social security largely responses to national emergencies, or did the creation of social security systems encourage retirement? Both situations can be found, and particular political parties, unions, and interest groups pushed differently for state pensions.

The Bismarck pensions in Germany are often described as the policy of a conservative politician seeking to steal an issue from the socialists. It was not an issue that was high on the socialist agenda before the late nineteenth century, but it had appeared from time to time on the European left since the French Revolution. Nineteenth-century political thinkers spoke about a social debt to the aged, but little was actually done for elderly other than soldiers or civil servants. By the late nineteenth century, a right to retirement was proclaimed from many quarters. Bismarck's state socialism developed out of an awareness of how private pensions served to discipline workers. Social welfare systems financed by general revenues are commonly assumed to be most highly developed in Scandinavian countries as a result of social democratic activism in the 1930s; however, Peter Baldwin has argued that in the late nineteenth century Danish and Swedish agrarian middle classes demanded universalist and solidaristic social legislation so as not to be denied benefits socialists were demanding for urban working classes.

STATE INTERVENTION

Before the spread of social security, European states addressed issues of aging and retirement at two levels: rewards to civil servants in the form of pensions and assistance to the poor. The structure of pension systems was elaborated in the world of the relatively privileged public servants. Formulas for arriving at payment schedules were worked out long before the social security era. Early modern pensions had usually been paid at a wide range of ages for services rendered, not as a reward at the end of a career. Dock workers in the English customs service (1684–1712) and tax farmers in France (1768) were early beneficiaries of retirement systems, but military pensions in the eighteenth century provided the most influential models for civil service pensions in the nineteenth. Different government ministries often set up their own systems, which were eventually standardized and centralized in France in 1853, Great Britain in 1859, and the German Empire incrementally in the 1870s and 1880s.

Salaried industrial workers were next to receive pensions, and miners tended to be first in that group: 1854 in Prussia, 1894 in France. Railroad workers followed. Meanwhile, private pensions continued to play a role, paternalistically aiding and disciplining a minority of workers. In Britain friendly societies were more common, thus maintaining the middle-class ideal of the provident worker. But that image changed as social investigations, similar to those conducted on the continent, revealed a significant population of aged poor. Social insurance was passed in Germany under Bismarck in 1889, in Britain in 1908, and in France in 1910, but coverage varied: the Germans covered white-collar workers, the British focused on the poor, and the French included farmers. Coverage of the self-employed and professionals generally awaited the welfare state legislation following World War II. Private pension schemes, far from being replaced, continued to grow in the welfare state era. Income packaging was more common than dependence upon a single source of support.

The image of the retired worker included the Bismarck pensioner who was really a victim of disability rather than age and the French pensioner who had a "right" to leisure at a particular age, but the image was always male, and all across Europe state pensions were designed for older men. Women were offered widows' pensions or their own, usually at lower rates. Age at retirement varied as well, but national systems tended to imitate each other. The Bismarck pensions had an impact throughout Europe, and the return of Alsace and Lorraine to France after World War I resulted in the continuation of German rules in French territory.

Studies of state pension systems indicate the eventual emergence of retirement as a way of managing old age, but that stage was reached incrementally. Often parties of the Left avoided the issue, seeing forced retirement as a trap and old age pensions as devices for cutting wages. They were particularly hostile to contributory pensions, demanding instead non-contributory pensions paid out of general revenues. Businessmen and civil servants saw contributory pensions as fiscally responsible and providing a clearer individual right; they saw noncontributory ones as open-ended, too expensive, and overly redistributive. Members of friendly societies feared losing control of pension funds. But they eventually compromised, and the late nineteenth and early twentieth centuries saw the development of social welfare policies that dealt with old age, retirement, widowhood, and medical care.

Over the long run, social security systems contributed to the development of a three-stage life course: training, work, and retirement. Particular debates about retirement pensions revealed serious disagreements over issues of equity and purpose. Pensions based upon male breadwinner assumptions marginalized women, who were consistently the majority of the elderly. Age of eligibility and requirements to leave the workforce were hotly contested. Did pensions exist as insurance for the aged poor or as a right for all elderly?

MEDICALIZATION AND INSTITUTIONALIZATION

As European welfare states created greater coherence out of individual institutions dealing with income, housing, and health, attention focused on the medicalization of old age. The process was not completely new. A medical literature on preventing aging and works addressing the diseases of the aged go back to the ancients; like other wisdom from the classical past, these ideas were revived in the Renaissance. The eighteenth century saw a western European campaign for public health, the beginnings of a long-term professionalization of health practitioners, a greater differentiation between age groups in medical publications, and the proliferation of projects for hospitals and hospices.

Institutions changed slowly, but hospitals and workhouses assigned different roles to people of different ages. Nineteenth-century poorhouses were transformed into old age homes. Nursing homes and other facilities emerged in the twentieth century, and hospitals themselves, overcoming popular fears that they were essentially places to die, witnessed a dramatic aging of their populations. Young men were more likely to be found in French and German urban hospitals than old men or women at the beginning of the twentieth century. All that would change. In a sense, the popular turn to medicine still preceded the medical profession's discovery of its new clientele. Consuming medicines, paid for by the state, became the norm for the European elderly in the second half of the twentieth century. An unmedicalized old age became virtually unthinkable.

Geriatrics has proved successful, but it has hardly shared the heroic image of other specializations. A medical practice that emphasizes treating chronic illness, easing pain, improving quality of life, and observing the process of dying was often less attractive than one that cured acute illness and restored patients to youthful vigor. Gerontology, resulting from the fusion of different strands of the social and health sciences, has perhaps been more successful than geriatrics, which developed as a branching off from mainstream medicine. We are back in the realm of culture.

CULTURAL REPRESENTATIONS AND POPULAR ATTITUDES

Some historians have moved relatively easily between cultural representations of old age and popular attitudes about it. King Lear provides a lesson about the risks of premortem transmission both for kings and farmers. It has spoken to rather diverse audiences ever since Shakespeare wrote it, and it derived from earlier tales. But as paths of inheritance in the twentieth century have tended to skip generations, and as aging Europeans depend more upon state-administered transfer payments and less upon private patrimony, that great tragic expression has probably come to be more about intergenerational sentiment than property, which long remained a subject for peasant proverbs. Throughout Europe one might have heard that a father can raise one hundred children, but not one of a hundred children can support an aged father. Such folklore survived into the twentieth century.

Stereotypes of the elderly still abound. Modern Europeans have an entire menu of possibilities. Attitudes toward the elderly are multiple, but emphases have been different at different times. In the early modern period, witchcraft became associated with elderly women. Even when witch-hunting came to an end, the image survived. The respected elder emerged as a common figure in eighteenth-century culture, which frowned upon traditional ridicule. It is possible to recognize an emphasis on both the decrepit aged in certain discussions of the welfare state and the young old in appreciations of the positive features of age-transformed populations.

A significant change occurred in the last quarter of the twentieth century, when retirees could look back on an earlier generation that had pioneered retirement. Expectations changed accordingly. Retirees not only traveled and became active consumers, but increasingly changed residence after retiring from the workforce. But knowledge of what previous generations have achieved is tempered by the various ways in which aging people move from the "active" life to the third age. Some still experience retirement as disability. Others experience it as a choice and a cultural opportunity. They take up serious projects and participate in "universities of the third age." Still others approach it through premature unemployment, which is a challenge for individuals and for social security systems. The unemployed may become the retired long before becoming elderly.

The third age is the happy side of contemporary European aging. It combines health, wealth, and possibilities for cultural enrichment. The fourth age, looking much like indigent old age of a century ago, but lasting longer, poses challenges of a philosophical as well as economic and political nature. Social history suggests that neither broad demographic changes nor individual predicaments can be understood in isolation. It is hard to imagine a reversal of demographic aging, and demand for labor in countries with large numbers of elderly will result in population movements. The twentieth century has seen immigration to Europe from the former colonial world—that was the specter for some of the conservative demographers who first noticed the phenomenon of demographic aging. The formation of the European Union is accelerating another historical trend, the migration of Europeans from countries of relatively high fertility and unemployment to other parts of Europe. And yet fertility declines in Italy, formerly sluggish economies develop, and European governments, recognizing the historic trend of increasing productivity, are experimenting with cuts in working hours. Leisure becomes as much of a problem as work. Questions of intergenerational equity, not as yet so explicitly posed as in the United States, force their way onto political and social agendas. And the institutional challenges of the very old may test European ideals of intergenerational solidarity.

See alsoThe Population of Europe: Early Modern Demographic Patterns; The Population of Europe: The Demographic Transition and After; The Life Cycle (volume 2); and other articles in this section.

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