title: Conflicting notions of citizenship in old age: An analysis of an activation practice.
abstract: Ageing societies and increasing healthcare expenditures are inducing Western welfare states to reform their care arrangements. In a qualitative research project, we explored how citizenship in old age is constructed in a public innovative care practice situated in the southern part of the Netherlands: the shaping of 'life cycle robust neighbourhoods'. Life cycle robustness entails a further not formally defined ideal of age-friendly places, enabling older adults to live independently for longer periods of time. Participation is being presented as an important element towards life cycle robustness. We used ethnographic methods to understand different constructions of citizenship in old age. We analysed documents and interviewed local policymakers and civil servants, managers and directors in the fields of housing, care and welfare, professionals working for these organisations, and older adults living (independently) in these neighbourhoods (n=73). Additionally, we observed formal and informal meetings and organised focus groups. Our findings demonstrate conflicting notions of old age. Policymakers and civil servants, managers and directors, professionals, and even representatives of older adults share a belief an activation policy is necessary, although they differ in how they interpret this need. Policymakers and civil servants are convinced that societal and financial incentives necessitate current reforms, managers and directors talk about quality and organisational needs, while professionals mainly strive to empower older adults (as citizens). Simultaneously, older adults try to live their lives as independent as possible. We argue that, whereas old age became a distinct category in the last century, we now recognise a new period in which this category is being more and more de-categorised.
authors.affiliation: Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands; Academic Collaborative Centre for Public Health Limburg, Regional Public Health Service, Geleen, The Netherlands. Electronic address: s.vanhees@maastrichtuniversity.nl.
authors.forename: Susan
authors.initials: S
authors.lastname: van Hees
authors.affiliation: Department of Health Ethics and Society, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. Electronic address: k.horstman@maastrichtuniversity.nl.
authors.forename: Klasien
authors.initials: K
authors.lastname: Horstman
authors.affiliation: Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands; Academic Collaborative Centre for Public Health Limburg, Regional Public Health Service, Geleen, The Netherlands. Electronic address: maria.jansen@ggdzl.nl.
authors.forename: Maria
authors.initials: M
authors.lastname: Jansen
authors.affiliation: Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. Electronic address: d.ruwaard@maastrichtuniversity.nl.
authors.forename: Dirk
authors.initials: D
authors.lastname: Ruwaard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D003220:Conflict, Psychological; D003695:Delivery of Health Care / Q000379:methods*; D004779:Environment Design; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D036301:Qualitative Research; D012111:Residence Characteristics; D058992:Social Participation / Q000523:psychology*; D012946:Social Welfare
keywords: Age-friendly places; Care practices; Citizenship; Older adults; Participation