From Exclusion To Inclusion In Old Age A Global Challenge Thomas Scharf Editor Norah C Keating Editor

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5. From Exclusion to Inclusion
in Old Age
A global challenge
THOMAS SCHARF AND
NORAH C. KEATING
AGEING AND THE LIFECOURSE
Edited by

6. From Exclusion to
Inclusion in Old Age
A global challenge
Edited by Thomas Scharf and Norah Keating

7. First published in Great Britain in 2012 by
The Policy Press
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Beacon House
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ISBN 978 1 84742 772 4 paperback
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been asserted by them in accordance with the 1988 Copyright, Designs and Patents Act.
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or property resulting from any material published in this publication.
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8. To Jane Scharf and Norman Looney – critical thinkers,
fine supporters and spouses extraordinaires

10. v
Contents
List of tables and figures vi
Acknowledgements vii
Notes on contributors viii
Foreword by Judith Phillips x
one Social exclusion in later life: a global challenge 1
Thomas Scharf and Norah Keating
two Globalisation, economic recession and social exclusion: policy 17
challenges and responses
Chris Phillipson
three International migration: patterns and implications for exclusion in 33
old age
Sandra Torres
four Social inclusion of older people in developing countries: relations 51
and resources
Peter Lloyd-Sherlock, Armando Barrientos and Julia Mase
five Exclusion from material resources: poverty and deprivation among 71
older people in Europe
Asghar Zaidi
six Social inclusion of elders in families 89
Jim Ogg and Sylvie Renaut
seven The impact of changing value systems on social inclusion: 109
an Asia-Pacific perspective
David R. Phillips and Kevin H.C. Cheng
eight Age discrimination as a source of exclusion in Europe: the need for 125
a human rights plan for older persons
Astrid Stuckelberger, Dominic Abrams and Philippe Chastonay
nine Towards inclusive built environments for older adults 145
Atiya Mahmood and Norah Keating
ten Revisiting social exclusion of older adults 163
Norah Keating and Thomas Scharf
Index 171

11. vi
From exclusion to inclusion in old age
List of tables and figures
Tables
4.1 Participation in pension schemes and aggregate pension coverage, 56
Brazil and Mexico, 2002
4.2 Satisfaction with different life domains among respondents aged 62
60 and over, South Africa and Brazil, 2008
5.1 Capability deprivation for older people in the EU, 2008 81
Figures
4.1 Self-reported capacity to help others, South Africa and Brazil, 2008 64
5.1 Average capability deprivation for older persons (aged 65+) in 83
EU countries, out of the total of five chosen aspects, 2008
5.2 Capability deprivation rate for older persons (aged 65+) in 84
EU countries, defined as deprivation in at least three out of the
total of five chosen aspects, 2008
8.1 Percentage of respondents from different countries in the European 130
Social Survey who regard age discrimination to be a quite serious
or very serious problem, 2008
8.2 Perceptions of discrimination on the basis of age and other criteria, 131
EU, 2009

12. vii
Acknowledgements
The creation of this book has taken us on a journey across time and continents.
It began with a country walk in Haslington, Cheshire, in which we agreed
that a book on the social exclusion of older people could make an important
contribution to our knowledge of the diversity of older adults and of those at risk
of exclusion as they age. It has concluded with an intensive period of writing in
Summerland, British Columbia, to do our final editing that allowed us to reflect
on the theoretical and substantive contributions of authors and to write our
concluding remarks. Throughout the process, our spouses, Jane Scharf and Norm
Looney, have been our best supporters. They made tea, picked peaches and took
us hiking up mountains to clear our brains. They also challenged us with critical
questions about the broad relevance of our work and the clarity of our ideas and
celebrated with us when we completed the project.
Friends and colleagues have travelled with us through different phases of the
journey. We greatly appreciate the perseverance, tolerance and flexibility of Emily
Watt, Commissioning Editor at The Policy Press, whose support from first ideas
through publication has been unfailing. Janet Fast, University of Alberta, provided a
key part of the intellectual stimulus for this book. It was she who brought together
a team of scholars to debate ideas of social exclusion and to conceptualise its
application in understanding diversity in the lives of older persons. Authors of the
chapters are at the heart of this project. They were remarkably good-humoured
throughout the lengthy process of editorial comments and revisions. We are
grateful for their contributions. We also appreciate Siobhan Fitzgerald’s support
in helping to produce the final manuscript.
This was truly a joint endeavour. As editors we met face-to-face when we
could, sent files back and forth, and had many phone calls to deliberate ideas and
strategies. At the end, we were editing each other’s work without ‘track changes’,
reflecting a level of trust and camaraderie that is rare. While we may not sign on
immediately for another intensive long-term project, we look forward to future
collaboration on theoretically challenging questions about the lives of older people.
Thomas Scharf and Norah Keating

13. viii
From exclusion to inclusion in old age
Notes on contributors
Dominic Abrams is Professor of Social Psychology and Director of the Centre
for the Study of Group Processes, School of Psychology, University of Kent, UK.
Armando Barrientos is Professor and Director of Research, Brooks World
Poverty Institute, University of Manchester, UK.
Philippe Chastonay is Professor of Public Health, Institute of Social and
Preventive Medicine, Medical School, University of Geneva, Switzerland.
Kevin H.C. Cheng is Assistant Professor, School of Humanities and Social
Sciences, Tung Wah College, Hong Kong.
Norah Keating is Professor of Human Ecology and Co-director, Research on
Aging, Policies and Practice, University of Alberta, Edmonton, Canada.
Peter Lloyd-Sherlock is Professor of Social Policy and International
Development, School of International Development, University of East Anglia,
UK.
Atiya Mahmood is Assistant Professor, Gerontology Department, Simon Fraser
University, Vancouver, Canada.
Julia Mase is a PhD Researcher, Brooks World Poverty Institute, University of
Manchester, UK.
Jim Ogg is a Researcher, Unité de Recherche sur le Vieillissement, Caisse
Nationale d’Assurance Vieillesse, Paris, France, and a Research Fellow, The Young
Foundation, London, UK.
David R. Phillips is Chair Professor of Social Policy, Department of Sociology
and Social Policy, Lingnan University, Hong Kong.
Chris Phillipson is Professor of Applied Social Studies and Social Gerontology,
Centre for Social Gerontology, Keele University, UK.
Sylvie Renaut is a Researcher, Unité de Recherche sur le Vieillissement, Caisse
Nationale d’Assurance Vieillesse, Paris, France.
Thomas Scharf is Professor of Social Gerontology and Director, Irish Centre
for Social Gerontology, National University of Ireland, Galway, Ireland.

14. ix
Astrid Stuckelberger is Senior Lecturer and Researcher, Institute of Social
and Preventive Medicine, Medical School, University of Geneva, Switzerland.
She is Chair of the NGO Committee on Ageing, United Nations, Geneva and
President, Geneva International Network on Ageing.
Sandra Torres is Professor of Sociology and Chair in Social Gerontology, Uppsala
University, Sweden.
Asghar Zaidi is Research Director, European Centre for Social Welfare Policy
and Research, Vienna, Austria.
Notes on contributors

15. x
From exclusion to inclusion in old age
Foreword
Judith Phillips
Tom Scharf and Norah Keating introduce us to the debates surrounding exclusion
and inclusion in later life within a comprehensive global context. The book takes
a multidimensional lifecourse perspective, addressing the drivers as well as policy
and practice responses. The authors of each chapter offer us a better understanding
of the concepts of inclusion and exclusion through issues such as poverty and
economic recession, migration, the family, the built environment and human
rights and place exclusion in a truly global context with reference to developing
countries, the Asia-Pacific rim, as well as Europe. Consequently, the book advances
our theoretical understanding, bringing fresh and challenging perspectives on the
family and wider community which interact to foster exclusion and provides
a way forward for policy discourse on how to develop inclusive communities.
This book is an original contribution to the theoretical debate around exclusion/
inclusion and will be a good resource for undergraduates, postgraduates and, in
particular, policy makers working with older people.

16. 1
One
Social exclusion in later life:
a global challenge
Thomas Scharf and Norah Keating
Introduction
Social, economic and demographic trends associated with population ageing have
the collective potential to increase dramatically the exclusion of older adults from
societies’ major institutions and resources. In this respect, older people are especially
prone to the recent volatility in the always-cyclical economic environment that
results from increasingly enmeshed world economies (Jenson, 2004). The economic
decline that began in 2008 with the collapse of major financial institutions and
subsequent attempts to reduce the over-indebtedness of many Western nations
has fundamentally changed the context of debates relating to population ageing.
In times of austerity and growing economic instability, the potential risks of
exclusion for older people become even more pronounced. In many Western
nations, for example, there has been a marked shift in recent years from policies
that acknowledge societies’ obligations towards different generations – as reflected
in the notion of an ‘intergenerational contract’ that underpins national welfare
states – towards a set of policies and practices that encourage individuals to assume
personal responsibility for the ‘risks’ associated with their ageing (Baars et al, 2006).
In other parts of the world, fledgling social policies – for example, in the form
of non-contributory pensions or social health care programmes – or aspirations
to introduce social protection schemes may also be threatened by the economic
downturn (International Labour Organization, 2010). The capacity of individuals,
families and communities to respond to an increasing individualisation of risks is,
in turn, challenged by other social changes. For example, in many industrialised
nations, family histories are becoming increasingly diverse: divorce and remarriage
rates are higher, families are becoming smaller, and lifelong singlehood and
childlessness are more common (Vanier Institute of the Family, 2004). Caring
for family members is becoming a normative midlife experience, creating a cruel
paradox, especially for women, who may experience disadvantage in old age as
a result of earlier efforts to prevent ageing parents from experiencing it (Jenson,
2004; Szinovacz and Davey, 2007). Similarly, mobility patterns are changing the
cultural fabric of many countries, resulting in growing numbers of transnational
families (Baldassar, 2007; Hwang, 2008).

17. 2
From exclusion to inclusion in old age
Taken together, these challenges dramatically increase the inequalities that
characterise later life, and potentially reduce nations’ capacity to support the type
of policies and practices that would minimise the gap between the haves and the
have-nots. However, growing inequalities in later life and related risks of social
exclusion for older adults have been largely absent from global debates. Even in
Europe, where social exclusion has been a central focus of research and public
policy for some time, exclusion discourse tends to overlook the situation of
older people (Atkinson et al, 2004; Burstein, 2005; Social Exclusion Unit, 2006).
Exclusion is of fundamental importance in ageing societies, since it threatens
societal cohesion and individual quality of life (Silver and Miller, 2003; Levitas
et al, 2007). As will be argued in this book, older adults may be particularly
vulnerable in this regard.
Instead of a focus on the ways in which older people may experience forms
of disadvantage, there has been an alarming countervailing tendency in public
discourse to view demographic ageing – and, consequently, the growing
proportions of older people – as a threat. Blame for many social and economic ills is
attributed to population ageing, based on erroneous assumptions that older people’s
use of society’s resources is disproportionate to their contribution (Richmond
and Saloojee, 2005; Podnieks, 2006). Whether it is the notion of ‘greedy geezers’
in the United States (Binstock, 2010), the ‘unsustainable burden’ of pensions in
France and Germany (Schmidt, 2000), or suggestions that the Baby Boomers Stole
Their Children’s Future (Willetts, 2010) or that the country has ‘bankrupted its
youth’ (Howker and Malik, 2010) in the United Kingdom, rhetoric about a ‘silver
tsunami’ (Fox, 2001; Delafuente, 2009) and entrenched views of older adults as
dependent (Street and Cossman, 2006) take the focus away from those older adults
who are excluded or do not benefit from full citizenship (West, 2006; Phelan,
2008). Such perspectives pervade despite the lack of research evidence of serious
intergenerational conflict and plentiful evidence of sustained solidarity (Arber
and Attias-Donfut, 2000; Saraceno, 2008).
Set against such a background, this book aims to make a case for adopting
an exclusion focus for older adults. A range of recent research suggests that the
likelihood of experiencing multiple forms of exclusion increases disproportionately
with advancing age (Scharf et al, 2002, 2005a; Barnes et al, 2006; Becker and
Boreham, 2009; Ferraro et al, 2009). Moreover, the risk of exclusion tends to
be greater for some groups of older adults, including those who have a low
socio-economic status, are female, belong to particular minority ethnic groups,
have a disability or some type of chronic health condition, and live in particular
geographic settings (eg a socially deprived urban community or a remote rural
community). Different birth cohorts may also be vulnerable to exclusion. In the
United States, and increasingly in other Western nations, the idea of cumulative
advantage and disadvantage has been influential in showing the systemic nature
of intra-cohort variation in terms of older adults’ differential access to key societal
resources across time (Dannefer, 2003). Elsewhere in the world, cohort differences
are just as important. In many sub-Saharan nations in Africa, for example, the

18. 3
Social exclusion in later life
HIV/AIDS pandemic has placed particular burdens on older people who are not
only obliged to take on care responsibilities for their children and grandchildren
(Ssengonzi, 2007), but may also lack the support of their own children as their
health deteriorates (Kautz et al, 2010). In China, similar issues arise as a result of the
country’s one-child policy (Poston and Chengrong, 2000; Zhang and Goza, 2006).
Drawing on such a research base and contributing new perspectives that can
help to challenge singular and/or negative constructions around the so-called
‘burden of ageing’, this book seeks to address conceptual and empirical voids in
our understanding of marginalised older adults. This requires that we determine
who are the ageing adults at risk of social exclusion, discover the processes and
conditions that exacerbate that risk, and identify strategies for creating societal
conditions that minimise exclusion. Better understanding of the interplay of
resources and social contexts that facilitate or constrain opportunities for inclusion
can lead to enhanced strategies for establishing and maintaining the full citizenship
of older adults.
While exclusion clearly affects individuals, the book’s focus is primarily on the
ways in which groups of older adults – in different national and regional contexts
and with different characteristics – are prone to forms of exclusion. In the next
section of this chapter, we consider the value of the linked concepts of social
exclusion and inclusion as they relate to ageing and older people. We review
contrasting interpretations of exclusion and inclusion in order to understand better
the circumstances under which groups of older adults may be at risk of exclusion
from societal resources. Our aim is to provide a conceptual orientation point
for subsequent chapters. This is especially important given that the contributing
authors are purposely drawn from a variety of disciplinary perspectives and
focus on issues pertaining to markedly divergent national and supranational
contexts. While contributors inevitably fall back on their own interpretations of
the concepts of social inclusion and exclusion, they are consistent in regarding
the concepts in terms of their multidimensionality, relativity and dynamism. As
will be seen, they are also consistent in recognising the potential of a deepened
understanding of inclusion and exclusion to inform both long-standing and
emerging debates on the key challenges associated with population ageing in
different national and regional contexts.
Conceptualising social exclusion and inclusion
According to Silver (1994), while the idea of social exclusion can be traced back
to political debates occurring in France during the 1960s, the term only entered
into widespread usage during Europe’s economic downturn of the 1980s. It has
been suggested that the European Commission adopted the term in preference
to the notion of ‘poverty’ on the grounds that Britain’s then Conservative
government viewed with suspicion any attempts to identify poverty as a matter of
shared European responsibility (Atkinson, 1998). The fight against social exclusion
subsequently became a European Union (EU) social policy goal and, since 2000,

19. 4
From exclusion to inclusion in old age
has led to a requirement for EU member states to submit regular updates in the
form of National Strategy Reports on Social Protection and Social Inclusion
on their efforts to ‘prevent the risks of exclusion’ and provide help for the ‘most
vulnerable’ (European Commission, 2008; Scharf, 2010).
Given its relatively recent emergence as a concept, and the politicised
circumstances under which it gained momentum, it is not surprising that there
continues to be a lack of clarity about the definition of social exclusion. According
to Silver (1994, p 536), the vagueness of the concept initially had advantages: ‘The
expression is so evocative, ambiguous, multidimensional and elastic that it can be
defined in many different ways … [therefore] it can serve a variety of political
purposes’. In this context, the UK government adopted a working definition
of social exclusion in 1997 that identified exclusion as being: ‘a shorthand term
for what can happen when people or areas suffer from a combination of linked
problems such as unemployment, poor skills, low incomes, poor housing, high
crime environments, bad health and family breakdown’ (Social Exclusion Unit,
2001, p 11). Scientific approaches to conceptualising social exclusion typically
seek to move beyond the identification of problems associated with exclusion, and
refer instead to the ways in which individuals and groups are cut off from society’s
major institutions. For example, Alan and Carol Walker (1997, p 8) define exclusion
as being: ‘the dynamic process of being shut out, fully or partially, from any of
the social, economic, political and cultural systems which determine the social
integration of a person in society’. Silver’s (2007, p 15) approach refers to social
exclusion as a ‘multidimensional process of progressive social rupture, detaching
groups and individuals from social relations and institutions and preventing them
from full participation in the normal, normatively prescribed activities of the
society in which they live’. Other authors introduce elements of personal choice
into their exclusion definitions, reflecting the fact that individuals might choose
not to be ‘included’ within a particular society:
An individual is socially excluded if (a) he or she is geographically
resident in a society, (b) he or she cannot participate in the normal
activities of citizens in that society, and (c) he or she would like to so
participate, but is prevented from doing so by factors beyond his or
her control. (Burchardt et al, 1999, p 229)
There are at least three key themes that cut across the different approaches
(Atkinson, 1998, p 7f). First, exclusion is perceived to be a relative concept. In this
sense, judging whether a person or group is excluded only makes sense if their
situation is contrasted with the general (normative) context of the society and time
in which they live. Second, the notion of agency features in many understandings
of exclusion, as in the approach of Burchardt et al (1999) just cited. According to
Atkinson (1998, p 7), ‘exclusion implies an act, with an agent or agents’. In this
context, individuals and groups may not only be excluded against their will, but
may also opt to exclude themselves. Third, exclusion is seen as being dynamic,

20. 5
Social exclusion in later life
changing over time and potentially extending its reach from one generation to
the next. In relation to both individuals and groups, there is the possibility that
people will move in and out of exclusion as they progress through time. Ideally,
assessments of social exclusion should, therefore, reach beyond individuals’ or
groups’ current status to take in a life-course and generational perspective.
In addition to the three features of social exclusion definitions highlighted
by Atkinson (1998), and in order to differentiate exclusion from a traditionally
rather narrow, income-based view of poverty, many definitions also refer to
the multidimensional nature of exclusion. While the dimensions highlighted in
such definitions vary, they typically identify access to material resources and
social relationships, as well as a range of cultural and civic activities, as being key
determinants of inclusion or exclusion (eg Gordon et al, 2000; Burchardt et al,
2002). Drawing these ideas together, and recognising that the definition underplays
the dynamic nature of exclusion, for the purposes of this book we follow Levitas
et al (2007, p 25) in regarding exclusion as representing ‘the lack or denial of
resources, rights, goods and services, and the inability to participate in the normal
relationships and activities available to the majority of people in a society’.
While considerable effort has been expended in recent years on conceptualising
social exclusion, the concept of ‘social inclusion’ still remains relatively under-
explored. Indeed, researchers tend to use a range of terms to describe what they
view as being the antonym of exclusion. For example, Walker and Walker’s (1997)
definition of exclusion, cited earlier, refers to processes that determine individuals’
‘social integration’. And, writing about the UK experience, Ruth Levitas (2005)
has been consistent in her critique of what she terms ‘the inclusive society’. Daly
and Silver (2008) also note a recent change of emphasis, in policy circles at least,
in favour of the term ‘social cohesion’. In their view, the changing focus suggests:
first, an attempt to sound ‘positive’ instead of ‘negative’, pronouncing
a goal rather than describing a problem. Second, inclusion is the
implied antonym of exclusion, but in fact may connote something
quite different. Inclusion calls attention to the supposed ‘opportunity’
and openness of society, beckoning outsiders in, whereas exclusion
points at exclusionary mechanisms of society, its potential breakdown,
disorder, or incoherence. (Daly and Silver, 2008, p 551)
For the purposes of this book, and notwithstanding a lack of clarity around its
definition and the need for further theoretical development, we treat ‘inclusion’
as an appropriate alternative to ‘exclusion’. In this sense, inclusion represents a
valuable goal for all societies marked by growing inequalities and by processes
that exclude and marginalise key social groups.

21. 6
From exclusion to inclusion in old age
Social exclusion of older people
To date, most of the debate around social inclusion and exclusion has focused
on children and families, on people of working age, and on the ways in which
exclusion affects the lives of individuals and groups perceived to be at the margins
of society. Conceptual development has addressed younger adults whose immigrant
status, tenuous attachment to the labour force or work-limiting disabilities increase
their risks of
,
exclusion from material resources (Smith and Ley, 2008; Stewart
et al, 2008; Reutter et al, 2009); and also persistent poverty in deprived urban
neighbourhoods where people are disadvantaged because of their community
surroundings (Marsh et al, 1999; Scharf et al, 2002; Burstein, 2005; Migration
Resource Centre, 2006). Notwithstanding some notable exceptions (Scharf et
al, 2000, 2002, 2005a; Craig, 2004; Ogg, 2005; Barnes et al, 2006; Moffatt and
Glasgow, 2009), there continues to be relatively little work that addresses issues
of exclusion and inclusion as they relate to older people. Moreover, where this
work exists, its focus tends to be on ageing and older people who live in Western
industrialised nations. Given the nature of the challenges posed by population
ageing and the risks of exclusion faced by growing proportions of older people
noted earlier, there is much to be gained by viewing broad social changes in
different world regions through the lens of inclusion and exclusion.
Adopting an exclusion focus implies addressing two key concerns. First, there
is a need to consider the ways in which exclusion in later life might differ from
exclusion at earlier stages of the life course. In particular, this involves reflecting
on the dimensions of exclusion that appear to be most relevant in relation to
ageing and later life. Second, there is a concern to identify the prime drivers
of exclusion in later life. This, in turn, focuses attention on the potential policy
responses to older adults’ exclusion and measures that might promote inclusion
in ageing societies.
Addressing the first of these questions, it is useful to begin by examining the
potential characteristics of exclusion as it relates to ageing and older adults.
Here, we can draw on Atkinson’s (1998) assessment of the common features
of approaches to understanding exclusion, since this helps to identify the rich
potential of an exclusion focus, as well as some major challenges, for social
gerontology. For example, if exclusion is to be understood as a relative concept, a
key issue emerges concerning the sources of comparison that apply to older adults.
Is older people’s exclusion to be assessed in relation to the ‘normal relationships
and activities available to the majority of people in a society’ (Levitas et al, 2007,
p 25) or to the norms that apply to other older people, or to people belonging to
the same birth cohort? This becomes especially important when one seeks older
people’s own views about their material and social resources, since a tendency
has been noted in some studies for older people to downplay the degree to
which they acknowledge their disadvantage (eg Scharf et al, 2006). There are also
under-explored issues concerning the nature of older people’s agency in relation
to issues of inclusion and exclusion. While there has been considerable attention

22. 7
Social exclusion in later life
in gerontological debates to issues around ‘structured dependency’ (Townsend,
1981), which some researchers take as implying a lack of agency on the part of
older adults, rather less focus has been placed on the ways in which older people
might opt to exclude themselves from ‘mainstream’ society. Equally, in terms of
the dynamics of exclusion in later life, issues arise concerning the potential for
older people to be lifted out of their disadvantage – either through their own
actions or through state interventions of one type or another.
Rather more work has been undertaken in recent years regarding the
multidimensionality of exclusion in relation to ageing and older people. Researchers

have begun to articulate elements of exclusion that are especially relevant to older
adults, including truncated social connections, limited access to public services,
persistent poverty and an inability to engage in civic activities (Evandrou, 2000;
Phillipson et al, 2001; Brodie, 2002; Freedman, 2002; Arber, 2004; Burstein, 2005;
Barnes et al, 2006; Martinson and Minkler, 2006; Patsios, 2006; Social Exclusion
Unit, 2006; Grenier and Guberman, 2009). In this context, Scharf et al (2005a)
draw on a substantial body of evidence to identify five domains of social exclusion
that, they argue, reflect the unique circumstances of older people:
• Exclusion from material resources, acknowledging the central role
played by income and material security in determining individuals’
and groups’ ability to participate in society;
• Exclusion from social relations, reflecting the importance
attributed to the ability of older adults to engage in meaningful
relationships with family, friends and neighbours;
• Exclusion from civic activities, recognising the need for individuals
to be able to be involved in wider aspects of civil society and in
decision-making processes which may in turn influence their
own lives;
• Exclusion from basic services, drawing upon the key role played by
access to services in and beyond the home in terms of individuals’
ability to manage everyday life; and
• Neighbourhood exclusion, reflecting the contribution made by
the immediate residential setting to an individual’s sense of self
and, potentially, the quality of their lives. (Scharf et al, 2005a, p 78)
These domains represent a useful basis for interrogating the extent to which older
adults are excluded from specific domains of societal participation (Jenson, 2004;
Miliband, 2006). Under certain circumstances, the identified domains of exclusion
overlap, generating particular risks for those marked by multiple forms of exclusion
in later life (Scharf et al, 2005a, 2005b). The different domains of exclusion also
provide a valuable orientation point for the chapters in this book, each of which
addresses one or more of the dimensions of exclusion referred to here.
A second concern in terms of gerontological research on social exclusion relates
to the potential drivers of exclusion in later life. This, in turn, focuses attention on

23. 8
From exclusion to inclusion in old age
potential policy and practice responses aimed at reducing the exclusion of older
adults. Three key drivers, operating at different levels although closely interrelated,
might contribute to exclusion. First, there are a variety of structural drivers,
which operate at a broad national or supranational level. They encompass, for
example, ageism, age stereotypes and age discrimination, changing social values,
norms and behaviours that contribute to the marginalisation of older people, and
an array of social and economic policies that engender ‘structured dependency’
in later life. A second set of ‘environmental drivers’ relates to older adults’ living
environments. These include urbanisation and the separation of family generations,
the changing nature of urban and rural communities that contribute to ageing in
places that have become unfamiliar, and a trend towards age-segregated living in
some Western nations that restricts the interaction between young and old. Third
are ‘individual drivers’ of exclusion that arise from low socio-economic status
earlier in the life course, disruptions to individuals’ personal and social networks,
the onset of chronic ill-health and disability, or a migratory life course.
Societies are challenged to respond to the different dimensions of exclusion
affecting older people and to address the drivers of such exclusion. In relation to
policies to reduce exclusion, Daly and Silver (2008, p 553) suggest that ‘The social
policy implications of social exclusion call for multi-pronged, joined-up programs,
anti-discrimination safeguards, social dialogue and stakeholder involvement in
decision-making and program provision’. In terms of older people, there are a
variety of potential policy responses to address the multiple domains of exclusion.
Anti-poverty strategies or the introduction of non-contributory pension schemes
might represent effective ways of targeting exclusion from material resources.
Initiatives that seek to build new friendship relations or support people at times
of relationship breakdown might respond to risks around individuals’ exclusion
from social relations. Similarly, a variety of initiatives might support people at
risk of exclusion from basic services (eg by ensuring access to public, private or
voluntary services), from civic activities (including ensuring that older people have
access to decision-making processes) or from the neighbourhood or community
in which they live (such as a range of crime-reducing measures).
Other policy responses are oriented towards longer-term strategies to address
the causes or drivers of exclusion. Responding to structural drivers of exclusion
might entail addressing negative societal attitudes and behaviours towards older
adults through ensuring that their human rights are acknowledged. Changes to
the living environments of older people through the creation of ‘ageing-friendly’
environments might address environmental drivers of exclusion. Addressing
individual drivers of exclusion is likely to require a policy focus on adopting
preventive strategies at all stages of the life course, and improved coordination
of policies and programmes aimed at supporting older people’s participation in
society.
If social exclusion in later life is to be addressed effectively, and greater inclusion
achieved, concerted action will be needed. However, there also remains a need to
better understand the concepts of inclusion and exclusion, and to understand how

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25. Has smiled, and said good-night, and gone to rest.
EDMUND BLUNDEN
ALMSWOMEN
At Quincey's moat the squandering village ends,
And there in the almshouse dwell the dearest friends
Of all the village, two old dames that cling
As close as any trueloves in the spring.
Long, long ago they passed three-score-and-ten,
And in this doll's house lived together then;
All things they have in common being so poor,
And their one fear, Death's shadow at the door.
Each sundown makes them mournful, each sunrise
Brings back the brightness in their failing eyes.
How happy go the rich fair-weather days
When on the roadside folk stare in amaze
At such a honeycomb of fruit and flowers
As mellows round their threshold; what long hours
They gloat upon their steepling hollyhocks,
Bee's balsams, feathery southernwood and stocks,
Fiery dragons'-mouths, great mallow leaves
For salves, and lemon plants in bushy sheaves,
Shagged Esau's Hands with five green finger-tips!
Such old sweet names are ever on their lips.

26. As pleased as little children where these grow
In cobbled pattens and worn gowns they go,
Proud of their wisdom when on gooseberry shoots
They stuck egg-shells to fright from coming fruits
The brisk-billed rascals; waiting still to see
Their neighbour owls saunter from tree to tree
Or in the hushing half-light mouse the lane
Long-winged and lordly.
But when those hours wane
Indoors they ponder, scared by the harsh storm
Whose pelting saracens on the window swarm,
And listen for the mail to clatter past
And church clock's deep bay withering on the blast;
They feed the fire that flings a freakish light
On pictured kings and queens grotesquely bright,
Platters and pitchers, faded calendars,
And graceful hour-glass trim with lavenders.
Many a time they kiss and cry, and pray
Both may be summoned in the self-same day,
And wiseman linnet tinkling in his cage
End too with them the friendship of old age,
And all together leave their treasured room
Some bell-like evening when the May's in bloom.
GLEANING
Along the baulk the grasses drenched in dews
Soak through the morning gleaners' clumsy shoes,
And cloying cobwebs trammel their brown cheeks
While from the shouldering sun the dewfog reeks.
Then soon begun, on ground where yesterday

27. The rakers' warning-sheaf forbade their way,
Hard clucking dames in great white hoods make haste
To cram their lap-bags with the barley waste,
Scrambling as if a thousand were but one,
Careless of stabbing thistles. Now the sun
Gulps up the dew and dries the stubs, and scores
Of tiny people trundle out of doors
Among the stiff stalks, where the scratched hands
Red ants and blackamoors and such as fly;
Tunbellied, too, with legs a finger long,
The spider harvestman; the churlish, strong
Black scorpion, prickled earwig, and that mite
Who shuts up like a leaden shot in fright
And lies for dead. And still before the rout
The young rats and the field mice whisk about
And from the trod whisp out the leveret darts
Bawled at by boys that pass with blundering carts
Top-heavy to the red-tiled barns. And still
The children feed their cornsacks with goodwill,
And farm wives ever faster stoop and flounce.
The hawk drops down a plummet's speed to pounce
The nibbling mouse or resting lark away,
The lost mole tries to pierce the mattocked clay
In agony and terror of the sun.
The dinner hour and its grudged leisure won,
All sit below the pollards on the dykes,
Rasped with the twinge of creeping barley spikes:
Sweet beyond telling now the small beer goes
From the hooped hardwood bottles, the wasp knows,
And even hornets whizz from the eaten ash—
Then crusts are dropt and switches snatched to slash,
While, safe in shadow of the apron thrown
Aside the bush which years before was grown
To snap the poacher's nets, the baby sleeps.
Now toil returns, in red-hot fluttering light,

28. And far afield the weary rabble creeps,
Oft clutching blind wheat black among the white,
That smutches where it touches quick as soot—Oft
gaping where the landrail seems afoot,
Who with such magic throws his baffling speech,
Far off he sounds when scarce beyond arm's reach.
Mongrels are left to mind the morning's gain,
But squinting knaves can slouch to steal the grain;
Now close the farm the fields are gleaned agen,
Where the boy droves the turkey and white hen
To pick the shelled sweet corn; their hue and cry
Answers the gleaners' gabble, and sows trudge
With little pigs to play and rootle there
And all the fields are full of din and blare.
So steals the time past, so they glean and gloat;
The hobby-horses whir, the moth's dust coat
Blends with the stubble, scarlet soldiers fly
In airy pleasure; but the gleaners' eye
Sees little but their spoil, or robin flower
Ever on tenterhooks to shun the shower,
Their weather-prophet never known astray;
When he folds up, then toward the hedge glean they.
But now the dragon of the sky droops, pales,
And wandering in the wet grey western vales,
Stumbles, and passes, and the gleaning's done.
The farmer, with fat hares slung on his gun,
Gives folk goodnight as down the ruts they pull
The creaking two-wheeled hand carts bursting full,
And whimpering children cease their teasing squalls,
While left alone the supping partridge calls—
Till all at home is stacked from mischief's way
To thrash and dress the first wild, windy day,
And each good wife crowns weariness with pride,
With such small riches more than satisfied.

29. GORDON BOTTOMLEY
THE PLOUGHMAN
Under the long fell's stony eaves
The ploughman, going up and down,
Ridge after ridge man's tide-mark leaves,
And turns the hard grey soil to brown.
Striding, he measures out the earth
In lines of life, to rain and sun;
And every year that comes to birth
Sees him still striding on and on.
The seasons change, and then return;
Yet still, in blind, unsparing ways,
However I may shrink or yearn,
The ploughman measures out my days.
His acre brought forth roots last year;
This year it bears the gloomy grain;
Next Spring shall seedling grass appear;
Then roots and corn and grass again.
Five times the young corn's pallid green
I have seen spread and change and thrill;
Five times the reapers I have seen

30. Go creeping up the far-off hill:
And, as the unknowing ploughman climbs
Slowly and inveterately,
I wonder long how many times
The corn will spring again for me.
BABEL: THE GATE OF THE GOD
Lost towers impend, copeless primeval props
Of the new threatening sky, and first rude digits
Of awe remonstrance and uneasy power
Thrust out by man when speech sank back in his throat:
Then had the last rocks ended bubbling up
And rhythms of change within the heart begun
By a blind need that would make Springs and Winters;
Pylons and monoliths went on by ages,
Mycenae and Great Zimbabwe came about;
Cowed hearts in This conceived a pyramid
That leaned to hold itself upright, a thing
Foredoomed to limits, death and an easy apex;
Then postulants for the stars' previous wisdom
Standing on Carthage must get nearer still;
While in Chaldea an altitude of God
Being mooted, and a Saurian unearthed
Upon a mountain stirring a surmise
Of floods and alterations of the sea,
A round-walled tower must rise upon Senaai
Temple and escape to God the ascertained.
These are decayed like Time's teeth in his mouth,
Black cavities and gaps, yet earth is darkened
By their deep-sunken and unfounded shadows

31. And memories of man's earliest theme of towers.
Space—the old source of time—should be undone,
Eternity defined, by men who trusted
Another tier would equal them with God.
A city of grimed brick-kilns, squat truncations,
Hunched like spread toads yet high beneath their circles
Of low packed smoke, assemblages of thunder
That glowed upon their under sides by night
And lit like storm small shadowless workmen's toil.
Meaningless stumps, unturned bare roots, remained
In fields of mashy mud and trampled leaves,
While, if a horse died hauling, plasterers
Knelt on a plank to clip its sweaty coat.
A builder leans across the last wide courses;
His unadjustable unreaching eyes
Fail under him before his glances sink
On the clouds' upper layers of sooty curls
Where some long lightening goes like swallow downward,
But at the wider gallery next below
Recognize master masons with pricked parchments:
That builder then, as one who condescends
Unto the sea and all that is beneath him,
His hairy breast on the wet mortar calls
"How many fathoms is it yet to heaven!"
On the next eminence the orgulous King
Nimrond stands up conceiving he shall live
To conquer God, now that he knows where God is:
His eager hands push up the tower in thought...
Again, his shaggy inhuman height strides down
Among the carpenters because he has seen
One shape an eagle-woman on a door-post:
He drives his spear-beam through him for wasted
day.
Little men hurrying, running here and there,

32. Within the dark and stifling walls, dissent
From every sound, and shoulder empty hods:
"The God's great altar should stand in the crypt
Among our earth's foundations "—"The God's great altar
Must be the last far coping of our work"—
"It should inaugurate the broad main stair"—
"Or end it"—"It must stand toward the East!"
But here a grave contemptuous youth cries out
"Womanish babblers, how can we build God's altar
Ere we divine its foreordained true shape?"
Then one "It is a pedestal for deeds"—
"'Tis more and should be hewn like the King's brow"—
"It has the nature of a woman's bosom"—
"The tortoise, first created, signifies it"—
"A blind and rudimentary navel shows
The source of worship better than horned moons."
Then a lean giant "Is not a calyx needful?"—
"Because round grapes on statues well expressed
Become the nadir of incense, nodal lamps,
Yet apes have hands that but and carved red crystals—"
"Birds molten, touchly tale veins bronze buds crumble
Ablid ublai ghan isz rad eighar ghaurl ..."
Words said too often seemed such ancient sounds
That men forget them or were lost in them;
The guttural glottis-chasms of language reached
A rhythm, a gasp, were curves of immortal thought.
Man with his bricks was building, building yet,
Where dawn and midnight mingled and woke no birds,
In the last courses, building past his knowledge
A wall that swung—for towers can have no tops,
No chord can mete the universal segment,
Earth has no basis. Yet the yielding sky,
Invincible vacancy, was there discovered—
Though piled-up bricks should pulp the sappy balks,
Weight generate a secrecy of heat,

33. Cankerous charring, crevices' fronds of flame.
THE END OF THE WORLD
The snow had fallen many nights and days;
The sky was come upon the earth at last,
Sifting thinly down as endlessly
As though within the system of blind planets
Something had been forgot or overdriven.
The dawn now seemed neglected in the grey
Where mountains were unbuilt and shadowless trees
Rootlessly paused or hung upon the air.
There was no wind, but now and then a sigh
Crossed that dry falling dust and rifted it
Through crevices of slate and door and casement.
Perhaps the new moon's time was even past.
Outside, the first white twilights were too void
Until a sheep called once, as to a lamb,
And tenderness crept everywhere from it;
But now the flock must have strayed far away.
The lights across the valley must be veiled,
The smoke lost in the greyness or the dusk.
For more than three days now the snow had thatched
That cow-house roof where it had ever melted
With yellow stains from the beasts' breath inside;
But yet a dog howled there, though not quite lately.
Someone passed down the valley swift and singing,
Yes, with locks spreaded like a son of morning;
But if he seemed too tall to be a man
It was that men had been so long unseen,
Or shapes loom larger through a moving snow.
And he was gone and food had not been given him.

34. When snow slid from an overweighted leaf
Shaking the tree, it might have been a bird
Slipping in sleep or shelter, whirring wings;
Yet never bird fell out, save once a dead one—
And in two days the snow had covered it.
The dog had howled again—or thus it seemed
Until a lean fox passed and cried no more.
All was so safe indoors where life went on
Glad of the close enfolding snow—O glad
To be so safe and secret at its heart,
Watching the strangeness of familiar things.
They knew not what dim hours went on, went
For while they slept the clock stopt newly wound
As the cold hardened. Once they watched the road,
Thinking to be remembered. Once they doubted
If they had kept the sequence of the days,
Because they heard not any sound of bells.
A butterfly, that hid until the Spring
Under a ceiling's shadow, dropt, was dead.
The coldness seemed more nigh, the coldness deepened
As a sound deepens into silences;
It was of earth and came not by the air;
The earth was cooling and drew down the sky.
The air was crumbling. There was no more sky.
Rails of a broken bed charred in the grate,
And when he touched the bars he thought the sting
Came from their heat—he could not feel such cold ...
She said "O do not sleep,
Heart, heart of mine, keep near me. No, no; sleep.
I will not lift his fallen, quiet eyelids,
Although I know he would awaken then—He
closed them thus but now of his own will.
He can stay with me while I do not lift them."

35. ATLANTIS
What poets sang in Atlantis? Who can tell
The epics of Atlantis or their names?
The sea hath its own murmurs, and sounds not
The secrets of its silences beneath,
And knows not any cadences enfolded
When the last bubbles of Atlantis broke
Among the quieting of its heaving floor.
O, years and tides and leagues and all their billows
Can alter not man's knowledge of men's hearts—
While trees and rocks and clouds include our being
We know the epics of Atlantis still:
A hero gave himself to lesser men,
Who first misunderstood and murdered him,
And then misunderstood and worshipped him;
A woman was lovely and men fought for her,
Towns burnt for her, and men put men in bondage,
But she put lengthier bondage on them all;
A wanderer toiled among all the isles
That fleck this turning star or shifting sea,
Or lonely purgatories of the mind,
In longing for his home or his lost love.
Poetry is founded on the hearts of men:
Though in Nirvana or the Heavenly courts
The principle of beauty shall persist,
Its body of poetry, as the body of man,
Is but a terrene form, a terrene use,
That swifter being will not loiter with;
And, when mankind is dead and the world cold,
Poetry's immortality will pass.

36. NEW YEAR'S EVE, 1913
O, Cartmel bells ring soft to-night,
And Cartmel bells ring clear
But I lie far away to-night,
Listening with my dear;
Listening in a frosty land
Where all the bells are still
And the small-windowed bell-towers stand
Dark under heath and hill.
I thought that, with each dying year,
As long as life should last
The bells of Cartmel I should hear
Ring out an aged past:
The plunging, mingling sounds increase
Darkness's depth and height,
The hollow valley gains more peace
And ancientness to-night:
The loveliness, the fruitfulness,
The power of life lived there
Return, revive, more closely press
Upon that midnight air.
But many deaths have place in men
Before they come to die;
Joys must be used and spent, and then
Abandoned and passed by.

37. Earth is not ours; no cherished space
Can hold us from life's flow,
That bears us thither and thence by ways
We knew not we should go.
O, Cartmel bells ring loud, ring clear,
Through midnight deep and hoar,
A year new-born, and I shall hear
The Cartmel bells no more.
TO IRON-FOUNDERS AND OTHERS
When you destroy a blade of grass
You poison England at her roots:
Remember no man's foot can pass
Where evermore no green life shoots.
You force the birds to wing too high
Where your unnatural vapours creep:
Surely the living rocks shall die
When birds no rightful distance keep.
You have brought down the firmament
And yet no heaven is more near;
You shape huge deeds without event,
And half made men believe and fear.
Your worship is your furnaces,
Which, like old idols, lost obscenes,
Have molten bowels; your vision is
Machines for making more machines.

38. O, you are buried in the night,
Preparing destinies of rust;
Iron misused must turn to blight
And dwindle to a tettered crust.
The grass, forerunner of life, has gone,
But plants that spring in ruins and shards
Attend until your dream is done:
I have seen hemlock in your yards.
The generations of the worm
Know not your loads piled on their soil;
Their knotted ganglions shall wax firm
Till your strong flagstones heave and toil.
When the old hollowed earth is cracked,
And when, to grasp more power and feasts,
Its ores are emptied, wasted, lacked,
The middens of your burning beasts
Shall be raked over till they yield
Last priceless slags for fashionings high,
Ploughs to make grass in every field,
Chisels men's hands to magnify.
RUPERT BROOKE
Born 1887
Died at Lemnos 1915

39. SONNET
Oh! Death will find me, long before I tire
Of watching you; and swing me suddenly
Into the shade and loneliness and mire
Of the last land! There, waiting patiently,
One day, I think, I'll feel a cool wind blowing,
See a slow light across the Stygian tide,
And hear the Dead about me stir, unknowing,
And tremble. And I shall know that you have died.
And watch you, a broad-browed and smiling dream,
Pass, light as ever, through the lightless host,
Quietly ponder, start, and sway, and gleam—
Most individual and bewildering ghost!—
And turn, and toss your brown delightful head
Amusedly, among the ancient Dead.
THE SOLDIER
If I should die, think only this of me:
That there's some corner of a foreign field
That is for ever England. There shall be
In that rich earth a richer dust concealed;
A dust whom England bore, shaped, made aware,
Gave, once, her flowers to love, her ways to roam,
A body of England's, breathing English air,
Washed by the rivers, blest by suns of home.

40. And think, this heart, all evil shed away,
A pulse in the eternal mind, no less
Gives somewhere back the thoughts by England given;
Her sights and sounds; dreams happy as her day;
And laughter, learnt of friends; and gentleness,
In hearts at peace, under an English heaven.
THE TREASURE
When colour goes home into the eyes,
And lights that shine are shut again,
With dancing girls and sweet birds' cries
Behind the gateways of the brain;
And that no-place which gave them birth, shall close
The rainbow and the rose:—
Still may Time hold some golden space.
Where I'll unpack that scented store
Of song and flower and sky and face,
And count, and touch, and turn them o'er,
Musing upon them; as a mother, who
Has watched her children all the rich day through,
Sits, quiet-handed, in the fading light,
When children sleep, ere night.
August, 1914.
THE GREAT LOVER

41. I have been so great a lover I filled my days
So proudly with the splendour of Love's praise,
The pain, the calm, and the astonishment,
Desire illimitable, and still content,
And all dear names men use, to cheat despair
For the perplexed and viewless streams that bear
Our hearts at random down the dark of life.
Now, ere the unthinking silence on that strife
Steals down, I would cheat drowsy Death so far,
My night shall be remembered for a star
That outshone all the suns of all men's days.
Shall I not crown them with immortal praise
Whom I have loved, who have given me, dared with me
High secrets, and in darkness knelt to see
The inenarrable godhead of delight?
Love is a flame:—we have beaconed the world's night.
A city:—and we have built it, these and I.
An emperor:—we have taught the world to die.
So, for their sakes I loved, ere I go hence,
And the high cause of Love's magnificence,
And to keep loyalties young, I'll write those names
Golden for ever, eagles, crying flames,
And set them as a banner, that men may know,
To dare the generations, burn, and blow
Out on the wind of Time, shining and streaming......
These I have loved:
White plates and cups, clean-gleaming,
Ringed with blue lines; and feathery, faery dust;
Wet roofs, beneath the lamp-light; the strong
Of friendly bread; and many-tasting food;
Rainbows; and the blue bitter smoke of wood;
And radiant raindrops couching in cool flowers;
And flowers themselves, that sway through sunny hours,

42. Dreaming of moths that drink them under the moon;
Then, the cool kindliness of sheets, that soon
Smooth away trouble; and the rough male kiss
Of blankets; grainy wood; live hair that is
Shining and free; blue-massing clouds; the keen
Impassioned beauty of a great machine;
The benison of hot water; furs to touch;
The good smell of old clothes; and other such—
The comfortable smell of friendly ringers,
Hair's fragrance, and the musty reek that lingers
About dead leaves and last year's ferns ...
Dear names,
And thousand other throng to me! Royal flames;
Sweet water's dimpling laugh from tap or spring;
Holes in the ground; and voices that do sing;
Voices in laughter, too; and body's pain,
Soon turned to peace; and the deep-panting train;
Firm sands; the little dulling edge of foam
That browns and dwindles as the wave goes home;
And washen stones, gay for an hour; the cold
Graveness of iron; moist black earthen mould;
Sleep; and high places; footprints in the dew;
And oaks; and brown horse-chestnuts, glossy-new;
And new-peeled sticks; and shining pools on grass;—
All these have been my loves. And these shall pass,
Whatever passes not, in the great hour,
Nor all my passion, all my prayers, have power
To hold them with me through the gate of Death.
They'll play deserter, turn with the traitor breath,
Break the high bond we made, and sell Love's trust
And sacramented covenant to the dust.
—Oh, never a doubt but, somewhere, I shall wake,
And give what's left of love again; and make
New friends, now strangers....
But the best I've known,
Stays here, and changes, breaks, grows old, is blown

43. About the winds of the world, and fades from
brains Of living men, and dies.
Nothing remains.
O dear my loves, O faithless, once again
This one last gift I give: that after men
Shall know, and later lovers, far removed,
Praise you, 'All these were lovely'; say, 'He loved.'
CLOUDS
Down the blue night the unending columns press
In noiseless tumult, break and wave and flow,
Now tread the far South, or lift rounds of snow
Up to the white moon's hidden loveliness.
Some pause in their grave wandering comradeless,
And turn with profound gesture vague and slow,
As who would pray good for the world, but know
Their benediction empty as they bless.
They say that the Dead die not, but remain
Near to the rich heirs of their grief and mirth.
I think they ride the calm mid-heaven, as these,
In wise majestic melancholy train,
And watch the moon, and the still-raging seas,
And men, coming and going on the earth.
The Pacific

44. THE OLD VICARAGE, GRANTCHESTER
Cafe des Western, Berlin.
Just now the lilac is in bloom,
All before my little room;
And in my flower-beds, I think,
Smile the carnation and the pink;
And down the borders, well I know,
The poppy and the pansy blow ...
Oh! there the chestnuts, summer through,
Beside the river make for you
A tunnel of green gloom, and sleep
Deeply above; and green and deep
The stream mysterious glides beneath,
Green as a dream and deep as death.—
Oh, damn! I know it I and I know
How the May fields all golden show,
And when the day is young and sweet,
Gild gloriously the bare feet
That run to bathe ...
Du lieber Gott!
Here am I, sweating, sick and hot,
And there the shadowed waters fresh
Lean up to embrace the naked flesh.
Temperamentvoll German Jews
Drink beer around; and there the dews
Are soft beneath a morn of gold.
Here tulips bloom as they are told;
Unkempt about those hedges blows
An English unofficial rose;
And there the unregulated sun
Slopes down to rest when day is done,

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