Aging Well: A Challenge That Can Be Met

06/09/2011 08:35 am ET | Updated Aug 09, 2011

Sadly, in our society, the idea of aging well is virtually a contradiction in terms. Age is so identified with disability that when older people who are not disabled say they are "old," they are quickly assured that they are not.

"You're only as old as you feel."

"Age is a state of mind."

"Whether you are 65, 70, 75 or 80, if you're still active, and enjoying life, you're not really old."

In fact, you are old when you reach a particular age. The Older Americans Act says 60. Medicare puts it at 65. Social Security is 66, phasing up to 67. Whatever the number, if you're lucky, sooner or later you will be old.

When you are, you may be in poor health. You may not be able to get around easily or at all. You may have significant memory impairment. You may need help dressing, eating, going to the bathroom or paying bills.

But chances are that you will still have most of your capabilities. The vast majority of people 65 and older are under 80, in decent health and mostly independent. Even at age 85, fewer than 50 percent of people are disabled and in need of help for basic functions.

So it is a mistake to equate age and disability. It is a mistake to believe that it is normal for old people to be incapable of leading active, involved, satisfying and personally meaningful lives.

Friends and family remain an important part of the lives of old people. Love, intimacy and -- yes -- sex can be central parts of their lives. Many older adults continue to work. Careers that are valued for their personal fulfillment and for their contribution to society can continue past ordinary retirement age. Work that generates an income and makes it possible for us to support ourselves and our families and to have daily contact with people we enjoy can also continue well past retirement age and provide both pride and pleasure.

Those who do retire often find so much to do that a common complaint is, "I don't know where the time goes." Whether it's little projects in the house, playing golf, developing an artistic skill, taking care of grandchildren, volunteer work or being active in governmental, political, religious, communal or philanthropic organizations, there's plenty to do in old age.

Of course, age does take its toll. Psychological adaptations are necessary when we retire, when our own children grow up, when our physical and mental skills diminish, when we have chronic illnesses, when the deaths of friends and family mount up and when we face mortality. In addition, the chances of becoming disabled and needing help increase with age.

To oversimplify, there are two populations of older adults -- those who retain most of their capacities and are fundamentally independent and those who are significantly impaired. Both populations can age well or badly.

Aging well for those who are not disabled is easy enough to understand. The key is staying active and involved and avoiding what the developmental psychologists call "despair." Ambitions from youth need to give way to a more realistic sense of what is possible in the limited time left. Satisfactions are found more in the moment and/or from pride in the past and contributions to the future of those who will survive us.

Can people who are disabled and dependent also age well? This is a matter of considerable controversy. Many people look at this kind of experience from the outside and decide that it is a truly awful way to live. Some people living in a state of disability and dependency who are unable to be the people they once were hate it and wish for death. But most seem to want to live, and it is possible for them to find satisfactions in contact with and knowledge about those they love and in activities that they find interesting and pleasurable. For those with limited memory, there are still satisfactions in the moment.

For both "healthy" and "disabled" populations, aging well depends heavily on social conditions as well as individual choices and attitudes. Having enough money to lead a life you find satisfying, having family or paid caregivers to help you stay in the home you choose, having access to good health care, being connected with a community that accepts responsibility for people who need help and living in a nation that makes support and services available to sustain a decent human life in old age -- these are all critical to aging well.

The elder boom that began this year will result in a vast increase in the number and the percentage of older adults. Whether they age well or badly will depend not just on biological fate but also on personal, familial and societal preparation. Are you ready? Is the American society?