One can feel old, or one can feel vital, but society has a difficult time defining what it means to age well.
Since the largest share of healthcare expenditures goes to treating people over age 65, it’s easy to view old age from a medical perspective. But this does a great disservice to the elderly and their sense of self-worth.
The medical model views old age in terms of physical health. Important factors that are considered when defining successful aging include the absence of disease and good mental and physical functioning.
But one does not have to be disease free to define themselves as successful. In terms of physical health, 50% of all seniors believe they are aging successfully. By the medical model, only one-fifth are.
The psychosocial approach sees things very differently. This model emphasizes life satisfaction, social functioning and participation, and psychological resources.
The medical model’s view leads to severe underdiagnosis of psychological challenges in seniors. The psychosocial view can leave seniors with significant physical health issues feeling diminished. The result on policy is programs that may not fit the needs or expectations of geriatric individuals as all are lumped into one category or the other with little regard for how they define themselves.
So what do lay people, the seniors themselves, consider successful aging?
When surveyed on what makes for a good old age, seniors most often mention the following categories, from most important to least:
Physical health, psychological factors, social roles and activities, finances, social relationships, and the neighborhood in which they live.
The list is taken from a survey in Britain of 859 people age 50 or over who live at home. To a person, no one mentioned only one of the factors as important. Positive life views on several of the factors are considered by the seniors surveyed to be necessary to age successfully.
When seniors consider these factors and are asked if they are aging successfully, fully 75% believe that they are.
It’s incompatible that policy makers believe that programs for the aged must be corrective, while most seniors feel they are doing just fine.
The trouble with the medical and psychological establishments, and the trouble with policy makers in general, is that they view issues only through the limits of their own academic expertise. They view opportunities to assist seniors to improve their lives as problems only experts can solve.
Rarely are the lay people, even the ones most affected by the development of theories and decisions, consulted on this work.
Broad policy initiatives may in fact impact very few people, or not speak to the needs or expectations of those they seek to assist at all. Why develop policy goals for the elderly if seniors do not regard them as relevant.
Many policies and treatments focus on the burden of old age and the decay and failure of the body. Unconsidered is the fact that most seniors feel ok.
This emphasis on physical outcomes fails to address the individual as a full person, and can lead to the poor outcomes and loss of independence these therapies seek to avoid.
As noted in the conclusion of the research paper cited in this post and sourced below, “Health professionals need to respect the values and attitudes of each elderly person who asks for help, rather than imposing our medical model onto their lives.”
The truth is that almost no one would meet the requirements for successful aging set forth by the medical and psychosocial establishments. But many seniors feel well and are pleased with their lives and the way they are aging.
Maybe we should look to the ones we are addressing to determine if they feel successful or not instead of projecting criteria they may not find important onto them. Maybe we should be more optimistic.
Want to know if a person is aging successfully? Just ask them.