Rethinking Aging in Context

Systems thinking often involves moving from observing events or data, to identifying patterns of behavior overtime, to surfacing the underlying structures that drive those events and patterns.

~ Michael Goodman / thesystemsthinker.com

Aging in Place

The underlying assumption with “aging in place” is that older people are capable of remaining home by choice. Along with this idea is the notion that human development occurs throughout the life-span and not limited solely to youth (aka Critical Gerontology Theory).

But to embrace this concept our society must change its view of what it means to grow old. As has been pointed out eloquently over a decade ago in Nortin M. Hadler’s thought provoking book, Rethinking AGING (UNC Press 2011), The secret to longevity is the structure of society, not whether anyone eats bran (p.50). It is the social construction that Americans have been taught and nearly all have accepted about aging and its issues, that really matters (aka ageism).

Systems Thinking

To really understand how we age, a systems approach is essential. To think that a bottle of “high-tech snake oil” is going to reverse aging, or that low T can be fixed by a magic elixir without long-term side effects, is a fools errand. So called “Successful Aging” is done in context, that is, it can occur if multiple conditions are met. For example, as Dr. Hadler explains:

Social inequalities burden people who are in their older decades at least as much as they did earlier in life. This burden goes well beyond purchasing power. This is dramatic even in Norway, despite its egalitarian ideology and a national health service. People with a higher education live substantially longer than those with a basic education (p.10).

Hadler goes on to say:  One’s position on the socioeconomic gradient prior to retirement is the major determinant of one’s health in later life and one’s longevity. And he further notes: But health adverse behaviors explain only a fraction of the effect. More malevolent are the moral hazards that lurk in our neighborhood, in our self-actualization, in our wealth or lack thereof, in the stability of our income stream, in our family structure, and in our intimate relationships. This is no reason to assume that any particular influence or combination of influences pertains to a given individual. The secrets to longevity are in the fine structure of human ecology.

The New Longevity

Having expressed all this, it’s important to understand that in the mid-twentieth century the temporal gap between traditional “retirement” and death was narrow indeed–so narrow in fact, that it drove the construction of facilities dedicated to the compassionate shepherding (Hadler’s term) of the elderly through the final transitions of life soon after the ending of “productive” life.

At issue, is the fact that “rest homes” are an outdated concept both socially and logistically–the majority of aging Americans will be aging in place and doing so for many, many years to come.  Thus, successful aging in place, not unlike successful aging itself, will require a systems approach (theme here).

Technological advances and aging in place remodeling features, as well as aging-in-community supports are pieces of the puzzle–but not the full solution.

The most important line in this post is: The secrets to longevity are in the fine structure of human ecology. Our focus on longevity and aging in place in this country is short-sighted, piecemeal, quick-fix, and death-denying in its limited scope. Solutions will take a mature and sober eye, encompassing a wide array of concepts from the physical sciences like biotechnology, to the built environment of affordable housing, shared housing, village concepts, and/or some combination of new technology driven solutions. To be effective they will all have to be considered within the fine structure of human ecology–anything less is doomed to fail.

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Aging is contextual–that is, it happens within context of a larger system.