Recently, I traveled to Charlotte, N.C., to visit friends in my most recent former home town (I’m a native New Yorker). While there, I co-produced and participated in a local public radio program discussing the “Age-Friendly Cities and Communities” movement, comparing efforts in Charlotte with those in Portland, Ore., where I now live.
It was a lively exchange among the program’s host and guests, as we discussed such topics as the importance of creating more affordable housing and transportation for older adults in order to reduce their social isolation and ensure their continued economic prosperity and cultural engagement. Although the discussion of these particular topics conveyed some of the challenges of aging in our culture, I was left wondering whether or not our society truly “gets it” about the need to change how we view the process of aging. Because it seems to me that how we perceive aging and the viability of older adults determines our willingness –– or reluctance –– to tackle social inequity, lack of access to services and opportunities, and other common challenges our elders face.
How do we know if we are aging well? What are the criteria by which we should measure our ability to function fully as older adults?
A popular way to describe what I’m talking about is the phrase “successful aging,” which is usually contrasted with “normal” or “usual” aging. One description of successful aging involves “freedom from disability and disease, high cognitive and physical functioning, and social productivity and engagement.” But that’s only one reference. Searching the term on the Web yields nearly 6 million results, the overwhelming number of which emphasize personal lifestyle choices and behavior, such as how much and often a person chooses to exercise or whether he or she has saved enough money for retirement.
But there’s an inherent problem with equating aging with the kind of success that is solely based on conscious individual achievement. For how many conscious decisions, including exercising and saving for retirement, do we really make on our own without the influence of other, external factors?
Let’s take exercise. If you belong to an athletic club, it’s probably because you have the financial means to do so. If you have the time to walk, jog, or run in your neighborhood on a regular basis, perhaps it’s because you don’t have such burdensome obligations as being a full-time caregiver or having to work two or more jobs.
If you have enough money for retirement, perhaps it’s because you worked a long time at a company that offered employees a pension, and you didn’t get laid off in the recession because of your age. Or you didn’t suffer a debilitating illness that drained you financially, despite having health insurance. Or you have a spouse or partner that has contributed significantly to your household income. Or you have a child who was able to attend college on a scholarship.
Of course, I’m not saying that personal decisions make no difference at all in how “successfully” we age. But I am asserting that society shouldn’t attribute unsuccessful aging primarily to a lack of personal responsibility. Many obstacles can get in the way of elders’ well-intentioned efforts to remain functional in mind and body, economically solvent, and socially engaged –– obstacles primarily related to racism, sexism, homophobia, and of course, ageism.
If the older adults in our communities aren’t aging successfully, it can’t be because each and every one of them has failed to live in a responsible way. Instead, it just might be that we have opted for “normal” or “usual” aging and haven’t yet created a society that actively promotes and supports the successful kind.
In short, maybe it’s because we are failing them.
I am an AGING 320 student at the Erickson School of Aging and I found your post to be fascinating. The sentence “maybe it’s because we are failing them” made me realize that most elders are faced with multiple challenges through external factors such as one’s financial status.
My class discusses the importance of how finding a good diet, participating in social activities, modifying one’s home, and surrounding yourself with positive and healthy supporters can promote healthy aging. The class challenges students to create agendas and plans in order to increase awareness in aging. Through different scenarios, we are challenged to create interventions that may possibly promote healthy aging. We learn about the important aspects of aging and the health consequences of poor diets and nutrition. We state our views and aspects of what healthy aging is and how we can educate others and implement change. The class also allows students to explore health related websites and teaches us that elders are faced with daily obstacles and medical or psychological conditions.
Before reading this blog, i was blinded and was unaware of the fact that most elders can not afford to save money for retirement while partaking in social activities that can improve their social, mental, and spiritual well-being. Getting screened for diseases and finding treatment centers are all influenced by external factors such as the ability to afford treatment as well as having accessible transportation. Also, modifying one’s home to prevent falls such as adding bar handles ties in with the elder’s financial status.
Most individuals view aging as the “freedom from disability and disease, high cognitive and physical functioning, and social productivity, and engagement”. However, aging is beyond that. Through this blog, I learned that external factors can influence an elder’s decision of whether they can afford to be in a athletic club or even modify their homes, such as adding bar handles. I agree that society should not attribute unsuccessful aging primarily to a lack of personal responsibility. I grew aware that most elders do not have access to transportation and are faced with multiple obstacles.
I believe aging should be viewed as a multifactorial process instead of a simple one.
Jeanette Leardi says
Many thanks for your extremely thoughtful comment, Ellen. I wish you continued success in your studies.
Tom Bradley says
Every age has its issues and problems based on years of conditioning. Unless you have reached old age, not just retirement, you haven´t a clue as to what seniors are experiencing in detail. You can generalize forever and submit your beliefs but you really don´t know. This is an area of expertise that those not experiencing aging into and beyond their understanding can never write about no matter how well their intentions may express themselves. I guess what I mean is that youth can never know or explain what it is like to be very old. Beware of what they say no matter how well intended it may be.
I urge you to read Being Mortal by Atul Gewande for so many reasons. It will , hopefully, give you the perspective you feel is lacking. The important thing for me is that the veil of silence surrounding the aging process is being lifted and it really doesn’t matter who’s pulling the cord.
Nice piece. For more on critiques of successful aging, see our recent article in The Gerontologist, “Successful aging and Its discontents: A systematic review of the social gerontology literature.” Find the abstract here:
Leslie Kernisan, MD MPH says
Clara, I found your article on successful aging extremely interesting! Is it available in the public domain somewhere? (I had to use my UCSF credentials to access it.)
Interesting coincidence: a recent article in the Journal of the American Geriatrics Society asks whether we (geriatricians) should get more involved in addressing “healthy aging” and “successful aging.”
Me, I like to aim for helping people have better health in aging…it is always possible to help people improve their health & wellbeing! I’m far more comfortable aiming for better — which is largely defined by individuals — than for “health” or “success”.
Cricket Weston says
It seems that the challenge of adequate public transportation, with appropriate accommodations for all, is a big barrier to successful aging. Age-friendly cities should be addressing this concern.
Leslie Kernisan, MD MPH says
These are important issues. A coalition of grantmakers in aging recently funded the Frameworks Institute to study how the public thinks of aging, and how this differs from experts. The issue of individual responsibility vs a collective issue was highlighted as a major “gap” between the public and experts.
You can read the report here, there are some good ideas on how we might want to change the narrative of aging.
Jeanette Leardi says
Thanks, Leslie, for mentioning the FrameWorks Institute study. It is an extremely important report that will — and should — inspire advocates for positive aging for years to come!
Patrick Roden says
Jeanette’s post is a perfect example of “Systems Thinking.” Well done.
Jenny Rosenthal says
Jeanette Leardi poses questions we all need to consider. She challenges us with her insights and observations.