This book examines the relevance of modern medicine and healthcare in shaping the lives of elderly persons and ageing societies. Combining individual and social dimensions, Planning Later Life discusses the ethical, social, and political consequences of increasing life expectancies and demographic change in the context of biomedicine and public health. By focusing on the field of biomedicine and healthcare, the authors engage readers in a dialogue on the ethical and social implications of recent trends in dementia research (...) and care, advance healthcare planning, or the rise of anti-ageing medicine and prevention. Bringing together the largely separated debates of individualist bioethics on the one hand, and public health ethics on the other, the volume deliberately considers the entanglements of envisioning, evaluating, and controlling individual and societal futures. The process of devising and exploring the various positive and negative visions and strategies related to later life is rarely reflected systematically from a philosophical, sociological, and ethical point of view. As such, this book will be crucial to those working and studying in the life sciences, the humanities, and the social sciences, particularly in the areas of bioethics, social work, gerontology and aging studies, healthcare and social service, sociology, social policy, and geography and population studies. (shrink)

Predictive medicine presents opportunities to consider later life under conditions of illness, such as dementia. This paper examines how family caregivers (N = 27) assess the opportunity of prediction and early diagnosis of dementia for oneself based on their particular experience. Furthermore, it compares their attitudes with laypersons’ attitudes (N = 43) towards genetic testing of APOE. By this, we elaborate how much personal experience impacts anticipation and affects, but also moral attitudes towards predictive medicine. Differences in our (...) settings do not allow for direct comparison, so our analysis focuses on multiple similarities in the assessments of predictive (non-genetic vs. genetic) testing. Groups’ reasoning showed also differences influenced mainly by personal experience. Family caregivers addressed more responsibility towards family and had more hopes into medical treatments. To cope with the disease, they expressed expectations to start with medicine and care decisions as early as possible. Laypersons, however, stressed self-determination more and expressed worries about the influence of the pharmaceutical industry by referring to unnecessary medication and, implicitly, the medicalization of aging. (shrink)

Good aging : toward an ethics of aging -- The ethics of love -- Why we do not love the elderly -- Taking care of your old self -- Love for aging neighbors.

The biblical love imperative—reframed as "Care for the aging other, as you care for your aging self"—is fundamental for an ethics of aging. Kantian, utilitarian, and eudaemonist theories assume an ageless, rational, active individual. Frail old age, however, comes with dependency and decay. An ethics of aging therefore needs to be relational and must account for the fear of aging. The elderly remind us that death is inescapable; the body, fallible; and self-esteem, transitory. The love command offers a relational ethics (...) that overcomes the fear of aging and enables us to see that love for our aging self makes good elderly care possible. (shrink)

Endometriosis, a chronic inflammatory condition affecting 10% of biological women, is widely understudied and particularly overlooked in later life. Discussions surrounding endometriosis predominantly centre on medical gender bias during reproductive years, with limited attention to intersecting factors of discrimination and the impact of ageism on affected individuals. As endometriosis is framed as a disease of reproductive age, research is lacking when it comes to the effects of the illness on the older population. Symptoms in (post)menopausal individuals are frequently (...) misattributed to other ailments due to ageist and sexist preconceptions, leading to prolonged diagnoses and mistreatment. This is a social justice issue in which age and sex contribute to the discrimination of a certain population – namely older biological women living with endometriosis. In this paper, we approach this issue from the perspective of epistemic justice. The experiences of the affected persons are shaped by a lack of knowledge about endometriosis among both the healthcare personal and the affected person, as well as a lack of acknowledgement and consideration of the persons experiences. Using the lens of epistemic justice, we develop an analytical model to understand the intersection of age and gender in the experiences of endometriosis patients. This article contributes to ongoing debates on epistemic injustice and intersectionality within medicine and healthcare, offering an analytical model that connects the critical approaches of epistemic injustice and intersectionality to address health injustice. Ultimately, this work advocates for a comprehensive, lifespan approach to endometriosis that acknowledges and addresses intersecting forms of discrimination. (shrink)

ObjectiveAlthough childhood adversity can have lasting effects into later life, positive adaptations have also been observed, including an increased tendency toward prosocial behavior. However, little is known about the link between childhood adversity and later life prosocial behavior, with a particular scarcity of research on intrafamilial childhood adversity. Therefore, this study aimed to examine older adult's experiences of childhood adversity and identify mechanisms linked to prosocial behavior. Two adversity contexts were compared to explore individual, as well (...) as broader cultural and contextual mechanisms linking childhood adversity and later life prosocial behavior.MethodSemi-structured interviews were conducted with N = 29 Irish adult survivors of childhood adversity: n = 12 intrafamilial survivors, n = 17 institutional survivors. Interviews were analyzed using the framework analysis method, with reference to the conceptual model of altruism born of suffering.ResultsFive themes were identified on prosocial mechanisms, with three themes in both survivor groups, and two group-specific themes.ConclusionResults identified motivational processes and volitional factors linked to later life prosocial behavior. Connections to caring roles, support, and social norms in childhood, as well as the need for a sense of purpose and meaning from the adversities in adulthood, highlight potential targets for psychotherapeutic intervention to promote prosocial responding and positive adaptation for childhood adversity survivors. (shrink)

Feeling old: being in a phase of transition in later life The aim of the study was to illuminate very old persons’ experiences of feeling old in order to get a nuanced understanding of the ageing process in later life. Fifteen persons 85–96 years of age, living in their own homes, were interviewed in‐depth. Data were analysed utilising a phenomenological‐hermeneutic approach. Eight persons reported that they felt old. The experience of feeling old entailed four characteristics: being (...) able to date the beginning of feeling old, fear of helplessness and of being unable to manage one’s life situation, not recognising one’s former self, and feeling different from others. These characteristics corresponded to the main properties of a transition process. The comprehensive understanding was that the very old persons who also felt old were in a phase of transition. The distinguishing qualities of those that felt old were also found to be in line with the dystonic dominance in the ninth stage designated by Joan Erikson of the previously described life cycle. Knowledge about transition processes and sensitivity to very old people’s experiences of feeling old are of great importance to nursing in order to provide adequate health care services and prevent unhealthy transitions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Ethics and the Elderly: The Challenge of Long-Term Care by Sarah M. Moses, and: Loving Later Life: An Ethics of Aging by Frits de LangeDolores L. ChristieEthics and the Elderly: The Challenge of Long-Term Care Sarah M. Moses maryknoll, ny: orbis, 2015. 206 pp. $38.00Loving Later Life: An Ethics of Aging Frits de Lange grand rapids, mi: eerdmans, 2015. 169 pp. $19.00Today many women (...) and men live beyond the so-called third age of life and enter their eighties, the "fourth age," during which the toll of time and the growing incidence of life-limiting conditions wear down even the best-preserved of the human species. Debilitating disease and normal ebbing of human function become more concentrated in this demographic bubble. As people enter their eighties, their world tends to narrow both physically and mentally, creating a need for increasing care. Often the elderly are rendered passive and dependent, forced to cede both autonomy and dignity. They become objects with little voice, requiring greater care and increasing cash. Likewise, as the baby boom generation enters this group, those living in the fourth age make up an increasing percentage of the population. Additionally, modern models of care for the elderly, often based on efficiency and cost-effectiveness, tend to erode their human dignity. Together these factors demonstrate a growing moral problem.What to do? These two books provide valuable road maps for how to proceed. They detail the reality and moral urgency of the situation. Both offer principles from philosophical and religious traditions that outline a good moral model: one of care, compassion, dignity, and community. They draw insights from Augustine and Thomas Aquinas, Karl Barth, and Dietrich Bonhoeffer, among [End Page 214] others. Both reference the Western biblical tradition, which honors the elderly even in the face of their limitations.Although the authors offer wise and thoughtful suggestions to address this growing moral crisis, they approach the serious moral issue very differently. Sarah Moses outlines a compelling case for a new interventional model for elderly living. While her book plays some muted chords that hint at "dissertation," the melody it conveys is strikingly forte and well worth the read.She presents two concrete examples of what good interaction with the elderly might look like. One draws from the international intentional outreach and residential community (the Community of Sant'Egidio), the other is a brick-and-mortar model (the Green House Project). Using both biblical paradigms and church teaching over the centuries, Moses makes the case for treating all persons with dignity and promoting their involvement in decision making as much as possible. The scriptural message she highlights—both our duty to the elderly and the "disappointment and depression" (105) of growing old—is particularly compelling.In her examples of good long-term care, community development is important. In the Sant'Egidio model, volunteers share a common life "through gathering for prayer and various outreach services to the poor" (39). There is motivation to support elderly in their own homes, but the project promotes small, family-like resident facilities when this is not possible. The physical place is less emphasized than the relationship among various age and economic groups.The Green House Project is based in a new vision of homes for the challenged elderly. Results of the project show that not only did staff remain in their jobs longer (nursing home employment turnover is extensive) but visitation by family members increased. Even such a simple thing as a different physical model for the actual building—replacing long halls and routinization with a more home-like environment—has positive results.Moses calls on leadership in church and community to educate, to designate funds for elder care, and to look beyond the caring and the construction of good facilities. She notes how important it is to work politically to change attitudes and actions.She sees care for all dependent people as a responsibility of both the church community and society in general. This includes fostering awareness, encouraging ongoing participation of the elderly in life—including church life—and allocating public resources. Bottom line: she calls for smaller institutions, meaningful opportunities for the... (shrink)

Background: A growing body of evidence has demonstrated significant social and emotional benefits of music-making amongst senior citizens. However, several as-yet unresolved age-related barriers to ‘musicking’ have been identified. Positioned within the emergent field of gerontechnology, concerned with the interface between aging and technology research, this review of literature thus explores the potential for music technologies to function as a vehicle for creative musical opportunities in later-life. Methods: ERIC, PsychInfo and Web of Science databases were searched, focusing on (...) the intersection between music, technology and ageing. The criteria for inclusion were that the paper should: 1) be in English; 2) report empirical research involving the use of music technologies intended to support receptive (listening, interpreting, reflecting) or active (playing, creating, performing) engagement with music amongst older persons, defined as being aged 60 years or above (United Nations, 2017); 3) be published as a peer reviewed journal article. Results: Of 144 papers screened, eighteen papers were retained. Ten studies focused on using technology to support musicking in the form of listening, reflecting and interpreting. Just five studies explored the utility of technology in promoting singing or playing instruments, while a further three were focused on music and movement. Conclusions: Overall, the literature reviewed suggests that older people, even those with complex needs, are capable of, and interested in using music technologies to access and create personally meaningful music. The limited research that does exist points to multiple and significant benefits that may be derived from receptive or active musicking supported by a range of music technologies. (shrink)

This article uses data from the National Longitudinal Study of Youth to examine the phenomenon of later life education among women who first give birth as teenagers. The analysis first considers patterns of educational attainment through the middle 30s for all women, disaggregated by age at first birth. This allows for an examination of the amount of education received by teen mothers relative to women who delay giving birth until adulthood. The analysis also considers racial-ethnic differences in patterns (...) of attainment. Next, the analysis is restricted to teen mothers and focuses on an examination of the composition of educational attainment according to the amount of time that has elapsed since the first birth. The findings suggest that later life education among teen mothers is an important and understudied phenomenon with implications for welfare reform and adult education policies. (shrink)

For older workers, self-employment is an important alternative to waged employment. Drawing on social learning theory and social cognitive career theory we examine how attitudes toward one’s own aging, future time perspective (captured by perceived time left to live) and perceived support from referent individuals predict self-efficacy for entrepreneurship and outcome expectations, influencing self-employment interest. Findings from a sample of professional association members (n = 174, mean age 52.5 years), revealed that an open-ended time perspective relates positively to entrepreneurial self-efficacy, (...) while social support relates positively to outcome expectations. Consistent with social cognitive career theory, entrepreneurial self-efficacy mediated the relationship between future time perspective and interest in self-employment, and outcome expectations mediated the relationship between social support and interest in self-employment. This study extends current career and entrepreneurship theory in several ways. First, the inclusion of age-related psychosocial and sociocultural factors in the study model shed light on the intersection between older age, the contextual environment and development of self-employment interest. Second, the findings support earlier arguments that older entrepreneurship is a social process whereby the social context in which people work and live influences their interest in entrepreneurship, and that entrepreneurial behavior among older peop... (shrink)

ObjectivesThis study examined the association between childhood adversity and cognitive impairment in later life and explored the potential moderation effect of gender and race.MethodsThe study sample included 15,133 participants of the Health and Retirement Study who had complete data on key study measures and were more than 50. The outcome variable is a dichotomous indicator of cognitive impairment as assessed by the Telephone Interview for Cognitive Status for self-respondents and the 16-item Informant Questionnaire on Cognitive Decline in the (...) Elderly for proxies. A total of six childhood adversity indicators included grade retention, parental substance abuse, physical abuse, trouble with the police, moving due to financial hardship, and receipt of help due to financial hardship in early life. The estimation of the association between childhood adversity and cognitive impairment involved Cox proportional hazards regression. Results: Grade retention had the largest effect on incident cognitive impairment, followed by physical abuse by a parent. The impact of grade retention was more detrimental to women than men. Parental substance abuse was associated with a lower risk of incident cognitive impairment for most racial groups, but this association was reversed in “non-Hispanic other” race, consisting mainly of Asians.DiscussionSome aspects of childhood adversity continue to harm cognitive functioning in later life, while some events may have the opposite effect, with evidence of heterogeneity across gender and race. (shrink)

Public and academic medical ethics debates surrounding justice and age discrimination often proceed from a problematic understanding of old age that ignores the diversity of older people. This article introduces the feminist perspective of intersectionality to medical ethical debates on aging and old age in order to analyze the structural discrimination of older people in medicine and health care. While current intersectional approaches in this field focus on race, gender, and sexuality, we thus set out to introduce aging and old (...) age as an additional category that is becoming more relevant in the context of longer life expectancies and increasing population aging. We analyze three exemplary cases on the individual, institutional, and public health level, and argue that considering the intersections of old age with other social categories helps to accommodate the diverse identities of older people and detect inequality and structural discrimination. (shrink)

This chapter discusses three types of sociable robots for older adults: robotic caregivers ; robotic friends ; and sex robots. The central argument holds that society ought to make reasonable efforts to provide these types of robots and that under certain conditions, omitting such support not only harms older adults but poses threats to their dignity. The argument proceeds stepwise. First, the chapter establishes that assisting care-dependent older adults to perform activities of daily living is integral to respecting dignity. Here, (...) the argument establishes the vital role that carebots-of-the-future might play in aged societies as the supply of working age adults falls shy of demand. Next, the chapter extends this analysis to designing friendbots for socially isolated older adults. The argument holds that reasonable efforts to provide access to friendbots for socially isolated adults is also a future societal responsibility. Finally, the chapter applies similar reasoning to show that societies ought to make reasonable efforts to support sexual capabilities for older adults who want to be sexual but are bereft of sex partners. The argument draws on capability accounts of justice to show that when central human capacities, such as bodily integrity; intimate relationships; and the use of senses, imagination and thought, are at risk of falling below a threshold level, society should intercede. (shrink)

Little work has focused on resilience amongst older adults, and few factors have been identified that promote their resilience. Kalisch et al. suggest that socioenvironmental factors are distant influences. We argue, however, that community and societal influences are as important as individual ones. Further, an ecological framework explains why some older adults are resilient whilst others are not.

Young men are more distressed by a partner’s sexual infidelity, whereas young women are more distressed by a partner’s emotional infidelity. The present research investigated (a) whether the sex difference in jealousy replicates in an older sample, and (b) whether younger people differ from older people in their selection of the more distressing infidelity scenario. We presented forced-choice dilemmas to 202 older people (mean age = 67 years) and to 234 younger people (mean age = 20 years). The sex difference (...) replicated in the older sample. In addition, older women were less likely than younger women to select a partner’s emotional infidelity as more distressing than a partner’s sexual infidelity. Discussion offers directions for future work on sex differences and age differences in jealousy. (shrink)

In this article, we use an entry to an international architectural student competition on future care to explore how social norms about older bodies may be challenged by designs that are sensitive to the spatial contexts within which we age. The power of the My Home design by Witham and Wilkins derives from its hand-drawn aesthetic and thus we consider the architects’ insistence on drawing as a challenge to the clear and unambiguous image-making typically associated with digitally aided architectural designs. (...) The hand-drawn images of My Home prompt a focus on care as enacted through the relations between material environments and things, and the atmospheric qualities these relations evoke. Throughout our analysis, we argue for greater attention to the ways in which embodied practices, everyday affects and materialities can be represented within architectural design, and the role of hand drawing as a creative methodology in this process. (shrink)

A positive attitude toward later life is crucial for wellbeing among older adults. Maintaining a healthy relationship with adult children can help reduce older parents’ sense of loneliness and nurture a positive life attitude. This study aimed to investigate the associations between multidimensional intergenerational relationship quality and attitudes toward later life among aging Chinese adults in Hong Kong and examine the mediating effects of a sense of loneliness. Representative survey data were collected from 801 participants (...) with at least one adult child. Multiple linear regression was employed to investigate the associations between overall intergenerational relationship quality with a sense of loneliness as well as the attitude toward later life. To examine the mediating effects of a sense of loneliness, causal mediational analyses were performed. Results demonstrated that overall intergenerational relationship quality was positively associated with aging parents’ attitude toward later life, and this relationship could be partially mediated by a sense of loneliness. Among the four subdomains of intergenerational relationship quality, the influences of structural-associational solidarity and intergenerational conflict on attitude toward later life were almost fully mediated by a sense of loneliness, whereas the influences of consensual-normative solidarity and affectual closeness were partially mediated. These findings contributed to an improved understanding of the relationship between intergenerational relationship quality, sense of loneliness, and attitude toward later life, and could inform future policies and service programs that promote aging adults’ social integration and positive aging. (shrink)

In the original publication of the article, the title of the article was incorrectly published. It has been updated in this correction.

There is a rapid growth in published knowledge about different aspects of age and aging. While this is highly welcome, it becomes increasingly difficult to keep up even with the main insights provided by this literature. Our review thus aims to provide a compact overview of current social science research in three major domains of older people’s life: health, families, and work. Moreover, we briefly discuss some theoretical issues and introduce the Survey of Health, Ageing, and Retirement in Europe (...) (SHARE). The research findings discussed here demonstrate both the challenges and opportunities lying ahead of us as life expectancy is increasing steadily and as the proportion of older people in our societies will grow further. More generally, we find a great value of life course and cross-nationally comparative perspectives in aging research. We conclude with an outlook on perspectives for future studies in this field. (shrink)

This volume addresses the issues of the Third Age--that time after retirement when financial stability and reduced obligations to others, together, allow for freedom--and good health makes it possible to enjoy that freedom. How, in this special time of life, is meaning and purpose to be found? And what alternatives are available? These difficult questions are responded to by scholars in the field of aging, some themselves in the Third Age.

Based on fieldwork among Islamic bankers globally, this book questions the equivalence between money and ethnography and asks whether money can ever be adequate to the value backing it. "I enjoyed this book mightily.

One of intuitions driving the acceptance of a neat structured tree of life is the assumption that organisms and the lineages they form have somewhat stable spatial and temporal boundaries. The phenomenon of symbiosis shows us that such ‘fixist’ assumptions does not correspond to how the natural world actually works. The implications of lateral gene transfer (LGT) have been discussed elsewhere; I wish to stress a related point. I will focus on lateral function transfer (LFT) and will argue, using (...) examples of what many would call ‘superorganisms’, that the emergence of symbiotic individuals revives the importance of functional and adaptationist thinking in how we conceptualize the lineages of biological individuals. The consequence of the argument is that, if we really want to hold onto tree of life thinking, we had better accept that new saplings appear and disappear all the time. (shrink)

In his Letters and Papers from Prison, Dietrich Bonhoeffer urges Christians to feel their longings for earthly realities to the fullest, and argues that such yearnings strengthen faith. This issue has been overlooked by Bonhoeffer scholars, despite its central place in the Letters; this study seeks to correct that oversight. Through a selective, chronological analysis of the Ethics, this text shows Bonhoeffer progressively developing a positive view of the natural and of fallen life which undergirds his later encouragement (...) of secular longings in the Letters. This new perspective has rich implications for Christian anthropology and ethics. (shrink)

In this paper; having somewhat arbitrarily adopted a general line of interpretation of Wittgenstein on forms of life in which the word ’life' is taken in a biological sense, I try to work out ways of being more specific than that, which (a) are philosophically interesting, (b) are consistent with Wittgenstein's uses of the expression form of life' and with other remarks of his that seem closely connected, and (c) that take seriously both his disavowal of THESES (...) in philosophy and his (related) belief that the job of philosophy is not to devise better theories, but to show how the problem itself arises from a particular kind of misunderstanding of language. A number of ways in which the idea of a form of life could play that sort of part are explored, for example the question how we know from which direction a sound comes, which we might initially have supposed to be answerable by reference to a calculation of the time difference in the arrival of a sound wave at one ear and then the other is rejected in favour of a supposition that the waves affect the nervous system and thereby causes us to look in the correct direction. This is an important difference. A neurologist might spend half a lifetime tracking down the nerves that calculate the direction, ana fail because no such calculation is done. Misdirected questions about identifying and locating pains, and about mastery are investigated, and finally Wittgenstein is depicted as holding that the nervous system, together with membership in a community provides all the assurance we need of the general correctness of calculations. (shrink)

The paper argues that an internal debate within Wittgensteinian philosophy leads to issues associated rather with the later philosophy of Martin Heidegger. Rush Rhees's identification of the limitations of the notion of a “language game” to illuminate the relation between language and reality leads to his discussion of what is involved in the “reality” of language: “anything that is said has sense-if living has sense, not otherwise.” But what is it for living to have sense? Peter Winch provides an (...) interpretation and application of Rhees's argument in his discussion of the “reality” of Zande witchcraft and magic in “Understanding a Primitive Society”. There he argues that such sense is provided by a language game concerned with the ineradicable contingency of human life, such as (he claims) Zande witchcraft to be. I argue, however, that Winch's account fails to answer the question why Zande witchcraft can find no application within our lives. I suggest that answering this requires us to raise the question of why Zande witchcraft “fits” with their other practices but cannot with ours, a question of “sense” which cannot be answered by reference to another language game. I use Joseph Epes Brown's account of Native American cultures (in Epes Brown 2001) as an exemplification of a form of coherence that constitutes what we may call a “world”. I then discuss what is involved in this, relating this coherence to a relation to the temporal, which provides an internal connection between the senses of the “real” embodied in the different linguistic practices of these cultures. I relate this to the later Heidegger's account of the “History of Being”, of the historical worlds of Western culture and increasingly of the planet. I conclude with an indication of concerns and issues this approach raises, ones characteristic of “Continental” rather than Wittgensteinian philosophy. (shrink)