British Journal of Social Work (2010) 40, 1118–1134 doi:10.1093/bjsw/bcq001 Advance Access publication January 27, 2010 Perceptions and Presentations of Living with Everyday Risk in Later Life Joanna Bornat* and Bill Bytheway Joanna Bornat is Professor of Oral History at the Faculty of Health and Social Care, The Open University. She is joint editor of Oral History and joint reviews editor of Ageing and Society and a member of the Academy of Social Sciences. Her research interests include remembering in late life, methodological issues in interviewing and the re-use of archived qualitative data and intergenerational relationships within changing families in a changing society. She is a grant holder in the ESRC Timescapes Programme and principal investigator for the ESRC-funded South Asian overseas-trained doctors and the development of geriatric medicine. She has coauthored a number of edited collections, including Oral History Health and Welfare (2000), The Turn to Biographical Methods in Social Sciences (2000), Biographical Methods and Professional Practice (2004) and Developments in Direct Payments (2006). Bill Bytheway is Senior Research Fellow in the Faculty of Health and Social Care at the Open University. His main interests are in ageism, the experience of ageing and research methods. He has recently completed research on age discrimination (with Help the Aged), age and birthdays (with the Mass-Observation Archive) and medication in later life. He is a Founding Fellow of the British Society of Gerontology and a member of the Academy of Social Sciences. He was editor of the journal Ageing and Society (1997–2001) and author of Ageism (Open University Press, 1995). * Correspondence to Joanna Bornat, Faculty of Health and Social Care, The Open University, Walton Hall, Milton Keynes MK7 6AA, UK. E-mail: j.bornat@open.ac.uk Abstract In a context of neo-liberalism, individual responsibility for risk and the protection of individuals from risk has led to risk management and assessment becoming central to the practice of social work. Social workers’ involvement with older people tends to occur in crisis situations, with the result that stereotypical understandings of the vulnerability of older people may be reinforced. Drawing on data from interviews and diaries, the article presents a temporal analysis of the ways in which perceptions of risk are presented by older people themselves and the people close to them. It reveals how older people link risk to family, health and social relations, and how they account for their continuing survival. In interviews, older people present their lives as well ordered and organised. By contrast, diaries that detail their everyday activities offer evidence of a more active engagement in risk avoidance, suggesting that living with everyday risk is a salient feature of late life. Integrating these two temporal framings, we argue for a more processual understanding of risk in later life and how it is evaluated and experienced by older people. # The Author 2010. Published by Oxford University Press on behalf of The British Association of Social Workers. All rights reserved. Living with Everyday Risk in Later Life 1119 Keywords: Ageing and older people, risk, social policy, social work, qualitative methods Accepted: December 2009 Introduction In this paper, we draw on data from recent research to discuss substantive issues that emerge from a consideration of the meaning and management of risk in the everyday lives of people over the age of seventy-five. In a society with welfarist traditions, but moving rapidly in a neo-liberal direction (Webb, 2006), risk assessment and management have become central to the thinking and practice of social work through the increasing politicisation of its role (McLaughlin, 2008). Social work has become enmeshed in the identification and codification of risk factors. This leads to policies and practices, including the drive towards personalisation (Department of Health, 2008), that impose responsibility for certainty on individuals and that identify and target those seen as not managing their lives effectively or as offering some kind of risk to society (Kemshall, 2002; Webb, 2006). Risk tends to be associated in social work with assessing and preventing the possibility of future harm (Webb, 2006) and has, as Kemshall (2002) argues, replaced the meeting of need. This focus on protection has certain consequences, some of which we discuss later in the article. At this point, we would only suggest, with McLaughlin, that social policies that rest on protection from risk ‘view us all as weak and vulnerable’ (McLaughlin, 2008, p. 131) and, with Ray et al. (2009), that seek to avert risk-taking is ‘to promote and reinforce images of older people as passive and dependent, and to deny personhood’ (Ray et al., 2009, p. 47). Indeed, Tanner argues that ‘the freedom of risk-taking’ should be seen as ‘a fundamental right and part of everyday experience’ (Tanner, 1998, p. 21; see also Jordan, 1990). However, given social work’s role in regulating and identifying failure in a context in which risk avoidance is seen as a civic duty of the individual (Webb, 2006), such ideals may be hard to sustain or act upon, for both the social worker and their clients, actual and potential. Older people live with forms of risk that offer both opportunity and constraint. Opportunity is presented through retirement from paid work routines and, in contrast with previous cohorts of older people, the de-institutionalisation of the life course (Bengtson et al., 2005) and a shift away from normative expectations of age-appropriate behaviours and involvements. With this come possibilities for a ‘third age’ of choice and the selection of preferred identities and resistance to a feared ‘fourth age’ of frailty and dependence (Gilleard and Higgs, 2005, pp. 162 – 3). As at other ages, risk in late life is very much future-oriented (Webb, 2006). However, where risk is linked to safety and security and the future is 1120 Joanna Bornat and Bill Bytheway projected as a state to be feared, then risk in late life may be experienced more as a constraint and a curtailment of choice and independence. The data on which we base our argument, consisting of diaries and life history interviews, are both biographical and autobiographical as well as qualitative and longitudinal. The contribution of biographical work to userfocused professional practice is well attested from studies that demonstrate the value of an ‘intertwining of past and present’ in working to achieve individualised and appropriate outcomes (Chamberlayne et al., 2004, pp. 6 – 7). Here, we argue that understanding risk in late life requires an appreciation of its discursive production as well as its somatic presentation. By this, we mean ways in which perceptions of risk are constructed socially, subjectively and contextually, and experienced and anticipated through bodily experiences. From this, we argue that social work with older people involves recognising that living with risk is an ongoing process, open to rational evaluation and preventive action on the part of the risk taker and those close to them. However, this approach, which should be undertaken as a developing process, actively engaging with the expressed preferences of an older person, is unlikely to sit easily with assessments that are based on limited universalising predictions. Such assessments, determining access to resources, draw on narrowly conceived notions of safety (Webb, 2006). Beginning with a consideration of how risk has been theorised, we go on to consider the implications of the manner of its assessment for work with older people, before presenting our research methods and analysis, through which we view ways in which risk is recognised, evaluated, negotiated and acted upon in relation to social and bodily experiences. We conclude by arguing that life with risk should be viewed developmentally as a negotiation that constantly entails compromises in response to the existential realities of everyday late life. Theorising and experiencing risk in late life How risk is theorised has been consistently tested in relation to late life. Indeed, within social and health policies, risk has a long genealogy, assessments of risk identifying who might be deserving of support in late life, and segregating the recuperable from the irrecuperable (Pickard, 2009; Bornat et al., forthcoming). Despite this, late life scarcely features in more general theoretical debates of risk. It has been argued that the theorising of Beck (1992) and Giddens (1991) set the parameters within which social work theory has developed and debated the realities of risk (McLaughlin, 2008). In neo-liberal times, social policies, at one and the same time, demonise the welfare state yet insert ever more intrusive means of centralised social and political control within private areas of people’s lives. In this context, the discussion of risk has become an instrument for the injection of concern about safety Living with Everyday Risk in Later Life 1121 into everyday life and, with it, the privatisation and calculation of responsibility for protection from harm. Where Beck (1992) argues that ‘advanced modernity’ is typified by higher levels of risk, Giddens’ (1991) position is that risk is no greater, but that perceptions of threat and danger have increased. Both see the consequences as greater levels of reflexivity as people seek ways to moderate, maximise or avoid risk and, in so doing, engage critically with expert opinion. They deploy available resources and take on individualised responsibility for risk avoidance and ownership of the consequences of their decision making (Lupton, 1999). Late life presents challenges to ideas of individualised lifestyles that assume rational risk management and the maximisation of advantage and choice. For example, the significance of well-being takes on added meanings when linked to such basic aspects of the human condition as maintaining autonomy and independence in the face of financial insecurity or the concerns of significant others. In particular, risk takes on a different character when the individual is attempting to delay or deal with the prospect of foreseeable death. Late in life, the resources that are most important to people appear to be personal health, one’s own or that of a partner. Change in either may set limits on social engagement or may lead to a change in location or the severing of meaningful friendship ties. For younger people, changes in health status are not linked quite so closely to threats to identity and lifestyle (Scott et al., 2009). Overall, it would appear that in late life, Beck’s idea of ‘individualisation’ is, in its most positive sense, an aspiration rather than a goal. Indeed, it is qualified by social policies that, as Webb (2006) points out, seek to regulate and categorise risks and protect those perceived to be vulnerable. Assessment of risk is left to individuals until a crisis makes self-management too risky. At that point, social work risk assessment takes over, with its attendant aims of rationing and standardising care practices (Webb, 2006). Amongst the results of this for the individual are high levels of anxiety about the future and about being identified as vulnerable. In other words, social work intervention itself may be perceived by some as a risk in later life. Social workers, as they attempt to balance personalisation and protection, are left in a difficult position when intervening in the lives of older people for whom a lifetime of experience informs choice and preferences and who may choose a life with risk over other options. Assessing and reducing risk in later life Wenger points out that when older people have a ‘robust support network’ of family, friends and neighbours, all living within five miles, ‘the need for formal interventions occurs only at high levels of dependency’ (Wenger, 1997, p. 313). This is the most common of the five types of network that 1122 Joanna Bornat and Bill Bytheway she identifies as prevalent in the UK. The contrasting ‘private restricted support network’ in which people live alone and are distant from any kin is the group most at risk of needing support and is ‘the dominant network on social work caseloads, where it is four times as prevalent’ (Wenger, 1997, p. 315). One of the effects of this is that practitioners’ understanding and experience of risk management in late life are determined largely by persistent exposure to such situations. Richards and colleagues (2007) similarly argue that given eligibility criteria that lead to social workers working with only the most vulnerable older people, they tend to have a biased understanding of old age. This limited exposure will also be exacerbated by the increasing tendency to work in specialist teams. A lack of experience of working with a wider range of older people tends to reinforce the stereotypical view that old age is a time of high risk, limited ability and an increased need for protection (Richards et al., 2007). This may lead to people being defined by social workers as ‘at risk’ in order that they gain access to resources (Ray et al., 2009). A focus on assessment and intervention may neglect a lifetime’s experience in surviving risk or of how managing risk is a continuing and developing process in everyday life. Tools to assess risk that are based on checklists only exacerbate this situation, since they depend on a model of reality that is far from older people’s life experience. Webb (2006) suggests that open-ended questioning may be far more fruitful by providing richer insights into someone’s past and present life. Most aids to risk assessment, however, tend to be based on survey research that is typically quantitative and non-participative in style. As evidence-based procedures for preventive intervention, they are similarly limited, being easily quantified and providing measurable outcomes. This can lead to uneasy partnerships when the tool aims both to ‘facilitate a person-centred conversation suitable for older people’ and ‘be presented and designed to support professional judgement’ (see Department of Health, 2003, p. 2). Equality is likely to be difficult to maintain when outcomes are also measured against targets and funding constraints. Studies that evaluate the perception of risk by older people themselves reveal a greater range of complexity than is represented in these surveys (McKenna, 1993). Attempts to enable professionals to measure and anticipate vulnerability tend to ignore the prior and continuing engagement of older people in dealing with the ‘moral crises’ posed by critical health changes and the prospect of death (Ferguson, 2001, p. 43). With a focus on immediate risks, professional assessments displace the significance of past time and focus on a present time depicted as a series of snapshots of everyday action. Recommendations may be often imbued with ageist expectations, preventing older people from knowing the full implications of the decisions they are being encouraged to take. Victor et al. (2005), for example, argue that interventions to reduce loneliness among older people neglect changes in older people’s lives and their awareness of time passing. They conclude that a biographical approach, Living with Everyday Risk in Later Life 1123 rather than one based on a ‘static, single point-in-time’, is most likely to indicate when and who might be at risk. Loneliness takes different forms and changes over time, and its ‘onset’ may have different ‘pathways’ (Victor et al., 2005, pp. 371 –2). So, we would argue, an assessment of risk is just one event in the course of a complex and unfolding process. Drawing on data from The Oldest Generation project, we have identified a number of such pathways in analysing how people live with and articulate risk in everyday lives. The Oldest Generation is one of seven projects in the ESRC-funded Timescapes programme, RES-347-25-0003. Methodologically, Timescapes has generated qualitative longitudinal data with a view to understanding family and close personal relationships over time and through the life course. In this paper, we draw on three case studies and the analysis focuses on risks associated with accidents, providing care, the loss of independence and death. First, however, we provide a brief summary of our project methods and the data that have emerged. Sources and methods The fieldwork for our project involves tracking twelve families, initially over the course of eighteen months, by recording the biographies, past and present, of their oldest members and setting these in the context of unfolding family histories. A sample has been recruited purposively through the UK-wide Open University network. The twelve were selected from approximately forty volunteer families, using criteria based on sex, age, living arrangements, class, ethnicity and geographical location. This ensured that it was as diverse a sample as possible. The planned fieldwork required someone aged seventy-five or more in each family to volunteer to be ‘the senior’—a term we use to distinguish the interviewees from other older people in their families, who would then be the focus of the research. We also required one person to volunteer to act as ‘the recorder’. In one family, the recorder is also the senior and in another, the recorder is the senior’s husband. The other ten recorders are all of the younger generation: seven daughters, two sons and a niece. Repeat life history interviews with the senior enabled us to collect retrospective as well as prospective data. The first wave of interviews was undertaken between July and December 2007 and this focused on the individual’s history and heritage, retrospective accounts of key life events and current patterns of family and non-family contact. Life history interviewing does not pre-judge biographies, allowing the interviewee to dictate those events and experiences that have determined the course of their lives (Gluck and Patai, 1991; Roberts, 2002; Bornat, 2004; Goodley et al., 2004; Perks and Thomson, 2006; Reissman, 2008; McLeod and Thomson, 2009, Chapter 3). In this, it is rather like social work in its traditional form, before the introduction of the check-list approach to assessment. 1124 Joanna Bornat and Bill Bytheway Over the same period, the recorder has kept and posted to the project office a monthly diary and occasional photographs of family events. By having diaries returned routinely every month, the project has maintained regular contact with the families. The diaries, of course, offer accounts of the seniors’ lives that are filtered through the views and experiences of the recorders. There are substantial differences between the twelve families in the relationship between senior and recorder, in the locations of where they live and in their contact-keeping routines. Moreover, some recorders sought to produce an account that was almost exclusively of the senior’s lives whereas others sent us diaries that were much more broadly focused. Nevertheless, wanting daily entries that extended over a period of eighteen months, we realised that this was only possible if we allowed families to participate in ways that drew upon, and reflected, their continuing family practices and personal inclinations and opportunities. The two perspectives, diary and life history, present contrasting, sometimes complementary, sometimes contradictory, accounts of late life. They facilitate an understanding of the complex nature of risk and its management within families, and the need for risk to be interpreted as a developing process and continuing concern. Through their different styles and forms of narrative, interviews and diaries uncover contrasting temporal effects and responses to evidence of risk. In some instances, the life history interview makes the senior’s way of life seem secure and manageable, whilst the diary describes a more restricted, unpredictable and dependent existence. During the course of the fieldwork, two of the seniors have died, in both instances as a result of terminal illness. Of the other ten families, two recorders maintained their diaries for no more than six months. From the other eight recorders, however, we have received a detailed record, largely day by day, of the lives of the senior over a period of at least twelve months. In total, we have received 145 monthly diaries. Most of the diaries are handwritten, but four have used e-mail, finding this more convenient. Recognising the complexity of individual lives and family relationships, we have not sought to obtain systematic data (Gubrium and Holstein, 2002). To a large extent, we have allowed the participants to dictate the content of the interviews and diaries. In particular, we have not inquired specifically into the use of services, contact with professionals, risk or ways in which families have sought to make members of the oldest generation feel more secure. In our view, the serendipitous nature of the information gathered will reveal how and why certain family relationships are sustained or change, and what the consequences are for contact and support between the generations. Analysis Within the interviews and diaries of the twelve families, we first identified all explicit references to contact with ‘social work’ or ‘social services’. It is Living with Everyday Risk in Later Life 1125 quite likely, of course, that some contact has not been mentioned, but, if so, this, arguably, indicates that it was not considered sufficiently relevant. Conversely, when contact is mentioned, then we interpret this as something that was seen to have some significance in understanding the everyday lives of the seniors and their families. In three of the families, there was no mention of either ‘social work’ or ‘social services’. They include a senior who was a resident in a nursing home and another who has been a long-term carer for a disabled daughter. In two other families, the only references were unrelated to the oldest generation. This includes Alan Shaw’s family (his name is a pseudonym, as are the other names used in this paper); we discuss his experience of living with risk in more detail below. And, in another three, the seniors, rather than being clients or recipients of social care, were: one whose husband was assessed for respite care whilst she travelled to attend a wedding; another who contacted the social services on behalf of a neighbour; and a third, Alice Watson, who attended an assessment meeting regarding the needs of her disabled brother (see below). Of the remaining four families, two seniors were involved in an assessment for the Carer’s Allowance. In one, the senior’s daughter, already caring for her parents, had requested this, anticipating the possibility that she might decide to retire from work. And, in the other, the senior was assessed as the carer for his wife, who had dementia. This leaves two families, the only two in which the senior was in direct contact with social services as a result of their own particular needs. In one case, this occurred in the final months of terminal illness and the support of social services was part of a wider package centred on continuing medical treatment. Marion Arthur, the senior in the second family, was visited in September 2008, most probably by an occupational therapist employed by the social services, about ways in which the risk of accidents might be reduced. Although the outcome was that there was nothing more that could be installed to reduce risks, there is much to be learnt from how this assessment fitted into the wider context of Marion Arthur’s life. In the rest of this article, we consider in more detail, first, Marion Arthur’s experience of the risk of falling; second, that of Alice Watson in supporting her brother and coping with the risks that he poses; and, third, Alan Shaw, whose experience of health crises has generated a concern with the risks these pose both for himself and his family. Avoiding accidents Marion Arthur (MR) was interviewed for the project on 30 August 2007. In the course of this, she described her poor sense of balance. She said she had fallen ‘more than once’ and had had to be helped up. She had bought a personal alarm: ‘If I fall I have to push a thing round my neck and somebody 1126 Joanna Bornat and Bill Bytheway will ring up and say do I need local help or do I need an ambulance.’ She said it was ‘really useful’, even though she had not used it yet. When asked to elaborate about her ‘local help’, she described how a neighbour would ‘come in from across the road’ and how there were other neighbours who would help if needed. On Monday, 26 November 2007, Marion had bladder problems and nose bleeds and, following a visit from a doctor, was admitted to hospital. She was discharged on the 28th and the following day, she was visited by the GP and district nurse. She appeared to have recovered, but that evening, she fell. This is what Adam, her husband, the recorder, wrote in his diary: On hearing a cry from the bedroom, I found she had just slipped off the side of the bed, and from that position I know she is unable to climb in again. I cannot lift her either. So I resorted to the alarm call (about 10.30) and they managed to contact Fred and Margaret (who had been out when I called). They lifted her up on to a chair and then she was able to get to the shower room for a wash. She managed to get herself to bed then and I thanked Margaret and Fred and let them go (Diary, 29.11.07). So, this was an occasion, possibly the first, on which they had used the alarm. Neighbours (Fred and Margaret) had come round and helped Marion off the floor. The following day, she ‘got up, but couldn’t do much’. Adam went shopping and, upon his return, found that two other neighbours had called. There was no further trouble and, on 2 December, Adam noted that her appetite was beginning to return. This, then, is evidence of the broader context in which ‘the social services’ called on the Arthurs the following September to ‘inspect the house’ for possible additional safety devices: They decided our present arrangements are satisfactory. They also assessed that we don’t need any other assistance for the time being (Diary, 02.09.08). From the interviews conducted with Marion, Adam filling in when she couldn’t recall, we learn that the two of them have had a long life of managing opportunity when they had their own business, as well as adversity, coping with the death of one of their three daughters. They work as a unit, but with Adam as manager of a lifestyle that is deeply embedded both spatially and socially in the area they had retired to some twenty years earlier. Yet, the interview shows another side to their partnership when Marion was asked about turning points in her life (in this and the following extracts, ‘I’ stands for ‘interviewer’): MR: (coughing) Well, in a way, it would be . . . when we decided to form a limited company Agar Scientific Ltd and I went to work in the company, looking after the money, looking after the cash coming in and out. That was definitely a sort of turning point. I: Mm, why do you feel that was a turning point? Living with Everyday Risk in Later Life 1127 MR: Well I’d just been the housewife before quite happily. But when this happened I realised I could cope pretty well with this, better than almost anybody else in our employ. And did. (laughing) I: It was a success at any rate wasn’t it? MR: Yes it was a great success. It’s still going strong (Interview, 27.04.09). At these and other points in the interviews, Marion’s individuality and strength of character are shown to complement Adam’s resourcefulness. Risk and responsibility for other people Alice Watson’s younger brother, Jack, was born in 1935 and has suffered from cerebral palsy all his life. She has constantly faced the risks involved in looking after his interests: the stress and logistics of ‘getting it right’. In her interview, she recounted how, as a child, she had been embarrassed by him and now feels ashamed of herself. Her mother died early and, in adult life, Alice and her father had to battle with the authorities on behalf of Jack. In the course of recounting Jack’s history, she told horrific tales of his treatment in large mental hospitals. When their father retired, he looked after Jack at home until his own well-being was threatened by Jack’s behaviour: . . . it carried on until my father was dozing one day and I think Jack wanted company but you see by this time—and I’ll go back to that in a minute—he was walking with two sticks. And he must have been sitting there and he must have, I don’t know why, but he’d hit my father with the sticks. My father was sitting opposite him and his knuckles had all swollen up and the GP then said ‘Haven’t you got the message?’ he said ‘Now you are really going to have to do something’ (Interview, 04.09.07). Through an adult placement scheme organised by the social services, Jack now lives with a carer. In the interview, Alice described her as a ‘fantastic woman’. She has just two permanent residents and occasionally takes in a third. Initially in her diary (although her son was the recorder, Alice sometimes made her own entries in her diary), Alice reports her regular visits to Jack during the course of the winter of 2007/08. Generally, she was ‘pleased and happy’ with his care and carer, and ‘thankful’ she was able to be with him without having the ‘burden of physical care’. He regularly visited a day centre and ‘appeared happy in his surroundings and the staff are so caring and interested in their charges’. Evidence of anxiety over risks to his well-being appeared in the entry (written by her son) for 24 October 2008: High drama with senior, Jack’s carer, and where is he, and why is he not here and why is he there and so on. Very involved. Most personal. Senior on phone all day ‘complaining’ she had not been told this or that and so on. Jack was safe and being cared for, senior decided where he was staying temporarily was too far to travel for a visit (Diary, 24.10.08). 1128 Joanna Bornat and Bill Bytheway There were no details in the diary about the ‘high drama’ other than further indications that Alice was unsettled by it all. Three weeks later, Alice wrote: . . . I had a visit from my brother’s social worker to discuss his (Jack’s) present and future care. We talked for 11 hours and resolved nothing 2 except to have a group meeting in December encompassing all aspects of the care required by a partially paralysed cerebral palsy elderly 73 year old . . . (Diary, 13.11.08). The following month, she had a ‘long phone call’ with the review officer. The problem centred upon Jack’s respite care; three weeks later, she attended a care review meeting: It was attended by two carers who rotate his care, representatives of the Social Services and the Mental Health Trust. At 73 and unpredictable, Jack’s suitability to be in a mixed children/adult setting was discussed. Liability for ‘accidents’ was the joint responsibility of the two agencies. Much discussion took place! (Diary, 15.12.08) At this time, Alice was eighty-six. She has concerns regarding risks to herself. For example, she lives near the Pennines and is fearful of the frost. The previous year, she had written ‘it only needs one frosty night and I am housebound, as my front paths never thaw out once frozen over’ (Diary, 08.12.07). She has had to balance responsibility for herself and for her brother for most of her life. His vulnerability has put demands on her that have not always been met by adequate service provision. Even now, late in their lives, changes in his care situation pose challenges for her. She has an absorbing responsibility for his welfare but no longer an ability to take all the actions that she feels are necessary. Living with risk In addition to identifying all mentions of contact with social work or social services, we also searched for evidence of perceived risk, both in the past lives of the twelve seniors and in their current everyday lives. We were particularly interested in two types of risk: of losing a sense of independence and of death following an accident or illness. One senior in particular provided detailed evidence of how older people can perceive such risks. Alan Shaw is aged eighty-two and he and his wife, Beat, live near Colchester. They are both from Essex families and Alan has three siblings living in the county. In 2006, both their children, Chris and Josie, were living in Australia, and Alan and Beat had been thinking seriously about moving there themselves. Josie and family, however, had returned to the UK and, at the time of joining the The Oldest Generation project in March 2007, they were living in a village in Leicestershire, three hours’ drive from Alan and Beat. Josie informed us that her parents were intending to move to live near her and that she was actively looking for a bungalow for them. Living with Everyday Risk in Later Life 1129 Alan was interviewed on 1 October 2007 at Josie’s house. Early in the interview, he confirmed that Josie was still looking for a bungalow. A sign of tension was evident when he remarked ‘I’m here with my wife because she likes to come up and see her grandchildren amongst other things’. At that point, he was asked about the village in Essex where they lived and it became evident that he was anxious about the risks of moving house and losing his sense of independence: Alan: I’ve got lots of friends obviously at the golf club, we’re not a particularly social couple, we haven’t got what we call very close friends, not many of them anyway, we’ve got one or two . . . but apart from that we’re very family orientated. I’ve got three sisters and a brother all alive and we meet fairly regular for, er, meals you know and chats that sort of thing (Interview, 01.10.07). Thus, his everyday social life was centred on the golf club and his siblings. The interview continued: I: Yes, so when you move up here that’ll be . . .. Alan: We shall lose them . . .. I: That’ll be a change . . .. Alan: We shall lose them, that is if we ever find a bungalow to suit us both which might be a problem. (laughter) Even though this was considered a joke, it is clear that Alan sees the prospective move as one resulting in a sense of loss. Later in the interview, when the pros and cons of moving to Leicestershire were discussed, Alan was asked again how he felt about moving and he replied ‘It’s horrible’. It is clear from the interview that Alan was particularly anxious about the risks involved in moving house. In contrast, Beat, without the same involvement in social activities in Essex, was keen to move closer to their grandchildren. In making the case, she focused on the future and the prospect that Alan would give up playing golf and be unable to drive them over to Leicestershire. Two days after the interview, they returned home and that was the day Josie started her diary. Here is her first entry: Before they went we spoke at length about their plans to move to Leicestershire. I hope it is what they want. To Dad it seems to symbolise getting old þ dependent on others. Mum just wants to be near us. Must get on with the search for bungalows for them (Diary, 03.10.07). In January, Josie sent them details of various bungalows. Now, she wrote: Mum rang to say they didn’t like the look of the bungalows I had sent them. Mum finding it difficult to consider down-sizing. Still not convinced moving is the best thing for them when they are both well. Discussed putting in a stairlift as it is the stairs they struggle with. Both appalled at the suggestion! Anyone would think they are old (Diary, 08.01.08). 1130 Joanna Bornat and Bill Bytheway On 21 January, she noted that they had looked at another bungalow and she was ‘not at all sure they really want to do it’. On 2 February, Josie received a phone call from the estate agent in Essex saying there was a ‘full price offer’ for her parents’ house. Josie phoned them. They agreed to phone back. When they did, they said they had decided not to move. Josie’s summary was: ‘Dad has his golf so why put themselves through it.’ The following day, she expressed her own feeling: ‘We would really like them closer but would all miss the connection with Colchester if they did move.’ Subsequent entries in her diary, however, indicate that although Alan was ‘enjoying his golf’, problems remained over the stairs. Regarding the risk of death, Alan described in his interview a number of experiences that have alerted him to the risks of mortality. He had previously had meningitis and, after spending Christmas 2006 with Josie and family, he had felt ‘terrible’ on the drive back to Essex. The following day, Beat rang the doctor and by the time she arrived, Alan was unconscious. He was transferred to hospital: Alan: I was out. I was in a coma for three days. . . . Chris came over from Australia because they said I was . . .. Beat: On the way out. Alan: I was. It was possible that I would not make it. . . . Beat had also had a near-death experience shortly after they had returned from a visit to Australia. They were in the garden, washing their dog, when: Alan: Beat suddenly stood up and said oh, I feel terrible and with that spark, right out, collapsed, she was unconscious for at least an hour, hour and a half, she didn’t come to until they’d got in the ambulance ready to take to the hospital. They didn’t know what was wrong with her to start off with, and then they said she could have had a brain haemorrhage, and to me a brain haemorrhage meant that was very, very serious. And when she was up in the hospital to have the, I knew the operation was on Saturday morning I think it was, and we’d been, I’d been told that the you know there was a five or seven per cent chance that she might not survive and we were at home waiting to hear from the hospital and the phone rang. I feared the worst but when somebody answered it, it was my brother-in-law from Watford asking how she was and I don’t mind admitting I sat on the stairs and cried. Alan and Beat had had other intimations of mortality. When talking about his generation, Alan described how he’s always going to funerals of members of the golf club and how, recently, two of his three sisters had been widowed within three days of each other. Five months after the interview, Alan’s third sister lost her husband, and Josie commented in her diary: ‘I cannot believe all three of Dad’s sisters have lost their husbands so close together.’ Other seniors offered similar accounts of the demise of their generation. At the end of the interview, they were informed that the intention was that they would be interviewed again in eighteen months’ time, and Living with Everyday Risk in Later Life 1131 most recognised that there was a joke to be made of the possibility that they may not be around to be interviewed. Discussion These accounts of the everyday, whether framed in the context of a life history or a diary entry, uncover how the minimisation of risk is balanced against a preference for independence and how a degree of equilibrium is sought in relation to lifestyle preferences. In diaries such as those of Adam Arthur, recorders have noted how plans are negotiated and changes of direction achieved in ways that reduce some risks but raise others. What can be taken from the life history interviews with seniors such as Alice Watson is evidence of the different ways in which adversity and exposure to risk have been handled earlier in life. We see risks, or the exposure to risks, narrated over time, a biographical handling by survivors. From the life history or biographical accounts, we gain a sense of management and an achieved security. From the diaries, a more episodic and responsive impression is obtained—a more active engagement in risk management, as strategies are debated or played out from week to week. Taken together, the two complement each other, allowing for a more rounded view of how the risks of late life are viewed and experienced. These data provide insights into the complexity of power and attachment within families. The contribution of the recorder also plays a part in selecting, presenting and commenting on events. So, for example, Josie patiently reports on the unfolding debate about Alan and Beat’s decision to stay or move. Nevertheless, her voice as concerned yet relieved daughter comes through when the decision not to move is taken. Adam’s voice dominates the diary keeping, yet his expressed concern for Marion reflects their emotional and physical interdependence, both evidence of how they have developed ways to protect themselves from adversity. Alice’s diarist, her son, steps back and allows Alice to speak in first person on occasion. Unlike Adam Arthur, he evidently is does not feel able to speak for his mother when the intensity of her feelings for her brother’s welfare and security arise. In itself, this provides diary readers with additional insights into the impact of his uncle’s lifelong impairment on his mother’s continuing equanimity. The two data sources, the interviews and the diaries, have proved to be complementary. The interview data, with additional dialogue provided by questions and interpolations from others, include evidence of the way in which risk is narrated retrospectively in relation to life events: a biographical account. The diaries provide evidence of the conduct and negotiation of decision taking, the to and fro of the processes of estimating what to do ‘for the best’. The two framings each provide evidence of how risk is seen in a temporal perspective by those encountered in the project: they are both 1132 Joanna Bornat and Bill Bytheway produced at a point in time and concern past experiences, current concerns and future prospects. Conclusion The perspective that is currently driving professional approaches to the assessment of risk in later life emphasises prevention and protection as well as responsibility and an approach to independence—personalisation—that assumes a degree of reflexivity on the part of actual and potential users of services. It assumes a ‘surveillance of the social’, anticipating potential accidents and difficulties (Pickard, 2009). However, as Wenger (1997) and others have demonstrated, engagement with professional care managers is a comparatively rare, and possibly brief, experience for older people, largely limited to those previously living in what have been deemed particularly risky circumstances and who are now receiving care in what are intended to be comparatively secure environments. Our research has revealed how older people outwith the purview of social work perceive and respond to risk. In their everyday lives, risk is evaluated more as a range of actions than a programme of avoidance. We have uncovered evidence of many varied everyday responses and negotiations, both past and present. What we conclude is that risk in late life should be viewed as an ongoing process that older people have and continue to manage in relation to different kinds of adversity and changed circumstances. In late life, we are faced with existential challenges that load risks in ways that the state, with the help of social workers and other professionals, is seeking to anticipate and minimise through the tools of assessment and care management. Typically, engagement with professional help, as we have suggested, is likely to be minimal and crisis-driven. In this, it is far from the reflexive engagement of Beck (1992) and Giddens (1991). Though the personalisation agenda might seem to offer a way forward to more individualised and processually based resolutions, its rooting in resource management and targeting of those measured as at risk are unlikely to provide the change in culture that is claimed (Bornat, 2006). Nevertheless, it is evident that many older people encounter social work through their association with others well before their own personal needs necessitate an assessment. In this way, they become familiar with social work incrementally and indirectly, playing their part in the collective effort to reduce avoidable risks and generate a shared sense of security. In this way, our data, as Sheldon (2009) points out, are an antidote to the social isolation and danger that social work professionals are more likely to encounter in working with their older clients, particularly when they are responding to policies driving different interventions. As she suggests, there may be ‘a tension between policy approaches designed to support independence in later life and preventative strategies based on early Living with Everyday Risk in Later Life 1133 intervention’ (Sheldon, 2009, p. 99). Hearing how people manage support and independence may be a means to avoiding such tensions. Thus, we hope that our analysis will be seen to provide a realistic and humanistic account of how we live with risk in later life. 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