Time for a new approach to aging, say researchers

We usually associate aging with a shrinking life span, sickness and death. The difficulty of imagining ourselves as old means that we go to great lengths to avoid planning for later life. Yet researchers argue that we have everything to gain by looking at life as a journey where preparations for the future provide opportunities for living a full life—until it really is over.

We are all aware that we are aging. Yet there are many of us who would do anything to avoid planning for old age and who feel a reluctance to think ahead. In order not to have to identify ourselves as part of the category "older people," we distance from it by convincing ourselves that we will be a different kind of older people than previous generations.

That is partly a way of processing and coming to terms with the conditions of life, but it is also culturally ingrained because we are constantly told that we should battle aging by staying in shape, eating well and trying to appear younger than we are.

"Ageism plays a key role in the difficulty we have in imagining ourselves as an aging person. It is a complicated form of discrimination that is characterized by stereotypical attitudes about age. The low status of older people means that discrimination issues do not get much attention and this in turn means that certain rights are denied to older people," says Håkan Jönson, professor of social work at Lund University.

The debate surrounding ageism has increasingly gained attention within research, education and societal discourse in recent years. According to Jönson, a social movement among older people aiming to make the struggle against ageism "their" issue is still lacking. Jönson argues that the voices of older people need to get stronger and clearer, and one approach is to involve the people that the issue affects. At the same time, he does not believe that we can accomplish a society in which everyone's voices are heard on a level playing field.

"There is a harshness in society whereby as an older person you are considered to be past your 'sell-by-date.' The truth, however, is that this only happens at death. Older people today are actually far more active than before, and our outdated preconceptions need updating," says Jönson.

The ideal of aging successfully

Seen from a historical perspective, people have always looked at questions about the future and life's course as being outside of their control. These matters have been felt to be in the hands of God. Through new knowledge, we have started to understand that heredity and environment matter, and that our lifestyles affect how long we live.

We have now entered a new era in which technical and medical advances mean that we can more precisely predict how biological aging is going to look and what illnesses we are at risk of developing. This, in turn, means that we have to consider how much we really want to know about our future.

"Many of the illnesses we develop when we get older have a lifestyle element, and the more we know, the greater the opportunity we have to influence our health. The difficult part is that this places a greater responsibility on the individual. There is an ideal about aging successfully, as opposed to 'failed' aging with consequences such as illness," says Jönson.

Avoiding making plans for our own aging can, on the one hand, be pleasant and add to the quality of life now. On the other hand, putting things off means you risk falling behind in terms of your opportunities to affect how you want to live as an older person. For example, many stay living in their own homes for too long, despite the dwellings not being designed for restricted mobility or the use of mobility devices.

"In recent years, physical accessibility in apartment buildings has actually improved. Yet half of all those over 65 live in private detached houses, where people do not tend to think about building for a future as an older person, even if they do spend large sums on remodeling and renovations in middle age. We need to talk more about how housing should be laid out to accommodate the changes that often accompany aging, so that it doesn't feel so dramatic," says Susanne Iwarsson, professor of gerontology at Lund University.

Welfare technology is a major research field

Unless they die suddenly, most people will experience a period of needing health care and social services during their final years. There is research focusing on older people who live with municipal health care and social services and how their social rights can be realized.

Welfare technology is an area of intervention that public authorities hope will be able to address the challenges in health care and social services for older people. At present, safety alarms, electronic locks and cameras for night-time supervision are mainly used, but it is hoped that rapid technological development will provide a range of solutions that will make life easier for those receiving care, their relatives and staff in municipal health care and social services.

"Unfortunately, there are lots of products that are developed without older people with different abilities, needs and desires being involved. For example, much of today's new technology makes great demands on cognitive functions, meaning that people with dementia disorders struggle to learn how to use it. Even among healthy pensioners who have a smartphone, there are many who find it difficult to download an app, for example," says Iwarsson.

Early intervention is important

Active and healthy aging is not primarily about the absence of illness. Being able to maintain daily routines, staying physically active and only needing limited help are important building blocks for a good life. Iwarsson argues that there needs to be a greater focus on health promotion measures, in health care and social services as well as in society at large.

In general, early interventions are important, but we need to identify which measures are needed when in order to gain the desired effect later on. One example would be that within a year of having their first home help approved, 40% of older people need further health care and social services.

"If we can be proactive as soon as that first need arises and support the person in staying active in daily life, there is a lot to be gained, both in terms of the quality of life for the individual, and savings within the welfare sector," says Iwarsson.

Huge opportunities

Iwarsson argues that a paradigm shift in the welfare state is necessary, in which today's reactive interventions make way for proactive measures—from both the individual and society. There is also a need for general education about aging, its challenges and opportunities, in which we need to tone down the significance of chronological age and erase the divide between younger and older people.

"Research about older people and aging is traditionally primarily focused on the part of the population that is 65 years or older. We want to fill in the knowledge gaps that have prevented us from developing proactive methods for welfare services and societal planning. Preparations for the future do not need to be associated with illness, decline and failure. We should instead look at life as a journey with lots of opportunities for living a full life—until it really is over," says Iwarsson.