"Hundreds of care home residents killed by thirst" is one shocking but unsurprising recent headline concerning the plight of working class elderly. Another newspaper offered "the plan to solve our care home crisis" the author of which would do well to acquaint himself with the history of the Child Poverty Action Group. Truly, poverty is an age old 'problem', one which cannot be reformed away, as this Socialist Standard article from June 1988 explains.
In a capitalist society goods are produced to make a profit and workers are viewed primarily as economic units who can be exploited for their labour power. The elderly, having withdrawn from productive work are, therefore, at an economic disadvantage.
Hardship in old age is not a recent problem: pre-capitalist societies also recognised, and tried to legislate for, withdrawal from work. The Statute of Labourers in 1349 recognised that poverty might be the result of disability or old age. Although the Act regarded 60 years as the age at which a man might be expected to stop working, the average life expectancy in the Middle Ages was 35 years so the number of peasants surviving to old age was quite small.
Each parish became responsible for its own poor and helpless with the passing of Queen Elizabeth' s Poor Law Act in 1601. This Act distinguished the sick and aged from the able-bodied. Further legislation followed in the industrial era with the passing of Gilbert's Act in 1782, which enabled parishes to combine into unions and establish reformed workhouses to care for the elderly, the sick and infirm. George Crabbe, in his poem, The Borough, written in 1810, described the reformed workhouse as: " ... a prison with a milder name, which few inhabit without dread or shame", The Poor Law Amendment Act of 1834 obliged the destitute to enter an institution. And as many ofthe destitute were sick or elderly, these institutions were quite unsuitable.
The lack of pensions allowed few people to retire voluntarily. And, in Britain at the beginning of the twentieth century, two thirds of men aged 65 were still working. One in ten of the population over 65 years was a pauper, one in five at age 70, and one in three at age 75.
The fear of the workhouse in the 1880s has been described by Flora Thompson. "As soon as he realised where he was being taken, the old soldier, the independent old bachelor, the kind of family friend, collapsed and cried like a child. He was beaten. But not for long. Before six weeks were over he was back in the parish and all his troubles were over, for he came in his coffin." (Flora Thompson, Lark Rise, 1939)
The Poor Law was abolished in 1929 but many of the old buildings remain in use today as geriatric hospitals. Apart from the fact that these outdated buildings are devoid of comfort and entirely unsuitable for modern nursing, they retain a stigma of punitive discipline, shame and degradation that is remembered by the elderly.
To prevent the elderly becoming a burden on the parish a pension of five shillings (25p) a week for people over 70 years of age, subject to a means test, was provided in 1908.
Retirement age has fluctuated according to the need for labour: in the 1950s, at a time of acute labour shortage, politicians urged workers to retire later and warned that giving up a working routine caused premature ageing. The sociologists of the period pointed out that the increase in the proportion of the elderly population had been accompanied by a decrease in the proportion of the working population, and that the trend would continue for the next 30 years. In 1954 the Phillips Report suggested that the retirement age should be raised.
By the 1970s the need for labour was considerably reduced as a result of economic recession, and financial inducements were offered to older workers to retire earlier. This happened despite an increase in people aged over 65 years from ten per cent of the populationin 1951 to 12 percent of the population by the late 1970s. But this was consistent with the needs of capital for, at a time of recession, surplus labour was being discarded as no longer profitable to employ.
Low-paid, tedious work is often all that is available to those who have been compulsorily retired at the statutory retirement age and during periods of recession even their ability to form a pool of cheap labour declines. Women have been regarded as marginal to the labour force and permitted to work in mainly part-time and unskilled jobs when there is a demand for labour, only to become unemployed and expected to stay at home and care for sick and elderly relatives when public services are cut during a recession.
The role of older women as a reserve labour force has been demonstrated in hospitals prior to 1974 when there was a 20 per cent shortage of nursing staff. Women over retiring age formed up to ten per cent of the nursing establishment, particularly in the bigger hospitals in the larger cities, in the less popular branches of nursing such as geriatrics, mental illness and mental handicap, and in nursing auxiliary or nursing assistant grades. But with the closure of hospitals, reduction of beds and the availability of younger women prepared to work in hospitals as a result of unemployment, the services of older women were no longer required and they were compulsorily retired.
Workers forced into premature retirement by being made redundant often lack financial security in old age. "Too little to live on, too much to die on; too old to work, too young to die", may be the harsh reality of early retirement.
Elderly women often suffer greater hardship than men as they are less likely to have had the opportunity to partidpate in index-linked occupational pension schemes. The loss of a spouse and joint income is more likely to affect women because of their greater longevity and this often creates finandal difIiculties.
Property lacking in basic amenities and sub-standard housing are much more likely to be occupied by the elderly. lncreases in suicide rates, deaths from tuberculosis, mental disorders and hypothermia are all associated with poor house design. The elderly are particularly vulnerable to the effects of poor housing, being more likely to suffer from hypothermia. Elderly men have higher suicide rates than young people, and mortality from tuberculosis is more common in old age. The link between poverty and acddental hypothermia in old age is well established, one in eight pensioners are cold both by day and night in winter, and a study carried out ten years ago found that 700,000 people were "at risk" as a result of physical disability, low income and poor housing.
The financial help available to the elderly to assist them with fuel costs is poorly publicised, hopelessly inadequate and confined to the poorest pensioners in receipt of supplementary benefit. The link between poverty and malnutrition is well known, and the DHSS estimated that three per cent of the elderly suffered from malnutrition in 1972.
A lot more could be done to educate the ederly about the dangers of hypothermia, and dietary advice could be given to the housebound elderly as the bodv's requirements are altered when a person is unable to synthesize ergosterol in the skin, to produce vitamin D, by contact with sunshine. The money spent on health education is inadequate to inform the public properly, and is derisory compared with the massive advertising campaigns which accompanied the sales of nationalised industries.
Legal sanctions can be resorted to under section 47 of the 1948 National Assistance Act to deprive elderly people of their rights.
"Society applies lengthy proceedings befare the liberty of an individual is taken from him for other reasons. Yet the liberty of an old person who fails to achieve the standards of cleanliness and behaviour considered suitable by doctors, health visitors and social workers, can be quietly taken away with no one to come forward in the defence of the old person." (F. Barrowdough, "The elderly in institutions", Nursing Mirror, 1977)
The rising number of old people has severely strained health and social services, and although more efficient use of resources has been made (by exploiting health and social services workers) the fundamental problem - that non-producers rate low priority under capitalism - has not been resolved.
Private residential homes for the elderly have profited from the lack of adequate public services, assisted by government grants to cover the co st of residence. But the elderly have pressure put up on them to seil their own homes to pay for private care when they become "long-stay" patients in hospital. The state retirement pension is also considerably reduced for hospital in-patients - a further indication of their loss of rights and status. The standards of care in private residential and nursing homes are scrutinised (in theory) by each local authority. But local authorities are under pressure because they have to accept responsibility for the residents of homes that they close, which severely strains their limited resources.
Pressure groups try to improve conditions for the elderly but ultimately they fail because they try to reform capitalism instead of changing it. When workers decide to abolish the wages system and produce for human needs instead of profit, then hardship and insecurity in old age could become a memory of capitalism's barbaric past.