van Hees Susan, Horstman Klasien, Jansen Maria, Ruwaard Dirk
Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands; Academic Collaborative Centre for Public Health Limburg, Regional Public Health Service, Geleen, The Netherlands.
Department of Health Ethics and Society, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
J Aging Stud. 2015 Dec;35:178-89. doi: 10.1016/j.jaging.2015.09.001. Epub 2015 Sep 29.
Ageing societies and increasing healthcare expenditures are inducing Western welfare states to reform their care arrangements. In a qualitative research project, we explored how citizenship in old age is constructed in a public innovative care practice situated in the southern part of the Netherlands: the shaping of 'life cycle robust neighbourhoods'. Life cycle robustness entails a further not formally defined ideal of age-friendly places, enabling older adults to live independently for longer periods of time. Participation is being presented as an important element towards life cycle robustness. We used ethnographic methods to understand different constructions of citizenship in old age. We analysed documents and interviewed local policymakers and civil servants, managers and directors in the fields of housing, care and welfare, professionals working for these organisations, and older adults living (independently) in these neighbourhoods (n=73). Additionally, we observed formal and informal meetings and organised focus groups. Our findings demonstrate conflicting notions of old age. Policymakers and civil servants, managers and directors, professionals, and even representatives of older adults share a belief an activation policy is necessary, although they differ in how they interpret this need. Policymakers and civil servants are convinced that societal and financial incentives necessitate current reforms, managers and directors talk about quality and organisational needs, while professionals mainly strive to empower older adults (as citizens). Simultaneously, older adults try to live their lives as independent as possible. We argue that, whereas old age became a distinct category in the last century, we now recognise a new period in which this category is being more and more de-categorised.
老龄化社会以及不断增加的医疗保健支出促使西方福利国家改革其护理安排。在一个定性研究项目中，我们探讨了荷兰南部一种公共创新护理实践中老年人公民身份是如何构建的：“生命周期稳健社区”的塑造。生命周期稳健意味着一种尚未正式定义的适合老年人居住场所的理想状态，使老年人能够更长时间地独立生活。参与被视为实现生命周期稳健的一个重要因素。我们采用人种志方法来理解老年人公民身份的不同构建方式。我们分析了文件，并采访了当地政策制定者和公务员、住房、护理和福利领域的经理和董事、为这些组织工作的专业人员，以及（独立）生活在这些社区的老年人（n = 73）。此外，我们观察了正式和非正式会议，并组织了焦点小组。我们的研究结果表明了对老年的相互冲突的观念。政策制定者和公务员、经理和董事、专业人员，甚至老年人的代表都认为激活政策是必要的，尽管他们在如何解读这种需求上存在差异。政策制定者和公务员坚信社会和财政激励是当前改革的必要条件，经理和董事谈论质量和组织需求，而专业人员主要努力增强老年人（作为公民）的权能。与此同时，老年人努力尽可能独立地生活。我们认为，尽管老年在上个世纪成为一个独特的类别，但我们现在认识到一个新阶段，在这个阶段中这个类别越来越去类别化。
