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Qualitative Inquiry Group (QUIG) Seminar

By Alvin Warren,2014-05-17 22:25
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Qualitative Inquiry Group (QUIG) Seminar

    Qualitative Inquiry Group (QUIG) Seminar

    Doing Research on Aging When Nobody Is Old

    Stephen Katz

    Friday, October 12, 12 noon

    Room 108 Health Sciences Building, 155 College, University of Toronto

     Good afternoon and my thanks to Joan Eakin and the Qualitative Inquiry Group

    for inviting me to join you today to discuss the methodological issue of doing research

    on aging when nobody seems to be old. This seminar is inspired by my own

    ethnographic experiences and recent theoretical writing on the place of „function‟ in

    research on aging. I have been beset by two dilemmas in this research; first, how do we

    identify old age and the aging process in terms of age-based criteria. And second, how

    do we identify older people in relation to their own criteria, including their own

    „feeling‟ about age within their biographical narratives. As researchers we often assume

    that certain problems of aging can be associated with certain types of older people and

    we choose research subjects because they seem to embody these problems of interest.

    In the process, we can also assume that these problems and selected characteristics of

    aging seem to be obviously present in older people.

     Research problems of aging are by no means all health-related or about negative

    conditions. Indeed, the practical agendas of current gerontological research are to

    identify people who seem to defy the negative stereotypes of aging - decline, disease,

    decrepitude, dependency (all the D‟s) - and then promote new data about people who

    are mostly healthy, independent, active and live in supportive communities. These

    kinds of data also underpin the advocacy mission of gerontology to defend and liberate

    old age from social ageism. This is all well and good, but again, there are assumptions

    that social problems around aging can be aligned directly to certain older actors and

    their bodies. Questions that are rarely addressed, however, are: How did the

characteristics with which we associate age and aging became so distinguished? Who is

    old and how do we know them? What is the research relationship between bio-age

    markers, cultural age-markers and personal age-markers and with which do we start

    when we research aging?

     In 1999, I undertook a research project with a group of Canadian „snowbirds‟. Snowbirds, as you know, are retired individuals or couples who spend their winter

    months in the warmth of Florida, Arizona or Texas, often in mobile-home parks or „Sun

    City‟ type enclaves. In Europe there is a similar pattern between Nordic snowbirds who seasonally migrate to southern areas of Spain or the Mediterranean areas. When I

    decided to do my research I thought it would be interesting to consider how older

    mobile communities in Florida were creating new geographical arrangements or, as I

    called them, „elderscapes.‟ Snowbird elderscapes are mostly contained in a series of

    mobile home „parks‟ and gated communities carved out of areas close to Florida‟s coasts,

    often with little in common with the surrounding areas. They are Canadian American

    communities, intersecting both cultures. I visited two such communities, Maple Leaf

    Estates and Victoria Estates, in Charlotte County in the Gulf region of Florida.

    Unfortunately, each was subsequently devastated by Hurricane Charley in 2004.

     Charlotte County, Florida, is one of the fastest growing retirement regions in the

    world - with an average of 40-50% of the population being 65 or older. Its AARP office

    (Association of American Retired Persons) has a success rate of 75% in finding jobs for

    seniors, which is the second highest rate in the United States. Charlotte County is also

    home to the popular weeklong „Senior Fit For Life Games‟. There is every kind of medical service available, for pay, and the drugstores are the super-stores in the local

    malls. So, when I went to talk to people about snowbird and elder living in Charlotte

County, I faced my dilemma - with the entire County practically reinvented to cater to

    an aging population, nobody says that they‟re old or says that their chronological age

    really reflects who they are.

     Naively, when I started my interviews at Maple Leaf Estates, I said I wanted to

    talk to some older residents. Almost everyone pointed me to somebody else. „Oh, you

    want the Murray‟s next door, they‟re old. We‟re not old, just retired.‟ Then the Murray‟s next door would point me to the Wilson‟s down the road, who pointed me to

    the poor Mrs. Smith in the next street. And on it went. Everybody was retired, but

    nobody was old or even necessarily „senior.‟ When I asked about their taking advantage of „early bird specials‟ at restaurants and „discount days‟ at the malls, most

    claimed that these were events for „older people‟, not them. Even when they spoke of

    people who died, they weren‟t old, they just died before their time. The language of

    „seniorhood‟ was acceptable and being a „senior‟ was much preferred of course to being

    „old‟ or „elderly‟. Health problems that accumulated because of age were often seen as

    due to accidents or poor diet or lack of exercise, not age itself. At a local supermarket I

    was interested in interviewing older workers to find out more about their earlier careers.

    Nobody showed up to a meeting I arranged, however, because I had said I wanted to

    meet older workers, except one fellow who said there were no older workers at the

    supermarket, just some retired guys who worked there to keep in shape, get out of the

    house and make a little card money. I had a similar experience working with people in

    a University of The Third Age group in Britain. Most were retired and growing older,

    but few said that they felt they were actually aging.

     I thought there has to be some way to self-identify age groups based on age

    beyond the rather vague category of „senior‟. Marketing firms have this problem as

    well as they try to identify age-based demographic targets for their products. There was a recent attempt by Gerber‟s baby food to make a line of products called „senior foods‟, which would be just like baby food, since it was discovered that a great deal of

    baby food is purchased by older consumers. The campaign completely failed of course. I realized we live in a youth-obsessed society with a growing anti-aging culture that devalues age and all that is associated with it - wisdom, memory, tradition, time, biography (except for vapid celebrities) and generation. There are also far too few identities that are meaningfully associated with age and aging and I know that older people are not fooled by the post-modern industries attempt to fill that gap by blurring the boundaries of age with uni-age products, fashions and lifestyles. And there are more demands for age-sensitive and age-relevant technologies, housing, fashion, transportation and financial products. In addition, people do fight for entitlements, dignity and respect based on their age. So it‟s not just a matter of age-denial, but of age-

    identification both by the researchers and the people themselves.

     Some of the question from my research experiences led me to think about the cultural dynamics between Self and body in the aging process, and the coercive asymmetry between the subjective experience and „feeling‟ of age and the body‟s outward aging appearance. For those who experience their middle and later lives as youthful and thus feel younger than they look, the tension between young and old identities becomes a critical motif in their life-course narratives. British cultural sociologists Mike Featherstone and Mike Hepworth use the term „mask of aging‟ to

    characterize this growing space between the experiences of and the „look‟ of aging (Featherstone and Hepworth 1991). Just as middle-aged and older people are encouraged to emotionally feel themselves as permanently young; they are culturally

    betrayed by their aging faces and bodies. Hence the growing success of cosmetic, lifestyle, exercise and pharmaceutical products aimed at enhancing agelessness makes some sense. The cultural model here is that there is always a deeper, younger Self underlying the bodily signs of aging. And for those who live through age-related poverty or disability, their suffering is unfairly publicized as the result of an individual failure to participate in the so-called „empowering‟ opportunities of responsible

    consumerism.

     These aspects of the masking process apply more to women across a deeper personal and cultural horizon of experiences because of the inflated role appearance and the construction of beauty are made to play in defining successful femininity as triumphal over age. But for both men and women, as middle age becomes extended further and further into later life the subjectivity of aging itself becomes a continual middle-age experience. As Zygmunt Bauman says about the postmodern world, “life is

    a succession of self-cancelling determinations” where “no loss is irretrievable” (1992,

    pp. 169, 173). In those worlds where extreme physical performance means that careers end early, such as those of dancers or athletes, the clash between younger and older identities is even more pronounced.

     The question of how do we know what age means in the research process

    influenced a number of papers I produced with my colleague at Trent University, Barbara Marshall, about „functionality‟, and the idea of „functional age‟, to which I‟d like to turn to now. In addition to the cultural ambivalence around the meaning and masking of chronological age, there is also an intellectual and methodological ambivalence about our definitions of age itself. Historically, the establishment of the chronological age of old age and statistical lifespan probabilities distinguished the

sciences of aging from pre-modern medicine and its fanciful ideas about longevity. As

    Jean-Martin Charcot stated in the introduction to his seminal work, Clinical Lectures on

    the Diseases of Old Age: “The new physiology absolutely refuses to look upon life as a

    mysterious and supernatural influence which acts as its caprice dictates,” but rather,

    “purposes to bring all the vital manifestations of a complex organism to workings of certain apparatuses, and the action of the latter to the properties of certain tissues of

    certain well-defined elements” (1881, p.12). As this group is aware, the welfare

    programs and service economies that arose in the nineteenth and twentieth centuries

    also used age categories to create new social and economic groupings, hence the „ages

    of‟ military recruitment, schooling, retirement, etc. became institutionalized within the

    bureaucracies of a modern life course regime. So, chronological age has been an

    important way of organizing populations into economies and institutions.

     However, in terms of gerontological research chronological age became was an

    methodological obstacle. In particular, chronological age became was seen as

    unscientific because it lacked predictive value, methodological validity, and conceptual

    rigor. It tells us very little about a person. What does it really mean to be 55, 65 or 95?

    As gerontologist James Birren states, “chronological age is only an index, and unrelated

    sets of data show correlations with chronological age that have no intrinsic or causal

    relationship with each other. Thus a goal of theory and research is to replace

    chronological age with variables that reflect the causes of change we initially identify as being closely related to chronological age” (1999, p. 460). Gerontologists, as early as the

    1950s, had already begun working towards this goal and claimed that in order to

    understand the aging, we needed several „ages‟.

     For example, one of the first papers, by I. M. Murray (a Canadian), states: “It is

    well known that chronologic age is not necessarily the same as physiologic age.” (1951,

    p. 120). Murray‟s research with an all-male group of 21-84 year olds at Dalhousie University demonstrated that physiologic and chronologic ages varied relative to each

    other, producing in the end a measurable „age‟ based on „functions‟ which would be,

    notes Murray, not only advantageous to researchers but also to life insurance

    companies. However, Murray‟s functions are calculable instances of variation that

    culminate in the physiological materialization of the aging body. In other words, age is

    a relationship to function and in Murray‟s research “a man would not be judged

    physiologically older or younger unless his physiologic age differed by more than +/-

    14.7 years from the chronologic age” (p. 123). In short, individuals of similar

    chronological ages could have different physiological ages. You could be 75 with the

    heart of 55 or 45 year old and the arthritic conditions of a 95 year old.

     Beginning in 1963, these ideas about functional age were elaborated and tested in

    a major gerontological undertaking called The Normative Aging Study (NAS),

    conducted at the American Veterans Administration Outpatient Clinic in Boston.

    Results of the study were gathered into a special issue of the journal Aging & Human

    Development in 1972 (3 (2)); with the journal‟s leading editorial, „Is Functional Age

    Functional?,‟ posing functional age as the alternative to chronological age. The editorial asks: “Are we ready, as a society, to base age-related decisions upon scientific findings rather than tradition and expediency? Are we ready to make individual rather than

    class decisions?” (p. 143). Are we ready, in other words, to jettison chronological age as meaning anything? The NAS study used four indices of functional ages based on

    biological measurements, sensory and motor abilities, and two more based on “a multi-

factor description of personality” and “a set of sociological assessments of life style

    pertaining to family, work, and retirement” (Bell, 1972, p. 146). If the body can be

    broken down into regions of functionality determined by testable and codifiable bio-

    standards of measurable performance, then the logic of functional health is extendable

    to a person‟s whole life.

     Murray initiated the vision of age as a quantifiable world of correlations and

    statistical relationships. This also meant there could be as many „ages‟ as a researcher

    could identify, endless „ages‟ in fact, an empire of „ages‟ just as there is an empire of functions, including social and behavioural ages and functions. But was „functional

    age‟ really a new threshold, a breakthrough in the gerontology of bodily aging? Not

    really, especially since the supposedly objective and population-wide functional

    standards promoted by the researchers, were based on the all-male NAS sample of 2000

    mostly healthy veterans aged 28-83, were tainted with the industrialist, masculinist, and

    familialistic biases of the time.

     The critics of „functional age‟ complained about four problems. First, it is erroneous to presume that there are uniform rates of aging across different systems, and

    that such rates correlate to single standards of biological age. Second, gerontology has

    not really abandoned chronological age, nor could it hope to do so. After all, how would they know who to test if age didn‟t matter? Third, rates of aging, even when

    functionally isolated to specific bodily regions or processes, change over time.

    Therefore, a test showing a „young heart‟ and slower-than-average age rate for an

    individual is far more likely to be due to the interaction between physical and external

    factors than to physical factors alone. Fourth, different researchers use different

    combinations of different test-battery criteria.

     Given these and other criticisms, the question arises as to whether or not

    functional age actually exists at all. Indeed, an issue of Scientific American in a Position Statement on Human Aging, citing fifty-one leading researchers on issues of aging and

    anti-aging, notes in a sidebar on „Determining Biological Age‟: “Despite intensive study,

    scientists have not been able to discover reliable measures of the processes that

    contribute to aging. For these reasons, any claim that a person‟s biological or “real age”

    can currently be measured, let alone modified, by any means must be regarded as

    entertainment, not science” (May 13, 2002). So, again, no „real‟ age. In which case, how are researchers to study older people and how are older people supposed to know

    themselves and their bio-identities as older, when age is either erased from their lives or

    dispersed throughout the functional states of their physiological abilities, behaviours

    and activities? This leads back to the question of the subjective interpretation of the

    meanings and experiences of growing older. In that 1972 special issue of Aging & Human Development on functional age, gerontologist Robert Kastenbaum posited that

    there is a subjective reality to functional age, determined by correlating the degree of

    „consensuality‟ between „personal age‟ indicators (based on self-reporting status) and „interpersonal age‟ indicators (based on status viewed by others) (1972, pp. 197-211). By administering an interview schedule called the „ages of me‟ to a sample of 75 adults

    aged 20-69, the researchers find that personal age tends to be viewed as younger than

    chronological age, with the gap increasing further up the chronological scale (p. 206). In

    the study, people reported feeling younger than they were; hence the research stresses

    that subjectivity is a significant component in the determination of functional age,

    whereby people acquire the self-skills and professional vocabularies to judge

    themselves as functional.

     Now liberated by scientific gerontology from the uncertainties of chronological

    age, the subjects of the „ages of me‟ study were free to embrace youth-based self-

    conceptions and treat functional age as a mediation point between self and body. In

    their conclusions the authors ask: “Is it „healthy‟ or „pathological‟ to embrace an ever-

    more-youthful self-conception as one grows older?” (p. 210). Good question. Research

    relying on self-reporting or self-evaluation rarely asks this question or how it is that

    people know the difference between general health performance indicators and

    functional health status. Indeed, do people who are better versed in vocabularies of

    self-assessment based on class or cultural capital offer a more reflexive account of the

    relation between feeling a younger versus an older physical or embodied age? They

    know how to talk the talk of health and well-being. Indeed, do functional age

    categories create a discourse of disaggregated ages such that they encourage research

    subjects to think of their lives in terms that disregard age altogether?

     In a recent review of Medline research studies, Liliana Coman and Julie

    Richardson ask if the information obtained through self-reporting is different from that

    obtained from performance measures in cases of disablement (2006). There are

    discrepancies in the information produced in the two approaches, but the authors also

    question what the two approaches are actually reflecting? Without a qualitative

    approach that examines the behavioural and social contexts that influence older adults

    when they are reporting functional ability, or asks the research subjects why they think

    there is a discrepancy between the subjective and the objective measures of their

    abilities, then, again, it is very difficult to know how age is meaningful.

     Gerontological research is about age, aging and growing older. Age matters, in

    other words. However, if there is a cloud of ambivalence about age in our cultural and

    scientific communities, then what does this imply methodologically for doing research

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