Review: Taking care of yourself in later life: A qualitative study into the use of non-prescription medicines by people aged 60+

The last 40 years have witnessed substantial changes to the experience of later life. Health and life expectancy have improved and the emergence of a putative third age has allowed post-working life to move beyond being a residual social category to become an arena in which later life lifestyles can be constructed. Greater emphasis is now placed on expectations of self-agency and choice. Allied to this is the growing role of consumerism as a way of organizing key aspects of social life. Not only do these changes place increased emphasis on individual responsibility for health, but they also engage individuals in various forms of health consumerism.This study draws on these aspects of contemporary society to provide an explanatory framework for understanding older people’s engagement with, and consumption of non-prescription medicines. We present a qualitative study in which we interviewed 22 men and women aged 60 plus who were purchasing or interested in purchasing non-prescription medicines, including complementary and alternative medicines. Our findings suggest that the use of non-prescription medicines is both pluralistic and makeshift. Moreover, while this pluralism led to tensions with conventional bio-medicine, conventional bio-medicine still maintained the legitimacy of its knowledge base. Self-care using non-prescription medicines appeared more governed by hope than by evidence or knowledge of the treatments concerned.We conclude that such pluralism of approach reflects the growing consumerism in health and self-care and that older people may in fact be similar to other age groups in terms of their approach to such commodification.

[1]  F J Ascione,et al.  Exploring the Iceberg: Common Symptoms and How People Care for Them , 1987, Medical care.

[2]  M. Kelner,et al.  Health care and consumer choice: medical and alternative therapies. , 1997, Social science & medicine.

[3]  U. Kelle Theory Building in Qualitative Research and Computer Programs for the Management of Textual Data , 1997 .

[4]  R. Ferner,et al.  Over the counter medicines: proceed with caution , 2008, BMJ : British Medical Journal.

[5]  J. Hills Inequality and the state , 2004 .

[6]  A Furnham,et al.  Why do patients turn to complementary medicine? An empirical study. , 1996, The British journal of clinical psychology.

[7]  S. Katz,et al.  New sex for old: Lifestyle, consumerism, and the ethics of aging well. , 2003 .

[8]  E. Ernst,et al.  The BBC survey of complementary medicine use in the UK. , 2000, Complementary therapies in medicine.

[9]  R. Andersen,et al.  Self-care: Substitute, Supplement, or Stimulus for Formal Medical Care Services? , 1984, Medical care.

[10]  D. Slater Consumer culture and modernity , 1997 .

[11]  L. Prior Belief, knowledge and expertise: the emergence of the lay expert in medical sociology. , 2003, Sociology of health & illness.

[12]  Nikolas Rose,et al.  The Politics of Life Itself , 2001, The New Social Theory Reader.

[13]  S. Wyatt,et al.  'Ignorance is bliss sometimes': constraints on the emergence of the 'informed patient' in the changing landscapes of health information. , 2003, Sociology of health & illness.

[14]  M. Kelner,et al.  Older Adults' Use of Medical and Alternative Care , 2001 .

[15]  B. Schwartz The Paradox of Choice: Why More Is Less , 2004 .

[16]  N. K. Bell Responsibilities and rights in the promotion of health: differing positions of the individual and the state. , 1996, Social science & medicine.

[17]  Elizabeth Vidler,et al.  Creating Citizen-Consumers: New Labour and the Remaking of Public Services , 2005 .

[18]  Peter Laslett,et al.  A Fresh Map of Life: The Emergence of the Third Age , 1991 .

[19]  Velina Hasu Houston The Politics of Life , 1993 .

[20]  Paul Higgs,et al.  Cultures of Ageing: Self, Citizen and the Body , 2001 .

[21]  U. Beck,et al.  The Theory of Reflexive Modernization , 2003 .

[22]  Paul Higgs,et al.  Contexts of Ageing: Class, Cohort and Community , 2005 .

[23]  R. Wiggins,et al.  Class, cohort, and consumption: the British experience of the third age. , 2005, The journals of gerontology. Series B, Psychological sciences and social sciences.

[24]  Z. Bauman Work, consumerism and the new poor , 1998 .

[25]  Paul Ransome,et al.  Work, Consumption and Culture: Affluence and Social Change in the Twenty-first Century , 2005 .

[26]  J. Nicholl,et al.  Use and expenditure on complementary medicine in England: a population based survey. , 2001, Complementary therapies in medicine.

[27]  J. Hockey,et al.  Resisting the ‘mask’ of old age?: the social meaning of lay health beliefs in later life , 1998, Ageing and Society.

[28]  M. Dewey,et al.  Self‐reported medication use for older people in England and Wales , 2001, Journal of clinical pharmacy and therapeutics.

[29]  G. Andrews Placing the consumption of private complementary medicine: everyday geographies of older peoples' use. , 2003, Health & place.

[30]  J. Clarke New Labour’s citizens: activated, empowered, responsibilized, abandoned? , 2005 .

[31]  Paul Watt,et al.  Understanding Social Inequality , 2006 .

[32]  Complementary Medicine Today: Practitioners and Patients , 1991 .

[33]  T. Cartwright 'Getting on with life': the experiences of older people using complementary health care. , 2007, Social science & medicine.

[34]  C. Bond,et al.  How and why are non-prescription analgesics used in Scotland? , 2004, Family practice.

[35]  Dietlind L. Wahner-Roedler,et al.  Complementary and alternative medicine: use and disclosure in radiation oncology community practice , 2011, Supportive Care in Cancer.

[36]  D. Jones,et al.  Relationships between prescription and non-prescription drug use in an elderly population. , 1999, Archives of gerontology and geriatrics.

[37]  P. Taylor-Gooby Choice and Public Policy , 1998 .

[38]  D. Hannay The symptom iceberg: A study of community health , 1979 .

[39]  G. Andrews Private complementary medicine and older people: service use and user empowerment , 2002, Ageing and Society.

[40]  N. Britten,et al.  Using Reflexivity to Optimize Teamwork in Qualitative Research , 1999, Qualitative health research.

[41]  Z. Bauman Life in Fragments: Essays in Postmodern Morality , 1995 .