Aging and the Digital Life Course

David Prendergast and Chiara Garatt ini (eds), New York and Oxford: Berghahn Books, 2015, ISBN: 798-1-78238-691-9, 289 pp., Hb. £80.00

Reviewed by Henglien Lisa Chen

  • Part of the series: To See Ourselves as Others See Us: Reviews of Anthropological Works by Non-Anthropologists

Aging and the Digital Life Course provides an interesting and often thought-provoking read. Part 1 covers technologically mediated ways of connecting and interacting with people. In Part 2, a potpourri of topics is explained by reference to technologies that support a healthy lifestyle and wellbeing. These include reports of empirical studies (assistive technology in self-management and behavioural change, living well with dementia and hands-on tech care) alongside theoretical and conceptual analysis and discussion (co-designed technology with older people and the process of normalisation and system-level change in home telehealth). This part, for this gerontological social work reader, was much the most compelling section overall. Part 3 is given over to four original chapters on life-course transition for caregivers, retirees, older migrants and older gamers and addresses digital traces at the end of the life course and beyond.

Overall, the book includes a mix of up-to-date internationally funded research and commentaries on developments in core digital technology and service fields in ageing and ageing care with more specific, issue-based, chapters, such as combating social isolation (Singh; Wherton et al.) and dementia care (Neven and Leeson; Astell). The editors have succeeded in assembling an engaging and effective compilation from amidst the range of material that might have been included. The authors write clearly and accessibly about their subjects, allowing a wide range of readers (e.g. policymakers, practitioners and academics in engineering, health and social care) to get quickly to grips with a huge diversity of facts and concepts. They include an international group of research students, practitioners and campaigners, whose work is as fluent and coherent as the more familiar academic names. However, the absence of authorship grounded in what is now sometimes called ‘expertise from experience’, rather than in academic study alone, seems a little odd given the paradigmatic shift in digital, social and healthcare policy as a discipline and practice (e.g. client-centred and patient-centred in social- and healthcare respectively) towards the revalorisation of the users.

The chapters are factually well-informed and also theoretically articulated, although some stand out. The life-course transition discourse in Part 3 is arguably more uneven in breadth of description and depth of analysis because of the very wide fields some authors are attempting to cover. The most successful – notably Singh’s ‘life course’ analysis and López and Sánchez-Criado’s ‘hands-on-tech care’ – combine an immediacy and freshness in capturing the particular dynamic of contemporary ageing issues and strategies with a depth of understanding and a grasp of the wider historical, political or organisational significance of contemporary conjunctions. In Part 2, the health and wellbeing chapters are particularly effective because they not only provide an excellent complementary set of accounts that link wider debates about conceptual frameworks in research into digital care for older people but also make excellent use of ethnographic evidence to contribute to the knowledge base.

Overall, the book successfully challenges the stereotypical perception of older people’s incapability of engaging with technology. It shows, through critical thinking and demonstration, how either healthy or frail older people could develop resilience in adopting digital and technologically mediated ways to develop their normality and to maintain or improve their quality of life. Furthermore, the book provides some exemplary anthropological approaches to biographical interviews and observation which care practitioners and researchers could learn from in order to gain a more holistic understanding of older people and their families and, most importantly, to work with an increasing number of older people who have cognitive impairments.

Breaking the Chains

Erminia Colucci (Director), U.K. / Australia 2015, Mini DV PAL / 64min / Sundanese, Bahasa, English, Italian (English subtitles), https://www.therai.org.uk/film/film-sales/breaking-the-chains

Reviewed by David Orr

In the often depressing history of mental health care, there are celebrated moments when changes took place that allowed individuals affected by mental disorder to enjoy rights and freedoms previously denied them. Particularly iconic is Philippe Pinel’s abolition of the use of chaining in Paris’s Salpêtrière hospital after the French Revolution. This film’s title implicitly alludes to such moments, but its subject is present-day Indonesia’s national campaign against the widespread practice of pasung: chaining or confinement of individuals who develop psychotic symptoms. These efforts are both locally driven by Indonesian psychiatrists, activists and policymakers, and reflective of international developments, where the call for a new ‘Movement for Global Mental Health’ (MGMH, see www.globalmentalhealth.org) has given impetus to human rights activism for mental health across the globe.

Erminia Colucci’s film is a visual anthropologist’s advocacy for the changes promoted by the MGMH. Its opening scenes challenge any reflex complacency viewers – perhaps influenced by the World Health Organization’s studies that found better outcomes for schizophrenia in lower-income than high-income countries – may hold about the beneficence of indigenous treatments. To the sound of chanting, the camera pans across what is described as a ‘spiritual healing centre for mental disorder’ in West Java, showing a squatting, naked man rubbing furiously at his head, shackled feet chained in the corner of a room, and a prostrate man whose back is being rubbed raw in the course of treatment. Over the rest of the film, Colucci’s camera accompanies team workers promoting the pasung eradication efforts, as they visit villages and engage in discussion with families who are holding mentally unwell members in restraints or confinement. They discuss treatments and the possibility of release. After months or even years of captivity, this can sometimes be a delicate negotiation. At one point the teamworker muses about a confined woman: ‘we want to release her but her family is not ready yet … so we need to train her more’. They address family members’ fears over whether the person may act unpredictably with a child in the house, or the community’s stigmatisation of the ‘mad’, and generally acknowledge that without help or mental health facilities in the area families often see few available options other than restraint. The documentary refrains from making overtly condemnatory judgements on the relatives’ actions and Colucci for the most part remains a silent presence behind the camera, capturing interactions without comment. Yet deeply uncomfortable questions are raised as the camera circles around the wooden cage which is home to a young man named Eman, peering through the slats. Both the conditions in which he is forced to live and the camera’s intrusion, with which the film makes viewers complicit, are highly discomfiting and provoke an emotional response from the audience.

This documentary is not a traditional anthropological exploration probing explanatory models and cultural idioms of mental distress, where some argue that anthropology’s contribution might best lie; the spiritual centre at the beginning is not shown again, nor are the families’ assumptions explored in any depth, occasional mention of jinn spirits aside. Rather, it is a rights advocacy documentary in a field where such work is needed, where the ethnographic focus is embedded primarily with the campaign workers and patients themselves. In this respect it succeeds; it shows what changes might be possible, but also indicates the difficulties that reform faces. The ethnographic immediacy of film makes this work a valuable tool in educating and prompting discussion about the aims and challenges faced by Global Mental Health initiatives.

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Contributor Notes

Henglien Lisa Chen (PhD) is a qualified social worker and Lecturer in Social Work, Wellbeing and Social Care at the University of Sussex in England. Her academic and professional specialities are gerontological social work and comparative care policy. Her publications cover care needs, social inclusion, partnership and the workforce in ageing care systems. E-mail: H.L.Chen@sussex.ac.uk

David Orr is Senior Lecturer in the School of Education and Social Work at the University of Sussex. He was awarded his PhD in Social Anthropology from University College London in 2011. His current research interests focus on the implementation of Global Mental Health initiatives and the challenges and debates around adult safeguarding work in U.K. social care. E-mail: d.orr@sussex.ac.uk

Anthropology in Action

Journal for Applied Anthropology in Policy and Practice