The Tyranny of Aging Well: Why the Ideal Leaves So Many Behind

‘This dread of disability’

“If it’s exclusive of disability, it’s not helpful,” Putnam says. “Embedded in ageism is ableism and this dread of disability.” 

Yet, as Putnam cowrote in an article in The Gerontologist earlier this year, “decades of medical advances have resulted in people with disability surviving into older age at a greater rate than previously medically possible. These individuals often experience accelerated aging.”

Others may acquire a disability later in life. Despite the proliferation of the idea that “age is just a number,” the truth is that disability becomes more common as we get older. A full 45 percent of Americans over the age of 75 report a disability, according to data from the U.S. Census Bureau. Putnam says structural barriers, including difficulty getting the care and support they need, can affect how people with disabilities age.

“We want that for everyone,” she adds. “But the likelihood of that easily happening for people who have experienced disability over the life course, and have had these cumulative effects [that contribute] to them not being as healthy or well later, then they’re not going to fit that model.”

Nor are plenty of others. “A lot of [aging] has to do with luck, a lot of it has to do with genetics, and a lot of it has to do with socioeconomic status as well,” says Caroline Cicero, an associate professor at the Leonard Davis School of Gerontology at the University of Southern California.

Those living in a food desert, for example, don’t have easy access to fresh vegetables and other foods considered vital for good health. If your neighborhood has broken sidewalks, or no sidewalks, regular strolls may be impossible.

An aspirational society

Cicero knows articles on healthy aging are a draw. “We are an aspirational society, and as readers, we want these; we’re suckers for ways that we can live better,” she says. But she wishes these pieces went deeper than diet, exercise, sleep and friendships. Cicero says that missing from the discussion is something everyone should ponder: our own mortality.

“I actually think that to age well, we need to acknowledge our own death,” she says. “And so, instead of trying to avoid disease so we can live as long as possible, we need to acknowledge that we are mortal, and maybe we need to think more about what we want our final years or decades on Earth to include.”

But much of the advice on how to age is not profound. And the pressure to keep an exercise routine, munch the right foods and keep socializing, all while wearing sunscreen, can amount to an exhausting prospect, making aging one more thing to compete at.

Barbra Teater, a professor of social work at City University of New York, says Western culture implies that if you’re not thriving physically, mentally and socially, “you failed.”

What really matters

She also says aging well means different things to different people.

 A 2020 study by Teater and Jill Chonody in the journal Social Work in Health Care examined the attributes of successful aging that were important to older adults. While No. 1 was “remaining alert and mentally active,” the second point was related to money. The study said that “of particular importance to older adults was access to affordable health care, which was rated as important or very important by 96.8 percent of the respondents.”  

Those respondents also wanted to be able to act according to their own values and cope with the challenges of their later years. Teater says they wondered, “Can there be some changes and adaptations that can allow me to still feel like I have choice and autonomy and independence?”

Striving for improvement

Mary Ann Smith, of Eagle, Idaho, has adapted to the aftereffects of a series of medical events that have hampered her mobility for the last few years. Smith, who is in her late 70s, says she felt she was aging “successfully” and was “healthy up until I turned 70. And then it seemed like my body started to fall apart quite a bit.”

Mary Ann Smith, of Eagle, Idaho, says she was aging successfully until she turned 70, when it felt like her body started to "fall apart." But she doesn't let her pains keep her down.

Andy Anderson

First she slipped on black ice, breaking her ankle, followed by a fall in her hospital room, where she broke her arm. Then she suffered cardiac arrest while on the operating table. She left the hospital in a wheelchair and is still plagued by neuropathy and edema due to nerve damage in her ankle. “So for the past three years I’ve been fighting that,” she says. “I’m trying to stay active as far as I can — but I can’t walk very far for very long, or stand very long.”

Living their best possible lives

But Smith tends to see the possibilities in a situation rather than the downsides. She says while she now spends a lot of time at home, she still gets out with her husband and friends from time to time. She says having a good relationship with her husband and a lively mind still make her someone who is aging well.

Smith is typical of people in her age range, according to a 2022 study on Americans’ perceptions of aging by AARP and National Geographic. The study found that “about 2 out of 3 of the oldest adults, age 80 and older, say they’re living their ‘best possible life’ or close to it, compared with just 1 in 5 younger adults.”

“I don’t allow this pain to keep me down,” Smith says. “I’m constantly seeking ways to improve myself, and a lot of the articles I do read give me encouragement on finding ways to be optimistic and positive about life.”

Pearl Schachner is similarly determined to forge her own path. She sought out online support groups for her lung condition and takes comfort from the other members. She just had a hip replacement because she wants to keep walking with friends, and a bad hip was holding her back. She has accepted that life can be unfair and sometimes difficult.

“You’re not in control of everything. So all you can do is kind of do the best [you can] and not get depressed about it,” she says. She’d like to see a few articles on how to age well when one has chronic conditions like hers, with a qualified headline: “How to Age as Well as Possible.”