SECOND EDTTTON
Leslie Morgan • Suzanne Kunkel
CHAPTER 1
Aging and Society
with Robert Atchley
"The individual does not act alone, although conscious beings will do and act as if they had control over their lives and could do what best pleased them.... No person really acts independent of the influences of our fellow human beings. Everywhere there is a social life setting limitations and influencing individual action. People cooperate, compete, combine, and organize for specific purposes, so that no one lives to him/herself." (Blackmar, 1908, p. 3-4).
Aging is something that happens to all of us. It is a natural and virtually inevitable process. Yet older people are often the subject of bad jokes and negative stereotypes, and many people in our society dread growing old. A quick visit to the birthday card section of your local card shop will confirm our preoccupation with aging. Despite this preoccupation, our ideas about what aging really means are notably diverse. Consider:
■ At age 40, people in the labor force are legally defined as "older workers" by the Age Discrimination in Employment Act.
■ Cliff's mother died when she was 73. At age 47, Cliff had become the oldest generation in his family.
■ In 1989, United Airlines Captain Al Haynes was credited with saving the lives of over a hundred people in a plane crash in Iowa. His years of experience were cited as the major factor in his ability to respond so effectively to the emergency. A few months after this dramatic event, Captain Haynes turned 60 and was forced to retire.
■ "Until the mid-sixteenth century.... few people knew exactly how old they were (Cole, 1992, p. 5)."
■ Most people who are age 75 do not think they belong in the "old" age category.
■ At age 16, people are "old enough" to be licensed drivers, at age 18 they are "old enough" to vote, and at age 21 they are "old enough" to drink alcohol. Why do we say "old enough"?
■ Men can join the senior professional golf tour at age 50. The senior tour in men's tennis is for those age 35 and older.
■ There is no age at which a man is too old to legally marry or to father children.
■ Members of the armed forces can retire as early as age 37.
3
4   Part I ■ Understanding Aging
■ At age 90, Ludwig Magener won the national swimming championship in six masters' swimming event.
■ The human genome project could potentially extend life expectancy significantly. What will it mean to be 75, if life expectancy is 200? What will happen to our ideas about education, careers, and grandparenthood?
These examples illustrate two very important points. First, our society has many different formal and informal social definitions of age and aging. Second, the meanings, definitions, and experiences of aging vary across cultures and across time. So, questions about when aging begins, or what it is, can only be answered by paying attention to the social contexts in which aging takes place.
If you ask the person behind you in line at the grocery store checkout to define "aging," she might reasonably respond that it means growing older. But, what does growing older mean? Is it simply the passage of time, having another birthday? Increasingly, scholars argue that chronological age is a relatively meaningless variable (Ferraro, 1990; Maddox, 1988). Age is only a way of marking human events and experiences; these events and experiences a re what matters, not time itself (Botwinick, 1978). Time's passing is of concern only because it is connected, however loosely, with other changes: physical, psychological, and social.
The passage of time for human organisms is related to a large number of specific physical changes such as gray hair, wrinkling of skin and decrements in reproductive capacity, immune system response, and cardiovascular functioning. An interesting question about these physical changes is whether they are inevitable, natural consequences of growing older. In fact, research shows that some of the changes we think of as normal are modifiable, preventable, and related to socially influenced lifestyle choices and cultural practices. For example, while some wrinkling of the skin and some loss of arterial elasticity appear to be related to physical aging processes, it is clear that the magnitude of change and speed of deterioration are affected by lifestyle choices and culture. We know that wrinkling of the skin is accelerated and accentuated by sun exposure and by smoking, and some of the changes over time in cardiovascular functioning are related to diet, exercise, and smoking. Similarly^ most of us know 70 year olds who are as active, healthy, and vigorous as an average 40 year old. Increasing evidence shows enormous variability in physical aging among individuals; this growing evidence of variability has resulted in new ways of describing aging.
In the past, researchers searched for the "normal" changes that accompanied aging; a most important part of this search was to distinguish normal age changes from pathological or disease processes that became more prevalent
Dimensions of Aging
Physical Aging
Chapter 1 - Aging and Society 5
Exhibit 1.1    Variability of Physical Aging
CD C
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Usual
Pathological
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Maturation
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Later Life
Adapted from: Machemer, 1992.
with age but were not caused by aging. With the growing knowledge about the modifiability and variability of physical aging processes, the distinctions among usual, optimal, and pathological aging emerged (Rowe and Kahn, 1988). "Optimal" aging is characterized by minimal loss of physical function and a healthy, vigorous body; "pathological" aging is aging accompanied by multiple chronic diseases and negative environmental influences. "Usual" aging refers to the typical or average experience- somewhere in between pathological and optimal. Exhibit 1.1 illustrates this view of the variability of physical aging (Machemer, 1992). These distinctions reflect new ways of thinking about physical aging as a variable, contingent, and sometimes modifiable set of processes that often have important social components.
As we continue to find that the changes we call physical aging are merely age-linked and not age-caused, that they are in fact modifiable, we are forced to reconsider the question of what aging means as a physical process. The ever-increasing evidence that individuals vary greatly in their experience of physical aging suggests that few if any of the significant aspects of aging are purely or even primarily physical. These issues are discussed further in Chapter 4.
Psychological Aging
Psychological aging processes include changes in personality, mental functioning, and sense of self during our adult years. Some changes are considered a normal part of adult development, some are the result of physiological changes in the way the brain functions, and some psychological dimensions show little change at all in later year. As in the case of physical aging, a wealth of research has explored the complexities of these processes.
6  Part I • Understanding Aging
For our purposes, several generalizations are important. First, personality does not undergo profound changes in later life; most personality traits, self-concept and self-esteem remain fairly stable from mid-life on. For example, people do not become wise, grumpy, or rigid in their thinking as a result of growing older; the grumpy old man was very likely a grumpy young man. Although the developmental challenges and opportunities we encounter do vary through our lives, the strategies we use to adapt to change, to refine and reinforce our sense of self, to work toward realizing our full human potential are practiced throughout our adult lives. The simple passage of time seldom requires or causes fundamental changes to these basic personality structures and strategies.
Similarly, loss of cognitive functioning is not an inevitable result of aging. Just as significant loss of physical function is not mevitabIe~or universal, so too memory and other cognitive skills may remain stable or even improve with age. However, it is important to be accurate here. Research on the physiology and psychology of aging shows that, in the absence of disabling disease, aging causes only minimal declines in functioning until around age 85, at which point about 25% of elders begin to show frailty even in the absence of disease. Chap-ter 5_.provides more detail on the psychological aspects of aging.
Social Aging
If aging brings only relatively small universal and inevitable changes in physical or cognitive functioning, in the basic structure of personality, and in the trajectory of adult development, why does it matter in people's lives? In this book, we argue that, at least before age 85, age is significant primarily because of the social meanings, structures, and processes attached to it. Gray hair, wrinkles, longer reaction time, and even some short-term memory loss matter only because the social world in which we live has defined those characteristics as meaningful. Much of the social meaning of aging is tied to erroneous beliefs about the effects of aging on physical and mental capabilities. Aging does not inevitability cause us to become rigid in our thinking, forgetful, or unable to carry out our favorite physical or intellectual activities. For most people aging is a process of change that is so gradual that we compensate for most of it so that it has little impact on our lives.
The importance, meanings, and implications of the changes people experience as they age are heavily influenced by, or we might even say constructed by, the social reality in which those changes take place. Society uses age to assign people to roles, to channel people into and out of positions within the social structure, as a basis for allocation of resources, and as a way to categorize individuals. In its most benevolent form, using age to allocate opportunities is a reasonable mechanism. For example, our society has rules about minimum ages for employment; these laws were designed to protect young people from being exploited, and, according to some, they are good for the labor force because they control the flow of new workers into the labor market. In a more constraining
Chapter 1 • Aging and Society 7
way, however, age artificially and inequitably limits the opportunities of people. Gray hair and wrinkles, perhaps the most visible signs of aging, and the chronological age of 65— the most often-used criterion of old age— have no effect on physical functioning or cognitive capability. They do, however, have profound effects on social interactions and role opportunities for individuals in the social world. Whether we would seriously consider someone as a possible candidate for a job, or as an interesting partner in social interaction is, in fact, influenced by our assessment of the age of that person and what that person's age symbolizes to us. Again, it is not because age 65 or gray hair are symptomatic of competence or incompetence or of a boring or dazzling personality, or even that visible signs of aging are inherently unattractive or attractive. We make these assessments because we live in a society that has constructed the meaning of aging in particular (primarily negative) ways.
It is important to think about the extent to which the very same processes work at other ages and stages of life. In our culture, it is possible to be "too young" just as it is possible to be "too old" for certain roles and opportunities. We have very clear social prescriptions, often in the form of federal and state laws, about when a person is old enough to drive a car, get married, and be president of the United States. In these examples, "old enough" seems to imply the window of opportunity between legally too young and socially too old.
Social aging is a multidimensional and dynamic force. It includes the transitions into and out of roles, expectations about behavior, societal allocation of resources and opportunities, negotiations about the meaning and implications of chronological age, and the experience of individuals travelling the life course and negotiating life stages. Chapter 6 explores these issues in detail, and the chapters in Part Three apply the concepts of social aging to the major dimensions of our social lives.
The ways in which the experiences of aging are largely constructed by society is an example of an important sociological idea: the "social construction" of reality. This concept suggests that reality does not exist "out there," waiting to be measured and known._Rj[flTer, reality is created out of interactions among humans and by the socialinstitutions in which people live therHives. For an illustration of the gap between physical reality and people's lived experience aspect of aging, think about witnesses to an unusual event, such as an auto accident. While we know that there are "facts" in such a situation— for example, the color of the cars, the direction and speed they were traveling—eyewitness accounts often vary greatly on even these details. Human beings pay attention to different things, remember different things, and report different things. If one of the people in the accident is a friend of a witness, the witness might be motivated (consciously or unconsciously) to notice and report details that will be favorable to the friend. In our everyday lives, we see differences in how people interpret a word, phrase, or gesture. And we can observe the ways in which people communicate in order to make sense out of the social world, reconstructing events, providing meaning, creating accounts of what is happening.
8   Part I' Understanding Aging
So, we construct reality out of interaction. Social institutions also play a major role in creating the experiences of individuals living in society. We will explore this idea throughout this book.
Population Aging
Beyond the "social construction" of aging, social forces influence the experience
of aging in another important way. Societies themselves experience aging. As the proportion of population in the "older" age categories increases, profound changes in the social structure take place. Societal aging— these demographic, structural, and cultural transformations— affects every aspect of social life, from social institutions to the experiences of aging individuals. Health care, education, and the economy are good examples of social organizations and institutions that are affected greatly by the growth of the older population. Our health care system faces special challenges as we plan for the long-term care needs of increasing numbers of older people. The impact of population changes on the educational system in the United States can be seen in the growing number of attempts to address the needs of older learners and in the growing number of college and university programs targeting the older population. Some of you may have summer Elderhostel programs at your institutions or free tuition available for students over age 65. The University of Massachusetts at Boston has a certificate program in gerontology; over half of the hundreds of people who have earned that certificate are over the age of 60. The impact of population aging on our society is discussed in greater detail in the chapters of Part 3.
Another impact of the growth of the older population is the increased visibility of aging. Because there are more older people in the general population, more people are aware of the diversity among older individuals. As older people become more numerous and visible, stereotypical attitudes and discriminatory practices that disadvantage older people are more likely to be challenged. For example, in comparing magazine advertisements in the year 2000 to those from 1980, we see a definite increase in both the number of ads that feature older
Societal aging, and its consequent increase in the proportion of older adults, requires societies to make adjustments in many areas of social life.
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people and in the average age of many models (other than the "supermodels" who still are very young). While most people in ads are still young, the increased visibility of older people begins to change our images of aging.
The aging of a population influences how aging itself is a social construction. As cohorts of different size and with unique characteristics move through the age structure, they are affected by, but also have an impact on, the experience of being older. The baby boomers will experience aging in a very different way than the current generation of older people. There are growing challenges to pervasive negative stereotyping of older people, including age discrimination legislation, increasing visibility of and diversity among older people, and increased targeting of products and services to an aging market. When these social changes combine with the political activism that has historically characterized the baby boomers, and with their potential power in the marketplace and in the polling booths, their experiences and definitions of aging will be altered. We are already seeing more middle-aged and older people in advertisements and as lead characters in TV shows. In addition, products and services designed for middle-aged and older generations are appearing with increasing frequency.
The aging of groups of older people also has an impact on social institutions such as the economy and health care. For example, the current generation of older people grew up during the Great Depression. Their investment, purchasing, and savings habits have been shaped by that experience; they tend to save at higher rates than other groups of adults, especially the baby boomers, and they are less likely to make risky investments or purchases. The baby boomers grew up during relatively comfortable economic times, are not good savers, and are more likely to make non-essential purchases. During the past decade we have seen tremendous growth in the "games for adults" industry; a walk down the games aisle at your neighborhood toy store will reveal a very large number of board games designed for adults, far beyond the number available just ten years ago. This trend is related to the purchasing power, leisure preferences, and buying habits of baby boomers. You can use your imagination to think about new leisure, health care, or convenience products for aging baby boomers. Thus the aging of cohorts (groups of people born at the same time), as a dimension of population aging, has an impact on the economy: on product and service development, on savings, and on consumer demand patterns.
With these examples we do not mean to oversimplify societal aging, or social change in institutions such as the economy. Rather these examples are intended to illustrate how the experiences of aging, and the social contexts in which they take place, change over time as a result of the aging of unique cohorts. As new groups of people go through stages of growing older, they bring with them a unique historical profile, and they alter meanings, values, and norms associated with growing older. The movement of new groups into old age also places new demands on the social system. Changes to the social structure emerge in response to the size, characteristics, and demands of each new group of older
10  Part I - Understanding Aging
people. The intricacies of this dynamic recreation of the meanings, opportunities, and values associated with the later stages of life will be discussed in further detail in later chapters. For our purposes at this point it is important to acknowledge that societal aging is a significant dimension of the social processes of aging. We can define societal aging as the demographic, structural, and cultural transformations a society undergoes as the proportion of its population that is aging increases.
Ways of Categorizing People by Age
As we consider the many dimensions of social aging, we need a way to mark or measure the age of individuals. Most often people are categorized using chronological age, functional status, or life stage. Each type of measure has advantages and disadvantages, and the decision to use any measure should be based on the conceptual assumptions and frames of reference underlying them.
Keep in mind that whether we use chronological age, functional need, or life stages, we are applying socially constructed labels and definitions, which allow us to treat people as members of meaningful social categories. We use these definitions in many ways: to determine the proportion of people in various age groups, to predict significant attributes of specific individuals, to select a specific target for social action or policy, to define a subject of study, and in many other ways. Remember, all these definitions, including chronological age, are human creations designed to serve a purpose. In selecting definitions of aging or age categories, we need to be conscious of our underlying purpose and select our definitions accordingly.
Chronological Age
This is one of the simplest assessments of age and thus it reduces administrative complexity. Chronological age is used in our society as the basis for determining many social roles (voting, driving, marrying, holding public office), for eligibility in social programs (such as Social Security, AARP membership, or Older Americans Act services), and inclusion in research projects.
The use of chronological age to mark major life transitions is taken for granted in modern urban societies. However, it is a relatively recent development coinciding with the rise of bureaucratic industrialism (Moody, 1993). The industrial economy required that human lives be ordered efficiently so that work years coincided with the years assumed to be associated with peak productivity. Chronological age was adopted as a simple way to define a worker's life stage.
The meaningf ulness of chronological age is questioned in many ways today, however. The number of birthda)^ an individual has had tells us little in and of itself. The fluidity and multiplicity of today's life styles defy the use of bound-
Chapter 2 ■ Aging and Society  11
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aries so rigid as numerical age (Moody, 1993). When it is possible to have two career peaks— one at age 40 in your first career, and a second at age 60 in your second career; when it is increasingly common to find people having children when they are forty— about the age at which others are becoming grandparents— the usefulness of chronological age as a life stage marker is indeed questionable.
In the world of social policy and programs, the validity of age-based policies and pro-
grams is being questioned at another level (Torres-Gil, 1992). The age for eligibility for full benefits under Social Security is gradual ly being raised, so that by the year 2027 you will need to be 67 to retire with your full benefit. Older Americans Act services, for which people are eligible at age 60, are increasingly being
12  Part I ■ Understanding Aging
targeted to groups within the older population with the greatest need: frail, low-income, and minority groups. In general, policies seem to be moving away from such a central focus on chronological age. We will discuss these policy issues in greater detail in Part III, but these policy shifts are further examples of the challenges to the meaningfulness of chronological age.
Functional Age
What measures or markers of age will we use if chronological age continues to lose its meaning, significance, and utility? In the case of policies, programs, and services, increasingly common is the "targeting" of services to specific groups of people in need of certain kinds of assistance. For example, if we are interested in identifying people who have physical limitations that require assistance by another person, we can use measures of functional need such as Activities of Daily Living, a generic term for several scales that measure an individual's ability to accomplish, without assistance, routine personal care activities such as bathing, eating, dressing, and getting in and out of bed. Such measures are useful if we are interested in targeting home care programs to those who need them because of physical frailty. To the extent that we continue to use age as a convenient way to determine eligibility for services, we are assuming that age is a proxy for the need for those services. Functional status is a way to move beyond that negative assumption about age, but it is obviously a much more complicated way to grant access to programs and services.
Life Stage
As lives progress, people tend to reach certain plateaus of stability (life stages) punctuated by period of change. Thus people can be categorized as being in roughly comparable circumstances, such as adolescence, young adulthood, middle age, and later maturity. We can assume that people going through the "empty nest" transition have living adult children and are in the process of launching them into lives as independent adults. We can assume that people in very old age (sometimes call "old-old" age, referring to people 85 and above) are probably physically frail and live quite simple lives. Life stages are thus broad social categories that encompass changes in social roles, physical changes, and societal and self-definitions of transition.
Life stages roughly correspond to chronological age ranges, but are much more fluid, dynamic, and socially negotiated than chronological definitions of age. For example, when is someone an adult? When they move out of their parents' home, reach age 18 or age 21, have a child, have a full-time job, act mature? Life stages rely on some information about physical changes, but are much more attentive to social attributes such as the roles people play. For example, the "empty nest" described above implies something about chronological age, but derives its meaning from the new family roles and relationships emerging