It is important to acknowledge that this chapter has a different tone to that of Chapters 5 and 6. Primarily, this reflects the nature of the literature; there is a well-developed sociological discourse in relationship to the constructs of the fourth age, frailty and transitions. It also reflects the more experiential evidence base; the voices and agency of older people are much more visible dimensions. The fact that it is exploring processes such as transitions also affects its shape and content. Links with mental health issues mirror this difference. There is a mix of specific evidence about the management of a change in circumstance, for example admission to a care home, and the impact on a person's mental health of coming to terms with the changes and losses that accompany the fourth age and ‘becoming frail’. There is relatively little on mental illness.

Introduction

One of the implications of an ageing population is the growing number of very elderly people; those aged 85 years and over. Chapter 1 identified that ‘later life’ is a long life stage, potentially lasting up to 40 years. One of the ways in which later life has been subdivided is into the ‘third age’ and the ‘fourth age’. The idea of the third age emphasises opportunities for freedom and growth in a post-employment life (Lloyd, 2012). The agentic third age lifestyle is constructed around the principle of delaying the mental and physical decline associated with the fourth age by engaging in leisure and fitness activities, holidays and ‘healthy lifestyles’ (Higgs and Jones, 2009). This links with the discourse on active and successful ageing explored in Chapter 2. It is important to remind ourselves about the role played by the social gradient of health in relationship to mortality and morbidity discussed in Chapter 3. While the most disadvantaged older people may not survive to experience very late life, nevertheless, the impact of inequalities on those who do reach the fourth age remain both relevant and underexplored.

According to Twigg (2006), quoted in Lloyd and colleagues (2014a), optimistic accounts of the third age are possible only ‘by projecting into a dark fourth age all the problems and difficulties associated with ageing’ (p 2).