The Capability Approach and Later Life in Dignity

ussbaum has proposed a list of ten central

human
capabilities that she regards as essential
and universal.
Her idea is to apply these universal
capabilities to
particular contexts.I believe that the
concept of capa-
bility requires some clarification and
refinement for
the context of elderly for older people.A
capability can
easily be mixed up with an ability to
function. A per-
son’s own ability to function is a central
but not essen-
tial part of a capability.Ability to
function incorporates
the actualization of one’s ability with the
means of
doing so. Capability is more a
multidimensional
concept. Capability entails the
dimensions of des
ussbaum has proposed a list of ten central
human
capabilities that she regards as essential
and universal.
Her idea is to apply these universal
capabilities to
particular contexts.I believe that the
concept of capa-
bility requires some clarification and
refinement for
the context of elderly for older people.A
capability can
easily be mixed up with an ability to
function. A per-
son’s own ability to function is a central
but not essen-
tial part of a capability.Ability to
function incorporates
the actualization of one’s ability with the
means of
doing so. Capability is more a
multidimensional
concept. Capability entails the
dimensions of des
ussbaum has proposed a list of ten central
human
capabilities that she regards as essential
and universal.
Her idea is to apply these universal
capabilities to
particular contexts.I believe that the
concept of capa-
bility requires some clarification and
refinement for
the context of elderly for older people.A
capability can
easily be mixed up with an ability to
function. A per-
son’s own ability to function is a central
but not essen-
tial part of a capability.Ability to
function incorporates
the actualization of one’s ability with the
means of
doing so. Capability is more a
multidimensional
concept. Capability entails the
dimensions of des
Nussbaum has proposed a list of ten central human capabilities that she regards as essential
and universal. Her idea is to apply these universal capabilities to particular contexts. The
concept of capability requires some clarification and refinement for the context of older
people. The following states how each of the central capability of Nussbaum can be applied
to the care of older people so they may live a life in dignity.

1. Life: Having already traversed a normal lifespan, older individuals in care deserve
the chance to experience the essence of a life worth living, wherein the
opportunity for a dignified death becomes paramount, for example, respecting
end-of-life preferences. Achieving this requires providing quality care that
ensures, to the best of its ability, a comprehensive set of capabilities for older
individuals.
2. Bodily Health : Ensuring Nussbaum's capability of bodily health in the care of
older individuals involves promoting preventive healthcare, comprehensive
medical support for chronic conditions, nutritional well-being, and encouraging
physical activity. Additionally, addressing mental health and pain management
contribute to a holistic approach.
3. Bodily Integrity : Declining physical and cognitive abilities in aging may limit free
movement. To address this, subsidized transportation and escorts can ensure
mobility. While sheltered home residents are generally safeguarded from violent
assaults, preventing the use of force by caregivers is crucial. Additionally,
promoting freedom of expression, including sexuality and romances among
residents, should be permitted. In the context of care of older people, a sense of
trust and security in the home should be there.
4. Senses, imagination and thought : In old age homes, it would be just to have
opportunities to do everything that one does when living at home, e.g. cooking
and cleaning in accordance to their ability and wishes. The cultural, religious, and
political activities should of the residents should be respected. The point of
avoiding nonbeneficial pain is salient when considering the elderly as ageing can
lead to physical pain caused, for example, by arthritis and attrition of the joints.
5. Emotions : Maintaining affection among residents in sheltered homes involves
common rooms for socializing, private spaces for family visits, and access to
modern communication tools. Personal connections to possessions can be
preserved by furnishing apartments with residents' own furniture and
ornaments. The care givers should foster an environment that encourages
emotional expression, empathy, and meaningful relationships.
6. Practical reason : Nussbaum points out that stressing rationality is problematic
when considering the increasing number of cognitively disabled people in ageing
societies. The ability to form a conception of the good and to plan one’s life
according to it means having proper, understandable information about one’s
own situation and one’s choices. Therefore, it is important for the relatives and
care givers to communicate in simple language. The old age home may also
inquire close relatives to provide valuable information about an individual’s
conception of the good life and quality care.
7. Affiliation : Affiliation is a capability concerning social interaction and sense of
being a member of a community. This capability can be elucidated under four
dimensions – desire – Though the old age may give the care receiver an
opportunity to be in company, it is the choice of the care receiver to be alone or
among people ; ability - A care receiver must have the ability to engage with
others, and if physical limitations hinder this interaction, the care system should
facilitate it by providing sufficient moving aids, such as wheelchairs; means- the
availability of means is crucial, and having the desire and ability to socialize
becomes futile without proper spaces. Old age homes should prioritize providing
care receivers with comfortable common rooms; access - The accessibility of
common spaces is vital, and care receivers’ lives in sheltered homes should align
with their desires, not just organizational needs. Ensuring independent time
management, akin to those living at home, preserves the dignity of older
individuals. Nussbaum associates self-respect with affiliation. Providing care for
older individuals must address unique needs, with self-respect as a crucial
element.
8. Other species: There can be two ways for care receivers can be closer to nature:
take them to nature or bring nature to them. Accessible gardens or yards around
sheltered homes can provide a serene environment. In urban areas, regular trips
to gardens are an alternative. Additionally, having a variety of indoor plants can
enhance the care receiver’s connection to nature.
9. Play: The capability of play involves creating tailored recreational programs,
fostering outdoor activities, and encouraging social engagement. Incorporating
cognitive games, artistic expression, and providing access to cultural events
further enhances their experience. Flexible scheduling, intergenerational
programs, and technology-based games can contribute to a holistic approach,
promoting joy, social connections, and a sense of fulfillment in the lives of older
individuals in care.
10. Control over one’s environment : The basic political participation of care receivers
can be facilitated through institutional voting, allowing voting within geriatric
facilities and assistance during elections.
Nussbaum (2009b) points out that stressing rationality is problematic when considering the
increasing number of cognitively disabled people in ageing Western societies.

The utilization of the capability approach in our research study on the dignified lives of
residents in old age homes is particularly advantageous in addressing a major criticism levied
against mainstream gerontological frameworks. Mainstream approaches have often been
criticized for their inability to appreciate and incorporate issues of diversity and difference
when engaging with experiences of aging. This limitation is significant given the socially
structured nature of inequalities, as these differences play a crucial role in shaping
experiences and social constructions of aging.

The capability approach offers a valuable alternative for studying the lives of residents in old
age homes. Emphasizing on individual autonomy and the ability to lead valued lives, it
recognizes the diverse dimensions of a care receiver's experiences. This focus on actual
capabilities, not just well-being, is crucial in considering the unique needs influenced by
factors like cultural background and socioeconomic status and varied health requirements.

Additionally, the approach's normative framework critically evaluates socially structured

inequalities. It examines current conditions and freedoms for individuals in different
demographic groups, addressing disparities in the dignified lives of residents. By recognizing
diversity, the capability approach provides a more nuanced understanding of aging
experiences within old age homes, surpassing the limitations of mainstream gerontological
frameworks.

Given the unique vulnerabilities and needs of care receivers in old age homes, our research
focuses on this specific demographic to shed light on how the capability approach can
enhance their experiences and contribute to a more dignified later life.

Our research focuses on care receivers in old age homes with the specific aim of determining
if these facilities are providing a dignified life in accordance with the capability approach. By
assessing the actual capabilities and autonomy of care receivers, we aim to contribute
valuable insights into the quality of life and well-being within the context of old age homes.

To recognize the critical need for a nuanced understanding of the distinct challenges and
opportunities within each sector, our research focuses on investigating both public and
private old age homes separately. By delving into the differences in resource allocation,
service offerings, regulatory frameworks, and ownership structures, we aim to elucidate on
how these factors impact the well-being and experiences of the care receivers. This
approach allows us to uncover potential disparities in accessibility, inclusivity, and the overall
quality of care provided.

Moreover, by examining the influence of market forces and cost considerations in private
homes, alongside the impact of government regulations in public homes, our research aims
to contribute valuable insights that can inform targeted interventions and policy
recommendations tailored to the specific dynamics of each sector.
In short, our research on elderly care receivers in old age homes employs the capability
approach to assess if these facilities uphold a dignified life. Emphasizing autonomy and
valued functionings, inspired by Amartya Sen and Martha Nussbaum's concepts, our study
delves into specific capabilities like affiliation, play, and control over one's environment. This
approach aims to contribute nuanced insights into the well-being of elderly residents,
fostering a holistic understanding and promoting dignity in old age homes.

Fostering affection in old age homes requires spaces for socializing, private areas for family
visits, and modern communication tools. Preserving personal connections can be achieved
by furnishing apartments with residents' belongings. Caregivers should encourage emotional
expression, empathy, and meaningful relationships in the environment.

Old age homes should provide opportunities for residents to engage in activities like cooking
and cleaning based on their abilities and preferences. Respect for cultural, religious, and
political activities is essential. Additionally, preventing unnecessary pain, common in aging,
such as arthritis and joint attrition, is crucial

Nussbaum's "Control over one’s environment" involves ensuring their active participation in
decisions and equal property rights. This is reflected in the basic political participation of
care receivers through institutional voting and assistance during elections. The recognition
of property rights is integral to fostering their agency and freedom.