is not merely a matter of accumulating years but also of “adding life to years, not years to life” (Kinsella & Phillips, 2005, p. 40). People grow old in a social and economic context that affects their psychosocial development: their feelings of self-esteem, value, and place in family and society. These factors have a combined effect on the morale of older people, and a number of models have been developed to explain why some people remain more active and healthier at older ages than others. These models can identify factors that favor healthy lifestyles and ways in which society can assist its members to grow old with dignity and comfort.
Defining Successful Aging
Successful aging has been empirically defined to include (1) a low probability of disease and disease-related disability, (2) a high level of physical and cognitive functioning, and (3) an active engagement in life (Rowe & Kahn, 1997). To some extent, these components represent a hierarchical relationship, as it is suggested that the absence of disease and disability leads to a prolonged maintenance of physical and cognitive functioning, which enables a higher level of engagement defined as the combination of social activity and productive activity (Tate, Lah, & Cuddy, 2003), participation in leisure activities (Bono, Sala, Hancock, Gunnell, & Parisi, 2007), and belonging to neighbor groups (Zunzunegui et al., 2004). Individuals who meet these hierarchical components during the aging process maintain the capacity to adequately function during daily living, leading to greater independence (Guralnik, Fried, & Salive, 1996). Continued independence is suggested to be an important factor throughout the aging process as it facilitates control and autonomy, both of which increase well-being and life satisfaction (Hertz & Anschutz, 2002). In addition to the psychosocial benefits associated with successful aging, the absence of chronic disease seen in older adults who have aged successfully has the potential to reduce health care costs required for an aging population (Thorpe & Philyaw, 2012). While there are older adults who are successfully aging, the majority of older adults are dealing with some kind of limitation (Carr, Weir, Azar, & Azar, 2013).
The concept of successful aging is related to the broad issues of coping and adaptation in later life. Successful aging is viewed as maximizing desired outcomes and minimizing undesired ones. Older adults can compensate for losses and declines and retain the potential for further growth. Successful aging can be viewed as the confluence of three functions: decreasing the risk of diseases and disease-related disabilities, maintaining physical and mental functioning, and being actively engaged with life (Kinsella & Phillips, 2005). This is evident today as growing numbers of older people do not exhibit the chronic health problems and declining cognitive skills that were once assumed to accompany aging. The concept of successful aging is illustrated in Guided Practice Exercise 3.1 from the viewpoint of older persons at a lower socioeconomic status (SES). The issues present challenges for the mental health counselor to examine successful aging from a completely different perspective.
Guided Practice Exercise 3.1
Successful aging is a subjective phenomenon that is comprised of various dimensions. Each elderly person experiences it differently, and it varies based on situational experiences. As a mental health practitioner, can an elderly person be seen as aging successfully if he or she has numerous health problems and limited income? Explore your feelings as to what constitutes successful aging. Visit a nearby senior center and examine how individuals with limited education, few financial resources, and multiple health challenges define successful aging. Share this information with your peers and examine if your definition of successful aging has changed.
Successful aging is a perspective that assumes that healthy functioning and even achievement of certain gains is possible in later life. A series of studies called the MacArthur Study explores these possibilities (Rowe & Kahn, 1998). The fruits of 10 years of intensive investigations involving thousands of participants, millions of dollars, and the combined expertise of biologists, neuropsychologists, sociologists, epidemiologists, geneticists, and gerontologists, among others, tell us a great deal about successful aging.
Most importantly, the MacArthur Study provides evidence for positively influencing the aging process and enhancing the quality of life in later years. The more physically and mentally fit older individuals are, the more likely they will age successfully. One’s lifestyle prior to old age can have a tremendous influence on the quality of later life. A healthy diet and regular exercise, including aerobics and weight training, confers a real physical advantage. Although maintaining healthy habits provides protection from disease and should ideally be maintained consistently, the MacArthur Study revealed that positive changes in eating and exercise habits, even in old age, can help people live longer and healthier lives. Equally important to successful aging are social relationships. Older people benefit more from emotional rather than instrumental support in many cases.
Some potential gains in old age relate to the task of obtaining fulfillment in meeting social and civic obligations. For example, older people accumulate knowledge about life (e.g., wisdom) and can thus contribute to the development of other (younger) people and to society, providing wins for all. As the proportion of older people continues to increase, advancements in understanding the aging process will likely lead to identifying further developmental tasks associated with gains for and purposeful lives among older adults (Wrosch, 2006). In addition, the presence of meaning in life that refers to the extent to which people comprehend, make sense of, or see significance in their lives, accompanied by the degree to which they perceive themselves to have a purpose, mission, or overarching aim in life (Steger, Oishi, & Kashdan, 2009), was found to increase throughout the life span. Older adults reported the highest levels of meaning in their lives. Therefore, meaning thus emerges as an important resource for well-being, especially in later life (Steger et al., 2009).
Reichstadt Sengupta, Depp, Palinkas, and Jeste (2010) conducted qualitative interviews with 22 community-dwelling adults over 60 to obtain older adults’ perspectives on what constitutes successful aging. Reichstadt and colleagues (2010) found that older adults viewed successful aging as a balance between self-acceptance and self-contentedness on one hand and engagement with life and self-growth in later life on the other. This perspective supports the concept of wisdom as a major contributor to successful aging.
Productive, Healthy, and Active Aging
In addition to successful aging, concepts such as productive aging (the ability to contribute directly and indirectly to society in older age) and healthy aging (the ability to remain physically and mentally fit) have been identified. Active aging has been identified as well. It refers to continuing participation in social, economic, cultural, spiritual, and civic affairs, not just being physically or economically active. This type of aging encompasses individuals who have retired as well as those who are frail, disabled, or in need of care, and it takes place within a broader social context of friends, family, neighbors, associates, and the workplace. Active aging recognizes principles of independence, participation, dignity, care, and self-fulfillment. A life course approach to active aging recognizes older people not as a homogeneous group, but as individuals who, collectively, are as diverse as younger members of a society (Kinsella & Phillips, 2005).
A sense of being productive appears to be a benchmark of healthy aging as well. Healthy men and women are three times more likely than those with physical or mental health problems to be engaged in paid work or volunteer activities. However, even people with physical limitations often manage, with some creativity, to engage in activities that keep them in touch with the world. Productive engagement with others, in whatever form it takes, is linked to a sense of mastery or personal self-efficacy. A “can-do” attitude contributes enormously to well-being.
Mental Wellness
The term mental wellness is used to reflect the belief that health and illness are not dichotomously arranged in nature or in life and because people can, in collaboration with knowledgeable
