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Summary

The previous chapter outlined the argument that the successful ageing paradigm seamlessly ‘translated’ or ‘migrated’ into the anti-ageing industry (Flatt et al, 2013). In this chapter, I argue that successful ageing ideas have also made their mark on policy, feeding into the notion of active ageing. Active ageing is ‘primarily a policy concept’ (Juul Lassen and Moreira, 2014, p 33). Gerontologists have contributed to the translation of successful ageing ideation into the policy sphere, where the ideas take on a more practice-oriented form; this is a manifestation of what I call modelling ageing.

The meaning of active ageing remains somewhat vague, largely because the actors who employ the concept use it ‘as a convenient term for a wide range of policy discourses and responses concerning demographic change’ (Walker and Foster, 2013, p 28). Despite this blanket application, Foster and Walker (2015) argue that active ageing has emerged in Europe as ‘the foremost policy response to the challenges of population aging’ and that it ‘presents a more holistic, lifecourse- oriented approach than successful aging’ (p 83). Immediately following this statement, however, Foster and Walker qualify that the active ageing perspective ‘has been dominated by a narrow economic or productivist perspective that prioritizes the extension of working life’ and ‘has also been gender blind’ (p 83). Foster and Walker argue that the active ageing paradigm is split into two contrasting branches, one focused on productivity and employment, the other more ‘social’ and all-encompassing; a ‘comprehensive, non-coercive and inclusive approach’ in keeping with the latter type of active ageing is endorsed by Foster and Walker (2015, p 84). Their view of the concept is deeply bifurcated into ‘the good’ meaning of active ageing (understood as attempts to help everyone to age well, in accordance with their resources and with the help of supportive policies) and the ‘bad’ meaning of active ageing (understood as agendas for driving productivity and growth without regard to structural barriers that many older adults face). The parallels to the confusion over the meaning of the concept, and the objectivist and subjectivist understandings of successful ageing (outlined in Chapter Two) are striking.

Summary

In this chapter, I take the first steps towards the model ageing theory. I employ the term ‘model’ in two different but closely related ways.

First, I use it to describe what various actors do with and to ageing, and what then ensues: they model (verb) old age and the people who are defined as old. As a result of this modelling, different models (noun) of what are good, appropriate, proper ways to age have come into existence. Use of the terms successful ageing, active ageing, positive, healthy, productive ageing and so on is ubiquitous and variable. However, all these concepts attempt to model ageing as a phenomenon and stage of life that is perceived to be in need of direction, reshaping and control.

For instance, gerontologists model (verb) successful ageing by generating data on how people within the older population fare (how long they live, how healthy they are, to what extent they take part in paid and unpaid work) and then assigning labels that signal how different categories of old people are performing (‘normal ageing’, ‘pathological ageing’, ‘successful ageing’ and so on). In addition to gerontologists, policy makers are very interested in older adults, and so they have also sought to model (verb) old age policy and older adults’ incentive structures in a particular way, for instance in a direction that would be encouraging of longer working lives. Businesses and entrepreneurs are another group interested in old people, in their case as consumers of goods and services, and so they also model (verb) their target group in a particular way: typically as dynamic and attractive, provided they become consumers of various goods and services.

As a result of the efforts of these actors who model ageing, models (noun) of ageing have come into existence. For instance, the model (noun) of old age that suggests that older adults should continue working until retirement – and preferably longer – is now firmly a part of the definition of how to age appropriately in most developed welfare states. Another widespread model (noun) of ageing pertains to the idea that older adults should consume goods and services, that is, that they should promote both their own well-being and the good of the economy as a whole through their consumer power and choices.

Summary

Puzzlement and curiosity underlie all discoveries and advancement of understanding. The discourses and scripts around ageing are replete with paradoxes, puzzles and contradictions that make me wonder about the ageing societies we live in. Paradoxes, puzzles and contradictions can be frustrating in practice, but they are also ripe material for theorising because they make us ask: ‘why do they exist?’ and ‘what do they tell us?’ – and even ‘whose interests do they serve?’ In the course of seeking to understand seemingly irreconcilable and contradictory phenomena, theory in the sense of accounts of what explains the existence of and relationships between (conflicting) concepts emerges. I will begin by drawing out some of the key paradoxes and puzzles in contemporary ageing-related discourses, with a view to identifying sensitising concepts that are important starting points in developing new critical insights and theory.

Despite policy documents, marketing and media exhorting older adults to remain active contributors to society and to maintain their independence, older adults are often construed in ambivalent terms in parallel discourses. The paradigms of active and successful ageing (and the centrality of agency and individual responsibility inherent in these) are evident in, for example, the expectation that older people must act as ‘informed consumers’ who make choices and assume responsibilities regarding their own care (Bertelsen and Rostgaard, 2013). Yet older adults (especially those with care needs) are often treated as lacking personhood and agency (O’Dwyer and Timonen, 2010). I label this

• the paradox of (in)dependence: exhorting independence among a group of people who are simultaneously construed as dependent and vulnerable.

What might explain this paradox? I will offer explanations in subsequent chapters, but my opening gambit is that this paradox exists because policy and literature are in fact not referring to the older population in totality but, rather, sending messages about sub-groups that they consider somehow problematic, in contrast to groups that are adhering to ideals of ‘ageing properly’.

Policy aspirations pertaining to older populations have a strong gender dimension, both because women form the majority in older populations and because the aspirations have more extensive ramifications for women's life courses, which have traditionally diverged more than men's from some of the paths and patterns that are now prescribed (especially with regard to paid work).

Summary

‘Model ageing’ vs anti-model

Chapters Two and Three have provided ample evidence of the productivity of policy makers and academics in developing and ‘selling’ the concepts of active and successful ageing. I have already alluded to my aim to examine these two concepts, as well as other related concepts such as productive, positive and healthy ageing, under the umbrella term of model ageing. This chapter elaborates on the case for viewing the notions of active and successful ageing, as well as other ‘prescriptions’ for ageing appropriately, through the prism of model ageing – an integrative concept that throws light on the reasons for, and the consequences of, thinking about ageing populations within models of ‘how to age well/properly’.

In order to examine the interface of these models and individual experience, I will employ the heuristic devices of ‘model’ and ‘antimodel’ older person – ‘model’ being aligned with active/successful ageing, and ‘anti-model’ deviating from the model behaviours and outcomes. We can begin to understand some of the parameters of being a ‘model older person’, as well as obstacles to becoming a ‘model older person’, by reflecting on who might fit the model, and on those who do not conform to it. The ‘model’ ageing citizen is a social construction and a policy aim; but it is also manifest (embodied) in people who (intentionally or unwittingly) adhere to (elements of) the model.

We can surmise that some of the ‘model agers’ are privileged (for instance a professor who continues to work in her 70s – because she can, and wants to); others are socially disadvantaged (for instance an older low-income worker who derives no enjoyment from his menial and exhausting work but needs the income). Some enjoy fitting the ‘model’; others resent it. However, it is important to acknowledge that we know little about the lived experience of being an ageing ‘model citizen’, or the ‘antithesis’ of the model. Investigating the lived experience of ‘model citizens’ is important for scholarly and policy reasons, because this helps to elucidate the drivers of and obstacles to ‘model’ behaviour. But we cannot fully understand the dynamics of the model unless we also study people who do not adhere to the model, and stand in stark contrast to it.

Summary

The ubiquity and longevity of successful ageing

If you have had any exposure to gerontology, the study of ageing, the chances are that you have come across the concept of successful ageing. Indeed, if you observe any Western ageing society you will come across the term very quickly: in advertising, policy documents and in the media. However, if asked to define the concept, you would most likely proffer a different definition than the next person (even if you are both gerontologists). This is because successful ageing is a construct that has no single widely accepted and applied definition. Depp and Jeste (2006), in their review of 29 successful ageing studies, identified almost as many (28) definitions of successful ageing. Cosco and colleagues (2014) identified 105 operational definitions of successful ageing. This does not mean that the concept is unimportant, or too vague to have exerted an influence on the study of ageing. On the contrary, the fact that diverse definitions abound demonstrates the ‘appetite’ for a summative concept like successful ageing, in the sense of a desire to spell out what it is, and who is living it – in all cases underpinned by a particular understanding of what constitutes ‘success’.

The idea of a ‘recipe’ of successful ageing is old: one of the earliest examples of pointing to a path to a good old age can be found in Cicero's (106–43 BCE) De Senectute(‘on old age’). When his two young friends enquire about the positive and negative aspects of old age, the elder statesman Cato responds that he continues to enjoy intellectual activities; does not miss the physical vigour of his youth; and has adjusted his activities to be manageable. For Cato/Cicero, old age ‘may well be very busy indeed, always in the middle of some activity, or projecting some plan – in continuation, of course, of the interests of earlier years’. However, Cicero was dismissive of advice regarding good old age: ‘Advice in old age is foolish; for what can be more absurd than to increase our provisions for the road the nearer we approach to our journey's end.’ Notions of successful ageing, therefore, have abounded through history, but few recent writers have taken Cicero's reluctant stance on sketching out how to age well.

Summary

In 2014 I became preoccupied with the idea of successful ageing and cognate concepts such as positive, productive, active and healthy ageing. It seemed to me that these concepts shared something – a family resemblance, if you like. I found myself wondering: what do these concepts that seek to encapsulate ‘ageing well’ have in common? I had of course come across these concepts before then, many times, but perhaps there was something about another birthday bringing me a little closer to ‘old’ that set off a keener interest in the concepts. I was also aware that yet another ‘Centre for Successful Ageing’ was about to be opened in a local hospital, and I started to marvel at the longevity and prevalence of this concept that had always struck me as bordering on marketing lingo.

A Web of Science search, using the key words ‘successful’ and ‘ageing’ (or the US spelling ‘aging’) resulted in staggering 2,743,785 hits, despite the search's being limited to recent publications. It is evident that in addition to policy makers and salespeople who promote successful and active ageing as a way to achieve their aims (reforming old-age policy, selling stuff to older people), academics and researchers have generated a huge corpus of work around these concepts. There are also many academic works that challenge the concepts of successful and active ageing; yet the literature lacks a comprehensive, theory-oriented critique of these ubiquitous concepts. Perhaps this is not surprising in view of the fact that people who conduct research on ageing are one of the vested interests that drive the use of these concepts.

There is one book in particular that made me quite determined to marshal a comprehensive critique of successful ageing, active ageing, and related concepts. The book is entitled Winning Strategies for Successful Ageing (Pfeiffer, 2013). I found this book so astonishing that I felt I had no choice but to take to task the concepts that incorporate ‘models’ (noun) of ageing – and those who ‘model’ (verb) ageing in the sense of presenting ideas and ideals of how to age well – hence my term ‘model ageing’. The following are selected highlights from Pfeiffer's manifold exhortations and advice for older adults who want to age successfully.

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Three - Critique of active ageing models

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Five - Towards a theory of model ageing

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One - Paradoxes and puzzles in ageing societies

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Miscellaneous Frontmatter

Four - The problem with modelling ageing

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Frontmatter

Two - Critique of successful ageing models

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Preface

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5 - Leadership in interprofessional dementia care

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Glossary

8 - Person- and relationship-centred care in dementia

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Acknowledgements

List of figures and tables

Appendix

Contributors

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1 - The Model of Interprofessional Practice and Education – Dementia

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3 - National and international perspectives: Interprofessional education and collaborative practice

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Introduction to dementia

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6 - Personal and professional knowledge

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