Lassen_FinalDOC Lassen | Anthropology & Aging Vol 40, No 2 (2019) ISSN 2374-2267 (online) DOI 10.5195/aa.2019.166 http://anthro-age.pitt.edu 22 Agencements of Reanimation Facilitating an Active Old Age through Danish Co-Creation Initiatives Aske Juul Lassen University of Copenhagen Author contact: ajlas@hum.ku.dk Abstract Contemporary healthy and active aging policies coincide with new forms of governance in European welfare states promoting active citizenship, which in Denmark has been termed “co-creation.” As active aging and co-creation policies go hand in hand, new forms of health promotion programs and public-private collaborations emerge. This article centers on two initiatives that target older people in two Danish municipalities: a local COPD-choir in Vordingborg and the local department in Ishøj of the (inter)national Cycling without Age association. The municipalities take on the assignment of reanimating old age through such initiatives, by challenging the institutional barriers of the municipality. The article describes how co- creation is a redistribution of agency in the European welfare states and how older volunteers are called upon to participate in the organization of municipal initiatives, while at the same time these initiatives come with pre-fixed definitions of “good” old age. The article explores the co-creation initiatives as indicative of the agencements (Çalışkan and Callon 2010) of reanimation that endeavor to revive old age and subjectivise older people as active citizens. While such agencement involves health promotion, this article argues that the aim of initiatives is instead to engage older citizens, and hence to facilitate an active old age. Keywords: energy; co-creation; cycling without age; COPD; active aging Anthropology & Aging, Vol 40, No 2 (2019), pp. 23-36 ISSN 2374-2267 (online) DOI 10.5195/aa.2019.166 This work is licensed under a Creative Commons Attribution 4.0 International License. This journal is published by the University Library System of the University of Pittsburgh as part of its D-Scribe Digital Publishing Program, and is cosponsored by the University of Pittsburgh Press. Lassen | Anthropology & Aging Vol 40, No 2 (2019) ISSN 2374-2267 (online) DOI 10.5195/aa.2019.166 http://anthro-age.pitt.edu 23 Agencements of Reanimation Facilitating an Active Old Age through Danish Co-Creation Initiatives Aske Juul Lassen University of Copenhagen Author contact: ajlas@hum.ku.dk Activating older people in Denmark has become a key policy issue, especially for the municipalities, which have the responsibility for prevention and health promotion programs. The concern is that retirees can easily become trapped in a vicious cycle of passivity, which is then seen as leading to a rapid onset of diseases and decline, thereby making older people a burden on the healthcare sector (Lassen and Jespersen 2017). In the context of this policy concern, a wide range of municipally established and/or supported types of initiatives targeted at older people has seen the light in recent years. Initiatives such as reablement programs (Aspinal et al. 2016; Schwennesen 2017), activity centers (Lassen 2017) and patient schools (Nielsen and Grøn 2012) endeavor in different ways to activate older persons experiencing varying degrees of frailty. This article centers on two initiatives in two Danish municipalities: a local choir for people suffering from chronic obstructive pulmonary disease (COPD) in Vordingborg and the local department in Ishøj of the (inter)national Cycling without Age (CwA).i This article explores how the municipalities aim at reanimating old age through such initiatives, and how they also attempt to distribute this reanimating endeavor. As such, the ideals of old age that are enacted in the initiatives come about through a merging of active aging and co-creation policies, which has become more widespread in recent years (see (Scheele, Vrangbæk, and Kriegbaum 2019). Under the realm of active and healthy aging, reanimating old age have become key for its management in Western welfare states. Inscribed into this policy framework is the idea that an active old age is necessarily a “good” old age; an idea that took form through the 1990s and is being pushed by international policy organizations such as WHO and the EU (e.g., (Europe 2011; Kalache and Gatti 2003). As I have argued elsewhere (Lassen and Moreira 2014), active aging constitutes an unmaking of old age through its ambition to transgress thresholds that constitute old age—such as retirement and increasing frailty—through pension reforms and health promotion programs. As such, while active aging relies on a variety of differing theories of aging and take on many different forms in different organizational bodies, overall policies of active aging tend to articulate activity as rejuvenating and associate passivity with frailty and speeding up the aging process. Therefore, activity has become central to the way old age is managed (Katz 2000). This has been widely criticized as forming part of a neoliberal agenda blindly focused on productivity and efficiency throughout the life course (e.g. Van Dyk et al. 2013; Katz 2013; Lamb 2014; Rudman 2015). Such policy programs articulate aging as a key policy concern, as changing demographics pose a key societal challenge (Partridge, Deelen, and Slagboom 2018). However, while demographics tend to be the immediate explanation forming the so-called aging society, this problematization of aging relies on uncertainties regarding technology, production and health, and promises thereof, which are just as central in this regard (Moreira 2016). This endeavor to reanimate old age coincides with a shift in governance ideals, from the much- criticized new public management, with a focus on control through documentation, evidence and authority, to new public governance emphasizing active citizenship, collaboration and public-private partnerships (Osborne 2010). In Denmark, this governance model has been translated into samskabelse, Lassen | Anthropology & Aging Vol 40, No 2 (2019) ISSN 2374-2267 (online) DOI 10.5195/aa.2019.166 http://anthro-age.pitt.edu 24 Danish for co-creation, which has become a buzzword in recent years in Denmark and highlights collaboration and community rather than a municipality acting as the sole authority. As ideals of active citizenship go hand in hand with the endeavor to activate older people and reanimate old age, co-creation has become an explicit ambition in healthy aging policies ((Scheele, Vrangbæk, and Kriegbaum 2019; Voorberg, Bekkers, and Tummers 2015). Through co-creation policies, municipalities aim to reanimate old age by relying on the energy and free spirit of civil society organizations that engage volunteers to create social gatherings and outings at nursing homes—so-called visiting friends for lonely older persons with reduced mobility who are living at home, or the like. This involvement of volunteers in welfare work has become widespread in Europe (la Cour 2012). With the prefix co-, the term co-creation alludes to a joint effort, wherein all actors in society face and solve the challenges and uncertainties of the aging society. Co-creation is not limited to the healthcare and old age sector, but it has gained particular commitment in Denmark due to the increasing expenditure in this part of the administration, as well as the expected benefits from activating older people in the welfare services. As such, co-creation aspires to increase participation amongst the independent senior citizens— thereby leading to better quality of life and better health— and to lower the public expenditure on services to the care-dependent senior citizens, as the co-creation initiatives often target the social and care needs of this group. The ambition of this type of collaboration is to create a feeling of community and shared responsibility across the public and civil spheres. This coalescence between active aging and co-creation, I argue, is a rearrangement of the possibilities of agency within the welfare state; an agencement of reanimation, wherein agency is distributed to a wide range of actors, and older people are urged to be active and not be victims of past prejudices about the maladies of old age. The term agencement refers to arrangements endowed with the capacity to act, which generate specific forms of action, create differing agencies and positions and are socio-technical in the sense that they are comprised of bodies and material, technical and textual devices (Çalışkan and Callon 2010: 9). As such, the reanimation of old age relies on a shift in the infrastructure of the welfare state. Instead of acting as authority, the municipality attempts to facilitate co-creation processes among municipal care workers, associations, and volunteers. This is a paradoxical assignment, as much of the literature, and often the municipalities themselves, point to the idea that it is the 20th century welfare institutions themselves that are responsible for passivity in old age (see for example (Townsend 1981; Walker 1980). The same institutions that have been criticized for sucking the life out of old age are now endeavoring to reanimate this life phase. While active and healthy aging policies aim to set older people free from the constraints of 20th century old age policies and instead highlight their potentials, these policies also massively improved the living conditions of older people in the Western hemisphere (Walker 2008: 77). With the co-creation policies, older citizens are enabled to become so-called masters in their own lives—a term much used in Danish municipalities when defining the good old age. As such, they are also institutionally enabled to act, be active and participate in the many collaborations and networks offered. Good citizenship is active citizenship—also for older citizens. As my analysis will show, reanimating old age through activities is often a task that requires continuous engagement on behalf of the municipalities. Supporting and initiating activities is rarely sufficient, and the municipalities are constantly attempting to find ways of starting sustainable, self-driven initiatives that can continue without municipal involvement. In this regard, the interlocutors in this study (municipal employees and older people engaged in the initiatives) often talk about energy when referring to the aging process and co-creation initiatives. Lassen | Anthropology & Aging Vol 40, No 2 (2019) ISSN 2374-2267 (online) DOI 10.5195/aa.2019.166 http://anthro-age.pitt.edu 25 As Rupp has shown in her analysis of New Yorkers’ conceptions of energy, energy is a concept that constantly shifts meanings. People tend to slide between different registers when talking about energy (Rupp 2013). In this line of thought, energy is difficult to define. We know its capacities, but not exactly what it is (McGinn 2011). Energy has the capacity to make people and things move, but is often treated as an object, where it should instead be seen as an interpretation (Coelho 2009). When experimenting with how mechanical power turns into heat, the conversion as something measurable relies on an interpretation of the way heat is also a form of motion. As such, energy is a methodology that enables interpretation of the ways that things convert (ibid.). In other words, the agencements of reanimation aim at investing municipal funds into initiatives that create more active and healthy older citizens through the invocation of civil society and through a redistribution of agency in the Danish welfare state. Denmark is a welfare state organized around universal rights to healthcare, education, basic pensions, unemployment subsidies, and so on that are financed through taxes. As part of the Scandinavian model, Denmark has succeeded in surviving as a small state through social reforms, ensuring a high level of citizen satisfaction, security, and livability. While public old age care has been much criticized for its poor services, the municipalities provide home care and care facilities, as well as supportive structures such as preventive home visits (Otto 2013). Denmark has a long tradition of volunteerism and associations of various kinds. Forty-five percent of citizens aged 70+ are engaged in volunteer work, and they spend an average of 20 hours monthly as volunteers (Center for Frivilligt Socialt Arbejde 2017). In a country with less than six million inhabitants, there are approximately 101,000 associations. There is a folk saying that if there are two guys in a village collecting stamps, they will establish a local stamp-collectors-association. The largest association in Denmark, DaneAge, has more than 850,000 members (more than half of the population 65+ are members), and engages in the rights of older people through political lobbying and a huge network of 19.000 volunteers. These associations are increasingly called upon to enter collaborations with the local administration, in order to solve some of the challenges in the care and social sector. As such, old age is reanimated through agencements forming and engaging active older persons. Before describing how this plays out in the two initiatives, I will briefly describe the methods and setting of my study. Methods and Setting The abovementioned field sites (the COPD-choir and CwA) are part of a larger ethnographic study about co-creation policies and initiatives targeted older people in Danish municipalities. Through the collaboration between the Centre for Healthy Aging at the University of Copenhagen and three municipalities — Copenhagen, Ishøj, and Vordingborg — I have followed the municipalities’ co-creation initiatives for two years (2015-2017). In this process, I have conducted 19 qualitative interviews with employees in the three municipalities, from front line personnel like home-helpers to managers of the health and old age administrations. Moreover, I have conducted participant observation at several initiatives and meetings between municipal employees and local actors, as well as interviewed volunteering citizens and organizers. Of particular interest in this article is the fieldwork I have conducted amongst the care- and administrative staff in Vordingborg and Ishøj, the COPD-choir in Vordingborg, the local section of CwA in Ishøj, and the employees from the CwA association, as well as the volunteers involved in the initiatives. The COPD-choir is an initiative where the local music school (“Vordingborg Musikskole”), the municipality, and the region ii have collaborated to offer local COPD patients a place and a choirmaster to sing. The choir has been a huge success, and according to them, the participants have experienced both an increased ability to breathe as well as a better quality of life. At the time of the fieldwork, the initiative was Lassen | Anthropology & Aging Vol 40, No 2 (2019) ISSN 2374-2267 (online) DOI 10.5195/aa.2019.166 http://anthro-age.pitt.edu 26 in its 3rd and 4th seasons. It was the health authorities in the municipality who originally took the initiative to put together the choir. They wanted to create some new initiatives for fragile groups of older people and had decided on a football team for men with cancer and a COPD-choir. They wanted to include the local football club and music school in the initiatives. The region supported it with some money for salaries, third halves (a social gathering with cake and coffee after each session, which I will discuss in the analysis) and marketing. I have participated in the class for the COPD-choir and interviewed some of the members, as well as the choirmaster and the organizers from the local music school and the municipality. CwA is a Danish initiative and association started in 2013 that has spread all over the country and worldwide. Using local volunteers as so-called pilots, older people with reduced mobility are offered rides on rickshaw bikes. The bikes are usually placed in care homes and financed by the municipality. In Ishøj, I have volunteered as a so-called pilot, which is a person who bikes passengers around on a rickshaw. The passengers are usually receiving homecare or living at a nursing home. My interest in the fieldwork has first and foremost been the pilots, as they are often also retirees. I have participated in events where groups of pilots meet to bike passengers together. I have also interviewed pilots and been a pilot on typical bike- tours where I have driven one or two passengers around. Moreover, I have followed the municipal office of old age services where CwA is organized, as well as the office’s initiative “Ældres Netværk” (old people’s network), which is a collaboration among the co-creation initiatives targeted at older citizens by the office. I conducted semi-structured interviews during fieldwork that centered on themes such as volunteering, ideals of old age and collaboration. All interviews have been transcribed verbatim. I conducted different forms of participant observation, as I have followed the different initiatives as either a volunteer (CwA) or a participant (COPD-choir). During participant observation, I took short notes and photos, and then I filled in my fieldnotes shortly afterward. Transcriptions, photos and field notes have been coded and analyzed according to themes emerging in the data. In the spirit of the collaboration with the municipalities, the analysis has been tested and developed through dialogue with municipal employees, local CwA organizers and volunteers, as well as some of the COPD-choir participants and organizers. The two sites have been chosen in order to shed light on two distinct ways of reanimating old age through co-creation. With regard to the choir, it is a co-creation between the municipality and a local business (the music school) that endeavors to use singing in order to transform the lives of the participants. With regard to CwA in Ishøj, it is a co-creation initiative that aspires to transform the entire community through a reshuffling of the relations among older citizens, civil society and the municipality. The volunteers, the employees, and the older recipients of the service are all engaging in the community through CwA. But these distinct initiatives, despite their particularities, are both examples of the ways in which old age is reanimated through new agencements in the welfare state and through coinciding ideals and policies of active aging and co-creation. The COPD-Choir: Reanimation through Singing Vordingborg is a geographically large municipality by Danish standards. A rural area, with 45,000 inhabitants on 625,000 km2, it is sparsely populated. Although it is only 90 km from the capital, Copenhagen, it is often considered as part of the outskirts of Denmark, with emigration to the urban areas by younger people and the older citizens and low-income families staying behind. While this picture is of course much more nuanced, the municipality is challenged by its demography and unequal access to health care. This has led to a range of co-creation initiatives endeavoring to reanimate old age by reshuffling the barriers between the municipality and civil society. Lassen | Anthropology & Aging Vol 40, No 2 (2019) ISSN 2374-2267 (online) DOI 10.5195/aa.2019.166 http://anthro-age.pitt.edu 27 An example of such co-creation, is the collaboration between the municipality, the region and the local music school resulting in the COPD-choir. While the region provided the initial funding, the region also enabled the music school to organize the choir by providing support from healthcare professionals about how to handle the COPD patients, “They helped us to understand the social realities there are about being a COPD-patient. It is not just about decreased ability to breathe, but people that have huge social problems, people who are lonely and introverted” (Henrik, music school manager, November 2015).iii As such, the COPD-choir is not just about singing, but also constitutes an important social network for the participants. The choir was free in the first season, but afterwards they needed to introduce a small monthly fee; however, the music school has decided to keep the fee to a minimum and pay part of the choirmaster’s salary themselves. They receive support from the national board of culture to teach children and had never had students in this age group before. Due to curiosity about what music and singing can do for another user group, they found it valuable to support the COPD-choir after the immediate funding ran out: Music has the ability to change something for you, and it can also change them, and they can feel that. When you let go of the blocks that make you unwilling to participate, which they were in the beginning. But now they are with me, and they can feel the effect, it creates a change for/in them (Mette, choirmaster, March 2017). On my first visit to the COPD-choir in Vordingborg in November 2015, I entered a room with a feeling of intensity and collectivity that I had not experienced previously in my fieldwork amongst municipal initiatives for older people. Due to bad weather, I was running half an hour late. When approaching the classroom, to which the door was open due to the need for ventilation because of the participants’ breathing conditions, I was struck by the force and quality of the song, which was heard across the cultural center where the choir is located. I reached the entrance to the room as the song, which had reverberated through the hallway while finding my way, was about to end. While the song had struck me, the scenery that revealed itself from the doorway was equally striking. Located at the banks of Storstrømmen, a sound connecting the two seas Kattegat and the Baltic Sea, the back of the room had a huge window connecting the rather dull room with the wildly tossing sea and the rainy and stormy sky this November morning. The song powerfully performed by the group of COPD- patients and the charismatic choirmaster Mette melded together with the raw outside elements. This togetherness and intensity are, according to participants, part of what has made the choir a popular activity amongst the COPD-patients in the municipality. The choir attracts patients in such severe stages of COPD that for some, the choir is the only time of the week when they are out of their homes. Mette ascribes this to the connecting powers of singing: Song is something that connects us, because it is something that we do all of us at the same time. We vibrate at the same frequency (...) It is a feeling of community that you cannot entirely explain. It is more than words. It is something in the air, the beautiful lyrics, the memories (...)There is an energy that is higher than what you can deliver yourself. It is multiplied by many. (Mette, choirmaster, March, 2017) When the song ended, Mette introduced me to the choir. I took a seat amongst the participants and was handed a song sheet. Before singing the next song, Mette explained a breathing exercise in a rather technical manner, wherein the participants were urged to scrape their upper ribs while inhaling deeply. During the song, Mette continuously shouted “scrape the snow off the ribs.” Often, the breathing exercises are an integral part of the songs. It was obvious that the participants were used to thinking about their Lassen | Anthropology & Aging Vol 40, No 2 (2019) ISSN 2374-2267 (online) DOI 10.5195/aa.2019.166 http://anthro-age.pitt.edu 28 breathing, and that the choir was part of their way of handling COPD. After another song, Mette told a tale about the importance of being in the moment while singing, and how this can give a feeling of freedom. But this requires a will to struggle to breath. Even though breathing can be a challenge for those with COPD, singing can structure their breathing and force them to take deep breaths. As such, the choir has some immediate effects in the lives of the participants, who experience improvements in lung capacity, social activity and wellbeing. This reanimation relies on a specific agencement where the municipality is constantly looking for ways to motivate citizens to become involved in initiatives, and for ways to break down institutional barriers. For example, one municipal consultant during a seminar in January 2016iv stated that in order to create sustainable and self-driven initiatives, the municipality needed to understand the ‘existential motivators’ of their citizens to engage in their local community. The consultant explained that such motivators were not likely to consider institutional barriers (e.g., between the municipality and the region). Therefore, the municipality should act more as facilitators and ambassadors of citizen initiatives, rather than as initiators. The same consultant stated in an interview in March 2015, “We tend to talk about the municipality as if it us, the employees, who are the municipality. But the municipality belongs to the citizens. They are the municipality. Our role is to support them, enable them to do what they want to, motivate them to be active.” So, the key focus for this consultant was to network and talk with the citizens, in order to facilitate local initiatives that are joint efforts. In this regard, the reanimation of old age relies on an agencement that redistributes agency to citizens, while at the same time has the specific goal to motivate them to be active. This agencement generates specific forms of good actions and position the engaged seniors as ideal senior citizens. This way of collaborating has been criticized for being a colonization of the social life of citizens, wherein the public domain tries to reshape those they collaborate with (Hodgson 2004). At the same time, co-creation proponents argue that the colonizing collaboration belongs to the outdated mode of governance in new public management (see Brandsen, Trommel, and Verschuere 2014 for an overview of this debate). When interviewing Mette and Henrik in November 2015 about the effects of the COPD-choir on the members, they did not mainly talk about lung capacity or health, but about singing as awakening and capacity-building: Mette: Singing awakes the will to breathe from within, through spirit, images, memories, life, the life we have within us. (…) We talked about that word today [in class], that beautiful word that means to breathe, inspiration, to take something in that you are then able to give. Those images of breathing can wake us up in another way; can awake some new senses, which have been blocked. There are many resources, which we don’t get through the medical and physical world, because we don’t reach them where they can act. (...) Henrik: It is important to note here that they are not met as patients, they are met as humans, and they are met as a choir that needs to make something synchronous. It is not just a process. It is also a product. It is still not good enough, so let’s forget for a moment that we are sick and that it is hard, and then you do it. For Henrik and Mette, singing in the choir is a way for the participants to create something together. The choir establishes a mutual dependence, where all parts of the collective need to be synced and engaged. You need to be completely present in the music and in the song for it to work and sound good. Henrik and Mette both talk about how this is possible through high expectations, and they contrast this to the way that the participants are usually seen: as patients with limitations. Thus, the target subject differs from the subject embedded in most health initiatives, as focus here is not on the disease. In this way, the reanimation Lassen | Anthropology & Aging Vol 40, No 2 (2019) ISSN 2374-2267 (online) DOI 10.5195/aa.2019.166 http://anthro-age.pitt.edu 29 of old age is also done through a redistribution of agency, as the singers are not patients, but are provided the capacity and responsibility to act through the music school, Mette, their diagnoses, expectations, mutual dependence, exposure, the window facing Storstrømmen, and so on. While Mette draws attention to the link between breathing and inspiration, another origin of breathing links it to the spiritual. The Latin word for breathing, “spirare,” was later translated as spirit, and in many religions singing is an important way of relating to God or other divine figures. One can receive the spirit through song, and it connects to something higher. While Mette and Henrik do not refer to the religious aspects of singing, they talk about singing as possessing connecting powers. Within the same spiritual framework, Mette points to the sharing of vibrations and the seducing elements in music. Indeed, while the stretch from municipal initiative to spiritual experience might seem far, this is exactly what the municipal consultant points to when addressing the need for understanding the existential motivators of the citizens. The agencement of reanimation requires the municipality to distance itself from being solely an authority, and instead to become a motivator and a facilitator. The collaborators involved in co-creation with civil society advocate for different interpretations of health, energy and subjectivity, than what is put forth in narrow official health guidelines. But the co-creation initiatives are also in accordance with recent Danish health campaigns that aim to foster subjects with reflexive stands towards the balancing between pleasure and risk (Karlsen and Villadsen 2016). One of the existential motivators that the municipality often alludes to is the need for social activity, in particular when addressing citizens such as the COPD-choir-participants, who often lack the energy to go out during the week. Addressing such existential motivators is also seen as key to engaging people in the long run after municipal funding has run out. While most of such initiatives end when the municipalities withdraw, Vordingborg is deliberately attempting to solve this by establishing strong social bonds between the participants. After every activity for older people connected to Vordingborg Municipality there is what they call a “Third Half,” which is a gathering around cake and coffee. An employee explains, We have been very conscious about it and think that this is really the key and sometimes more important than the activity itself. We always arrange the Third Half whenever we are part of an activity, and strongly encourage the activities to continue with the Third Half once we withdraw. This is where the magic happens and people feel that they are part of something (municipal employee in Vordingborg, January 2016). After the municipality has withdrawn from the choir, the Third Halves have continued, due to a common will and a woman in the choir who bakes before every class. While the concept of the Third Half comes from sport activities, where it is usually a euphemism for drinking beer, in Vordingborg, they have changed the concept to coffee and cake, which seems to sit well with the generation and Danish traditions for togetherness. While the activity (in this case the COPD-choir) provides the content for conversation, the Third Half provides the participants with the opportunity to stay and talk with the other participants. As a health initiative, the COPD-choir differs from many health promotion programs, such as disease management programs and courses for stress or obesity. It does so by engaging in an activity—singing— which is usually seen as recreational and cultural rather than health-related. Consequentially, it also differs by inserting a health initiative into a cultural institution (and business) like the music school. The municipality breaks down its institutional barriers in its attempt to reanimate old age. This way of challenging the boundaries of the municipality and health initiatives is characteristic of the sort of activities involving older people initiated under co-creation in the Danish municipalities. Also, such a health Lassen | Anthropology & Aging Vol 40, No 2 (2019) ISSN 2374-2267 (online) DOI 10.5195/aa.2019.166 http://anthro-age.pitt.edu 30 initiative targeting older people also differs by emphasizing social relations and community rather than specific health measures. It is an agencement of reanimation that redistributes agency and challenges traditional administrative boundaries among municipal administrations, the state, and the community. The second field site I discuss in this article, which I will turn to now, is also an example of this. Cycling without Age: Reanimation through Co-Biking With 22,000 inhabitants, Ishøj is a small suburban municipality south of the capital Copenhagen. While Ishøj has its share of social problems, it is also a closely-knit municipality where many are engaged in the local community. A large portion of the residents has lived in the municipality for many years, and people tend to know each other as they would in a village. Despite the cold and dark winters, Denmark is a country with a widespread biking culture due to tradition, investments in infrastructure and promotion of good biking behavior (Larsen 2017). As the extract from the field notes below describes, many passengers find it too cold to bike on the CwA rickshaws during winter. And, as the excerpt below also shows, CwA is about much more than just biking: I finally biked with some old people today. It has been a long winter and hard to get passengers. They have all said it was too cold. When calling Inge last week, she expressed the same concern, but when I told her jokingly that spring would surely arrive when we went biking, she accepted. (...) And spring did arrive. Although it was still chilly, we had a lot of spring flowers. I went with Inge and her friend Kirstine to the marina and down the coast, and the two friends were buzzing with joy, constantly affirming the blissfulness of the situation with statements like “Oh, this is life,” “What a sweet time of year,” and “I already feel recharged, like a new person” (excerpt from field notes, March 2016). On the day the field notes above were written, spring had just arrived in Denmark. This is a special time of the year at this latitude. After months of rain, cold winds, and few hours of sunlight, the days are getting longer, the sun is shining brighter, and eranthis (buttercups) are peeping up from the ground. This brings a radical change in behavior, where people are flocking to the parks, streets, cafés, bars, woods, and coastline. People typically state that in the spring, they feel recharged. Inge and Kirstine met each other seven years ago, living next door to each other in social housing in Ishøj, and are now very close as they engage in the many activities for seniors in their local community together with other neighbors and sometimes Inge’s ill husband. They are no longer able to visit the marina, the local art museum, and the coastline landscaped as a park with fields, bike lanes, a long beach, and small woods, as this would require good walking or biking ability, which they no longer have. Inge and Kirstine both have long histories in the municipality and often use the bike trips to visit biographically meaningful places, like former homes, work places and their children’s schools and kindergartens. Thus, CwA is both a way of having good company, “getting wind in the hair” (part of the motto of the CwA association), experiencing the local landscape, and reconnecting with their life stories. All of which “recharges” them, an expression they used on many occasions during our trip. CwA started in 2013 in Copenhagen and within five years has spread to three-quarters of Denmark’s 98 municipalities, as well as to five continents. The founder, Ole Kassow, lived close to a nursing home in Copenhagen, and often saw an old man sitting on a bench in front of it, looking at all the passing bikes as if he would like to go biking as well.v One day Ole rented a rickshaw and offered to drive some of the residents at the nursing home around. It was an instant success, and when he contacted the municipality Lassen | Anthropology & Aging Vol 40, No 2 (2019) ISSN 2374-2267 (online) DOI 10.5195/aa.2019.166 http://anthro-age.pitt.edu 31 to ask if they would fund a bike, it turned out that they had a pool of money waiting to support active citizenship. They had just been waiting for ideas like this. They funded five rickshaw bikes to five nursing homes and the story immediately spread across the country. In 2017 there were more than 3,000 so-called pilots driving old people around, primarily from nursing homes and senior housing. The pilots themselves come from all age groups and both men and women, but the initiative has attracted many retired men as pilots, a group that is often difficult to reach in municipally organized activities focused on physical activity. While CwA started as a citizen initiative, and therefore is often highlighted as the golden standard for co-creation, it spread across Denmark through the municipalities. Media coverage has made the organization successful and it engages volunteers and employees who spend time conversing with new potential partner municipalities (Torfing 2015). As such, it is a form of co-creation that has come to rely on a strong organization providing the concept and infrastructure (e.g., bikes, online booking system, events), a municipality (or sometimes a fund) buying the bikes and providing a place to park them, and volunteer pilots. Under the slogan “Everybody has the right to wind in the hair,” CwA is underpinned by the Danish biking culture and a widespread belief that biking and fresh air is healthy, and that biking can strengthen the community and break down barriers between public authorities and civil society. Like the COPD-choir, CwA forms part of the reanimation of old age by reshuffling the agencement in the welfare state. The pilots and the passengers experience new forms of agency. In what has been termed activation policies, citizenship in old age becomes increasingly linked to activity (van Hees et al. 2015). In CwA, volunteering pilots often become ambassadors of their local community and embody active citizenship through the way they help the passengers, salute passersby and pick up trash, as well as through the empowering lingo of CwA. Likewise, passengers are not only provided the opportunity to reconnect with their old neighborhoods, but also disseminate history about the local community and become proof that it is never to late to take a bike ride. While CwA provides much of the infrastructure, the municipality has to facilitate bike rides and support the precarious relations among pilots, passengers, sheds for bikes, nursing homes, the home care department, batteries, flat tires, etc. As such, in order to organize volunteer bike trips, the municipality needs to invest in the bikes and find volunteers, as well as to sustain the initiative by fixing bikes and running the online booking system. The agencement of reanimation endeavors to create active older citizens mastering their own lives, but at the same time, such requires constant facilitation. The redistribution of agency within the welfare state is often criticized for being merely a way of saving public funding, but while many (often aging) volunteers engage in the care of frail, older citizens, the endeavor to reanimate old age through co-creation also requires municipal employees and funds to organize volunteers and their efforts. The agencement of reanimation is formed through a variety of means. First, physical activity is used as a way to create more energetic lives for the older volunteers, as they are believed to get in better shape mentally and physically through biking. Second, the social activity of pilots and passengers are seen to improve the quality of life of the participants. In particular, the social activity embedded in the initiative is staged to be about togetherness, community and life stories. The togetherness is visible in the conversations between passengers and pilots and the smiles and chit-chat with people they pass. The community is facilitated by a strong sense of identity and storytelling on behalf of the CwA association through events, slogans, media and merchandise. The life stories of the passengers are given much emphasis in this storytelling, where the bike rides become occasions for reconnecting with past events and what has been termed biographically meaningful places (Rowles 1983). Third, it is comprised of a variety of socio- technical devices such as PowerPoints, town hall meetings, bikes, batteries, pedaling bodies, nursing Lassen | Anthropology & Aging Vol 40, No 2 (2019) ISSN 2374-2267 (online) DOI 10.5195/aa.2019.166 http://anthro-age.pitt.edu 32 homes, etc. And fourth, the fresh air and scenery in itself, as shown above with Inge and Kirstine, enables the participants to recharge. As such, the reanimation of old age is fuelled by participants, movement, devices, history and nature, as well as the constant articulation of the ways institutional barriers are broken down: What is important is to get the bikes on the roads. We (municipal employees) should not decide how. Just because the tax money enters the municipality’s account, it is not our money, nor is it our decision. We facilitate good lives in old age. We want the bikes on the roads by April, but we don’t want to do it the usual way. In this way, there is much more ownership. We all decide, so we all have the responsibility for spreading the word. They [the citizens] must be part of the process and the decision about what to do with those bikes. (municipal consultant in Ishøj, March 2015). In the above quote, the municipal consultant was just about to launch CwA in Ishøj. However, in accordance with the push towards democratic participation in co-creation (Pestoff 2009), she did not want to decide on how to organize CwA. Rather, she involved citizens and local associations in deciding where to build the shed, how to repair the bikes, how to spread the word, etc. As facilitators of good lives in old age, the municipality aimed at distancing itself from the authority provided by legislation, and instead become a positive and wanted presence in the everyday lives of its citizens. The agencement of reanimation is as such paradoxical in its nature: in its endeavor to become more than authority, the municipality invites citizens into the decision process of how to organize CwA. At the same time, due to budget constraints and project funds, they need to decide the rules of the collaboration. The goal is to get the bikes on the roads and to do so by April 2015. As such, the municipality cannot escape from its role as an authority. While the introduction of CwA in 2015 succeeded, the municipality experienced that they needed to constantly nurse the initiative by looking for volunteers, patching bike tires and adjusting routines around the bike shed, batteries, lock, etc., as well as managing differing positions regarding such routines among the involved volunteers. In November 2015, the ‘old-people’s-network’ office managing CwA invited all senior citizens and associations in the municipality to a meeting about how to spend next year’s funds on 100,000 Danish Kroner (around $20,000 USD). Around 25 senior citizens and association representatives attended the meeting, which started with a PowerPoint presentation from a municipal co-creation consultant stressing that this was the future of municipal work. Where traditionally the municipality would focus on the relation between itself and citizens and between volunteers and associations respectively, they would now focus on local participation and how the municipality could become part of the larger network. The municipality would usually hand out assignments, define the framework, take the initiative, deliver services and communicate with the public, but now it would now define renegotiate the assignments and framework together with citizens, be more open towards citizen initiatives, and engage in continuous dialogue with local actors. However, the next slide of the presentation by the consultant emphasized that the common focus for all who were engaged was to counteract loneliness and improve the quality of life among senior citizens, which should be done through meaningful relations, good health and the ability to master one’s own life. Next on the agenda was a plenum, where a municipal consultant would write directly in a projected Microsoft Word document the attendees’ suggestions on how to operationalize this focus. This topic would then be discussed by all with the consultant moderating the discussion. While these examples are local and situated, they illustrate how the agencement of reanimation works. To reanimate old age, a redistribution of agency is required, and civil society with all its many actors is invited to the table. But, the ambition to redistribute agency entails its own kind of (authoritative, Lassen | Anthropology & Aging Vol 40, No 2 (2019) ISSN 2374-2267 (online) DOI 10.5195/aa.2019.166 http://anthro-age.pitt.edu 33 municipal) agency, and as such, the municipality becomes paradoxically trapped in its ambition to transcend its role as authority. While the municipal co-creation consultant above connected well with the attendees, she had already framed the meeting and decided the focus of the network. As the funds were allocated to citizen initiatives targeting senior citizens’ loneliness and a specific version of quality of life, this formed a particular subject engaged in a particular way of reanimating old age. As the following example illustrates, the involved citizens in the initiatives seem to embrace this paradoxical subjectification unproblematically because they want to bike and be active citizens. Jørgen is one of the local ambassadors of CwA in Ishøj. He is a man in his early 70s, who bikes the rickshaws four to six days a week when he is not ill or hospitalized, which happens more and more frequently due to the wide range of conditions he suffers from. He started as a pilot in order to retrain his knee, as he no longer had the balance to bike on normal bikes (the rickshaw has three wheels and is therefore easier to balance). As such, it was a way for Jørgen to be physically active in a way he has enjoyed throughout his life. But it was also a way for Jørgen to get the fresh air that he craved and did not get sufficiently, according to him, as his health declined. CwA became an occasion to exercise and to get outdoors and became an obligation towards the passengers. Moreover, while Jørgen did have friends, his family lived far away from him (by Danish standards), and he mostly saw them during their vacations. CwA was not just a way for him to give the passengers company and good experiences, but it served as a mutual exchange through which Jørgen also kept his occasional loneliness at bay. As Jørgen explains it, the exercise was part of the reason to become a pilot, but it has become less important, as he has seen his social life thrive from his new role: The talks we have on the bikes are amazing. And they really enjoy the fresh air. Many of them seldom come out from the nursing home. So, the energy they give me when they do come out, I really enjoy. It’s amazing to hear their stories and feel how happy they are to get out. You can really bond on such a trip. I don’t think I would be able to bike up Sjællandsbroen [a bridge connecting the two islands Sealand and Amager, 15 km from Ishøj], were it not for them and the good company (Jørgen November 2015). Jørgen spent a great deal of time biking and repairing and maintaining bikes as well as arranging events, but as he explains in the quote above, he gains energy through the trips and the passengers. Jørgen has enthusiastically engaged in CwA and makes a concerted effort to keep the local CwA department going by constantly promoting it to potential pilots, passengers and those he passes by; investing time and resources into the initiative; and giving feedback and advice to the municipality. The example of Jørgen is key to understanding the way the agencement of reanimation works through CwA and in Danish municipalities focused on co-creation. Firstly, the agencement of reanimation promotes older citizens volunteering, which benefits both the recipients (often frail, older people) as well as themselves, as volunteer work keeps them engaged and active. Secondly, the agencement more broadly subjectivizes older persons as active citizens who engage in their local community. Thirdly, physical activity is seen as rejuvenating and reenabling, and it is often said that it is never too late to start exercising. And finally, although Denmark is a small country and family rarely lives far away, the social ties of older people are often dependent on the local community and associations. As such, the agencement of reanimation combines active aging and co-creation policies. Lassen | Anthropology & Aging Vol 40, No 2 (2019) ISSN 2374-2267 (online) DOI 10.5195/aa.2019.166 http://anthro-age.pitt.edu 34 Conclusion While old age is changing, the way the new old age is formed in Denmark is a question of welfare politics, the vigor of the current generations of retirees, and a shift in the way agency is distributed—the way reanimation is arranged. As I have shown in the article, the reanimation of old age relies on a particular agencement, which differs in many aspects from the way the administration of old age has been organized in European welfare states in the 20th century. Comprised of the socio-technical devices described here, this agencement promotes an active old age by urging older people to participate and/or organize local initiatives promoting specific forms of activity—such as singing or biking—that differ from stereotypical old age activities. Through such generation of actions and positions, the agencement questions the distribution of agency among older citizens, the municipalities and civil society associations. Within co-creation and active aging, the municipalities become facilitators rather than authorities. Such form of governance requires the municipalities to learn about ‘existential motivators,’ and with this, issues such as spiritual experiences, the social worlds and ideas of nature and scenery of older people become relevant for the municipalities. The co-creation activities presented in this article configure a different version of old age. They also configure a different version of health promotion, as the initiatives seem mostly concerned with engaging people in an activity, rather than limiting such activity to merely being physical. The activities do not promote cardiovascular or muscular exercise per se, but rather an ideal of active citizenship in old age. The energy articulated by many of the interlocutors in the study seem to be a way of describing a new old age— a way to interpret the possibilities of the 21st century life course. The active citizenship in the reanimated old age requires a particular subject, which the municipalities subjectivise in their many encounters with older citizens. Local associations and individual older citizens are constantly urged to participate and are invited into the decision-making processes in the municipalities, while at the same time, the municipalities have a clear agenda: to engage older citizens. As I have shown, older citizens involved in the initiatives embody such engagement and are active citizens. While this is partly enabled by an aging population with an increasing health span, it is also a result of the agencement of reanimation. Such agencement demonstrates how increasing life expectancy interlinks with forms of governance in contemporary welfare regimes. Notes i http://cyclingwithoutage.org ii The public administration in Denmark is divided into 5 regions and 98 municipalities with different areas of responsibility. iii All quotes from the fieldwork have been translated from Danish, and all the names of the interlocutors have been changed in the interests of confidentiality, except for Henrik and Mette, who are difficult to anonymize and have specifically asked to be mentioned with their right names. iv During the collaboration between Center for Healthy Aging and Vordingborg Municipality, a range of seminars was organized to share and discuss research findings between researchers and municipal employees. v A TED Talk about the beginning of CwA has later been produced: https://youtu.be/O6Ti4qUa-OU Lassen | Anthropology & Aging Vol 40, No 2 (2019) ISSN 2374-2267 (online) DOI 10.5195/aa.2019.166 http://anthro-age.pitt.edu 35 References Aspinal, Fiona, Jon Glasby, Tine Rostgaard, Hanne Tuntland, and Rudi GJ Westendorp. 2016. "New horizons: Reablement-supporting older people towards independence." Age and ageing 45 (5): 574-578. Brandsen, Taco, Willem Trommel, and Bram Verschuere. 2014. Manufactured civil society: Practices, principles and effects. London: Palgrave. Çalışkan, Koray, and Michel Callon. 2010. "Economization, part 2: a research programme for the study of markets." Economy and Society 39 (1): 1-32. Center for Frivilligt Socialt Arbejde. 2017. Frivilligrapporten 2016-2018. Odense: Center for Frvilligt Socialt Arbejde. Coelho, Ricardo Lopes. 2009. "On the concept of energy: History and philosophy for science teaching." Procedia- Social and Behavioral Sciences 1 (1): 2648-2652. Europe, Age Platform. 2011. "How to promote active ageing in Europe-EU support to local and regional actors." Brussels: Committee of the Regions. Hodgson, Lesley. 2004. "Manufactured civil society: counting the cost." Critical social policy 24 (2): 139-164. Kalache, A, and A Gatti. 2003. "Active ageing: a policy framework." Advances in gerontology= Uspekhi gerontologii 11: 7-18. Karlsen, Mads Peter, and Kaspar Villadsen. 2016. "Health promotion, governmentality and the challenges of theorizing pleasure and desire." Body & Society 22 (3): 3-30. Katz, Stephen. 2000. "Busy bodies: Activity, aging, and the management of everyday life." Journal of aging studies 14 (2): 135-152. ---. 2013. "Active and successful aging. Lifestyle as a gerontological idea." Recherches sociologiques et anthropologiques 44 (44-1): 33-49. la Cour, Anders. 2012. "The love affair between the policy and the voluntary organizations." In Hybrid Forms of Governance, 46-63. Springer. Lamb, Sarah. 2014. "Permanent personhood or meaningful decline? Toward a critical anthropology of successful aging." Journal of aging studies 29: 41-52. Larsen, Jonas. 2017. "The making of a pro-cycling city: Social practices and bicycle mobilities." Environment and planning A 49 (4): 876-892. Lassen, Aske Juul. 2017. "Shaping old age: Innovation partnerships, senior centres and billiards tables as active ageing technologies." In Framing Age: Contested Knowledge in Science and Politics, 222-236. Routledge. Lassen, Aske Juul, and Astrid Pernille Jespersen. 2017. "Getting Old and Keeping Going: The Motivation Technologies of Active Aging in Denmark." In Successful Aging? Global Perspectives on a Contemporary Obsession, 141-153. Rutgers University Press. Lassen, Aske Juul, and Tiago Moreira. 2014. "Unmaking old age: Political and cognitive formats of active ageing." Journal of Aging Studies 30: 33-46. McGinn, Colin. 2011. Basic structures of reality: essays in meta-physics. OUP USA. Moreira, Tiago. 2016. Science, technology and the ageing society. Routledge. Nielsen, Annegrete Juul, and Lone Grøn. 2012. "Standardising the lay: logics of change in programs of disease self- management." Culture Unbound: Journal of Current Cultural Research 4 (3): 425-442. Osborne, Stephen P. 2010. The new public governance: Emerging perspectives on the theory and practice of public governance. Routledge. Otto, Lene. 2013. "Negotiating a healthy body in old age: preventive home visits and biopolitics." International Journal of Ageing and Later Life 8 (1): 111-135. Partridge, Linda, Joris Deelen, and P Eline Slagboom. 2018. "Facing up to the global challenges of ageing." Nature 561 (7721): 45. Lassen | Anthropology & Aging Vol 40, No 2 (2019) ISSN 2374-2267 (online) DOI 10.5195/aa.2019.166 http://anthro-age.pitt.edu 36 Pestoff, Victor. 2009. "Towards a paradigm of democratic participation: Citizen participation and co-production of personal social services in Sweden." Annals of Public and Cooperative economics 80 (2): 197-224. Rowles, Graham D. 1983. "Place and personal identity in old age: Observations from Appalachia." Journal of Environmental Psychology 3 (4): 299-313. Rudman, Debbie Laliberte. 2015. "Embodying positive aging and neoliberal rationality: Talking about the aging body within narratives of retirement." Journal of Aging Studies 34: 10-20. Rupp, Stephanie. 2013. "Considering energy: E= mc2=(magic· culture) 2." Cultures of energy: Power, practices, technologies: 79-95. Scheele, Christian Elling, Karsten Vrangbæk, and Margit Kriegbaum. 2019. "Volunteer association perceptions of municipal policy strategies to promote co-production of healthy ageing services." Ageing & Society 39 (6): 1152-1171. Schwennesen, Nete. 2017. "When self-tracking enters physical rehabilitation: From ‘pushed’self-tracking to ongoing affective encounters in arrangements of care." Digital health 3: 2055207617725231. Torfing, Jacob. 2015. "Hvad hæmmer og fremmer spredning af offentlig innovation?". Townsend, Peter. 1981. "The structured dependency of the elderly: a creation of social policy in the twentieth century." Ageing & Society 1 (1): 5-28. Van Dyk, Silke, Stephan Lessenich, Tina Denninger, and Anna Richter. 2013. "The many meanings of “active ageing”. Confronting public discourse with older people’s stories." Recherches sociologiques et anthropologiques 44 (44-1): 97-115. van Hees, Susan, Klasien Horstman, Maria Jansen, and Dirk Ruwaard. 2015. "Conflicting notions of citizenship in old age: An analysis of an activation practice." Journal of aging studies 35: 178-189. Voorberg, William H, Viktor JJM Bekkers, and Lars G Tummers. 2015. "A systematic review of co-creation and co- production: Embarking on the social innovation journey." Public Management Review 17 (9): 1333-1357. Walker, Alan. 1980. "The social creation of poverty and dependency in old age." Journal of social policy 9 (1): 49- 75. ---. 2008. "Commentary: The emergence and application of active aging in Europe." Journal of Aging & Social Policy 21 (1): 75-93.