Successful Aging as a Contemporary Obsession

Sarah Lamb

• Publisher: Rutgers University Press
• Year: 2017
• ISBN:
  9780813585352
• Topic: Social Sciences
• Subtopic: Gerontology
• Index: Social Sciences

In recent decades, the North American public has pursued an inspirational vision of successful aging—striving through medical technique and individual effort to eradicate the declines, vulnerabilities, and dependencies previously commonly associated with old age. On the face of it, this bold new vision of successful, healthy, and active aging is highly appealing. But it also rests on a deep cultural discomfort with aging and being old.
 
The contributors to Successful Aging as a Contemporary Obsession explore how the successful aging movement is playing out across five continents. Their chapters investigate a variety of people, including Catholic nuns in the United States; Hindu ashram dwellers; older American women seeking plastic surgery; aging African-American lesbians and gay men in the District of Columbia; Chicago home health care workers and their aging clients; Mexican men foregoing Viagra; dementia and Alzheimer sufferers in the United States and Brazil; and aging policies in Denmark, Poland, India, China, Japan, and Uganda. This book offers a fresh look at a major cultural and public health movement of our time, questioning what has become for many a taken-for-granted goal—aging in a way that almost denies aging itself.
 

Part I

Gender, Sexuality, and the Allure of Anti-Aging

1

Successful Aging, Ageism, and the Maintenance of Age and Gender Relations

Toni Calasanti and Neal King

The notion of successful aging is not new. Robert Havighurst’s (1961) early formulation argued that aging can be positive, and it focused on social conditions that would enable life satisfaction without depriving other groups in society (Katz and Calasanti 2015). Today successful aging is most closely aligned with the construct espoused by John Rowe and Robert Kahn, whose views were spread widely by the MacArthur Foundation’s distribution of their 1998 Successful Aging book to everyone in the Gerontological Society of America, as well as the journalists’ attention it received (Holstein and Minkler 2003).

By their own account, Rowe and Kahn (1998) sought to construct their model of successful aging to counter ageism and the negative discourse of decline. They argued that ageism, which results from the focus of “both science and society” (1998, xii) on such issues as frailty and long-term care needs, depicts old people “as a figurative ball and chain holding back an otherwise spry collective society” (12). They have sought to reduce the ageism behind and inspired by this vision of old people as dying weight, by using evidence from a variety of scientific studies to demonstrate that people can, indeed, age successfully (12–13).

According to Rowe and Kahn (1998, 38), successful aging involves (1) the avoidance of disease and disability; (2) maintaining high levels of mental and physical function; and (3) active engagement with life, including “relationships with other people, and behavior that is productive” (40). In turn, productivity includes “all activities, paid or unpaid, that create goods or services of value” (47). Key to their framework is their claim that individuals can achieve these dimensions of successful aging through appropriate lifestyle choices: “Our main message is that we can have a dramatic impact on our own success or failure in aging. Far more than is usually assumed, successful aging is in our own hands” (18, our emphasis). Aging, they argue, is “largely under the control of the individual. In short, successful aging is dependent upon individual choices and behaviors. It can be attained through individual choice and effort” (37, our emphasis). Thus, successful aging posits individual responsibility for choosing whether to enter a devalued social location or work toward success instead. As such, it represents a positive aging discourse that, within the present neoliberal context, places the “bodily, financial and social risks of aging” firmly on the shoulders of individuals and away from states (Laliberte Rudman 2015, 11).

We argue that successful aging will not eradicate ageism by giving more people greater access to forms of personal discipline and engagement, because this does not challenge the inequities that give rise to ageism, the derogation of old age that leads to the calls for greater success in the first place. It does not confront the notion that old age is worse than middle age, that old people should find ways to be more like their younger selves. It fails to address the age relations that denigrate old age and uphold other life stages as the models against which elders will be assessed.

Successful aging does not address the ageism that ushers all who live long enough into this later life stage. Beginning with the insight that inequities intersect, that the subordination of old people is shaped by relations of gender, sexuality, colonialism, and other inequalities, this chapter focuses on the intersection of age and gender in the United States, to show how people hoping to age successfully accept individual responsibility, per the successful aging framework, and pursue their resistance to their own devaluation in gendered ways.

Age Relations

Relations of age draw invidious distinctions that privilege younger adults at the expense of old people (Calasanti 2003). Old people in the United States frequently are marked as relatively ill, unproductive, and needy. Depending on political stripes, groups may also see old people as unjustly consuming more than their share of resources, robbing younger generations via pensions and entitlement programs. These divisions have been institutionalized in work and retirement policies, long-term care policies, and an anti-aging industry that warns adults of the terrible consequences of growing old. Such organizational and mundane attention to the distinct status of old age and its many downsides keeps age salient and maintains the subordination of old people. Consequences for old people include widespread poverty as income and wealth polarize in old age, loss of rights of citizenship and often control over their bodies, and enduring stigma. Younger people face less competition for resources, such as jobs or intimate partners (Calasanti 2010; King 2006).

Widespread attention to “successful aging” in North America is in fact indicative of the institutionalized nature of ageism. No comparable theory exists for other life stages, with comparable discussions of successful infancy, “teenagehood,” or young adulthood. Scholarly theories and popular advice address each life stage, but no other stages are treated as if they had no value unique to them, as if no positives resulted from entry into those stages, or as if we needed to justify their existence by minimizing what is unique to them. In each of the other cases, the negatives are offset by positives that also are seen to accrue. It is only old age that, to paraphrase Molly Andrews (1999), we try to eradicate from the developmental landscape. Only in old age do we feel a need to discover and promote positive content where there apparently is little to none.

The inability of successful aging to address this ageism is suggested by Debbie Laliberte Rudman’s (2015) qualitative study of thirty middle-aged and older persons. Looking at the broader rubric of positive aging discourses, she finds that her respondents accept the neoliberal mandate to take personal responsibility for their bodily aging. However, they also find that there is only so much that they can do, and they see themselves as failures when they do not succeed in living up to these mandates. Perhaps more to the point of successful aging, an “aversion to oldness” also remains.

The difficulties of addressing ageism with successful aging have been documented in studies by Toni M. Calasanti (in press) and Sarah Lamb (2014). Calasanti found that her middle-aged US respondents understood the dictate to age successfully and sought to do so. But they also felt that they had limited control over their aging and feared growing old. Their comments indicated that ageism had not been alleviated by their belief in the possibility of successful aging. In Lamb’s (2014) recent study of thirty privileged Boston-area persons aged sixty-two to one hundred, some expressed dismay with the focus on individual control, which they felt as a sense of personal failure or embarrassment when faced with physical decline.

The findings of these studies suggest that adherence to the possibility of successful aging, and individual responsibility for so doing, can serve to justify ageism. As people age, they are asked to demonstrate that they are not old, and they do so by approximating what is taken to be middle-aged behaviors and appearances. Less privileged groups lack access to resources that might enhance their ability to age successfully (Holstein and Minkler 2003; Martinson and Berridge 2015). But in addition, it is not just a middle-aged standard; inequalities such as those based on gender also influence how and when one is considered “old” and thus not aging. That is, not only will old age happen, no matter what resources one has at one’s disposal, but it will be manifested differently for men and women. We discuss how gender might intersect with age relations below.

Gender Relations

Gender has been particularly salient in political economies that make it difficult for women to contribute to the production of goods and reproduction of people at the same time. That difficulty favors men’s control of production and thus wealth, rendering women dependent upon them in relations that require much unpaid labor, an expropriation often sublimated as familial love (Collins et al. 1993). These divisions of labor and entitlement incline men toward regular demonstrations of competence at productive labor (Connell 2005) and women toward regular demonstrations of beauty, as part of the capacity to bond themselves to male partners (Hurd Clarke 2011). Patrimonial relations in which women were reduced to property exchanged between men have given way to widespread individual citizenship for adults in North America and many other advanced industrial contexts (Collins et al. 1993). Still, masculinity and femininity, the activities by which groups distinguish women from men, remain rooted, to varying extents, in those reciprocal but unequal roles. Affiliation with these kinds of work can become a matter of gender identity, the notion that men are breadwinners on account of productive work, that women are objects of desire on account of beauty. Masculinity and femininity have been shaped accordingly, developing sets of gender ideals to which groups hold women and men accountable (West and Zimmerman 1987).

The intersections of age and gender are such that old women in North America may continue to focus on the maintenance of beauty and old men continue to focus on their capacities to perform—in production, strenuous leisure, and sex—as their younger selves may have done. With this chapter, we use self-reports of middle-aged people to assess whether orientations to successful aging reinforce or challenge intersecting inequalities of gender and age.

The Present Study

The data used to assess the impact of successful aging on the everyday lives and gender identities of middle-aged people were gathered by the first author, who conducted in-depth interviews among nineteen middle-aged men and women (ages forty-two to sixty-one) in the United States in 2006–2007 (one interview was conducted by a graduate student). The goal of the semistructured interviews was to understand how middle-aged men and women viewed their bodily changes and aging. Respondents were asked about a variety of related topics, such as bodily changes and concerns, now and in the future; ageism; age-appropriate behaviors and appearances; the meanings and their thoughts about middle age and old age; successful aging; and knowledge and use of anti-aging products and services.

The sample included nine men and ten women; while it was a relatively economically privileged group, and all were white, there was some diversity by class and sexuality in addition to gender. Sixteen were heterosexual, and three were nonheterosexual; three men had never married, and of the rest, one man and three women were divorced at the time. All were employed, with fifteen located in professional and semiprofessional fields, two were in pink-collar occupations, and two (one man and one woman) engaged in more physical or manual labor.

Interviews were conducted in a quiet location that respondents chose, lasted an average of two hours, and were digitally recorded and professionally transcribed. Coding was done iteratively (Miles and Huberman 1994; Taylor and Bogdan 1984) using QSR NUD*IST 6.0; themes were arrived at collaboratively by the first author and a graduate assistant.

Gendered Strategies for Successful Aging

The strategies that these middle-aged adults undertook, and their motivations for so doing, reflected these gendered concerns surrounding performance, professional and domestic productivity, sexuality, and attractiveness. Interviewees were asked about a wide range of products and services that Maxwell J. Mehlman and colleagues (2004, 305) consider anti-aging, including “cosmetic treatments and surgery; exercise and therapy; food and beverages; vitamins, minerals, and supplements; and cosmetics and cosmeceuticals.” For each type, respondents were asked if they employed any of these. If they answered affirmatively, they were asked follow-up questions to discern whether their reasons involved concerns about aging, appearance, health, or a combination of these.

Men and women were equally likely to report about modifying their diets, including taking supplements, and exercising. Throughout his interview, Greg, age sixty-one, talked about exercising as a key to fighting aging, as well as to being healthier and sleeping at night. He commented, “when you get older [there] is this desire for routinization and that’s, you know, I want to exercise because my acupuncturist says . . . you have to exercise every day or else you are not going to sleep.” But women were far more likely to report using products and services that promised to change how you look. Perhaps most revealing is not just which strategies are used—after all, men and women were equally likely to engage in exercise, diet modification, and vitamin/supplement use—but how respondents talked about them. Men spoke of working hard and physical effort, dietary modification, and exercise. They rejected products and services touted as changing bodily appearance without somehow involving hard work. Men stressed the “fight” against ageism and their avoidance of the use of such beauty products as cosmeceuticals.

For example, Greg was adamant about resisting aging “through what I view as being natural mechanisms,” by which he means you must work hard, and not just use products that will change the surface of your body. In talking about the extent to which he feels like he should be trying to fight aging, he says, “Well . . . yeah, I certainly go off and fight the aging process. There’s no question that this guy isn’t spending, you know, seven hours a week exercising, right? What’s he doing? . . . I don’t want this slope-off, . . . this slow-down thing. . . . But I subscribe to the fact that it requires work. It is work. . . . It does not come in a bottle or it does not come in a pill.” He continues, “I will certainly make an effort, but I will not do anything that isn’t natural. . . . I am not paying any nickels for surgery, you know. . . . I am not going to use hair products. . . . I don’t want to be accused of dyeing my hair, I don’t want to be accused of . . . having surgery or something, nip and tuck. . . . I will do everything I can if it means vitamins and supplement and health and good sleeping and rest and all that kind of thing, fine.”

Throughout his interview, Mike, age fifty, expressed admiration for those who were “working at maintaining their bodies.” He says that “when you are my age, it doesn’t mean you are ready to put yourself on a shelf. You just have to work a little bit harder and do a few things to allow you to continue having good quality of life and doing the things that you enjoy doing. . . . To me that’s the whole idea of exercise.” To be sure, women also talked about the importance of exercising, eating well, or otherwise monitoring their bodies, but they never talked about it as work.

That physical performance is key to men’s anti-aging strategies came up repeatedly, and often in contrast to domination in intimate relationships. Men and women alike mentioned products for sexual performance, especially erectile dysfunction, as part of men’s anti-aging arsenal, and this was often in contrast to what they felt women’s products should be doing. Greg’s comments were succinct in this regard: “Well, I think [for] women it’s basically facial appearance, and that’s hair, the whole business, makeup and that kind of thing. . . . Obviously cosmetic surgery and things like that. For men, it’s all about how big your, ah, other brain is [laughter]. . . . It’s all about performance and you know it’s all about . . . picking up women.”

Gendered expectations were also clearly differentiated when respondents talked about bodily strategies more closely aligned with aesthetics. Men and women alike agreed that women’s appearance marks them as old differently, and sooner, and that they should attend to this. Dreama noted that men may get gray quicker, but women better do something about it: “You get that dowdy look, . . . a washed-out look. . . . Men seem to have this charisma when they have some gray.” Maggie, age fifty-seven, said that “I think women are expected to make more of an effort to try to look younger than men are.” And men agreed with Maggie. In fact, in Darryl’s view, concern for how she appears to men is the essence of femininity: “I can tell a difference in women that take pride in being a woman than the ones that don’t care and don’t have any self-pride. I’ve seen women that are not the most attractive, but they do the best with what they’ve got and they worry about it and they doll themselves up—they work with what God gave them. I’ve seen other women that got the tools to work with and don’t care. That disturbs me. . . . It doesn’t take a lot for a girl . . . to try to doll themselves up to look like a woman.” In discussing...