Aging & Mental Health
Vol. 14, No. 2, March 2010, 121–128
Aging without agency: Theorizing the fourth age
Chris Gilleard* and P. Higgs
Centre for Behavioural and Social Sciences in Medicine, University College London, Charles Bell House,
67-73 Riding House Street, London W1W 7EJ, UK
(Received 28 January 2009; final version received 30 July 2009)
This article looks at the ‘‘fourth age’’ as a manifestation of the fragmentation of ‘‘old age’’. We argue that the
fourth age emerges from the institutionalization of the infirmities of old age set against the appearance of a
third-age culture that negates past representations of old age. We outline the historical marginalization of old age
from early modern society to the contemporary concentration of infirmity within long-term care which makes of
old age an undesirable ‘‘social imaginary’’. As ‘‘old age’’ fades from the social world, we liken this to the impact
of a ‘‘black hole’’ distorting the gravitational field surrounding it, unobservable except for its traces. Within this
perspective, the fourth age can be understood by examining not the experience itself but its impact on the
discourses that surround and orientate themselves to it.
Keywords: fourth age; third age; black hole; event horizon; nursing homes
Introduction
In 1941, concerned with the impact of growing
numbers of ‘‘senescent individuals’’ on the nation’s
economy, the US Public Health Service’s National
Institute of Health announced the establishment of ‘‘a
new unit for research in gerontology, the problems of
aging . . . direct(ing) attention particularly upon the
normal processes of late maturity, approximately the
period between 40 and 60 years of age’’.1
Over a half
century later, these age parameters seem curiously out
of date as well as missing a crucial point about what
aging means in contemporary society. Shifting the age
brackets ever upwards in line with increasing longevity
is no longer sufficient. Old age itself seems to have
changed and in so doing, frustrates any attempt at
chronologically defining its onset. In spite of this, what
old age means still confronts researchers and the need
to theorize the ‘‘problems of aging’’ links the concerns
of the 1940s with those of today.
Within contemporary gerontology, the idea that
there is just one old age has been challenged by the
growth of what may be termed ‘‘third-age studies’’
distinguished by their focus on contingency, diversity,
and difference. A number of authors have contributed
towards this cultural shift (e.g., Blaikie, 1999;
Featherstone & Wernick, 1996; Gilleard & Higgs,
2000; Katz, 2005; Weiss & Bass, 2002). In theorizing
a third age, they have drawn attention to some of the
more significant changes to age and aging thrown up
by developments within contemporary social and
cultural practices. The commodification of the body,
the development of anti-aging strategies, and the
increasing differentiation of mass consumer society
all illustrate how later life has been transformed as a
field of agency and choice.
Excluded from this discourse has been any deeper
articulation of what has been brought into, if not
existence, then at least contrasted relief – the ‘‘fourth
age’’ (Twigg, 2006). The fourth age, in this rough
formulation has been termed a social space marking
the end or collapse of ‘‘the third-age project’’ where
power, status, and citizenship can no longer be enacted
by those who are most identified by it (Gilleard &
Higgs, 2000, p. 162). The ‘‘cultural turn’’ however has
failed adequately to address what is seen as a condition
of old age now juxtaposed to an agentic ‘‘later’’ or
‘‘post-working’’ life. Nor has it resolved what, if
anything, separates old age from infirmity and chronic
illness. While many writers have tried to bring coherence
to the manifold experiences of aging by drawing
together the communalities of the aging experience,
they have avoided addressing the significance of the
divide between the third and fourth ages. This division
remains an unresolved tension in their work. It is also a
tension for those working within the field of mental
health for older people because it also describes many
of the origins of the contradictions that practitioners
deal with on a day-to-day basis.
The fourth age is important as a cultural and
structural component of aging but it is not constructed
around the same coordinates as those of the third age.
It is not simply the terminus of the third age, nor some
kind of third-age anti-matter – the unsuccessful but
necessary counterpart to successful aging. One way of
approaching this issue is to consider the fourth age as a
kind of social or cultural ‘‘black hole’’ that exercises a
*Corresponding author. Email: CGilleard@aol.com
ISSN 1360–7863 print/ISSN 1364–6915 online
ß 2010 Taylor & Francis
DOI: 10.1080/13607860903228762
http://www.informaworld.com
powerful gravitational pull upon the surrounding field
of aging. The purpose of this article is to develop this
idea, and by (re)theorizing the fourth age, give it a
more cogent status within gerontology, a status beyond
that of an under-theorized residual social category.
The third age and its shadows
Gilleard and Higgs have argued that the third age
should be interpreted as a cultural field developed most
extensively in post-working life and not a ‘‘new’’ stage
of life or a particular social stratum within the aged
population (Gilleard & Higgs, 2005). While individuals
from particular, iconic birth cohorts may participate
more completely than others in this field, individuals
from every cohort vary in their involvement.
Consumption practices provide much of the logic
governing this field and the socializing influences of
post-war mass consumer society determine much of its
habitus. Part of the definition of the third age is its
active exclusion of ‘‘old age’’ and ‘‘agedness’’. In that
sense the cultural and structural boundaries of the
third age may provide, through a process of antagonistic
reciprocity, the structural boundaries for the
‘‘fourth age’’. But this active exclusion of agedness
reflects as much as it determines the fourth age,
appearing as a kind of distortion in the mirror of the
third age. We argue that social gerontology needs to
become aware of the role of the fourth age as a ‘‘social
imaginary’’ (a largely unstructured and inarticulate
understanding of social situations (Taylor, 2004, p. 25)
of deep old age, if it is to fully understand the changing
circumstances of aging.
Before we pursue this further, we must be aware
that not all of the actions of older people can be
covered by the interpretive frameworks of the third
and fourth ages. Not participating in the third age –
whether for material, social, or more personal reasons
– does not automatically consign an individual to the
fourth age. Access to the third age and the acquisition
of, to use Bourdieu’s term, its habitus, varies for
historical and socio-structural reasons. Habitus in this
sense means a set of dispositions that define particular
cultural practices or lifestyles (Bourdieu, 1986, pp.
169–175). The lack of third-age habitus does not
determine entry into the field of the fourth-age identity
nor instill a fourth-age habitus. That such fourth-age
habitus are impossible, we shall demonstrate later. Our
point here is that significant parts of adult life at any
‘‘life stage’’ are conducted as part of the ‘‘everyday
round’’, maintaining a moral identity within particular
family or social networks and getting by without much
reference to consumption-oriented distinctions or
broader cultural aspirations. It is when people are no
longer ‘‘getting by’’, when they are seen as not
managing the daily round, when they become third
persons in others’ age-based discourse, within others’
rules, that they become subjects of a fourth age. At this
point an ‘‘event horizon’’ is passed, beyond which the
everyday round cannot situate a frame of reference
from which individual agency is interpreted. It is the
combination of a public failure of self-management
and the securing of this failure by institutional forms of
care that a key boundary is passed. Even then, it is not
just these particular conditions that create the objectification
of agedness, but the interpretations that are
used to define this event horizon, the meanings
attached to what lies beyond it, and the consequences
that these interpretative structures have on life outside
the fourth age that together give it its significance.
When Laslett wrote his seminal book on the third
age A Fresh Map of Life, he sought to rescue the third
age from what he termed the ‘‘ignominy’’ of the fourth
(Laslett, 1989, pp. 3–5). For Laslett, this was a period
of decline and decrepitude that particularly affected
those who lived beyond their mid-eighties (Laslett,
1989, p. 41). Laslett periodized the fourth age within
the lifespan of individuals, while he located the third
age within the history of society. The fourth age was
not a matter of collective achievement made possible
by social, cultural, and economic developments but an
inevitable end that could at best be marginalized to the
edges of life. While we share Laslett’s view of the third
age as a socio-historical phenomenon situated in the
confluence of particular social and historical trends,
rather than treating it as a periodized segment of the
lifespan, a ‘‘late middle age’’ (Twigg, 2004) or as a class
fragment, the continuation of ‘‘two nations’’ in retirement
(Bury, 1995; Evandrou & Falkingham, 2000;
Titmuss, 1958), we argue that it should be seen as a
cultural field shaped by the experiences of people who
grew up and are now growing old within mass
consumer society (Gilleard & Higgs, 2005; Higgs &
Gilleard 2006). In describing the third age as a cultural
field, we are referring to the development of generational
lifestyles whose origins can be traced to 1960s
youth culture with its emphasis upon choice, autonomy
and self-expression. As this generation has grown
older, it has carried these dispositions over into later
life.
What helped to define this field is the rejection of
that which is old because it is old. The old seemed to
represent much of what out of date in the new post-war
society and this mentality continues to resonate in a
generation which even now still hopes to die before it
gets old (Strausbaugh, 2002). The third age draws
much of its dynamic from this ‘‘generational schism’’,
which was presented publicly and privately as a break
with the ‘‘older’’ pre-war generation and which created
a reluctance to identify with that which was ‘‘old’’ or
‘‘aged’’. This resistance to be the social categorization
of old age has become a central habitus of the third
age, one that continues to be nourished by expanding
markets for anti-aging products and lifestyles
(Gilleard, 1996; Hurd Clarke & Griffin, 2007).
A key premise of our argument is that the third age
is a cultural field presaged upon the agency of its
participants. Non-participation in that field, not
choosing not to participate but simply not knowing
122 C. Gilleard and P. Higgs
or following its rules is not in and of itself a key
attribute to the fourth age. Non-participants in the
third age may well exercise agency within other
domains of life that are removed from the market
and the media. They are like observers of a game,
possessing some familiarity with its rules but remaining,
whether by choice or circumstance,
non-participants, non-players.
The fourth age is not about not participating in this
cultural field. It is a more distinct phenomenon, a more
unfathomable space within society, created by different
logics and shaped by different practices. The institutionalized
health and social-care practices that have
helped demarcate the event horizon serve as a portal
to an important symbolic space that shapes and
renders at times more desperate the habitus of the
third age. Adopting Charles Taylor’s terminology, the
fourth age can be seen as a particular ‘‘social imaginary’’
through which modern society’s unstructured
and inarticulate sense of the world is given meaning.
The fourth age functions as a social imaginary because
it represents not so much a particular cohort or stage
of life but as a kind of terminal destination – a location
stripped of the social and cultural capital that is most
valued and which allows for the articulation of choice,
autonomy, self-expression, and pleasure in later life.
Historical origins of the fourth age
As we have intimated, the conditions for a fourth age
are constituted by the practices of those who represent
the public good. In the process of securing a place for
old age, the modern nation state established practices
and institutions that removed or restricted the agency
and choice of the impotent poor, preventing alternative
ways of being old that were deemed too much, too
uncivilized for society to tolerate. The expansion of
state governance was accompanied by a parallel
growth in what Norbert Elias referred to as ‘‘the
civilizing process’’ in Western society (Elias, 1978).
Neediness left unmanaged called into question the
state’s capacity to represent itself as sovereign of all its
subjects. But the need for the state to concern itself
with issues of lack and neediness was also determined
by ideas concerning what is indecent and intolerable
for a well-governed society. Public signs of poverty and
lack became more noticeable as they became less
tolerable. Beginning in the eighteenth century, new
statuses and new communities were created for those
deemed incapable of civilizing themselves through the
mainstream institutions of work, school, and the
family. As one German reformer put it, ‘‘old age and
incurable diseases . . . were [seen as] evils which also
called for assistance’’ (von Voigt, 1796, cited in de
Schweinitz, 1961, p. 93). These newly ascribed identities
were constructed by the practices of others, the
Poor Law guardians whose task, as representatives of
state and society, was to protect both the individuals
themselves and society at large from the indecency of
their lives (Brundage, 2002).
The historical representation of old age in modern
Western society could be said to have undergone a
gradual transformation from a fundamentally moral
perspective associated with the ordering of the ages
and stages of life to a more collectively organized
identity, based upon the position, status and resources
allocated to those considered ‘‘aged’’ within society.
While the early Christian church treated old age as a
spiritually valued stage of life (Burrow, 1988; Sears,
1986), the expansion in state power in the late middle
ages led to new administrative structures changing the
way in which poverty and the poor were viewed. Issues
of poverty and neediness that had previously been
deemed ‘‘sacred’’ became ‘‘secular’’ concerns (Beier,
1986; Markus, 1990). One consequence was to shift the
earlier moral categorization of old age to a socially
constructed one – represented in the first instance by
formalizing provision for the aged as part of the
deserving poor (Gilleard, 2002).
While aged beggars seemed eternal fixtures of the
early medieval landscape (Elias, 1978, p. 208), things
started to change as new urban centers appeared.
Although there had been earlier attempts to address
the issue of the aged poor, it was not until the sixteenth
century that Henry VIII’s parliament specifically
legislated for the welfare needs of the aged and
impotent poor in England (Slack, 1995, p. 6;
Trattner, 1974, p. 8). From this point on, there was a
slow but steady expansion in the provision of welfare
for this new grouping of the poor. Indoor relief
accelerated during the industrial revolution. In
France, old age was recognized by the state as a
distinct social category in the eighteenth century when
systematic provision was created in hostels and
hospitals for the care of the aged infirm (Bois, 1994;
Gutton, 1988). Accompanying these developments was
an interest in demography, actuarial science, and the
delineation of national age structures (Bois, 1994).
National censuses were established in a number of
countries in the early nineteenth century and by its
close the ‘‘problems of old age’’ were firmly on the
political agendas of most Western countries (Baldwin,
1992; Nield, 1898; Spender, 1892).
With the introduction of universal old-age pensions
in the early twentieth century, the emphasis upon
‘‘undeserved impoverishment’’ was replaced by a focus
upon physical infirmity and its management and
remediation. Whereas the aging inhabitants of the
nineteenth-century poorhouse were by no means all
infirm or sick, their ‘‘medical’’ needs had generally
been woefully neglected (Smith, 1990). After the
Second World War, retirement had become an established
part of the lifecourse, separating the working
from the non-working population (Harper & Thane,
1989). Once a universal pensions system had been
implemented, the ‘‘problem’’ of ‘‘old age became a
central issue within the health care system’’ (Conrad,
1998, p. 133). The post-war welfare state articulated
Aging & Mental Health 123
new distinctions within the ranks of the aged poor,
distinguishing the aged with primarily social needs
from those whose needs stemmed from sickness and
infirmity. For the former, there was the prospect of
better pensions or a place in the new residential homes
for the elderly where they were to be treated more as
honored guests than workhouse inmates;2
for the latter
there was the prospect of medical assessment and
rehabilitation in ‘‘proper hospitals’’ and, if that failed,
being nursed in long stay (geriatric or psychogeriatric)
continuing care wards (Brocklehurst, 1974; Warren,
1943, 1946).
In this manner, the institutional structures framing
the fourth age first emerged. By the time of the
post-war welfare state, policies addressing old age were
institutionalized as either issues concerning social
security and income maintenance, or issues concerning
sickness and infirmity. The institutional outlines of an
incipient fourth age retained much of what had been
most feared from the new Poor Law era, namely
enforced indoor relief (Thane, 1999) but added to it a
deeper neediness that went beyond that located within
a framework of poverty and social need. This is the
social imaginary of a fourth age, in Laslett’s terms an
‘‘unwanted condition of half life’’ whose ‘‘onset and
hence. . . duration should be put off for as long as
possible by appropriate behavior during the Third
Age’’ (Laslett, 1989, pp. 20, 154).
Although the institutional segregation of indoor
poor relief had been austere, it retained the idea of
individual agency in its acceptance of separate spheres
of life for inmates (cf Cuttle, 1934; Taine, 1971). But
when old age shifted from occupying a marginal
position in the main healthcare systems of the nineteenth
and early twentieth century to one that was
increasingly central after the Second World War, this
institutional framework began to change. As the
memory of Poor Law indoor relief subsided, along
with its particular terrors, the dominant institutions
offering permanent relief for those no longer physically
or mentally able to look after their own needs became
the long-stay hospital and nursing home. Marjorie
Warren, the pioneer of geriatric medicine, had
promised to release hundreds if not thousands of old
people from their incarceration within the workhouse
infirmaries. By ‘‘active’’ rehabilitation, old age was to
be rescued from the margins of society and, through
the agency of ‘‘hospital’’ medicine, returned to a
real and valued position within society (Warren,
1943, 1946).
From the 1960s onwards, medical assessment and
remediation of excess disabilities became central
elements in the discourse of British geriatric medicine.
What had begun as a debate about the aged poor was
now a debate concerning the skills necessary to
distinguish the normal features of old age from the
unnecessary and abnormal accompaniments of agedness.
This debate provided the core rationale for
geriatric medicine, transforming avoidable/preventable
chronic sick pathways through later life into healthier,
more benign, and natural ones. Infirmity was neither a
natural nor an inevitable consequence of being old; it
was accidental, the consequences of material and social
neglect, the remediable consequence of age-associated
health inequalities. Geriatricians were to be the new
judges of who was old and who was sick, and amongst
the old and sick, who was remediably and who
irremediably infirm (Hodkinson & Jeffreys, 1972;
McAlpine, 1979; O’Brien, Joshi, & Warren, 1973;
Stout, 1979).
The immediate outcome was a progressive rise in
the number of people occupying nursing home and
residential home beds and an increase in ‘‘bed
blocking’’. Rather than reducing the numbers of aged
poor, the new professional discourse lead to an
expansion of their numbers (Bridgen, 2001). As a
result of the failure of hospital geriatric medicine to
reverse this position a new approach was ushered in,
the era of the community geriatrician whose task was
to develop new borderlands of anticipatory care,
tackling the ‘‘geriatric problem’’ before it reached the
hospital (Millard & Higgs, 1989; Williams, 1991).
Designed to pre-empt progress into an institutionalized
‘‘fourth age’’, the new precautionary (community) care
actively sought out those showing signs of an incipient
fourth age. Monitoring the health of old people at
home, which had begun in the 1960s (Williamson et al.,
1964), gathered pace as the numbers of people over 65
years in long-stay institutional care continued to rise
(Sinclair, 1988, p. 249).
The success of the new precautionary care has
proved difficult to establish (van Haastregt, Diederik,
van Rossum, de Witte, & Crebolder, 2000) but the
effect of this professional refocusing upon ‘‘old folk at
home’’ cast a shadow over the emerging field of the
third age. The post-war paternalism towards ‘‘old folks
at home’’ has in more recent times, been outflanked by
the demands of an ‘‘individualized’’ second modernity
of risk management, with its emphasis on
self-management of disease and the expectation of
universal precautionary self-care for everyone in and
approaching later life (Barlow, Turner, & Wright,
2000; Higgs, Leontowitsch, Stevenson, & Jones 2009;
Lorig, 2003). While in earlier times the fate of ending
one’s days in the workhouse cast a shadow over the
working class, ending one’s days in a nursing home has
become a fate more universal in its coverage. It is now
a more personalized risk. Moreover, if all are at risk,
everyone must look out for themselves. Health promotion
and precautionary self-care, as aspects of the
‘‘citizen consumer’’, have insinuated themselves into
the third age, distorting and disturbing its liberatory
message.
A decline from public to privately funded long-stay
provision for old people in England was evident in the
mid-1980s (Hansard, 2003). Similar shifts from public
to private long-term care provision have taken place
through much of the Western world. Countries, such
as Denmark and Sweden which once epitomized the
collective provision of welfare have seen their public
124 C. Gilleard and P. Higgs
long-stay provision turned into individual private
nursing homes (Sundstrom, Johansson, & Hassing,
2002). Continuing care hospital beds have shrunk
dramatically as an increasingly varied market has been
created, offering long-term care at home as well as in a
home (Turrell, Castleden, and Freestone, 1998).
Various cost-management solutions have been used
to restrict and reduce hospital bed usage. In 1992, local
authorities in Sweden were charged for each extra day
that anyone over 65 remained in hospital after
discharge was agreed. As a result, 10 years on, ‘‘there
are around 60–70% fewer geriatric wards in Sweden’’
(Wanless, 2002).
The increase in the size and density of the aging
population when combined with reductions in the
public provision of long-term care has changed the
nature of long-term institutional care. Fewer nursing
home residents are able to self-manage basic activities
such as bathing and dressing (Bowman, Whistler, &
Ellerby, 2004; Decker, 2005). A progressive concentration
of infirmity has taken place within the nursing
home sector making long-term care an alienating
prospect for what may be as many as one in three
people who reach age 65 (Liang, Tu & Whitelaw, 1996;
Liu, 2000; Murtaugh et al., 1990). Predicting who
will be that one in three implicates almost everyone,
as medicalized disabilities rather than making socioeconomic
status the principal determinants of nursing
home admission (Bharacha, Pandav, Shen, Dodge,
& Ganguli 2004; Wolinsky et al., 1993). The fourth age
is represented as neither a moral and final stage of life,
nor as the cumulative consequence of maintaining
a materially unsecured position in society. Rather it is
the result of personal bad luck.
Accompanying this interpretive change is the
abandonment of reversibility in the status of a fourth
age. When the Lancet surveyed the state of the chronic
sick in the Victorian workhouses of England, it claimed
that ‘‘If, as we assert ought to be the case, all the infirm
were medically treated, there would be a very large
percentage of recovery and consequently an important
saving of the rates’’ (Lancet, 1866, p. 9). Similar claims
of potential reversibility were made by other Victorian
reformers who believed that ‘‘they [workhouse
inmates] are indigent in their old age after a life of
toil because they have been robbed of the fruits of their
labor by the class from whom our guardians and
magistrates are mostly drawn’’ (The Clarion, 17
September 1892). Whatever the successes of the social
and medical reformers of the first modernity in
creating ‘‘rationalized’’ institutions, the result in a
second modernity has been the creation of a position of
institutionalized irreversibility – an ‘‘event horizon’’ of
historical contingency – for the fourth age.
The fourth age and its event horizon
The appearance of a fourth age, we have argued, has
been contingent upon developments in health and
social policy during the course of the twentieth century.
If the cultural field of the third age has emerged from
the social contestations around lack and old age, the
fourth age may seem the bitter fruit of that victory.
Unlike the habitus associated with the third age, the
fourth age cannot sustain a set of dispositions or
support new forms of symbolic differentiation. It is
undesired by, and distasteful to, all those subject to its
pull. These distortions in the mirror of the third age
are more than the concerns of ‘‘third agers’’ finding
themselves at the receiving end of services labeled as
‘‘geriatric medicine’’ or ‘‘care of the elderly’’; they also
act as a fundamental ontological challenge. The
irreversibility of nursing home placement, the disappearance
of any personal exchange in the processes of
admission, and the ‘‘deprivatization of experience’’
that results from admission (Gubrium & Holstein,
1999) create an immense negative force upon both the
third age that surrounds but remains imperceptive of it
and the general attitude to old age. In short, the fourth
age acts as a metaphorical ‘‘black hole’’ of aging.
In astronomy, a black hole creates a massive
gravitational pull that sucks in everything that comes
within range including light itself. This generates the
phenomenon of the ‘‘event horizon’’ which is a point
where light disappears completely. Any light emitted
from beyond this horizon can never reach the observer.
To many people in or approaching ‘‘later’’ life, the
position of those in the fourth age can be likened to
that of an object that has strayed too close to the event
horizon and has now gone over it, beyond any chance
of return. Equally, no light shines back once the event
horizon is traversed. In the absence of any reflexive
return it becomes impossible to separate what is
projected into it and what occurs within it. The fear
of the fourth age is a fear of passing beyond any
possibility of agency, human intimacy, or social
exchange, of becoming impacted within the death of
the social, a hyper-reality from which there is no reality
to return. This fear is not confined to those in the third
age nor is it exclusive to contemporary society’s citizen
consumers. The social imaginary of the fourth age
contains a universal ontological quality. As de
Beauvoir remarks ‘‘every society. . . dreads the
worn-out sterility, the decrepitude of age’’ (de
Beauvoir, 1977, p. 46) and this is what makes it more
than either the particular institutional organization of
frailty or the ‘‘perspectivism’’ of the third age.
However, in extending this metaphor of the black
hole, we seek to establish an interpretive frame for old
age that differs both from the classical distaste for
bodily aging and the early modern stigma attached to
the pauperization of age. The fourth age here represented
as a black hole carries with it the notion of
passing beyond the social world, beyond both its
comforts and its contradictions. For observers, influenced
in varying degrees by the commodification of
their life world, the fourth age offers no opportunity to
create a status or articulate a lifestyle; nor is there
reason to trust that previous agentic choices will ever
Aging & Mental Health 125
be honored or acted upon (Higgs & Gilleard 2006).
Borrowing a phrase from Zizek, this is indeed ‘‘the
desert of the real’’, a place where our greatest fears
reside but which can only be addressed by allusion and
metaphor (Zizek, 2002).
Attempts to measure this space within society fail
to assuage its power. Just as relativity theory has failed
to resolve the dilemmas posed by quantum mechanics,
so also the attempts of geriatricians and gerontologists
to calibrate frailty, the efforts of policy analysts and
health economists to assess the equivalencies of different
forms of long-term care as well as the aspirations of
third-sector advocates to give voice to the disempowered
cannot contain the forces of abjection that
emanate from the fourth age. The ‘‘mass’’ of a black
hole can only be apprehended through its effects on
objects that surround it. In a similar fashion, we
suggest that, the cultural perturbations created within
the third age are the nearest approximations to what
cannot itself be fully grasped.
If reflexivity is the marker of modern social
relations empowering the agency of the third age,
then the fourth age is marked by its negation. There are
no chosen choices in the fourth age. What may appear
as choices – in terms of food, clothing, or activity – are
the attributions of choice created by others’ actions, a
hyper-reality of choice. As with the event horizon
where light emitted from the outside disappears, so
also the intentions of carers and professionals generated
from outside the fourth age get lost within it. The
discourses of care and concern create their own
interpretive frameworks that never receive the confirmation
of mutuality and reciprocity.
The seeming mindlessness and immobility attributed
to the fourth age is just that. However difficult it
may be to grasp the ‘‘real’’ effects that any individual
has upon another, the abjection of the fourth age is
such that struggles to establish a conscious social
exchange seem too intractable, beyond any possible
resolution other than death and grief. All that is
evident are the various ‘‘civilized’’ exchanges of
professionals and carers, whose discursive reality
exists within the context of the agreed understandings
that inevitably lie external to the fourth age itself.
While such discourses are rendered sensible by the
institutional structures that generate them – the normative
frameworks of professionalized care – the
objects of that discourse play little role in any part
of them.
Such a conclusion may seem unpalatable to those
who devote considerable energies to tending to the
needs of the fourth age. Our intention is not to decry or
seek to diminish the essential humanity of those in the
fourth age. Still, we believe that treating the fourth age
as a metaphorical black hole disturbing all within reach
of its gravitational pull – however imperceptible the
source of its immense mass may be – opens up new
possibilities of understanding within social gerontology
that transcend the disembodied enumeration of the
morbidity and mortality of the older population.
It may also throw light on why the efforts of so
many researchers and practitioners to provide a
positive rendering of the fourth age and its needs
have not reduced its stigma or normalized its status.
Conclusion
Fifty years on since the National Institute of Health set
up its new unit, the problems of aging remain
unsolved. What has changed has been the problematization
of age itself. Paralleling the extension of life,
the securing of retirement, and the progressive reduction
in late life disability evident during the past
decades of the twentieth century, there has been a
progressive concentration in the depth of disability of
people admitted into institutional long-term care.
Increasing affluence across the life course, greater
individualization in later life, and the
de-institutionalization of the life course have established
the third age as a cultural field capable of
sustaining multiple meanings and numerous opportunities
for choice, autonomy, self-expression, and pleasure
in later life. Such progress is offset by the
‘‘othering’’ of old age – the shadowlands of disability,
diminishment, and death represented by Peter Laslett
as a ‘‘fourth age’’. It is here that many of the activities
that are familiar to mental health professionals take
place. Despite its naming as the fourth age, there have
been few attempts to understand what it is, let alone to
theorize it. This article seeks to make a start, considering
the fourth age not as a particular age cohort or
distinct phase of life, but as a metaphorical black hole,
which while incapable of being fully grasped or
measured nevertheless exercises a profound impact
on the cultures of aging.
Ending one’s days in a nursing home has become
a prospect for significant numbers of those reaching
65, but it is no longer seen as the consequence of
improvidence or indigence. Instead it has become
reflective of a totalizing infirmity pared of all other
significance. No longer the fate of the poor, or a choice
to be considered by the leisured classes, the nursing
home has become a new space – a new void – within
society. It exists as an institution that, although less
perceptible, remains every bit as terrifying as the
workhouse and its infirmaries, while the universalization
of this risk and the irreversibility of the process
give the nursing home a significance it scarcely
possessed some 25, let alone 50 years ago.
The new significance attached to the prospect of
admittance into a nursing home has not created any
new understanding of old age. Rather it has helped
create a new social imaginary, the fourth age, where
choice, autonomy, self-expression, and pleasure collapse
into a silent negativity. Considered in this way,
we have argued that the fourth age becomes a
phenomenon that cannot be studied directly by trying
to ‘‘recover’’ or ‘‘represent’’ the nursing home experience
but which can be detected indirectly, as if in a
126 C. Gilleard and P. Higgs
mirror, from the images, practices, and discourses of
those surrounding it. Its meaning can be gauged from
the advertisements for nursing homes; from the
discourse concerning the appropriate governance of
long-term care, the policy debates, and the training
manuals; the work habits of those who service it; and
the precautionary care practices expected of people in
later life in order to steer clear of it – shadows in the
mirror that those enjoying the third age half see and
half turn away from. Only by studying what happens
to the light cast upon the fourth age can we understand
what otherwise lies beyond reflection and beyond
enlightenment.
Notes
1. Reported in the Notes section of the American Journal
of Psychology, 1941, 54, 133.
2. In 1950, the Ministry of Health proclaimed ‘‘The
workhouse is doomed. Instead local authorities are
busy planning and opening small comfortable Homes
where old people . . . can live pleasantly and with dignity.
The old ‘master and inmate’ relationship is being
replaced by one more nearly approaching that of a
hotel manager and his guests’’ (Ministry of Health,
1950).
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