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Toward a Good Life in Later Life: Perspectives, Problems, and Responses

Klein, Robert R.
http://rave.ohiolink.edu/etdc/view?acc_num=osu1364341896

Abstract Details

2013, Doctor of Philosophy, Ohio State University, Geography.
America is aging. The older share of the U.S. population is expected by 2030 to reach 72 million, almost 20% of the country's total population. What will the experiences of later life be like for this group of people? In order to answer this question, one must consider different perspectives on what it means to age well. One influential definition of aging well is Rowe and Kahn's concept of "successful aging," consisting of three dimensions: avoidance of disease and disability, high physical and cognitive functioning, and active engagement with life. The successful aging paradigm emerged out of a sense of optimism about the new possibilities for older adults today, yet the paradigm also raises fundamental questions about the ability of different actors in society to define standards that can carry important ethical implications and practical consequences. Indeed, empirical research employing Rowe and Kahn's successful aging framework finds that only about 11% of older adults in the US would be considered successful, implying that the vast majority are failures. Similarly, using multilevel modeling for small area estimation and data from the 1999 National Long-Term Care Survey and the Behavioral Risk Factor Surveillance System Survey, this dissertation's quantitative state-level analysis shows that fewer than 150 older adults in 1,000 would be deemed successful agers in Wisconsin, the state found here to have the highest rate of successful aging. In short, the successful aging paradigm is well-intentioned, but far too exclusive to serve as a normative model for later life. In order to work toward a more inclusive vision for later life, one might alternatively seek out the perspectives of nursing home residents. What does a good life in later life look like from the standpoint of elders facing the challenges of nursing home life and what can such views tell us about a broader notion of aging well? Qualitative analyses, consisting of secondary qualitative data analysis and meta-ethnography, of interviews with nursing home residents suggest that an inclusive definition of aging well should include at least three components: defining oneself more than being defined by others, acting to realize preferences, and receiving the care one wishes. However, for a variety of reasons, it can be difficult to have the kind of later life one desires. By connecting archival research on a nursing home in Cleveland and its long-term care organization with an account of the growing use of technology in the hospital beginning from 1900 to 1925, the critical historical method of genealogy offers insights into the ways in which societal processes of medicalization and commercialization have impacted eldercare in the nursing home and end-of-life care in the hospital throughout the 20th century and up to the present. Suggestions for possible individual and societal responses to the problems of achieving one's own idea of aging well are offered. One hopes that the quality of aging experiences will be improved in time to benefit the largest group of older adults in US history.
Edward Malecki, PhD (Advisor)
Virginia Richardson, PhD (Committee Member)
Nancy Ettlinger, PhD (Committee Member)
211 p.
Aging; Ethics; Geography; Gerontology; Health; Health Care; History; Medical Ethics; Medicine; Philosophy; Philosophy of Science
aging well; successful aging; aging in place; end-of-life care; nursing home; hospital; critical gerontology; crystallization; geography; multilevel modeling; secondary qualitative data analysis; meta-ethnography; genealogy; Estes; Foucault; Dewey

Recommended Citations

Citations

  • Klein, R. R. (2013). Toward a Good Life in Later Life: Perspectives, Problems, and Responses [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1364341896

    APA Style (7th edition)

  • Klein, Robert. Toward a Good Life in Later Life: Perspectives, Problems, and Responses. 2013. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1364341896.

    MLA Style (8th edition)

  • Klein, Robert. "Toward a Good Life in Later Life: Perspectives, Problems, and Responses." Doctoral dissertation, Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1364341896

    Chicago Manual of Style (17th edition)

osu1364341896
425
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This open access ETD is published by The Ohio State University and OhioLINK.