Abstract:
My research career began focused on age-as-deficit; then, when studying productive aging, I moved to an age-as-asset perspective. I have come to another understanding of later life: deficits and assets exist within older adults and within the older population. We must tell the full and accurate story of aging and eliminate artificial limits curtailing engagement in life. Real limits exist as our bodies grow old; but powerful artificial limits are created by physical and social structures, policies, organizational practices, attitudes, expectations, and internalized beliefs about aging. If we eliminate artificial limits, we might handle real limits better, both individually and as a society.
Key Words:
ageism, productive aging, internalized ageism, age-friendly
My scholarship has focused on the productive engagement of older adults. The concept of productive aging originated more than 40 years ago. Dr. Robert Butler, the first director of the National Institute on Aging, introduced the term out of dismay over the discounting of older people and the rampant ageism in this society (Butler & Gleason, 1985). He railed against the negative characterization of older people as a drain on society and against the prevailing view of age as deficit. He advocated for moving attention away from the problems of old age to a more realistic picture of the current and potential contributions of older adults to families, communities, and societies.
Butler (1997) argued that our society needed the capacity of older adults as workers, volunteers, and caregivers. From these advocacy roots came a new paradigm for population aging wherein the capacity of older adults is recognized as a resource for families and communities and older adults are seen as assets (Bass et al., 1993).
I got on Butler’s productive aging bandwagon about a decade after scholars began developing conceptual frameworks and conducting analyses to understand antecedents and outcomes of productive engagement. That is not where I had started my scholarly work. As a gerontological social worker, I began my academic career with a focus on the problems, on addressing the need for assistance in the older population. My research centered on aging network services: who needed what, who got what, what were the barriers and unmet needs, what were the outcomes. These were, and still are, very central topics for a gerontological social worker.
Over time, I became aware that I was very unevenly exposed to the experiences of growing old and later life. In my work, all older adults were clients or patients—in need of assistance. My profession is devoted to helping people deal with challenges they face in everyday life. Social workers see people because something is wrong, because there is a social, psychological, or financial need. We are overexposed to problems, tough situations, and poor quality of life. It is easy to overgeneralize. I was totally immersed in the age-as-deficit reality. These issues are real, they are challenging, and they deserve our professional commitment.
When my colleagues and I at Washington University began to study the productive aging literature, I became aware of another reality, another side of the story about aging. Butler’s productive aging paradigm was an antidote for me, as it was to a field focused on the problems of aging. In my new scholarship, we focused on older adults doing paid and unpaid work, and we focused on programs and policies to optimize this engagement. We talked about positive outcomes to communities and society and how to ensure the best outcomes for the older adults themselves as workers, volunteers, and caregivers (Morrow-Howell et al., 2001). My new perspective: age as asset.
There are real limits as we grow old and there are artificial limits.
From the beginning of the scholarship on productive aging, there have been critics. Scholars and advocates worried about the potential to exploit and marginalize older people, especially those who had been disadvantaged over the life course. Moody (1993) argued that the productive aging paradigm forwarded the values of growth, energy, activity, accumulation, and efficacy, and suppressed a wider vision of later life. Scholars acknowledged that the paradigm was intended to confront the age-as-decline and the greedy-geezer narratives; but they were concerned that it was an extension of market logic, where economic worth was the highest value and where individuals who could not “produce” would be denigrated (Estes & Mahakian, 2001; Holstein, 1999).
Further, I often heard from others that my perspective was too optimistic, that it denied the reality of decline and incapacity. It denied the realities of later life for many (if not most) people and the end of life.
I am now at a different place, and I have arrived here for several reasons: I have entered my 7th decade of life; I have become involved in the Gerontological Society of America’s Reframing Aging Initiative (www.reframingaging.org); and I am surrounded at my university and community with heightened attention to diversity, equity, and inclusion. With these changes, I have reframed my own aging and scholarly work on productive engagement. I understand more about the concerns regarding the productive aging framework, and I am more aware of solutions.
I have concluded that the productive aging perspective enables us to “tell the whole story,” which is an accurate story of aging and older adults. Yes, there are declines and the need for help; and many older people are challenged or unable to engage in the roles we are advocating. There is truth to Bette Davis’s famous line: “Old age ain’t no place for sissies!” At the same time, there is much functional ability, human capital, vitality, and courage. Age as deficit and age as asset are both true at the same time. It took me a while to truly embrace this in how I think about aging. Neither side of the coin will do. If we focus on the deficits, we perpetuate stereotypes and “the elderly” become a monolithic group of dependent people.
If we focus on the capacity inherent in this group, we risk ignoring the need for services and the compromised functional positions most of us will experience.
Perhaps my strong leaning toward the assets of aging, the opportunities in older societies, was necessary to counteract the age-as-deficit narrative that was so pervasive in gerontological social work. But now I strive to tell the full story. Older adults need caregivers and older adults are caregivers; older adults need home-delivered meals and older adults deliver meals. Some older adults can work longer and some can’t. I’m personally experiencing both sides of aging: there is loss of strength, loss of physical resilience, and loss of speed; and there are new understandings about purpose, moderated emotions, wiser perspectives, and increased generative commitments. My realities have increased my understanding of deficits and assets.
Over my academic years, the realities about biological, psychological, and social aging are largely the same. I teach the same content, but I teach it differently. I lead with the heterogeneity of the older population—key message number one. I follow with stats that show how many people older than age 65 can do something as well as how many cannot. We usually show charts that report how many people in certain age groups have a specific condition or disability. What a different (yet true) story to report that 81% of the U.S. population older than age 65 does not report any significant disability (Administration on Community Living, 2021).
Alongside charts that show the upward trend of cognitive impairment with advancing age, I emphasize that most people live their lives without experiencing dementia. I make sure to point out that death is universal—most of us will experience chronic conditions, disability, and dependence, and all of us will die. There are limits to human functioning.
There are natural limits to our abilities. Many of us will lose the ability to work, to volunteer, to drive, to shop, to manage our own finances. I have gained some clarity that a significant challenge for us is to recognize that there are real limits and there are artificial limits. In the productive aging paradigm, we focus on artificial limits—organizational practices and physical and social environments that curtail engagement. We focus on policies and programs that could engage the capacity of the older population. Removing barriers and creating opportunities—these are words about eliminating artificial limits. Real limits in human functioning exist but, if we operate from an age-as-deficit perspective, artificial limits look like real limits.
Of course, gerontologists have long recognized the role of environment in enabling function (Lawton & Nahemow, 1973) and the role of policies and programs in shaping productive behavior (Bass & Caro, 1996). My new understanding is that these interventions are aimed at artificial limits. Further, gerontological professionals, including doctors, rehabilitation therapists, social workers, as well as family members, have struggled to identify what is artificial and what is real. I think that in general, we have exaggerated the “real limits” because it is more convenient. “You can’t do this because you are old,” rather than “you can’t do this because we don’t have the time (or resources, or structures, or knowledge) to facilitate that.”
One artificial barrier has become clearer to me: internalized ageism.
The age-friendly environment movement (including communities, healthcare systems, workplaces, and institutions of higher education) is based on the notion of eliminating artificial barriers. Some artificial barriers are clear—physical structures that prevent easy access, policies that work against older employees, or practices in higher education that discourage engagement of older students. Others are less obvious: societal norms about what older people should and shouldn’t do, family and organizational expectations that are age-based, and healthcare decisions that incorporate chronological age into the calculus. There is one artificial barrier that has become clearer to me: internalized ageism.
Internalized ageism is self-directed ageism and occurs when age stereotypes learned across the life course are assimilated and believed; these internalized messages are activated in later life (Levy, 2022). Well, at age 71, these ingrained ideas about being old are raising their ugly heads. Should I retire because it is expected of me? Is my hesitancy to drive at night due to real sensory declines or due to lack of confidence? Is my forgetfulness worse than it has ever been and is it dementia? It is complicated because I don’t know what is a real limit and what is artificial.
I have come to understand that ageism is a big part of the challenge to achieving a “productive aging society” (Bass et al., 1993) and I have come to situate it more clearly among the biases that limit the potential of longer, healthier lives. Ageism exists alongside racism, sexism, homophobia, classism, ableism, and other isms that thwart opportunity and pervert attitudes and expectations. My increased awareness of ageism as an artificial limit has heightened my appreciation of the unnecessary barriers to long and healthy lives created by the other biased beliefs related to race, ethnicity, gender identity, etc.
My productive aging lens is now different; my understanding of later life is now different (but still incomplete, I imagine, until declines in health prevent the engagements that I love). The full story of aging involves deficits and assets. Both sides exist within individual older adults and within the older population. We cannot focus on just one side. We must develop programs and policies for both sides. We must tell the full and accurate story of aging, and design accordingly. But no program or policy will be enough to facilitate productive engagement and long and healthy lives if ageism continues to permeate society. Ageism cannot be considered in isolation from the other prejudices that plague our society; nor can it remain as invisible and pervasive as we have let it be to this point.
Real limits exist as our bodies grow old; but there are powerful artificial limits created by physical and social structures, policies, organizational practices, attitudes, expectations, and internalized beliefs about aging. If we can eliminate artificial limits, we might handle real limits better, individually and as a society—with more formal and informal support, with more compassion, with more dignity.
Nancy Morrow-Howell, PhD, is the Betty Bofinger Brown Distinguished Professor of Social Policy at Washington University in St. Louis.
Photo credit: Shutterstock/beeboys
References
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