At the beginning of this month, Vitangeolo Bini, a retired policeman from Florence, visited his 82 year old wife, Mara, in hospital, in Prato, Italy. Mrs Bini had been suffering from Alzheimer’s disease since 1995 and was in the terminal stage of the illness. Unable to recognise Vitangeolo, Mara had lost the power of speech.

For years Vitangeolo had cared for his wife, and this day was like many others in the little ward of the hospital which specialises in care for people like Mara. Vitangeolo sat quietly by her bedside, gently stroked her face and murmured softly to her. He then placed two towels over her head and chest and shot her dead. He turned to the other patients in the ward and explained: ‘Excuse me, but I couldn’t bear to see her suffer any more. I did it because I loved her’.

How many of us will have to bear similar burdens of care and anguish in future? The ravages of incapacitating diseases such as Alzheimer’s and dementia, in all its many debilitating forms, will increasingly affect far greater numbers of our populations. In Europe, over 18% of women in Mara’s age group will suffer from Alzheimer’s, and as women grow older the figure nearly trebles for those women in their 90s. In England, a fifth of all adults will experience some form of dementia before they reach 70. It is estimated that nearly one million of the UK’s population suffer from some form of dementia.

Across Italy, despite its strong Catholic aversion to mercy killing, Vitangeolo’s act generated huge sympathy and support. It raised the profile of those who suffer from such debilitating conditions, and made the plight of those who care for them daily f far more visible.

Two thirds of the UK’s 250,000 care home residents have some form of dementia, yet only 6 out of 10 are in special dementia registered units. Only a month ago, the Alzheimer’s Society revealed that in British care homes people suffering from dementia are ignored for hours at a time and condemned to live out their lives in isolation, lost in their own inner worlds.

In the next 20 years the number of British people expected to suffer from dementia will grow by 40%. By 2027, over 1 million people in Britain will experience a form of dementia. By 2074, the New Scientist magazine predicts over 1 million of Britain’s population will be over 100 years old. Currently, average life span is increasing by 2.2 years a decade, or five hours a day.

Meanwhile a system poorly resourced system of ‘care’ struggles to cope, especially in England. For many the treatment is appalling and undignified. Government appears trapped in blinkered thinking and unrealistic expectations. Not only is institutional care bereft of resource and a clear strategy to equip it to meet the demands of demographic trends, informal carers, are being asked to shoulder a huge burden of responsibility, thus saving the State millions of pounds each year.

Care is becoming a scarce and expensive resource only available to the better off and only available if people sell their homes and use their life savings to pay for the inadequate care they receive. And many more children of loved ones, approaching retirement, will have to shoulder the responsibility of caring.

Respite for carers is institutionally limited and is a postcode lottery. For example, where the person I try and help to care for lives, there is a marvellous state of the art dementia residential and day centre where she can receive expert and loving care, while carers can receive some invaluable respite. But a few miles away, in her neighbouring county, there is no such facility.

Our civilisation deserves better from its Governments, not least a uniform and national approach to the welfare of the elderly. Spending billions on what I think are illegal and unwanted wars, for example, seems folly compared to the primary task of caring for our own. Vitangeolo’s single act of mercy elicited a wave of sympathy not just in Italy, but here in Britain. But sympathy is no substitute for a fully funded and caring system for all the Mara’s in this world, everywhere, and carers like Vitangeolo. He cared too much.

It is time to act before it is too late. We have been fiddling with other mistaken ventures while Rome burns. Between 1995 and 2005 the total number of households in England receiving social care services fell from 513,600 to 354,500, a fall of 31%. Over 160,000 people fell out of the net of social care in the decade as care, by the State, was rolled back.

An ageing population and its welfare are expensive. The Kings Fund estimate that just to stand still would mean raising the £10.1 billion spent in 2002 to £24 million by 2026. The Fund, unrealistically perhaps given the past record of Governments, predicted that at least 4 times that investment will be needed.

Caring for an increasingly elderly population is one of the key responsibilities of any country which likes to boast it is civilised. Ageism, as evinced by Government short sightedness, is a bigger threat to our national well-being as global warming, climate change, or even terrorism. Our failure to support and care for our vulnerable elderly, especially those with mental health problems, is the biggest scandal of our age. At Christmas, 2007, I would not raise your hopes too high that the Brown Government will change dramatically, but look out in the New Year for a new vision statement on community care for the elderly. Let us hope, this time, it is not simply hot air.

About the author

Dick Skellington edits Society Matters for the Faculty of Social Sciences at the Open University. He’s an administrator who manages the Environment, Development and International Studies programme.

I cannot imagine the despair of spending the rest of your life locked up. Even if you are not wrongfully convicted, in which case the depth of despair must feel bottomless, it must still be a staggering feeling to freeze time and space and exist in that state of mind where there is only past and present and no future. The future is nothing but anticipation. To hope is to be human. What must it feel like to learn to repress your hope?

It is intriguing to contrast such repression of hope with its possibility. After his release, when the BBC journalist Allan Johnston told his story of the harrowing ordeal of abduction and detention for 114 days in Gaza, it was clear how much strength he gained from the knowledge that the world was watching his detention. That he could hope enabled his survival.

As awful as it sounds, doing life in prison under conditions that are known and where certain rights are guaranteed or implied, is still incomparable to the situation of those locked up indefinitely without many of these same rights, if any at all. Guantánamo Bay has become a symbol of such detention. When a former detainee Moazzam Begg told his story we should no longer have been shocked. Yet when a colleague Kim Rygiel and I were writing an article about such detention centres around the world, which we eventually called ‘abject spaces’, we were absolutely stunned by the number of them that existed and the number of people that were held in such spaces.

We knew that many were designed not for criminals but for holding refuges, asylum seekers, migrants and seasonal workers. Of more than 20 million displaced peoples around the world estimated by the United Nations Refugee Agency (UNHCR), more than 12 million were held in such spaces. Australia’s Woomera (1999-2003), France’s Sangatte (1999-2002), America’s Guantánamo Bay (2001-) are only the tip of the iceberg of holding people, often indefinitely.

But governments are now turning their attention away from detention centres. ‘Offshore’ or ‘transit’ processing centres may sound like dodgy financial arrangements, but these are the spaces favoured by American and European governments to lock people up after so much attention has focused on these other detention centres. Besides, governments have wanted to restrict the rights of detainees and so have chosen these spaces, which are outside national and international laws, so that detainees would have less, if any, hope at all. Moreover, ‘outsourcing’ the processing of people, as offshore processing is now called, is apparently ‘cheaper’—a calculation that beggars any belief in ethics. These spaces seem to be designed to render detainees invisible and without voice, in effect as being without agency, in the hopes of denying them precisely the hope that Allan Johnson could count on, the hope that comes with the recognition of one’s subjectivity that enables a capacity for resistance.

To take hope from people and lock them up without rights is the aim of such centres. It is very difficult to do research on them precisely because governments do not want citizens to know about them let alone question them.

About the author

Engin F. Isin is professor in Politics and International Studies and director of the Centre for Citizenship, Identities and Governance at the Open University.

Cities have always attracted groups of artists, bohemians and other creative types who have often clustered together in distinctive neighbourhoods, districts and local quarters. Such places have offered the chance to mix and mingle with other artists but also a base from which to explore and absorb the sensual experiences of the city – so inspiring creative work. In the modern age, different cities and districts have emerged as centres of bohemian creativity. In the 19th Century, radical artists flocked to Montmarte in Paris; in the 20th century SoHo in New York became central; in the early 21st Century artists occupy Prenzlauer-Berg and other eastern districts of Berlin. Such spaces are socially valued for providing new art and culture, radical critique and alternative visions of society – dreams of what cities might be.

On a recent visit to Vilnius, Lithuania's capital city, I came across another alternative space - the 'Republic of Uzupis', a small, seemingly run-down enclave situated just outside the Old Town. Uzupis declared its 'independence' from Lithuania in 1997 in order to provide its resident community of artists, bohemians and cultural producers with their own free 'state' and a new constitution of rights and freedoms. These include 'Everyone has the right to love', 'Everyone has the right to have no rights' and 'A dog has the right to be a dog'. Uzupis is not meant to be taken too seriously perhaps - but neither should its radical credentials be lightly dismissed. Uzupis residents have often expressed their direct opposition to local governmental and economic reforms.

But while I was admiring the radical constitution, the tumbledown art galleries and street sculpture, imagining a utopian community of free creativity, the locals were telling me a different story – for them Uzupis was already 'over'. What could they mean? Firstly, the district had started to become gentrified, redeveloped and rebuilt, mainly for the benefit of incoming professionals and the middle classes (and, no doubt, occasional tourists like me). Indeed it was the arty and bohemian 'atmosphere' that was specifically attracting these new residents – they wanted to savour the 'alternative' delights that Uzupis had to offer. With property developers converting old buildings into luxurious apartments and more up-market businesses moving in, the artists and bohemians were now being squeezed out by the increased rents and land values. The artists and the creativity that once thrived were now being displaced by commercial concerns – ironically undermining the cultural value that made Uzupis 'special' in the first place.

This urban process of artistic growth, commodification and decline was first noted by the sociologist Sharon Zukin in her book Loft Living (1988) – and is now recognised as the widespread fate of the counter-culture. This leads us to question whether spaces of radical or critical art can any longer exist 'outside' of the mainstream. On the one hand, this might not be such a bad thing since art requires markets and consumers to thrive – but it is also the case that commerical concerns can sanitise art and subordinate its radical purpose.

About the author

Mark Banks is Reader in Sociology at the Open University. His research interests include the cultural and creative industries, popular culture, cities and urban space.