This ambitious edited collection demands that we change our approaches to studies of aging. Reading it, I felt as if I were seated with the 13 authors around a coffee table, listening to them advance their disparate views. They do agree that aging is a socially determined process shaped by the existential conditions of senescence and finitude; a process perhaps more deeply dreaded and disparaged under the contemporary conditions of late capitalism. Further, they concur that aging studies must consider the interplay between the political economy and individual meaning-making, thus requiring a reconsideration of assumptions regarding the relationship between agency and structure. Aging, they insist, is about the relationship between existential as well as contingent factors; yet our understanding of this is limited by our theories. Beyond these points, disagreements commence. The chapters challenged me to re-think and to “bear with” authors’ views that differ dramatically from each other’s as well as from my own. Although there was little consensus, the “conversation” was rich, interesting, and useful.
Stemming from an international project that drew together critical and humanistic gerontologists to help understand aging more fully, this book does not achieve an integration of these perspectives, but takes us some way down that road. Although many chapters are primarily theoretical, others report from empirical studies and developments in aging research. Three major and related but distinct questions run through these contributions. First, how best can studies of aging apply social theory to develop a conceptual language and framing that can support lives of dignity and respect for older adults? Second, what constitutes a “good” old age in the period of late modernity? Third, how do we ensure that the vulnerable people, who are variously said to be in “the fourth age”, or called “older adults with high need for support” (including those with dementia), live in conditions of dignity and respect?
Setting out the journey towards better theory for aging studies, Jan Baars and Chris Phillipson trace developments in social theory and the politics of late modernity to show how and why new approaches to aging are needed that integrate structural and interpretive views. They locate the challenge for theory in the “problem of ageing”: finitude and senescence are inescapable, but the conditions under which we experience this existential moment are structural, as is the production of aging as a social problem for individuals and for societies. How can theory adequately reflect this dialectic of structure and meaning-making? Amanda Grenier and Chris Phillipson’s contribution considers how autonomy can be understood in the context of the “fourth age” – when people affected by frailty may no longer fit the criteria of the rational (neo) liberal subject. This chapter unseats notions of agency that measure its presence or absence to situate agency as an expressive possibility contingent upon the conditions of everyday life.
But which research methods can introduce this integration of structural and interpretive approaches into the research process? Friederike Zeigler and Thomas Scarf explore the potential of participatory action research (PAR), a method that includes participants to both reveal and challenge structural constraints and their internalization. While commenting on the method’s limitations (including the new tyranny of participation that can coerce participants rather than include them), the authors also demonstrate its promise to promote structural change at various levels of scale and to advance theory.
Quality of life for older adults is addressed from a wide range of contrasting vantage points in this volume. Joseph Dohmen draws upon wide-ranging ethical perspectives to argue that aging well is too often equated with optimal health rather than impairment and frailty. How can one “age well” while taking into account the inevitability of death and the uncertainty of its timing? Dohmen suggests that relationships are key – an important intervention, in my view – but he fails to take this view seriously. His comment that “the caregiver decides for himself/herself whether and when he/she takes care of another or not”, for example, maintains an understanding of the subject that those steeped in the ethic of care literature – or experiences of caregiving – reject. I was irritated by Dohmen’s deployment of the term, “life style”, (which, in my materialist view, is by definition a market-related product rather than a worthy life) and the thoroughly privileged class perspective; however, I suspended my objections to learn about how various ethical perspectives can contribute to the notion of “a good old age”. This primed me for one of the more challenging chapters in the text.
In her chapter, Hanna Laceulle approaches the topic of a “good” old age and the possibility for self-realization in late life, including the fourth age, by deploying “spiritual” approaches in gerontology. Lacuelle promotes this approach by doing exactly what the editors espouse: situating her concept of spirituality and late life firmly in present-day political and social relations to indicate how social inequalities, discrimination, and oppression shape meaning, including spirituality. While her concept of spirituality remains fuzzy, her essay prompts me to wonder if this very fuzziness is a product of the conditions of late modernity. Staying with the theme of what counts as a “good” old age, Anja Machielse and Roelof Hortulanus report on empirical research that explores tensions between individual autonomy and connection as aspects of aging well for Dutch older adults. By mobilizing the concept of “balance”, these authors fail to challenge the neoliberal notion that connection and individual autonomy are necessarily opposites. Their findings potentially support a re-framing that could pose more emancipatory possibilities. For example, their research shows that people’s experiences in early life condition their abilities to build and maintain a social network in later life. While this may be an empirical finding, Machielse and Hortulanus analyse it without drawing on the critical social theories used in other chapters. For example, it has been argued by many others, and particularly by feminist scholars, that relationships are necessary to, and support, independence and autonomy.
The challenges faced by those with high needs for support, including discrimination, exclusion, and de-humanization, are addressed in several chapters, illuminating the relationship between perspectives on aging, politics, and quality of life. These chapters introduce policy and practice perspectives that put “meat on the bones” of theory integration. Bruens describes recent approaches to dementia and their relative strengths in integrating a perspective that emphasizes that those affected by this disease are entitled to dignity and respect, while also commenting on the enduring power of biomedical perspectives. Mo Ray contextualizes the exclusion of older people with high support needs through an examination of social work practice with this population in the United Kingdom. Her analysis indicates that managerialist approaches and policies, aimed at providing as little service as possible, need to be countered by uniting critical social work approaches with critical studies on aging, to produce “a vision for a transformed social care service”. Bringing the volume to a fascinating finish that returns us to a consideration of the relationship between theory and practice is an elegant commentary by Dale Dannefer and Jielu Lin. They take brilliant issue with many of the authors’ perspectives, at the same time drawing out the strengths of the contributions.
Clearly, the strength of this volume is its call to integrate structural and interpretive approaches on aging that is well matched by its interdisciplinary, European/North American scope, and by its range of authors that include senior, intermediate, and new scholarship. This strength is also its major weakness, in that the chapters do not build to any conclusion nor are they always in close dialogue with each other. This weakness is somewhat moderated by Dannefer and Lin’s commentary. The book will interest social scientists and humanities scholars engaged in aging studies and their graduate students, and most particularly those working on the challenges of bringing theory and evidence into closer dialogue. Although sometimes I wished for a more attentive copy editor and wondered if another arrangement of chapters would provide better flow, I have co-edited often enough to acknowledge that publishing is a fraught business, and these issues are difficult to avoid. This book will stay on my shelf for a long time, reminding me that reflection on our disciplinary and theorectical frames, as well as respectful disagreement, are tools to advance critical discussions.
