Successful Aging as a Contemporary Obsession, edited by Sarah Lamb, is a timely, thought-provoking collection of sociological and anthropological studies that critically tackles the neoliberal, Global North paradigm of healthy-active-successful aging. The authors are reputable scholars in the field of aging studies and/or medical anthropology, who have spent their careers investigating the various cultural understandings and practices of aging meaningfully.
‘Successful aging’ is understood here, as elsewhere in Lamb’s (2014) writings, to refer to a cultural-historical model of growing old, deeply ingrained in philosophical principles of individualistic personhood, bio-political ideologies of aging as a controllable process rather than a normal life stage, and neoliberal values of productivity in later life. Although intending to create a positive view of old age, the paradigm of successful aging ironically ends up, as some of the contributors argue, reinforcing ageist attitudes by “pursuing the goals of agelessness and avoiding oldness” (p. 7).
The book does not set out to target directly the tensions and contradictions inherent in the very model and practices of the successful aging ideology; rather, the contributors take a reverse approach. The failures implied by ‘successful aging’ (i.e. being interdependent, relying on families and communities, frailty and decline, both physical and cognitive) are presented as alternative and, more often than not, desirable ways of aging. In this respect, the book does not demonize the ‘successful aging’ movement as altogether wrong – “Who wouldn’t want to be healthy, active, fulfilled, and successful?” (p. 3). Instead, it aims “to ask such questions [about frailty and vulnerabilities that are independent of individual action], not to offer easy answers but to invite critical dialogue on a wider set of possibilities for imagining what it is to live meaningfully in later life” (p. XII.)
The contributions are organized in four parts: “Gender, sexuality, and the allure of anti-aging”; “Ideals of independence, interdependence, and intimate sociality in later life”; “National policies and everyday practices: Individual and collective projects of aging well”; and “Medicine, morality, and self: Lessons from life’s ends”. These titles allude to the major parameters of the bio-political and philosophical paradigm of successful-aging in late life (i.e. gender and sexuality; autonomy and independence; global and national political agendas; biomedicalization and end of life), but the authors go beyond these theories to point to everyday practices of challenging, negotiating and creating alternative modes of aging meaningfully. These practices not only deny the uniformizing character of the contemporary paradigm, as the cultural and individual differences presented vary greatly, but they also destigmatise frailty, which is antithetical to an ideology of aging focused on maintaining able/unchanging bodies and minds throughout the life course.
The authors’ implicit critiques of this paradigm frequently point to the gendered, hetero-normative and individualistic character of what is considered to be successful aging. For example, in North America, older women are pressured to maintain their youthful bodily appearance, while men, whose signs of aging, such as grey hair, are considered appealing, find themselves expected to maintain sexual functionality all the way into late life (chapter 1). The feminine model of successful aging contains similar contradictions: while some women view ‘choosing’ not to maintain a youthful appearance as a condemnable example of self-neglect, others find the refusal of cosmetic intervention, and corresponding opportunity for self-exploration beyond youthful beauty norms and bodily appearance, liberating (chapter 2). In intersection with gender, the authors further explore the hetero-normative ‘white’ character of the successful aging ideology with an account of African-American lesbians and gay men who must contend with ageism as yet another type of discrimination over the course of their lives (chapter 3). The extreme relativity of what it means to age ‘successfully’ is further problematized by models of ‘successful failure’ in other cultures. For example, in Mexico, some men embrace erectile disfunction in late life as a moral opportunity to engage in deeper, more responsible, and more affectionate relations with family, rather than understanding it as a shameful malfunction to be fixed (chapter 4).
Through other empirical cases, the authors expose various articulations of the concept, ‘aging in place’. Practices of professional-assisted care, for example, foreground the independence experienced by many late-life Chicagoans still residing in their own homes (chapter 5). This form of silenced (inter-) independence, while highly valued by the older beneficiaries, obscures burgeoning social stratification in the realms of health, economics and ethnic status. Some professional care-givers put their own health, financial remuneration, and immigration status second to their clients’ needs for comfort, independence, and autonomy. This self-disregard, in turn, can affect the care-givers’ own potential for ‘successfully aging’, by increasing their likelihood of impairment, economic insecurity, and residence distant from support networks later in life. When studied through the network of a religious community, such as Catholic nuns (chapter 6), the carer-cared dyad is understood in terms of valuing one’s (permanent) personhood and autonomy—fundamental aspects of successful aging—on a relational basis: the relations within the community of faith that continue after death. In a spiritual community that is experienced as extending past physical death, the personhood of an older individual, even in advanced stages of cognitive decline, is acknowledged and understood as not limited to its earthly embodiment. Such a view centres on reciprocal interdependence and a reverse of the activity-passivity divide between physical activity of the young and spiritual activity (i.e. prayer) of the elderly.
The authors (chapter 7) go on to present an example of old age understood as opportunity, in the Polish national policies of active aging, which include practices of attending third-age universities and gardening. While highly gendered, these practices point to the fact that those experiencing old age are afforded certain opportunities they could not attain in their younger years. These Polish policies reveal an interesting aspect of the materiality of old age in the cultural practice of maintaining a tidy garden on a rented plot— also highlighting the value of self-discipline in old age. In Chapter 8, the authors move on to more emotional discussions of people living with Alzheimer’s, in which the great challenge brought about by cognitive decline is seen as an opportunity for creating moral, compassionate communities. This approach mirrors a later chapter of tales from Brazil, in which heroic care for people with Alzheimer’s is seen as a dynamic cultural story that shifts the moral focus of sacrifice between the various parties involved (chapter 13).
While some papers focus on discourses of aging at the national level, such as the complicated inheritance of a colonial history in regards to cultural valuations of life stages and family ties (e.g. the case of Kenya and Uganda; chapter 12; Epilogue), others shift focus to the individual level of value negotiations. One example is the case of an older Japanese woman who, in spite of her culture’s norms of seriousness, modesty, and endurance, offers a more malleable view on life, frailty and mortality by approaching these life stages with humorous acceptance or, as the author calls it, ‘foolish vitality’ (chapter 10). In other examples from New York City’s elderly, people resist adding positive or negative value to activity and passivity by reframing the aging paradigm as one of ‘comfortable aging’, a model focused on finding ways to cope with pain, frailty and reduced mobility (chapter 14). All these examples point to the importance of positionality of the individuals involved in societies’ ongoing negotiation of value, such as the valuation of physical and mental fitness. These negotiations can become more flexible as people who engage in them age themselves, pointing to the potentiality of old age as a position from which to explore and embrace, rather than deny, late life’s challenges.
As someone who approaches the study of aging from an anthropology of death and dying viewpoint, I found the book to offer highly rewarding critical analysis about coming to terms with one’s frailty, vulnerability, and mortality during the stages before death. The book does not draw any parallels from the ‘dying well’ movement, one of the biggest counterparts to the successful aging paradigm, but it can still be quite useful for scholars of both aging and of death and dying studies more generally. The book’s greatest strength, I believe, resides in its range of examples on renegotiating aging as a reflective process that incorporates persons and communities in-the-making, counter to performative, pre-established, and morally-loaded ideologies of individual success. This clearly written and refreshing text could also be read by a larger audience interested or involved in various aspects of aging: policy makers; care-givers; social and health care workers. Ultimately, the book offers insightful and sometimes highly emotional accounts of how we find meaning in the limits of our human condition, making it a delightful read regardless of one’s professional orientation.
Lamb, S. 2014. “Permanent Personhood or Meaningful Decline? Toward a Critical Anthropology of Successful Aging” Journal of Aging Studies 29: 41–52.
Cristina Douglas is a PhD candidate in Social Anthropology at the University of Aberdeen, UK. Her research focuses on the relations between people living with a dementia diagnosis and therapy-animals.