"Successful aging," gerontological theory and neoliberalism: a qualitative critique

Generativity as a Traditional Way of Life: Successful aging among Unangan Elders in the Aleutian Pribilof Islands

Predominantly Western-based biomedical models of successful aging have been used to research, understand, and explain successful aging among diverse populations. With an increasingly heterogeneous older adult population nationwide, scholars have been exploring Indigenous understandings of successful aging. To add to the accumulation of knowledge of diverse Alaska Native populations, this study involved semi-structured qualitative interviews with 20 Unangan Elders from the Aleutian and Pribilof Islands. This community-based participatory research study explores the aging experiences and conceptualization of successful aging of these Elders from this remote and culturally distinct region of Alaska. Thematic analysis was employed to identify themes related to successful aging within this specific region, which supported our previous four themes, or characteristics, of Alaska Native successful aging: physical health, social support and emotional well-being, generativity as a traditional way of life, and community engagement and Inidgenous cultural generativity. Each of these themes or characteristics of Eldership is intertwined and together support successful aging within two remote communities in the Bering Sea. The findings of this study illuminate how Alaska Native Elders can live in geographically diverse regions of the State, yet the values and teachings they possess on successful aging possess the same cultural values and teachings. This study highlighted two new emerging constructs that influence Alaska Native Elders' successful aging based on geographical location. Findings contribute to the thematic saturation of the four main successful aging domains while outlining the importance of future research to conduct deeper investigations into the role of environment and history on Elders' perceptions and understanding of aging.

Proactive Care-Seeking Strategies Among Adults Aging Solo With Early Dementia: A Qualitative Study

OBJECTIVES

People living with dementia need increasing care over time, but 1 in 3 adults with cognitive impairment lives alone. The goal of this study was to explore the self-identified strengths and resources for future care needs of adults aging solo with early dementia.

METHODS

Semistructured interviews with 15 adults not living with a partner and with no children in the same state, who self-identified as having early dementia or mild cognitive impairment; hybrid inductive/deductive reflexive thematic analysis using a successful aging framework.

RESULTS

Participants placed a high value on maintaining independence and expressed concerns about preserving selfhood and becoming a burden to others. These values influenced how participants appraised financial and social resources available to address future care needs and strategies to preempt or respond to needs such as transportation, help with finances, or activities of daily living.

DISCUSSION

Adults without close family are heterogeneous and have variable resources available to address care needs associated with dementia progression. Common values of retaining independence and minimizing burden to others may be helpful in motivating adults aging solo to undertake planning and help-seeking early.

Neither the Third Nor the Fourth Age: Viewing Old Age Through the Philosophical Lens of Ambiguity

This paper argues that the philosophy of ambiguity, associated with Maurice Merleau-Ponty and Simone de Beauvoir, provides a helpful framework for understanding the complex and paradoxical nature of old age outside the dominant categories of the "third" and "fourth" ages. Building on philosophical literature in cultural gerontology including that focused on the "art of living" and other approaches that draw on existentialist thought, it suggests "ambiguity" as a theme that has been overlooked in such literature. The advantage of this approach is that it can accommodate contradictory elements and thus underpin an integrated approach to old age. At the same time, in distinguishing between ontological and social dimensions of ambiguity, the conceptual framework offers a new perspective on ageism that can help clarify the distinction between ageism as oppression and the negative aspects of deep old age itself. The paper is structured as follows. After making the case for the value and importance of "ambiguity" as a framework for viewing old age, I set out the key aspects of this philosophy as found in the work of Merleau-Ponty and particularly Beauvoir. I then apply this framework to a discussion of 2 literary memoirs of deep old age, by Diana Athill and Florida Scott-Maxwell, respectively. I argue that the picture of old age that emerges contrasts with the hegemonic discourses enframed by successful aging and frailed old age and offers the possibility not only of a true appreciation of old age but also of a more meaningful life course itself.

Protective Factors in the Context of Successful Aging in Urban-Dwelling Alaska Native Elders

Successful aging in rural Alaska communities has been established as a characteristic best described by reaching "Eldership," conveying reverence and respect from the community and implying leadership responsibilities. Most Alaska Native (AN) Elders believe that aging successfully or aging well happens within their home communities. However, limited rural resources lead Elders to relocate to urban settings. While protective factors supporting aging well in rural communities have been established, little is known about which factors support aging well after relocation to an urban setting. This exploratory, qualitative, community-based participatory research study explored AN Elder's (ages 48-84) experiences comparing successful aging within four rural Alaska communities and of Elders who relocated from a rural to an urban community. Thirteen rural-based Elders and 12 urban-based Elders semi-structured interviews were compared to explore how successful aging was experienced similarly and differently in rural and urban settings. To age well in urban Alaska, access to health care services, family, and community engagement were essential. The main challenges for urban Elders involved establishing a sense of community, intergenerational involvement, and the ability to continue traditional ways of living. This research identified challenges, similarities, and differences in aging well in an urban community. The findings of this study inform practices, services, and policies to improve existing urban services and initiate needed urban services to foster successful aging after relocation from remote rural areas into urban communities in Alaska.

Literary, Found and Research Poetry: New Approaches to Representations of Aging and Aged Care

At a time when rapid population aging is producing an emphasis on questions of healthy aging in the public discourse, conditions such as dementia, physical, and other disabilities still too often remain taboo, and this is particularly true in relation to the confronting subjects of aged care, neglect, and failures of care provision. This article considers the transformative potential of 2 different but complementary forms of poetry-research poetry and lyric poetry-to break these silences and represent experiences across the physical and emotional spectrum of aging, including the perspectives of older people and their families whose experiences are neutral, negative, or even distressing, as well as challenge and counter existing negative stereotypes of aging in the public and literary realms. Neither research poetry nor lyric poetry is common in gerontological research; however, they offer the radical potential to offer insight into the lived realities of older people and their loved ones. Research poetry uses the direct words of older people, drawing on transcripts and found texts, and giving voice to people who otherwise would not be heard. Lyric poetry, by contrast, draws more heavily on literary techniques such as metaphor and direct address to evoke sensory and intimate experiences of aging and aged care. This paper presents 2 poems comparing and contrasting the respective processes and techniques of these different poetic forms to represent the imaginary, feared, and hoped-for futures of older people, including those in aged care.

"Think positive and don't die alone" - Foreign-born, South Asian older adults' perceptions on healthy aging

South Asians are the largest and fastest-growing racialized group in Canada, yet there are limited data on various aspects of health and well-being within this population. This includes the South Asian older adults' ethnoculturally informed perceptions of ageing. The study aimed to understand how social and cultural forces impact the meaning assigned to healthy ageing amongst older South Asians in Canada. We recruited with purposeful and snowball sampling strategies in Southern Ontario. We conducted in-depth focus group and individual interviews (n = 19) in five South Asian languages, employing a multilingual and cross-cultural qualitative approach. In our analysis, we identified three central themes: (a) taking care of body (b) taking care of mind and heart and (c) healthy ageing through the integration of mind and body. Our study demonstrates that older immigrants are a diverse and heterogeneous population and that their conception of healthy ageing is strongly influenced by their country of origin. This study also demonstrates how racialized foreign-born older adults might provide distinctive perspectives on the ageing process and on social theories of ageing due to their simultaneous immersion in and belonging to global majority and global minority cultures. This research also adds to the limited body of literature on the theories of ageing, despite migration trends, still has a white-centric lens.

Positive health and ageing policies for older Irish travellers and older people who have experienced homelessness in Ireland: Life-course meanings and determinants

Marginalised groups of older people remain neglected in positive health and ageing (PHA) agendas, whether they concern healthy or active ageing concepts. Questions exist around the meaning of such constructs and the factors that enable disadvantaged populations to achieve equitable later-life experiences. Focusing on two such groups in Ireland, this study investigates the constituent dimensions of PHA for older Irish Travellers and older people who have experienced homelessness and the role of life-course and structural determinants in constructing PHA trajectories for these groups. The study involves a qualitative, participatory voice-led methodology, with analysis based on 49 in-depth life-course interviews with people aged 50 years and over from the two populations. Five interconnected dimensions of PHA are identified and presented. Four determinants related to life-course experiences and structural factors are identified as contributing to these dimensions: social relations, material and accommodation circumstances, formal supports and systems, and critical transitions and resilience. While illustrating the validity of PHA agendas for these groups when understood through their lived experiences, the findings highlight the significant deprivations and risks to rights that must be accounted for to secure meaningful gains in PHA for the groups.

The beautification of men within skincare advertisements: A multimodal critical discourse analysis

This study draws on the theory of Social Semiotics and the methodology of Multimodal Critical Discourse Analysis (MCDA) to examine the textual and visual design of skincare advertisements targeted towards men. The current proliferation of the market for male-oriented facial products represents an important shift towards the increased attention to the beautification of male bodies in Western societies. Such beautification encourages men to work on and improve the self (and face) through intensifying practices of "aesthetic labour." Aesthetic labour places emphasis on an entrepreneurial self-care and self-control regime that promotes an active late lifestyle fostered through ideas about "successful ageing." As expected, the analysis of the corpus consisting of advertisements from L'Oréal Men, Nivea Men and Clarins Men shows that the male face is generally constructed as a "problem" that can be cured through the consumption of skincare products. The consumption of these products increases men's visual literacies of the face and hence normalises male beauty practices that seemingly encourage men to care for and work on their skin, which can be construed of as a feminising practice. Nonetheless, the advertisements employ masculine traits and strategies that link cosmetic products to traditional values of masculinity. The beautification of the male body, thus, turns the consumption of skincare products into a performance through which men can maintain their already privileged status in society, rearticulating the double standard of ageing (Sontag, 1972).

Aging Successfully in the Changing Norwegian Welfare State: A Policy Analysis Framed by Critical Gerontology

BACKGROUND AND OBJECTIVES

In the 21st century, the future of the Norwegian welfare state is broadly debated. In Norway, as in other countries, concerns regarding the sustainability and affordability of the welfare state in light of the projected population development have been voiced in public and academic discourse, and not least in governmental statements and documents. Because we consider texts, such as government white papers, as both products and producers of discursively based understandings of the social world, a close examination of policy documents can provide insight into the predominant understanding of a distinct phenomenon in a specific society at a particular point in time.

RESEARCH DESIGN AND METHODS

The article is based on a critical discourse analysis of 3 recent Norwegian government policy documents addressing the older adult population.

RESULTS

We demonstrate that prominent ideas from the widely contested successful aging paradigm are embedded and forwarded in current Norwegian policies, where ideas about successful and healthy aging produced and reproduced in the documents frame and shape expectations toward older adults.

DISCUSSION AND IMPLICATIONS

We argue that the ideas and ideals of successful aging and neoliberalism in parallel pave the way for changes in the historically generous and comprehensive Norwegian social democratic welfare state. For decision makers, the rhetoric of successful aging that emphasizes activity, productivity, self-reliance, and freedom of choice is undoubtedly more convenient to communicate to the public than explicit arguments for the necessity of downscaling public services.

Existential well-being for the oldest old in nursing homes: a meta-ethnography

Ideas of well-being in old age are often anchored in the successful ageing paradigm, foregrounding independence, activeness and autonomy. However, for those oldest old living in nursing homes, these goals are largely out of reach. In this article, we use the meta-ethnographic method to explore and reinterpret existing findings on the ways in which well-being is experienced (or not) by the oldest old in institutional care settings. We frame our findings in existential well-being theory, which understands wellbeing as a sense of ‘dwelling-mobility’. Our analysis resulted in the following themes: (a) institutionalisation as both restrictive and liberating; (b) reciprocity and mattering: the importance of being seen; (c) the need for kinship and the problem of ruptured sociality; (d) rethinking agency: situated, delegated and supported; and (e) lowered expectations: receiving care is not a passive act. We conclude that while institutional care environments are not always conducive to well-being, this does not have to be so. By shifting our focus from successful ageing ideals onto relationally situated care practices, a possibility for existential well-being opens up, even in situations of decline and care dependency.

Alaska native successful ageing in Northwest Alaska: how family impacts how one ages in a good way

aged well, yet today they experience high rates of illness and lower access to care because of colonisation. Aand this research explores successful ageing from an AN perspective or what it means to achieve "Eldership" in the rural Northwest Alaska. A community-based participatory research approach was used to engage participants at every stage of the research process. Semi-structured interviews were conducted with 16 AN men and 25 women and the interviews were professionally transcribed. Kleinman's explanatory model served as the foundation of the questionnaire to gain a sense of the beliefs about ageing and guide the thematic analysis to establish an AN understanding of successful ageing. The foundation of the Norton Sound southern sub-region Model of Successful Ageing is the reciprocal relationship between Elders and family which enables Elders to access meaningful activities, including Native ways of life, physical health, spirituality, and emotional well-being. Community-based interventions should foster opportunities for Elders to share their Native way of life alongside family and community members, which will enable them to remain physically active, maintain healthy emotional well-being, continue engaging in spiritual practices, and contribute to the health and well-being of families.

Invisible, unrecognised and undervalued: examining stories of unpaid work performed by older adults in their local neighbourhoods

Over the past 40 years, positive ageing discourses that speak to an expectation of continued productivity have gained prominence within research and policy. Such discourses have been critiqued as placing disproportionate value on the extension of older adults' working lives, while obscuring other valuable forms of work performed by older adults. Despite the emergence of theoretical conversations about the expansion of conceptions of work, few studies have adopted an explicit focus on the work performed by older adults within their neighbourhoods. Informed by conceptions of work positioned at the intersection of critical gerontology and critical feminism, we drew upon qualitative data from a larger ethnographic study, generated from 17 participants aged 65 and older, to examine: (a) the various forms and contributions of unpaid work that older adults carry out at the neighbourhood level, and (b) the ways in which older adults' representations of this work relate to dominant notions of productivity. Specifically, each participant engaged in three types of qualitative interviews, including additional spatial and visual data generation: (a) completing a narrative interview; (b) carrying a small Global Positioning System (GPS) device to automatically log locations, completing an activity diary and a follow-up interview; and (c) participating in a go-along interview or a photo elicitation interview. Our findings highlight a range of unpaid work performed by participants in their neighbourhood, including formal volunteering, informal caring and informal civic participation. Although these forms of work were, at times, discussed by participants as enabling social inclusion, significant tensions arose from the general lack of discursive and social value assigned to them. In particular, participants described being subject to overwhelming expectations placed on older adults, and women in particular, to carry out this work, with little recognition or acknowledgement of their contributions to the neighbourhood. Taken together, our findings suggest the need not only to diversify understandings of the forms of work perceived as aligning with productive contributions to society in older age, but also to attend to the invisible work performed by older adults within their neighbourhoods. Additionally, we propose a variety of ways organisations and communities that benefit from older adults' unpaid labour may enhance accessibility, thereby reducing the work done by older adults to negotiate tensions between ableist expectations for productivity and their ageing bodies.

Demographic aging in Russia and new social reality

For the third year the population of Russia has been in the situation of a "perfect storm": under the conditions of the COVID-19 pandemic, rapid technological changes connected with digitalization of the entire living space, increasing international tensions against the background of the aging population of the country. These processes have contributed to the formation of a new social reality. The purpose of this study is to examine the dynamics of demographic aging in the context of the pandemic, to identify the specifics of socio-demographic challenges to the country in these conditions, to present opportunities and obstacles in the direction of forming a strategy of active longevity in the Russian Federation. The relevance of this project is due to the need to study the potential of the older generation in the conditions of the second stage of depopulation for the socio-demographic development of the country. The information base is the data of Rosstat, international organizations, as well as the works of Russian and foreign authors on this issue. The author's methodology of measuring the resource potential of the older generation is used. It is shown that Russia implements active aging programs. However, the development of infrastructure to support the older generation is not yet consistently combined with the goals of socio-economic development of the country. It is proposed to make a wider use of the methodology for preserving and developing the resource potential of the older generation, which allows a differentiated approach to the formation of an active longevity strategy with the account of the capabilities and motivation of various groups of the elderly and old people.

Neighborhood Attributes and Well-Being Among Older Adults in Urban Areas: A Mixed-Methods Systematic Review

Expanding urbanization rates have engendered increasing research examining linkages between urban environments and older adults' well-being. This mixed-methods systematic review synthesizes the evidence for the influence of urban neighborhoods' attributes on older adults' well-being. We searched for literature published up to December 2020 across six databases and performed quality assessment and thematic analysis. The results, based on 39 identified studies, showed that natural areas in neighborhoods and a sense of community are the attributes most often associated with positive effects on well-being. Transit-related variables, urban furniture, and access to healthcare are also positively related to well-being. Neighborhoods may promote well-being more effectively when these elements are considered. However, almost half of the studies did not include all environmental dimensions simultaneously, and self-reported instruments were largely preferred over more objective assessments of the environment. Future research should thus holistically examine physical, social, and service-related attributes to produce more robust evidence.

The trouble with personhood and person-centred care

The phrase 'person-centred care' (PCC) reminds us that the fundamental philosophical goal of caring for people is to uphold or promote their personhood. However, such an idea has translated into promoting individualist notions of autonomy, empowerment and personal responsibility in the context of consumerism and neoliberalism, which is problematic both conceptually and practically. From a conceptual standpoint, it ignores the fact that humans are social, historical and biographical beings, and instead assumes an essentialist or idealized concept of personhood in which a person is viewed as an individual static object. From a practical standpoint, the application of such a concept of personhood can lead to neglect of a person's fundamental care needs and exacerbate the problems of social inequity, in particular for older people and people with dementia. Therefore, we argue that our understanding of PCC must instead be based on a dynamic concept of personhood that integrates the relevant social, relational, temporal and biographical dimensions. We propose that the correct concept of personhood in PCC is one in which persons are understood as socially embedded, relational and temporally extended subjects rather than merely individual, autonomous, asocial and atemporal objects. We then present a reconceptualization of the fundamental philosophical goal of PCC as promoting selfhood rather than personhood. Such a reconceptualization avoids the problems that beset the concept of personhood and its application in PCC, while also providing a philosophical foundation for the growing body of empirical literature that emphasizes the psychosocial, relational, subjective and biographical dimensions of PCC.

"We Should Be at the Back of the Line": A Frame Analysis of Old Age Within the Distribution Order of the COVID-19 Vaccine

BACKGROUND AND OBJECTIVES

In the fall of 2020, it became clear that the initial doses of the coronavirus disease 2019 (COVID-19) vaccine would be limited, and a priority order would be necessary. This article examines the perceptions of old age in the context of establishing a priority order for the COVID-19 vaccine from the perspective of online newspaper commenters. Two research questions are investigated: (a) How do commenters place older people in line for the COVID-19 vaccine? and (b) What frames and factors do commenters use as reasoning for their proposed position of older adults?

RESEARCH DESIGN AND METHODS

This study involves a frame analysis of 440 online comments on an article published by The New York Times on December 1, 2020 about the U.S. recommendations for distributing the coronavirus vaccine.

RESULTS

Older adults were referenced as belonging to one of the 3 groups: older long-term care residents, older workers, and older adults retired and/or isolating at home. Two frames emerged from the data as criteria for prioritization: social contribution and vulnerability. Older commenters themselves frequently stated that they should be deprioritized so that others can be inoculated earlier.

DISCUSSION AND IMPLICATIONS

The findings may be interpreted as demonstrative of pervasive ageism throughout the pandemic; older commenters' sacrificial remarks may reflect generativity, internalized ageism, social pressure from online forums, or some combination thereof.

Why older rural women in Ireland want to work: it's not all about the money

This paper extends our understanding of employment and gendered rural ageing by examining the latent benefits of paid work for mid-life women in rural Ireland. Existing social gerontology literature deals extensively with manifest financial reasons to work, consequences of gendered pay and pension inequalities, work-related health concerns and the negative impacts to an extended working life for women. However, there is much less focus on the latent non-financial positive contributions that work provides for the older woman, especially within a rural context. Findings from this study show how mid-life women, even if in lower-paid, precarious work or in poorer health may choose to continue working into older age. Paid work provides not only financial autonomy, but also temporal structure, life purpose, personal agency, social connectivity and a self-identity that most women are reluctant to relinquish to retirement. Meaningful work plays a critical role in the ageing experience of older rural women. A qualitative study of 25 women aged 45–65 in Connemara, Ireland was undertaken from a lifecourse perspective and analysed using constructivist grounded theory to allow rich, novel narrative to emerge. Narrative from seven, who best represent all participants, are utilised in this paper. Conclusions suggest that the latent benefits of paid work are at least as, if not more important than financial gain for rural mid-life women.

The Relationship between Ageism and Well-Being as Mediated through COVID-19-Related Experiences and Discourses

Both COVID-19 and ageism can have a negative impact on the well-being of older people. Yet, our knowledge on the links between COVID-19, ageism and well-being is still emerging. The present study aimed to contribute to this knowledge by exploring the lived experiences of older adults during the COVID-19 pandemic. To do so, we analyzed older persons' subjective experiences and perceptions of ageism arising from COVID-19-related policies and discourses in two country contexts-Austria and Ireland-and the implications of these experiences for personal well-being. Based on the thematic analysis of 27 interviews with older adults, we found that participants perceived and encountered a discriminatory homogeneous representation of older people as a group. Three specific forms of this homogenization, namely stigmatization, paternalism, and scapegoating, were identified as impact on well-being. Moreover, our analysis showed how these forms of ageism challenge both the individual and social identities of older people, revealing older participants' different attitudes in responding to this challenge. With reference to the international research literature, we discussed the impact of these experiences on the well-being of older people and the possible legal and socio-political implications of our findings.

COVID-19 and Everyday ICT Use: The Discursive Construction of Old Age in German Media

BACKGROUND AND OBJECTIVES

Media discourses have the power to construct and perpetuate positive and negative aging images and influence public and individuals' attitudes. This study aims to critically examine the media portrayal of older persons' everyday information and communication technology (EICT) usage during the first and second wave of the COVID-19 pandemic.

RESEARCH DESIGN AND METHODS

A total of 51 articles published in three leading German newspapers between March 2020 and November 2020 were identified from the LexisNexis academic database. Data were analyzed employing critical discourse and thematic analysis.

RESULTS

EICT use was associated with youthful, consumption-orientated, and active lifestyles, while non-use was constructed as failures on the policy or individual level. The pandemic seemed to have acted as an amplifier, further exacerbating and perpetuating stereotypical, dichotomous, but also empowering aging images.

DISCUSSION AND IMPLICATIONS

Neo-liberal rational and binary distinctions of active users and non-users opened and encouraged critical discussions on positive aging trends, the concept of the third and fourth age, and aging-and-innovation discourses. Moreover, the crucial educative role of the media in raising awareness about power imbalances and reducing EICT-related ageism is stressed.

Communication officers in local authorities meeting social media: On the production of social media photos of older adults

European local authorities increasingly use social media to present services and activities organized for citizens living in the particular area. Previous studies found that authority-managed social media visually depicted older adults as being active, sociable, happy, and physically capable, reflecting the normative "third age" representation. Yet few studies to date have examined how local authorities produce the photos of older adults for social media posting. Drawing on semi-structured interviews with communication officers in a Swedish municipality, the purpose of this study is to investigate the production process for social media photos of older adults within local authorities from an institutional logics perspective. The analysis illustrates that communication officers strive to create a good image of the municipality and its services, follow municipal policy and EU law on data protection, seek photos through particular sources, adjust to and develop photographic standards of good photos, and endeavor to promote social media engagement in the photos. These motives and work practices of communication officers contribute to the visual representations of older adults as engaging in municipal services, being socially active, and staying physically capable. The analysis also indicates that both social media and bureaucratic logics encourage officers to produce photos of older adults that highlight the bright side of later life. The findings contribute to previous studies on online representations of older adults generated by local authorities, by showing how the third age representation may come about in practice, and which logics may influence officers to generate such representation. Furthermore, the knowledge provided could be used as a basis for assessment and improvement on authorities' production for social media photos of older adults, which in turn contributes to more diverse and thoughtful representations of older adults and later life in authority-managed social media.

Furthering Productive Aging through Public-Private Sector Alliances: The Case of the Mexican Government and Starbucks Company

This commentary focuses on the remunerated work dimension of productive aging in Mexico, specifically paid employment. The main purpose is to draw attention to productive aging policies and programs built on alliances between the Mexican government and private companies - e.g., Starbucks - and then to analyze the potential impacts of such alliances on the older population. We argue that although the Mexican government emphasizes the rights of older adults to engage in paid-employment programs through such alliances, it is not addressing the issues that underlie paid-employment activities in later life, such as conditions of inequality, lack of opportunities, and poverty. We also argue that the instrumentation of productive aging programs implemented by the government should consider the costs and benefits for older adults. Solid, research-based evidence is needed to better implement productive aging programs by accounting for the factors that influence older adults' decisions to continue working, the functional capacities of older workers, and their performance needs.

Growing Old in a Transnational Setting: Investigating Perceptions of Ageing and Changing Filial Ties Among Older Indians in Saskatoon

Numerous studies have examined the experience of growing old in a transnational context among Indians. However, in most of these studies, the older adults had immigrated as senior citizens to be with their adult children. Indians who have grown old in transnational settings have not been examined in detail in the gerontological scholarship. Adopting a cross-cultural lens, the present study focusses on perceptions of ageing among older Indians who have grown old in the city of Saskatoon. The study demonstrates how these older Indians refute the Successful Ageing model and accept their physical weaknesses in their course of ageing. Additionally, the study also examines how caregiving arrangements and intergenerational relationships are shaped among these older Indians and their adult children, in a transnational city, such as Saskatoon. Finally, the study highlights how later life gender roles are constructed in a transnational backdrop.

Anti-aging technoscience & the biologization of cumulative inequality: Affinities in the biopolitics of successful aging

This paper charts the emergence of under-remarked affinities between contemporary anti-aging technoscience and some social scientific work on biological aging. Both have recently sought to develop increasingly sophisticated operationalizations of age, aging and agedness as biological phenomena, in response to traditional notions of normal and chronological aging. Rather than being an interesting coincidence, these affinities indicate the influence of a biopolitics of successful aging on government, industry and social science. This biopolitics construes aging as a personal project that is mastered through specific forms of entrepreneurial individual action, especially consumption practices. Social scientists must remain alert to this biopolitics and its influence on their own work, because the individualization of cumulative inequalities provides intellectual and moral justifications for anti-aging interventions that exploit those inequalities.

The Institutional Active Aging Paradigm in Europe (2002-2015)

BACKGROUND AND OBJECTIVES

The paradigm of active aging has been slowly gaining ground in Europe as the ideal framework for public policy and for responding to the population's aging. Taking the work by Rune Ervik as its point of departure, this article updates his conclusions on conceptualizations and policies of active aging by performing a study of the institutional discourses in the matter produced by the World Health Organization (WHO), the Organization for Economic Cooperation and Development (OECD), and the European Union (EU).

METHODS

A corpus of 15 WHO, OECD, and EU documents published in the period 2002-2015 and tackling active aging were analyzed qualitatively through a combination of content and thematic analysis, based on a scheme integrated by deductive and inductive iterative manual and computerized codification.

RESULTS

The institutional discourses on active aging analyzed have not changed dramatically in the period considered. However, a divergent path has emerged regarding the accent placed on participation and contribution in the construction of the paradigm: the more socially productive and health-oriented WHO discourse is slowly separating from the more economically productive and labor-oriented discourses of the EU and OECD.

DISCUSSION AND IMPLICATIONS

The institutional paradigm on active aging is evolving into a reductive treatment of a phenomenon that is multidimensional. International institutions and researchers should pay closer attention and forge a path toward an honest and critical examination of the real conditions and expectations of older people concerning the discursive and practical proposals of active aging, in all its different forms.

The Changing Narratives of Death, Dying, and HIV in the United Kingdom

Death and infection were closely linked from the start of the HIV epidemic, until successful treatments became available. The initial impact of mostly young, gay men dying from HIV was powerful in shaping UK responses. Neoliberal discourses developed at the same time, particularly focusing on how citizens (rather than the state) should take responsibility to improve health. Subsequently "successful ageing" became an allied discourse, further marginalising death discussions. Our study reflected on a broad range of meanings around death within the historical UK epidemic, to examine how dying narratives shape contemporary HIV experiences. Fifty-one participants including people living with HIV, professionals, and activists were recruited for semistructured interviews. Assuming a symbolic interactionist framework, analysis highlighted how HIV deaths were initially experienced as not only traumatic but also energizing, leading to creativity. With effective antiretrovirals, dying changed shape (e.g., loss of death literacy), and better integration of palliative care was recommended.

Successful aging at work: A process model to guide future research and practice

Although aging workforces result in numerous practical challenges for organizations and societies, little research has focused on successful aging at work. The limited existent research has generated rather diverse conceptualizations of successful aging at work, which are often broad and difficult to operationalize in practice. Therefore, to advance research and practice, we offer a specific and practical conceptualization of successful aging at work by developing a process model, which identifies relevant antecedents and mechanisms. In particular, we define successful aging at work as the proactive maintenance of, or adaptive recovery (after decline) to, high levels of ability and motivation to continue working among older workers. We also argue that proactive efforts to maintain, or adaptive efforts to recover and restore, high ability and motivation to continue working result from a self-regulation process that involves goal engagement and disengagement strategies to maintain, adjust, and restore person–environment fit. Further, we propose that at various levels (i.e., person, job, work group, organization, and society) more distal factors function as antecedents of this self-regulation process, with age-related bias and discrimination potentially operating at each level. Finally, we offer a roadmap for future research and practical applications.

The paradox of aging and health-related quality of life in Asian Chinese: results from the Healthy Aging Longitudinal Study in Taiwan

Background

Declines in health, physical, cognitive, and mental function with age suggest a lower level of health-related quality of life (HRQoL) in late life; however, previous studies found that the associations were weak and varied, depending on the study designs and cohort characteristics.

Methods

The present study examined the paradox of aging in an East Asian context by regressing the age patterns of objective health indicators (physical, cognitive, and mental function), and subjective HRQoL (12-item Short Form, SF-12), on the independent and interactive effects of age and physical function in a cohort study of 5022 community-dwelling adults aged 55 and older in Taiwan.

Results

Age patterns differed across measures. The SF-12 mental health score (MCS) showed a slight positive association with age and this effect remained stable after controlling for various age-related covariates. The SF-12 physical health score (PCS), in turn, was negatively associated with age. Age differences in PCS were fully explained by age decrements in objective physical health. However, consistent with the so-called paradox of aging, the association between objective and subjective physical health weakened with age.

Conclusion

These findings add to prior evidence indicating that — in spite of objective health decrements — subjective HRQoL is maintained in later life among Asian Chinese. Also, these paradoxical patterns appear to vary for mental and physical components of HRQoL, and future research is needed to explore the underlying mechanism.

Trial registration

Healthy Aging Longitudinal Study in Taiwan (HALST) is retrospectively registered at ClinicalTrials.gov on January 24, 2016 with trial registration number NCT02677831.

What attributes of successful aging are important to older adults? The development of a multidimensional definition of successful aging

Older adults' experiences and perspectives have been missing in the quest to develop a unified definition of successful aging. Through an online survey using convenience sampling, respondents (N = 477) were asked to report how important 25 specific attributes of successful aging, originating from published literature that examined successful aging from the perspective of older adults, were to them as they age. Over 90% of respondents reported 11 attributes as important or very important to them as they age, which included "remaining free of chronic diseases" and "feeling good about myself." A factor analysis (N = 462) resulted in four dimensions explaining 57.06% of the variance: Adaptation and Coping; Being Healthy; Self-Determination; and Social Relationships and Interactions. The findings revealed older adults' definition of what is important to them as they age is multidimensional, with having access to affordable health care and remaining alert and mentally active as critical elements followed by elements of self-determination, coping, and physical and social health. Future research should replicate the study with diverse populations to continue to refine a definition of successful aging that could influence program development and intervention approaches in health and social services.

Healthy Aging in China: Benchmarks and Socio-Structural Correlates

The objectives of this investigation were to identify a valid and practical benchmark for the assessment of healthy aging in the Chinese population and examine its socio-structural correlates. Using data from the 2011 China Health and Retirement Longitudinal Study, we investigated the validity of a continuum of healthy aging definitions. We found that definitions of healthy aging that emphasize disease of "significance" and functional health offer a valid and practical approach to the assessment of healthy aging. Results of multilevel logistic regression analyses indicate that socio-structural characteristics of individuals (age, gender, education, and pension status), their households (structure and wealth), and communities (infrastructure and geographic region) are significantly associated with the odds of healthy aging. Policy-level interventions are needed to enable individuals, regardless of their gender, socioeconomic status, and place of residence to experience a healthy old age.

Towards meaningful mobility: a research agenda for movement within and between places in later life

Mobility or physical movement contributes to health and wellbeing in later life. Most studies have focused on the contribution of outdoor mobility to active ageing, but physical and cognitive impairments restrict the mobility of many older adults. This article aims to explore the gaps in the current literature on mobility in later life, and identify required innovations in the field through laying out key areas for future research. It discusses two, largely separate, areas of research, namely on mobility patterns and mobility experiences. The first focuses on quantitative and spatial research on outdoor mobility patterns in terms of routes, timing and transport modes. The second mainly concerns qualitative research on how older adults perceive mobility in their everyday lives. This article identifies three areas for future research on mobility in later life: (a) beyond outdoor movement; (b) diversity in mobility; and (c) the role of time in mobility. To conclude, addressing these areas jointly will contribute to further unpacking the concept of mobility as meaningful practice and to integrating quantitative and qualitative methods when studying mobility in later life. This will result in policy inputs on the mobility and wellbeing of our ageing population.

The Extended Body: On Aging, Disability, and Well-being

Insofar as many older adults fit some definition of disability, disability studies and gerontology would seem to have common interests and goals. However, there has been little discussion between these fields. The aim of this paper is to open up the insights of disability studies as well as philosophy of disability to discussions in gerontology. In doing so, I hope to contribute to thinking about the good life in late life by more critically reflecting upon the meaning of the body, ability, and the variability of each. My central argument is that we should conceptualize age-associated bodily variations and abilities not in terms of individual capacity, but in terms of what I call "the extended body." It is in light of the meaning of embodiment and ability in general that we must think differently and more capaciously about the meaning of late life in particular.

How Do Older Adults Define Successful Aging? A Scoping Review

Successful aging is a prominent theory that describes the aging process and the expected activities and behaviors older adults should engage in or exhibit to age successfully. Although this theory is used to gauge the extent to which older adults are aging successfully, older adults' experiences and perspectives of what successful aging means to them are missing from the theory. A five-step scoping review framework was used to explore and synthesize the existing research that investigated older adults' perspectives on successful aging. Twelve main themes were found and ranged from the importance of social relationships and interactions to having a good death. Findings indicated older adults do not define successful aging as strictly as is found in the literature. Old age and the aging process from the views of older adults provide future directions for theory development and research.

Quality of life among older people with a disability: the role of purpose in life and capabilities

Purpose: Purpose in life and capabilities are two significant individual elements that enhance quality of life among older people. Capabilities refers to the extent to which older people are free to make choices that are important to them. At present, it is not known how purpose in life interacts with capabilities to influence quality of life for those living with a disability. This study examined the extent to which purpose in life and capabilities interacts with health status to affect quality of life, particularly for older people with a disability.Methods: Self-report data from participants in a longitudinal cohort study of older New Zealanders were analyzed. Responses from 452 older people with a disability were compared with 3299 age- and gender-matched older people without a disability on indicators related to health and aging. The associations were tested using hierarchical regression. Mediational impact of purpose in life and capabilities were tested via path analysis.Results: Mental health, physical health, purpose in life, and capabilities accounted for a significant amount of variance in quality of life for older people with a disability. Purpose in life and capabilities were significant unique mediators for older people with a disability.Conclusions: Purpose in life may help older people with a disability to deal with early onset stressors or changes in mental and physical health to maintain overall quality of life. The role of capabilities suggests that the social environment and access to resources and choices are important in ensuring that older people aging with or into a disability achieve quality of life in a socially just environment.Implications for rehabilitationsPurpose in life and capability are unique mediators of the relationship between health status and quality of life.Purpose in life may act as an effective buffering mechanism to deal with disability in later life while capability can empower older people with a disability to achieve quality of life in a just environment.The notion of successful aging with disability should be re-defined as using psychological, social support, and healthcare resources to live a life consistent with personal values in the context of disabilityRather than emphasizing structural factors and physical functioning in activity participation, older people with disability should be supported to decide and pursue their own preferences.Rehabilitation professionals can work flexibly with older people with disability to maximize their resilience, dignity, autonomy and choice, and positive connection to others.

Factors influencing physical activity participation among older people with low activity levels

Despite the well-documented health benefits of physical activity in older adults, participation levels remain low. With rapid global population ageing, intensive efforts are needed to encourage higher levels of participation to ameliorate the negative effects of physical inactivity for older individuals and society as a whole. The aim of this qualitative study was to inform future physical activity promotion interventions by examining factors contributing to low activity levels among older people undertaking less than half the recommended level of moderate-to-vigorous physical activity (MVPA). Semi-structured interviews were conducted with 102 (65% female) community-dwelling Western Australians aged 60+ years (mean = 71.52, standard deviation = 6.26) who engaged in ⩽75 minutes of MVPA per week as measured by accelerometers. Several modifiable and unmodifiable barriers were identified, of which poor health featured most prominently. Lifetime physical inactivity, caring duties, low motivation, misperceptions of physical activity and ageing, and a lack of affordable and attractive options were the other barriers identified. The results suggest that strategies are needed to raise awareness of current physical activity guidelines, normalise engagement in MVPA throughout the lifespan, develop initiatives to motivate participation, improve the availability of affordable physical activity programmes that are attractive to this population segment, and facilitate participation among those with intensive caring responsibilities.

Perspectives of people with aphasia post-stroke towards personal recovery and living successfully: A systematic review and thematic synthesis

Background

There is increased focus on supporting people with chronic conditions to live well via person-centred, integrated care. There is a growing body of qualitative literature examining the insider perspectives of people with post-stroke aphasia (PWA) on topics relating to personal recovery and living successfully (PR-LS). To date no synthesis has been conducted examining both internal and external, structural influences on living well. In this study, we aimed to advance theoretical understanding of how best to promote and support PR-LS by integrating the perspectives of PWA on a wide range of topics relating to PR-LS. This is essential for planning and delivering quality care.

Methods and findings

We conducted a systematic review, following PRISMA guidelines, and thematic synthesis. Following a search of 7 electronic databases, 31 articles were included and critically appraised using predetermined criteria. Inductive and iterative analysis generated 5 analytical themes about promoting PR-LS. Aphasia occurs in the context of a wider social network that provides valued support and social companionship and has its own need for formal support. PWA want to make a positive contribution to society. The participation of PWA is facilitated by enabling environments and opportunities. PWA benefit from access to a flexible, responsive, life-relevant range of services in the long-term post-stroke. Accessible information and collaborative interactions with aphasia-aware healthcare professionals empower PWA to take charge of their condition and to navigate the health system.

Conclusion

The findings highlight the need to consider wider attitudinal and structural influences on living well. PR-LS are promoted via responsive, long-term support for PWA, friends and family, and opportunities to participate autonomously and contribute to the community. Shortcomings in the quality of the existing evidence base must be addressed in future studies to ensure that PWA are meaningfully included in research and service development initiatives.

Systematic review registration

International Prospective Register of Systematic Reviews PROSPERO 2017: CRD42017056110.

Psychological and social outcomes of sport participation for older adults: a systematic review

Sport participation is well known to promote health outcomes for children and adolescents. Nevertheless, there is insufficient evidence about the psychological and social outcomes of sport participation for older adults. This article provides the results of a systematic review of the psychological and social outcomes of sport participation for older adults. A systematic review of seven electronic databases was conducted and a total of 21 studies published that attended to psychological and/or social health benefits from sport participation of older adults (50 years old and over) were included. The outcomes of older adults’ sport participation included life satisfaction, depression, anxiety, stress, mood state, hedonistic values, socialisation, competition, and personal psychological outcomes such as personal empowerment, self-confidence, self-esteem and resistance to the negative view of ageing. Future studies are needed to conceptualise and operationalise the different levels of involvement of sport participation.

The Effects and Meanings of Receiving a Diagnosis of Mild Cognitive Impairment or Alzheimer's Disease When One Lives Alone

BACKGROUND

One third of older adults with cognitive impairment live alone and are at high risk for poor health outcomes. Little is known about how older adults who live alone experience the process of receiving a diagnosis of mild cognitive impairment (MCI) or Alzheimer's disease (AD).

OBJECTIVE

The aim of this study was to understand the effects and meanings of receiving a diagnosis of MCI or AD on the lived experience of older adults living alone.

METHODS

This is a qualitative study of adults age 65 and over living alone with cognitive impairment. Participants' lived experiences were elicited through ethnographic interviews and participant observation in their homes. Using a qualitative content analysis approach, interview transcripts and fieldnotes were analyzed to identify codes and themes.

RESULTS

Twenty-nine older adults and 6 members of their social circles completed 114 ethnographic interviews. Core themes included: relief, distress, ambiguous recollections, and not knowing what to do. Participants sometimes felt uplifted and relieved by the diagnostic process. Some participants did not mention having received a diagnosis or had only partial recollections about it. Participants reported that, as time passed, they did not know what to do with regard to the treatment of their condition. Sometimes they also did not know how to prepare for a likely worsening of their condition, which they would experience while living alone.

CONCLUSION

Findings suggest the need for more tailored care and follow-up as soon as MCI or AD is diagnosed in persons living alone.

Successful Aging in Colombia: The Role of Disease

Objective: This study aimed to determine the prevalence of successful aging (SA) and identify its predictive factors in a cohort of older people in the Colombian Andes Mountain. Method: Data were drawn from a prospective longitudinal study of community-dwelling elderly people in Manizales. SA encompassed indicators in four domains: physical, cognitive, emotional, and social functioning. Results: The prevalence of SA was 24.4%. The independent predictors were good and very good self-rated health, middle–high/high-income level, absence of chronic conditions, married status, high educational level, and very high spirituality. Discussion: The prevalence of SA was low: One of 10 people older than 65 years showed SA when presence of diseases was included in the criteria, compared with one of four when such an item was excluded. The identification of predictive factors allows distinguishing this population in primary care services and promoting strategies that ensure high functionality levels for as long as possible.

Giving Back Is Receiving: The Role of Generativity in Successful Aging Among HIV-Positive Older Adults

Objectives: Successful aging has been identified as an important emphasis for people living with human immunodeficiency virus (HIV). Little is known about how this population conceptualizes aging successfully and how this relates to generativity. This qualitative study examined the importance of generativity among 30 HIV-positive older adults to determine the role of generativity in successful aging. Method: Participants aged 50+ years were recruited in Ontario, Canada, through acquired immunodeficiency syndrome (AIDS) service organizations, clinics, and community agencies. Qualitative interviews were analyzed to explore strategies participants employed to engage in successful aging within their own personal context. Results: Participants saw themselves as pioneers and mentors, helping others to navigate the landscape of aging with HIV. Four themes were identified through consensus including (a) reciprocity, (b) mentoring, (c) pioneerism, and (d) connecting through volunteerism. Discussion: Interventions that promote intergenerational connections, community involvement, and generative acts within the HIV community can facilitate successful aging among older adults living with HIV/AIDS.

Assessing the Effectiveness of the Aging Mastery Program

Background: Successful aging is best determined by active management and self-determination of one’s aging roadmap. Some individuals are ready to respond to these challenges, others may benefit from assistance that might be offered through an evidence-based intervention. The Aging Mastery Program® (AMP) has been developed to meet these needs. Method: In a cross over design the intervention was tested in ten senior centers and aging network agencies looking at impacts upon general health and quality of life, patient activation, physical activity and advanced care planning. Results: There was a statistically significant (tested at a 0.05 level) level of improvement found in physical activity and advanced care planning. Conclusion: Findings support the program’s effectiveness and its value as an evidence-based intervention for older adult programming.

Thinking about Later Life: Insights from the Capability Approach

A major criticism of mainstream gerontological frameworks is the inability of such frameworks to appreciate and incorporate issues of diversity and difference in engaging with experiences of aging. Given the prevailing socially structured nature of inequalities, such differences matter greatly in shaping experiences, as well as social constructions, of aging. I argue that Amartya Sen’s capability approach (2009) potentially offers gerontological scholars a broad conceptual framework that places at its core consideration of human beings (their values) and centrality of human diversity. As well as identifying these key features of the capability approach, I discuss and demonstrate their relevance to thinking about old age and aging. I maintain that in the context of complex and emerging identities in later life that shape and are shaped by shifting people-place and people-people relationships, Sen’s capability approach offers significant possibilities for gerontological research.

Timing of Diagnosis: Understanding Resilience Narratives of HIV Positive Older Adults Diagnosed Pre- and Post-HAART

BACKGROUND

Despite the growing population of older adults living with human immunodeficiency virus/ acquired immune deficiency syndrome (HIV/AIDS), few studies have examined this population in terms of timing of HIV diagnosis. This study explores resilience and protective factors among HIV-positive older adults, 17 of whom were diagnosed prior to the development of highly active antiretroviral therapy (HAART), and 13 of whom were diagnosed after the development of HAART.

METHODS

We explored the concepts of resilience and protective factors in 30 older adults living with HIV in Ontario, Canada. A qualitative approach was used to conduct in-depth interviews and grounded theory techniques were used to analyze the interview transcripts.

RESULTS

Having lived with HIV for nearly 30 years, the pre-HAART group had developed more personal strategies for enhancing resilience, including self-care behaviors. They were more regimented and dedicated to their daily health, and were more engaged in their medical care as opposed to the post-HAART group who viewed self-care as staying adherent and refraining from risky health behaviors.

IMPLICATIONS

Although HAART has radically changed the prognosis of HIV, we have limited information about the differences between those who were diagnosed before and after the development of HAART. We will present recommendations for addressing previous trauma and improving self-care.

The ambiguities of self-governance: Russian middle-aged middle-class women's reflections on ageing

In a youth-centred culture, where ageing is associated with physical and mental decline, investment in a youthful appearance promises access to socially valuable resources. The need for regular care for the self, primarily through consumption, constitutes part of the narrative of successful or positive ageing. Due to its emphasis on self-reliance and efforts to remain healthy, productive and youthful, the discourse of successful ageing has been seen as intersecting with a neoliberal rationality, or a shift of responsibility for risks associated with ageing from the state to the individual. While some authors criticise an emphasis on individual effort to maintain personal wellbeing for a lack of attention to structural factors, others view such an approach favourably as a way of transcending state paternalism. In this paper, I engage with the discourse of ‘responsibilisation’ drawing on the interviews with middle-aged, middle-class women from Moscow about their experiences of ageing. I employ the theoretical framework of ‘governmentality’ to demonstrate how the interviewed women's attempts to make sense of what it meant to age ‘appropriately’ within their milieus informed both their awareness of a need to improve and reinvent the self constantly through consumption in the context of post-Soviet Russian society, and their questioning of and resistance to this pressure.

Successful Aging Among African American Older Adults With Type 2 Diabetes

Objectives

Rowe and Kahn's concept of successful aging remains an important model of well-being; additional research is needed, however, to identify how economically and socially disadvantaged older adults experience well-being, including the role of life events. The findings presented here help address this gap by examining the subjective construction of well-being among urban African American adults (age ≥ 50) with Type 2 diabetes.

Method

As part of the National Institute on Aging-funded Subjective Experience of Diabetes among Urban Older Adults study, ethnographers interviewed African American older adults with diabetes (n = 41) using an adaptation of the McGill Illness Narrative Interview. Data were coded using an inductively derived codebook. Codes related to aging, disease prognosis, and "worldview" were thematically analyzed to identify constructions of well-being.

Results

Participants evaluate their well-being through comparisons to the past and to the illnesses of friends and family. Diabetes self-care motivates social engagement and care of others. At times, distrust of medical institutions means well-being also is established through nonadherence to suggested biomedical treatment.

Discussion

Hardship and illness in participants' lives frame their diabetes experience and notions of well-being. Providers need to be aware of the social, economic, and political lenses shaping diabetes self-management and subjective well-being.