Gender and Age: A Focus on Women Valuing Old Age Without Leveraging Ableism By Clara W. Berridge and Marty Martinson Our medical model of “successful aging” without disability sets up the majority of the population, especially women, for failure. everal years ago, while working in a senior Lamb’s research involving a Boston retirement Shousing co-op development, one of us (Ber- home where residents considered banning ridge) witnessed a troubling conversation be- wheel­­chairs in the main dining hall. One resident tween several residents in a high-end Midwest who supported the ban explained that seeing the cooperative. The older adults discussed their de- wheelchairs disturbed her because, “I don’t like sire to keep people who used wheelchairs from the intermingling of the well and the sick.” playing cards near the sunny lobby windows, Such examples of elders distancing them- where they would be visible to passersby. On selves from and judging other elders who are another occasion, having heard from resident- disabled or ill are not surprising in the United members that they had downsized and moved States, where we often define and uplift the heal­­ into the co-op because they wanted to age in thy older adult as one who is not disabled and place there, Berridge asked the architect why is active, productive, and “not looking her age.” there were no universal design features—or at Phrases such as “70 is the new 50” reflect a “pos- least grab bars—in any of the newly built bath- itive aging” discourse, which suggests that the rooms. The architect explained that the units preferred way of being old is to not be old at all, would sell better this way. Some of the resi dents but rather to maintain some image of middle-age and architect apparently shared a concern that functionality and appearance. outsiders would see the co-op as a place for old We can celebrate the fact that baby boom- and disabled people—an image they wanted ers will “do old age” in many different ways than to avoid. those who came before them. It is not unusu- Anthropologists Lamb, Robbins-Ruszkowski, al for each new aging cohort to redefine old age and Corwin (2017) shared a similar story from from that of previous generations to fit with con- ABSTRACT Models of successful aging based primarily on the avoidance of disease, disability, and functional loss set up the majority of the older adult population for failure—a majority of whom are women, in particular, women of color. This article explores the ableism embedded in successful aging, as enacted through a medical model approach to disability. The authors propose understandings of aging that integrate a social model of disability, to de-pathologize disability, acknowledge the complex experi- ences of disability and disease, strengthen gerontology’s interdisciplinary work, and avoid lever­­aging ableism to combat ageism. | key words: disability, ableism, successful aging, social model Copyright © 2018 American Society on Aging; all rights reserved. This article may not be duplicated, reprinted or distributed in any form without written permission from the publisher: American Society on Aging, 575 Market St., Suite 2100, San Francisco, CA 94105-2869; e-mail: [email protected]. For information about ASA’s publications visit www.asaging.org/publications. For information about ASA membership visit www.asaging.org/join. Volume 41 .Number 4 | 83 GENERATIONS – Journal of the American Society on Aging temporary times. Like generative notions of gen- el’s critique of the medical model of disability can der performance (Butler, 1990), age is and can be stimulate an embracing and more relevant under­­ performed in ways that hold liberating potential standing of aging, particularly as it pertains to for older women to counter monolithic images women, who are more likely to experience dis- of this life stage and break out of expected ways ability and live longer with dis­­ability (Gorman of being. These diverse, norm-defying ways of and Read, 2006). We put forth the challenge of- being old may challenge aging models put forth fered by disability and transformative justice by gerontologists; or, as we describe here, they orga nizer Mia Mingus (2011), who asks, “How do may fall in line with these models of aging in less we build across our communities and movements liberating ways. so that we are able to fight for each other without Successful aging has become the most promi- leverag ing ableism?” nent of several popular “positive aging” models (e.g., active aging, productive aging) developed Limitations of a Normative Model by gerontologists in rejection of previous charac- for Successful Aging terizations of aging that forecasted imminent de- In previous work, we reviewed twenty-five cline and loss. In 1987, Rowe and Kahn first in- years of published critiques of successful aging troduced a new distinction between “usual” models and found several recurring themes: aging and “successful” aging; a decade later, their overly narrow criteria; the missing perspectives refined model defined successful aging through of older adults; perpetuation of individualistic three hierarchical components: first, avoidance views of aging consistent with neoliberal ideolo- of disease and disability, followed by mainte- gies; and ageist and ableist impulses (Martinson nance of cognitive and physical function, which and Berridge, 2015). We do not detail the many should enable social engagement (Rowe and critiques, but will highlight some key points to Kahn, 1997). provide context. Social gerontologists and other scholars have One major critique has been the narrow long noted the limitations of these binary mod- criteria for successful aging, as evidenced by els of positive aging, which imply that “negative” Mc Laugh­­­lin and colleagues’ (2010) finding that ag­­ing exists outside these parameters. In this only 12 per cent of people ages 65 and older meet ar­­ticle, we build upon two and a half decades of Rowe and Kahn’s three hierarchical criteria. compelling critiques of successful aging by div- Two key criteria—the avoidance of disease and ing into one particular aspect: successful aging’s disability, and the maintenance of physical and ableism, as enacted in its privileging of the avoid- cognitive function—prove to be particularly ance of disease, disability, and functional decline rare occurrences among American older adults. through the label of success. We define ableism While people may be living longer and health- as discrimination and prejudice against people ier than previous generations as a whole, those with disabilities, based on assumptions of infe- who live without some kind of impairment or riority, abnormality, or diminished humanity, chronic illness are in the minority. Among the rather than understanding disability as a dimen- more than 43 million Americans older than age sion of difference or another way for a body and 64, approximately 80 percent have at least one mind to be. chronic condition and 68 percent have at least We highlight the perspectives of several fem­­ two (National Council on Aging, 2017). About inist and disability scholars and activists whose half are expected to experience severe cog- work on social models of disability has chal- nitive impairment or require long-term care lenged our thinking and offered us a generative for support with two activities of daily living lens on aging. And, we explain how a social mod- (Favreault and Dey, 2015). Copyright © 2018 American Society on Aging; all rights reserved. This article may not be duplicated, reprinted or distributed in any form without written permission from the publisher: American Society on Aging, 575 Market St., Suite 2100, San Francisco, CA 94105-2869; e-mail: [email protected]. For information about ASA’s publications visit www.asaging.org/publications. For information about ASA membership visit www.asaging.org/join. 84 | Winter 2017–2018 Gender and Age: A Focus on Women Women are particularly impacted by disa- felt this pain as funders have de-prioritized older bility. Women are more likely than men to have adults in favor of other age groups that are non-fatal chronic conditions and disabilities and deemed needier. to live more years disabled (Gorman and Read, The positive aging narrative risks obscuring 2006), and almost 80 percent of women turn- the very real needs of many older adults, which ing age 65 will need long-term care in their life- has particular impact on women. In general, wo­­ time, compared with 58 percent of men (Kemper, men accumulate less income over the life course Komisar, and Alecxih, 2005−2006). Black and and are likely to outlive spouses and partners, Mexican American women experience more leaving fewer human and financial resources for functional limitations than do white women or them in later life. This means that older women men of any race (Erickson, Lee, and von Schra- are more likely to be harmed by cuts to health der, 2016), and American Indians and Alaska and social services. Natives experience far greater prevalence of About a third of the critiques we reviewed disability than do their age counterparts of called for the rejection—not the expansion or any race (Smith-Kaprosy, Martin, and Whitman, 2012). We often define and uplift the healthy older Suffice it to say, setting criteria for “success” in aging based primarily on adult as one who is not disabled and is the avoidance of disease, disability, and active, productive, and “not looking her age.” functional loss sets up the vast major- ity of the older adult population for failure—a revision—of successful aging as a concept and majority of whom are women, and in particular, ideal. They challenged the concept’s portray- women of color. al of aging and health as personally controlled Critics have also argued that successful aging through behavior and lifestyle choices.