Do we need a new book about successful ageing (SFA)? In this compact book, the authors discuss a concept that has been around for over half a century and manage to shed new light on the concept. They do so – as the book title reveals – not without ambivalence, but also not without ambition. It certainly helps that the authors are eminent scholars in the field of ageing. By cross-examining various conceptualisations of SFA, they present a rich scala of thoughts, and a deep and critical understanding of the subject matter. The book is nicely structured and provides a framework for future thinking and working. So yes, this book is a welcome addition to an ongoing debate.
The book is divided into three sections, the first concerns conceptions of SFA, the second explores strategies from the micro- to macro-level, and the final one discusses SFA's ambivalences and ambitions. The first chapter provides a history of the SFA concept. In their second chapter, the authors pinpoint several contradictions in existing conceptualisations of SFA. After a useful introduction to the biological dynamics of ageing, the core of the book consists of a taxonomy or ‘family’ of five SFA conceptualisations. Each conceptualisation is discussed in terms of its ambitions as well as its inherent ambivalences; each conceptualisation is scrutinised regarding its affinity with the three societal levels – micro, meso and macro; and of each conceptualisation the usefulness is explored for guiding governmental and institutional policies concerning ageing.
The five approaches to SFA conceptualisation are: pragmatic, hedonic, eudaimonic, capability-related and care ethics-based. A prominent example of the first approach is Rowe and Kahn's model of SFA that distinguishes three dimensions: health, functioning and participation. Paul and Margaret Baltes further developed this model, approaching it from the social and behavioural sciences. This book's authors term this model ‘pragmatic’, because it leans on the philosophical tradition of pragmatism, which emphasises practical use as a guiding principle. This model is considered by numerous scholars to cover fully the concept of SFA.
However, the authors demonstrate that other schools of thought lead to other conceptualisations that deserve the label SFA. Thus, the second approach leans on the hedonic philosophical tradition, which emphasises ‘the good life’, with life satisfaction and happiness as criteria. Here, the focus is on subjective experience and personal values. The third, eudaimonic, approach derives from the idea that to lead a worthwhile life, one should strive for wisdom, tranquillity of mind, self-actualisation and ego-integrity. Thus, personal growth is a central tenet, but SFA may also be achieved by the maintenance of factors such as positive relations, self-acceptance and autonomy. As the fourth approach to SFA, the authors introduce the capability-based model of a good life, which is rooted in welfare economics. This model emphasises the role of the context in facilitating or impeding a good life. The fifth approach, the care ethics-based model of SFA, acknowledges that many older people live with impairments, and that loss of functioning is inherent in ageing. The authors consider this model to be the only one that does not ‘simply worship middle adulthood’ (p. 29). In order to achieve SFA, care should be a co-construction based on each partner's needs and goals, including respectful interaction.
The second to fifth conceptualisations may not immediately be recognised as models of SFA, but it is the merit of the authors that they emphasise the close connection of these lines of thought with SFA. In a handy table (p. 31), the authors critically compare the models on five criteria: age relevance, inclusiveness, normativity, locus of responsibility and measurability.
In the four subsequent chapters, the five models are discussed regarding their appropriateness for strategies and interventions. These are my favourite chapters, because they constitute a truly integrative effort. They compare the SFA models against accepted theories and empirical evidence at the individual, meso- and macro-level, and their interactions. Thus, it becomes clear which SFA models, i.e. which assumptions and values, will be most useful to go forward at each level. A discussion of specific issues in light of the SFA models, such as social inequality, ageism and care at the end of life, as well as three existing examples of ‘policies for successful ageing’, shows the usefulness of the SFA models in their ability to pinpoint gaps in empirical research that should support such policies.
The final chapter of the book returns to the ‘ambitions and ambivalences’ of the concept of SFA. In the end, the ambivalences are outnumbered by the ambitions, the main ambition being that the concept of SFA provides a vision for a good life in old age.
Of course, in thinking out the links and contrasts between the SFA models and their relevance for policy and practice, simplification is inevitable. The reader may miss a discussion of their favourite concept. For example, a concept that receives increasing attention, resilience, is absent in all of the 128 pages. What would be the SFA model underlying resilience? On the positive side, readers are provided with ample conceptual tools that enable them to figure this out for themselves.
Every gerontologist and every practitioner working to help older adults age well is likely to have some concept of SFA in mind. This book helps readers identify what exactly their own concept of SFA is, and if this is indeed the concept that helps them make progress in their work. In all, the book provides a good guide to the concept of SFA in all its variety, how to approach it and how to use it. It forms a useful contribution to the ongoing SFA discourse. I warmly recommend it for students, researchers and workers in policy and practice.
