The Political Economy of Dementia

Building on the previous chapter’s critique of blaming under-supported people affected by dementia for institutional inadequacies, in this chapter, I explore aspects of the wider political economy of dementia that warrant critical social scientific attention. I argue that the contemporary political economy of dementia has not been sufficiently critiqued by dementia studies because of its lack of attention to neuropsychiatric biopolitics. This biopolitics supports a political economy centred on well-informed and correctly acting publics. The result is a political economy that is characterised by transformations of social support that are partially at odds with the interests of people affected by dementia. It is here that dementia studies has considerable scope for developing forms of resistance. To do so, I suggest that critical gerontological scholarship on the political economy of ageing can provide a basis for dementia studies to generate more robust analyses of political economy and the role of biopolitics in manifesting it.

To begin, I argue that the contemporary political economy of dementia, particularly following the 2008 financial crisis, is characterised by two transformations: (1) social support into information and (2) prospective dementia incidence into capital accumulation. First, there is a revitalisation of traditional anti-institution and pro-community care sentiment, operating under familiar moral and fiscal imperatives, with the latter proving particularly potent in the context of austerity politics. In practice, idealised notions of community care are too readily devolved to lone family members, often women, in distressing circumstances. This devolution is assisted through the provision of information and awareness, disciplining people into becoming individual sources of support. Second, there is a transformation of dementia into a speculative investment to facilitate capital accumulation. This relies heavily on the promissory technoscientific claims that characterise the neuropsychiatric biopolitics of dementia. Over recent years, such claims have cast traditional demographic alarmism in a new light as a financial opportunity, emphasising the size of the prospective market for curative therapeutics.

Having outlined the contemporary political economy of dementia, I then consider the position of dementia studies as a component of this political economy. As I have noted throughout the book, much dementia studies occupies an ambiguous position in relation to the dementia economy more broadly. The success of a neuropsychiatric biopolitics of dementia since the 1970s has been both politically and economically integral to the prosperity of dementia studies over recent decades. To some extent, this existential dependency undermines the capacity for dementia studies to develop robust critiques of political economy. This political economy can often serve a range of stakeholders within dementia studies more than it serves people affected by dementia. In response, I argue that dementia studies could learn from the successes of promissory technoscience in creating futures that materially transform the present. Dementia studies could pursue a promissory biopolitics of social support that presents desirable, feasible and inevitable alternatives to contemporary forms of welfare-as-awareness and cure-as-lucrative.