Researchers have defined a number of criteria related to the concept of “successful aging,” which usually include the absence of disease and disability, maintaining a high level of physical and cognitive functioning, and having meaningful engagement in life. In research on the different components of successful aging, the most frequent common elements are preservation of physical functioning and freedom from disability. However, the idea of successful aging has also become a more common phrase outside the context of research on aging. This broader usage of the term makes it important to understand what “successful aging” means from the perspective of aging adults. Of particular interest is how definitions of successful aging might differ across racial or ethnic groups, and for individuals with physical disabilities that wouldn’t meet researchers’ objective criteria for successful aging. To address this question, researchers recruited a diverse group of older individuals with late-life disabilities to determine how they defined and conceptualized successful aging.
For this project, 56 participants from diverse backgrounds were interviewed about what successful aging meant to them. All participants were required to have at least two impairments in activities of daily living (ADL) and/or instrumental activities of daily living (IADLs). Of the participants, the average number of dependencies in ADLs was 2.2 and in IADLs was 5.6. All participants were community dwelling and recruited through the San Francisco social and medical service provider On Lok. Each also met criteria for nursing home eligibility. The average age of the participants was 78, and 64 percent were women. Of the participants, 23 percent were African American, 32 percent were Chinese (Cantonese speakers), 20 percent were white and 20 percent were Latino. The Chinese participants had been in the United States for an average of 28 years (minimum of 11), and the Latino participants had been in the United States for an average of 34 years (minimum of 17).
In interviews, participants were asked if they considered themselves to be successfully aging. Despite all participants’ physical disability, 71 percent reported that they were. Of these, Latinos were the least inclined to say that they were aging successfully, with only 46 percent of Latinos answering that they felt this way. For the other groups, over 69 percent of participants reported aging successfully. Of those who were asked if they felt old, half of all participants said yes.
Turning to the themes about successful aging that emerged from these interviews, the overarching theme when considering successful aging was “living in a new reality.” Participants described this new reality as something that could either be acknowledged or rejected.
In acknowledging this new reality, aging was viewed as a natural process that included age-related disability. Part of successful aging then “means you accept your limitations” and “I have to get used to it.” However, this also goes beyond just accepting limitations to include adapting one’s outlook. By focusing on the things that can still be accomplished, there are fewer regrets. This acknowledging of a new reality also includes accepting the need to rely on others for some things. Some individuals interviewed said that this need for assistance is inevitable in the aging process, and that it didn’t interfere with successful aging. However, it is notable that the individuals interviewed preferred to rely on the government or their medical and social service provider rather than family and friends. For the African American and Latino participants in particular, trust in God was an important factor in acknowledging and accepting their new reality and successfully aging. The final aspect of acknowledging realities and successful aging uncovered in these interviews involved individuals realigning their perception of successful aging with their own personal situation. This involved distinguishing between different types of success and focusing on the successes they have had.
As for rejecting the new reality posed by aging, participants shared both positive and negative perspectives on how rejection could relate to successful aging. Some individuals chose to put their disability in the background and to deny the disability’s effects in order to achieve what they considered successful aging. This was often coupled with comparisons to individuals who were more disabled. For Latinos, a strong component of successful aging was being able to walk. When disability was acknowledged in these interviews, the impact of the disability was often minimized and dismissed. References to the relationship of a disability to successful aging were often followed by phrases such as “other than that,” which minimized the disability’s impact. Other individuals’ rejection of the new reality’s relation to successful aging involved claiming that they had not successfully aged. These individuals were unable to reconcile themselves with the situation in which they found themselves or to find ways to adapt. In particular, even though all participants in this study were recruited through a social and medical service provider, being a burden on one’s family was a source of distress for them, and this was perceived as an obstacle to success.
Overall, this study shows that successful aging has a subjective component that needs to be better understood. It also revealed that while there were some important differences across diverse populations, many perceptions of successful aging are shared across racial and ethnic groups. Despite their disabilities, the majority of participants in this study still felt that they had aged successfully, and reframed their personal situation in order to do so. As the authors conclude, “Understanding the subjective view of successful aging can help those working with elders to design interventions o anticipate increasing disability and assist elders to prepare for and adapt to age-related changes.”
Romo RD, Wallhagen MI, Yourman L, et al. Perceptions of successful aging among diverse elders with late-life disability. The Gerontologist (2013); 53(6): 939–949.