Every May, the Administration on Aging leads the national observance of “Older Americans Month.” The theme this year is “Engage at Any Age.”
But I found myself thinking that this would be a nice opportunity to consider: just what does it mean to “succeed” or do well as an older adult?
This is important, because our understanding of what is “success,” and what to strive for, is fundamental to how we judge ourselves and others.
And for us as a society, articulating what’s involved in experiencing “good” or “successful” aging is important because it can help us understand what kinds of things we should focus on, to help more older adults age well, or otherwise “succeed” in late-life.
So, just as philosophers and others have long debated what it means to “live a good life,” we should ask ourselves what it means to “succeed” as an older adult.
This way, we can know whether we are “succeeding” as a society that supports and values its older population.
What IS “successful aging?”
This is not a simple question to answer. It has long been the subject of vigorous inquiry and debate in gerontology. In fact, the journal The Gerontologist devoted an entire issue to the topic of “Successful Aging” in 2015.
(FYI: Gerontology is “the comprehensive study of aging and the problems of the aged,” whereas geriatrics is a medical specialty. We are related but not the same!)
I can’t summarize the debates on what constitutes successful aging here, but if you’d like to read more, this article from The Gerontologist offers a long and detailed overview of different ways that scholars have conceived of successful aging: Defining Successful Aging: A Tangible or Elusive Concept?
A common (and problematic) definition of successful aging
One prominent model of successful aging, developed in the 1990s (Rowe and Kahn), proposed that it means:
- freedom from disease and disability
- high cognitive and physical functioning
- active engagement with life
Gerontologists have gone way past this model, but this may be pretty close to what many people have in mind, when they think of “successful aging” or “aging well.”
And it’s certainly what many images of older adults convey: people who may “look older” but otherwise appear to do everything they could do earlier in life.
This is what we see in this AARP “Disrupting Aging” video, in which millennials are confronted with some older adults who are much more able than the millennials had expected.
But there’s an obvious problem with this conception of successful aging: many, if not most, older adults will eventually not be able to meet all three criteria.
So have they failed? And: will we tend to judge that it’s their fault if they don’t remain disease- and impairment-free as they age?
A better lens on “successful aging”
This article describes a newer way to frame successful aging that I find intriguing. (The authors are Eva Kahana, Boaz Kahana, and Jeong Eun Lee.)
The authors describe a model based on the assumption that with increasing age there is an accumulation of health-related and social stressors.”
They note that if it weren’t for common age-related challenges, there would be no need to distinguish successful aging from successful living at any age. (True!)
They propose that those who maintain good physical health, mental health, and engagement in social activities, without any conscious coping efforts, be referred to as “lucky agers”.
But most people will not be lucky, and hence they need to find ways to cope and adapt to age-related stressors, which include:
- chronic illness
- social losses
- “lack of person-environment fit”
Coping with age-related stressors in a purposeful way, and finding ways to maintain quality of life, is called making “proactive adaptations.”
The authors go on to describe how this can be done in a “preventive fashion” (e.g. anticipating a future or impending age-related stressor) and then also in a “corrective” way, which means making adaptations once a stressor or problem has occurred.
To adapt, an older person must marshal both internal resources (attitude, optimism, coping with challenges) and external resources (available social support, finances, etc).
The main quality of life outcomes in this model include:
- Self-evaluation of success
- Life satisfaction
- Meaning in life
- Positive affective state (which basically means positive mood or emotions)
- Valued activities
You can see the model diagrammed out in Figure 1 of the article.
In short: in this model, success is not defined as remaining free of disability or disease as one gets older.
Instead, succeeding means finding ways to cope with impending or existing illnesses, losses, and other challenges, by getting help and by marshaling one’s own resilience and internal resources.
In this way, despite experiencing losses and illness and “lack of person-environment fit” (e.g. a house that is a challenge or dangerous to live in), older people often find ways to meet these challenges.
In doing so, they continue to find ways to experience positive outcomes such as life satisfaction, meaning, contentment, and they are still able to participate in valued activities.
Personally, I like this model. (Granted, it’s a little wonky, but that’s true of all substantive academic work.) I especially like the attention to the way that older adults can be proactive and exert their autonomy by anticipating and adapting to common age-related challenges. In the words of the authors, this “reflects human agency directed at stress reduction, resource development, and problem resolution.”
In other words, this model gives credit to those who acknowledge that their lives may or are changing, and purposefully engage in addressing this.
This takes a certain courage. Which, in truth, is what most older adults muster when the time comes. But you’d never know it to see most media images of older adults, which either portray them as free of late-life stressors or instead emphasize their declines without highlighting their successes in adapting, and their ability to find meaning in a new normal.
How can we support older adults in anticipating & coping with age-related challenges?
Most people will encounter losses and impairments as they age.
What if, as a society, we were less afraid of this, and instead embraced it as an opportunity to be proactive, and then to step up to challenges?
What if as a society, we were better at acknowledging and celebrating the remarkable acts of resiliency and problem-solving that many older people are working their way through?
What if older people felt more comfortable getting help when it becomes necessary? What if we were better at providing it?
These are some of the things that I’ll be thinking about during Older Americans Month.
People really can engage at any age.
We need to make sure that message is clear — and actionable — even for those who aren’t among the “lucky agers.”
Now tell me: what comes to mind when you think of “successful aging”? And what could we collectively do to help more older adults feel successful?
Addendum: Here’s an important and relevant excerpt from the FrameWorks’ Institute’s 2015 analysis of the public view on aging:
“The biggest problem with the dominant patterns of public understanding identified in FrameWorks’ research is
the deep assumption that individuals are exclusively responsible for how they age.
In addition, while we know from previous research that the public maintains an ideal vision of aging, this “ideal” is uncontested in these stories, leaving people with a view of aging that, according to experts, is deeply unrealistic.
When the media and advocacy organizations fail to link successful aging to policies that enable older adults to remain active and socially engaged, they actually reinforce the public’s highly individualistic understandings of the aging process. The result is that people will understand the likelihood of successful aging to be about lifestyle choices rather than as affected by supports, larger social structures, or public policies.”
We must find ways to make it easier for aging adults to get the support they need, both to proactively prepare for late-life stressors and to help them adapt when they occur.
Bonnie says
My mother moved into a retirement community three years ago at age 88. She lives independently in an apartment. I believe this is the best living arrangement for her. However, I feel that as a society there is something not quite right in housing all our elderly in one place. Although I have no solutions I do feel most people would benefit from inter generational living.
Leslie Kernisan, MD MPH says
Agree that intergenerational living offers a lot of advantages and it is a problem that we are often so segregated by age and stage of life.
Dr. Bill Thomas is piloting a project called MAGIC (Multi-Ability, MultiGenerational, Inclusive, Community) this year, to address these issues. He’s really been a leader in redefining aging and spearheading much-needed innovations. He explains some of the ideas in the podcast episode here: 055 – Interview: Bill Thomas on Ageism & Innovations to Improve Aging
Victoria Bennett says
A most interesting and intelligent article however the question of our greatest fear has not been addressed. The fear of death.
Physical health as had been noted is not separate from emotional health and I would like to suggest if I may that fear of extinction must be addressed if optimal health is to be achieved.
Thank you.
Miranda Wolhuter says
Thank you for sharing your information. My husband (86) and I (78) live in a retirement village and
we are both still very involved with our small community. Louis, a geologist, is busy planning a garden for our new gate. I have been a self employed physiotherapist for the past 53 years and still help people with
various problems every day.
Leslie Kernisan, MD MPH says
Thank you for sharing this story. Wonderful that you have been so involved with your community. Doing things for others is a fantastic way to remain engaged at any age.
Annette says
In my mind, successful aging has little to do with physical issues and changes. At some level, we will each deal with an aging body and mind, choosing to adapt or lament the inevitable. This is a person journey that may or may not be visible except to ourselves or our spouses. And “success” means different things to everyone. Successful aging, to this senior, means still finding purpose and delight in every single day I am gifted to remain on this planet. Each unhappy friend lacks one thing, purpose. Even when we chat and they admit this is the problem, most will not motivate themselves to find one. Every vital senior I have ever encountered, regardless of physical limitations, is happy because they have found purpose that lights their inner fire.
Leslie Kernisan, MD MPH says
Yes, purpose is very important!
I also really like another point you bring up, which is that a person’s journey is often not visible to others…we need to keep that in mind because it’s easy to judge others when in fact we have little idea of what kinds of efforts they have made or are currently making.
Bonnie Lord says
When I was growing up, (I’m 74 now,) I remember most families had grandpa and or grandma living with them. I really loved talking to these “old” people. They had some really neat stories to tell if I’d take time to sit down and listen. I know times have changed, but I think it was good for all when families kept together like that. One grandma told me, as she sat there and hooked rugs, about how she met Abraham Lincoln when she was a girl. Very interesting! I think we’ve lost something along the way. Those people aged gracefully as other family members were there for them. My grandpa lived with his sons until he died at 92. I can remember his coming and staying at our house sometimes. Myself, I think aging gracefully is the answer. We need to accept the changes in our bodies and minds and ask for help when we need it. Life isn’t easy and know one said it would be. I have a lot of faith and I know that the Lord will love and direct me as I go along until the day He takes me home. That helps a lot. Also, if we can think of something we can do for others is very good too. It might be just a card or phone call, but it may mean a lot to a shut-in. Anyway, that’s my 2 cents.
Leslie Kernisan, MD MPH says
Great thoughts, thank you for sharing. Agree that times have changed and it’s a shame that so many older people find themselves alone, really didn’t use to be that way but society has changed and we also have more older adults now (who also live longer) plus smaller families.
To me this means we need a societal approach to supporting older adults, we cannot continue to leave it up to individuals and families to sort things out on their own.
Diane says
Great article! My Dad at 99 is one of those “lucky agers” but part of that “luck” has been his life-long adaptability, resilience & willingness to try new things. He still lives independently, up until his 99th still drove, but readily gave up his car realizing that his reaction times were not what they should be, adapted to living alone & preparing meals after my mother died 4 years ago, uses the computer & Facebook to keep in touch with family and friends and generally keeps in touch with his neighbors and community. My husband & I have modified things in the house for his comfort and convenience and I do his grocery shopping for him. He does have a house cleaner and gardener and we will will add help as needed. I know we and he are very fortunate but I can’t think of a better model of successful aging!
Ellen says
Diane, that is awesome! Your dad is a lucky ager and it’s great to know how he has lived to help him be this capable at 99. Wow, I can only imagine living that long. Thank you for sharing.
Leslie Kernisan, MD MPH says
What a wonderful story, thank you for sharing. Sounds like he has been lucky but he has also made some “conscious coping” choices that have made it easier for others to support him. He has been open to “interdependence” rather than insisting on trying to maintain independence, good for him!
Retired NC teacher says
I found myself alone after an unexpected divorce at age 60; I moved back to my native state from CA and bought a single story house. I’ve gardened and worked with a trainer to stay fit. actively sought new friends and a compatible church. I have signed up for an “aging in place” program run by an excellent local CCRC. My 3 adult children live scattered all across the US. More than a decade later, I struggle now with impaired mobility and challenges in my church communitybut I feel capable of coping with these issues with assistance from my “aging athome” program and my children. Live life to the fullest every day as each is a blessing.
netmouser says
I enjoy your articles a lot. But I can’t participate in comments as there is no email or notification when anyone replies. It is too difficult to go back later and try to find the articles, and my posts to see if there are replies, etc.
Leslie Kernisan, MD MPH says
Agree that this is a real flaw of the current commenting system. Unfortunately, it’s not something that I can change easily…this site is built on a platform that doesn’t allow plug-ins. When I can spare the time and funds we will probably move the site to a new and improved platform and then the commenting features will be improved…just not sure when that will be.
Dina Zinnes says
I think your conclusion: “Instead, succeeding means finding ways to cope with impending or existing illnesses, losses, and other challenges, by getting help and by marshaling one’s own resilience and internal resources” is right on target.
And I would add that to be able to accomplish this one must learn to be flexible! Too many people become increasingly unable to try new things or consider a variety of options as they age. Its a fear of the unknown. So it is important for others to provide support and council to help those of us facing these unknown events.
Leslie Kernisan, MD MPH says
Yes, agree that flexibility and being able to adapt is certainly very helpful.
I think the challenge for those around an older person is figuring out how to encourage them to consider changes without being too pushy. It certainly helps if everyone is able to take time, rather than having to rush in response to a crisis.
Alicia Butcher Ehrhardt says
Still being engaged in life in a meaningful way as long as possible.
To that end, we are preparing to move to a CCRC (continuing care retirement community) 10-15 years before most people do (the average entrant is over 80).
I’ve been disabled for almost thirty years; I have been pushing for and working on this move since before my husband retired three years ago.
We’re finally doing the work of putting a house we’ve lived in for 37 years on the market; we have visits to two CCRCs across the country happening this month.
It’s time to spend the money we’ve been saving for a rainy day. It’s raining.
Shelia says
I found the best CCRC and would like to make the move but the push back I get is “ oh you are too young” I visited and love all it has to offer but know my family would freak over the walkers lined up in the cafeteria
Leslie Kernisan, MD MPH says
Interesting that your family is the one pushing back! Sounds like more conversations will be needed. Good luck!
Leslie Kernisan, MD MPH says
Great that you are being proactive. Thanks for sharing!