Joanna Bornat, Leroi Henry, Parvati Raghuram The Open University

1. Joanna Bornat: Joanna Bornat: Age as professional and personal transition: UK and South Asia qualified geriatricians reflect on their lives Joanna Bornat, Leroi Henry, Parvati Raghuram The Open University

2. Theorising life transitions Zittoun (2007) • Changes in experience • In conduct • In meaning-making about age Gilleard and Higgs (2005) • Culturally defined • Marked by consumption practices • Distancing - ‘the fourth age’.

3. Theorising ageing as transition • Institutionalisation of functionality • As social/economic redundancy (Phillipson, 1998) • Structured dependency (Townsend 1981) • Ageing well (Havighurst 1961) • Biological - Medical

4. Ageing and medical science Geriatrics - the aged body as: • a system of signification • separate • dying (Katz, 1996)

5. Regulating age in a health care setting - geriatrics In this paper we want to look at how ageing is produced not merely as a technology of regulation but how it was also viewed as a culture of enablement by some of these authoritative structures in the context of discrimination and inequality that older people faced in the health sector in the UK. We thus focus on the care of unwell bodies and how it was influenced by both the powers of expertise and the governance of everyday life. Moreover, we also look at how the architects of such caring regimes themselves were produced through innovating and establishing regulatory practices around the health care of older patients.

6. History of geriatrics in the UK Marjorie Warren: classification, interdisciplinarity and rehabilitation as producing a recuperable ageing body Construction of expertise as providing career opportunities for marginalised doctors Marking and defining age transitions becomes a way of defining both the patient and the doctor

7. Our project Two year ESRC funded project to undertake oral history interviews with working and retired geriatricians trained in South Asia in order to explore their experiences and contribution to the development of the care of older people in the UK. http://www.open.ac.uk/hsc/research/research-projects/geriatric-medicine/home.php

8. The ageing body: between bare life and biopolitics Construction of the aged body • From poor houses - from bare life (Agamben,1998) to biopolitical life (Foucault ) • To hospitals (biopolitical life) • To care homes (and back again?)

9. Geriatrics in practice – vacating the bed ‘So there was great pressure on us to keep the patients moving, to treat everybody properly, to get people home, and it became a very hard-working but very successful geriatric unit’.

10. Transitions in caring – into the bed ‘The clauses were (a) people over 75, (b) people under 75 who the general practitioner thought would appropriately be treated in our... or anybody thought would be appropriately treated in the geriatric unit, and (c) anybody we’d treated before we would re-admit’.

11. Transitions in caring – no access to a bed ‘We tried not to take people who were just dying; sometimes I would. And, you know, we never had rules, I felt rules were always bad for patients really, although I’ve just said we had a rule about admissions, but that was to facilitate things’.

12. Geriatricians practicing – transitions in old age ‘And we agreed that we take all patients above seventy years seventy years (inaudible. So introduced) at admission policy in ’76. It was something new at that time anyway so I’d got two registrars by then, three SHOs, one registrar you see. They could rotate. And from that we never looked back you see. And we started acute management. It was hard work for me because as we got second consultant in 1980 so ’76 we opened the acute unit for four years I had hard work day and night actually. But I enjoyed every minute of it you see’.

13. Geriatrics as professional practice ‘I published a paper in 1980 in (inaudible) Journal. That was well received everywhere but I was so hard worked I needed colleague you see. So I tried ’79. They always (inaudible) funding, funding, funding, so at last we got and Dr Roy was appointed as second consultant you see. So I published a paper in 1980 and in 1982 I spoke to Royal College of Physicians, British Geriatrics Society (inaudible) about the services in Scunthorpe you see’.

14. Joanna Bornat: Conclusion • Neither age nor ageing stands still • Both the aged person and the geriatrician are constructed through demarcatory practices around ageing • These are spatial practices such as around beds – occupancy, admission, vacancy • They are also spatial in that they formed around nodes of expertise with their own disciplinary practices • They also change over time; ageing has its own transitions • Theorising ageing needs to recognise the spatiality and specificity of such practices in finding a mix of chronology and functionality in defining institutional practices