Last month my colleague Sam McLean posted a blog asking whether social capital was necessarily always a good thing. He was right in saying that too often we take it as read that strong social connections and a high level of trust create better outcomes in every scenario and on every occasion. While it is true that there has been a long standing debate about the merits of social bonding capital (connections within groups) vs. social bridging capital (connections between groups), this has really only skimmed the surface of what is a much more nuanced issue.
To give you a better sense of what these nuances actually look like, I’ve collated a few interesting examples about how complex social capital plays out in semi-formal and informal care settings. Before I lay these out, the first thing to mention is that, broadly speaking, social capital is a good thing when it comes to caring for older people and helping to maintain their independence. Eric Klinenberg’s famous study of the Chicago 1995 heat wave found that mortality rates among older people were much lower (30 per cent) in the neighbourhoods where they trusted others and felt safe to leave their buildings. Likewise, we now know from the work of John T. Cacioppo and others that health outcomes are directly linked to levels of loneliness and isolation. The risk of Alzheimer’s is said to be twice as high in older people who are lonely compared to those who are not.
All of that said, there are a number of reasons why we should be giving social capital a closer inspection, particularly when it comes to informal care and adjusting to an ageing society. The following points illustrate that the relationships and trust we have with others are neither homogenous, nor stable over time, nor indeed always positive:
1.There is a clear distinction between the support provided by neighbours, friends and family – the kind of care that older people receive is often ‘relationship-specific’. It has been suggested by some academics in the field of social care that spouses are the ones who provide both deeply emotional and physical support, adult children the emotional and instrumental support, and friends and neighbours the lighter companionship. No doubt all of these are important to older people but it does highlight the fact that neighbours and casual acquaintances are no substitute for close family when it comes to doing tasks that are of a very personal or physical nature (an important point when we think about housing policy, as my colleague pointed out recently)
2. Relationships are fragile and likely to change in times of illness – in a report on the social exclusion associated with ageing, AgeUK points out that the social stigma attached with certain illnesses can diminish or entirely sever even the strongest of friendships. The report includes the story of one man who felt like a ‘social pariah’ after his diagnosis of dementia: “Acquaintances would ‘pretend’ not to see me if I was in their presence and people stopped inviting me to dinner or events. They assumed I had changed in ways that I hadn’t, that I wasn’t the same person anymore and wasn’t worthy of conversations”. Friendships do not always weather the storm of illness.
3. Friends and family can be hyper-controlling and sometimes the best individuals to help older people with managing risks are those they have no relationship with at all – Fear can pervade the close relationships that older people have with their relatives and friends, often to the extent that the latter can become overly protective and risk averse. Care from close relatives and friends can turn into ‘containment’, severely limiting people’s independence. The same AgeUK research highlighted before found that some older people feel more comfortable discussing things with strangers who are impartial and who have ‘no vested interests’.
4. Older people do not want to be a burden to friends and family – Surprising research by Ipsos MORI shows that older people are far less enthusiastic about living with their children in old age than are their children. This is in part because they do not want to receive ‘reluctant attention’, but it is also perhaps because they fear the health consequences that may affect their spouses, children and close friends. Indeed, CarersUK found that nearly half of all carers providing significant support were in debt and affected by stress as a result of caring. Few would want to bring those kinds of difficulties on their loved ones.
If any of the above proves of interest, look out for an upcoming report from RSA Projects on risk, trust and an ageing society.