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Growing Old (Dis)Gracefully

Write By: Valentin Rosca on

The Feminization of Aging

Population statistics indicate that by the middle of the twenty-first century, it is likely that the world’s population aged over 60 will have reached two billion (or 21 percent of the global population), a situation which has defined the century as “the age of aging” (Magnus 2008). A specific feature of this population is that as it ages, it is becoming increasingly female-dominated since the further up the age scale the greater the proportion of women, with women outliving their male counterparts in nearly all countries (Central Intelligence Agency 2008). Life expectancy for women now exceeds 80 in at least 35 countries, with rapid economic development contributing to increased life expectancy in many other nations (World Health Organization 2005). For example, in Japan, which has the highest life expectancy of any nation, while men can expect to live on average to age 78.8, women’s life expectancy averages at 85.6 (Central Intelligence Agency 2008). A paradox of the longevity revolution is that, while it might be expected that the fact of people living longer would be received with celebration, longer life expectancy is instead often framed as a problem, and variously described as a demographic time bomb and even an “apocalypse of ageing” (Haber 2004). Concerns focus mostly on the impact on the economy, social and health care services, and even the environment, as later life is perceived as one of draining rather than contributing to national economies, increasing demands on welfare services, and using more of the world’s natural resources. One editorial in a science journal described the situation of increasing longevity as “even worse than expected!” (in Kirkwood 2001). For the individuals who live into ‘deep’ old age, most of whom are women, the consequences of these concerns are very real. Recent research found that discrimination against the aged is reported more than any other form of prejudice (Age Concern 2006). This appears to be largely grounded in a perception of aging as a significant health issue, with the aging body viewed as diseased. Older women suffer more negative stereotypes because they live longer and also because gender is so often the basis of social inequalities (see Arber and Ginn 1991; Gibson 1996; Vertinsky 1995). This interplay of gender and age impacts on recommendations for, and experiences of, exercise for older women as will be discussed in the next section.

 

The Gender/Aging/Exercise Nexus

old-couple-smilingPatricia Vertinsky (1998) argued that older women’s bodies are incapacitated as a result of the prevalent belief in western cultures of female bodily incompetence. A specific feature of this is the female menopause, which has traditionally been understood through a bio-medical model of aging as a deficiency disease (Bell 1987). During menopause, women are seen as losing not only their economic productive capacity in their post-employment years, but also their reproductive capacity rendering them useless to society (Vertinsky and O’Brien Cousins 2007). Despite this, older women are generally encouraged to treat their ‘ovarian failure’ with, for example, hormone replacement therapy (HRT). This is due to the alleged association between menopause and osteoporosis, coronary heart disease and Alzheimer’s: perceived relationships which are grounded in discourses reinforcing the perception of the fragility of the aging female body (Ballard et al. 2009; Vertinsky and O’Brien Cousins 2007). Significantly, this leads to a discouragement of strenuous physical exercise in later years, as it is seen as exacerbating weakening, burning up vital energy and so speeding up aging, which consequently obscures the actual benefits of exercise for menopausal women, including the relief of physical and psychological symptoms (see Vertinsky and O’Brien Cousins 2007). According to Vertinsky (1998), such stereotyped loss of physical competence in later life may not be an intrinsic feature of aging but more a consequence of a cultural process of enfeeblement. Furthermore, when aging female athletes have taken HRT for health reasons, many have been banned in international sporting competitions for the use of a ‘performance-enhancing substance’ by drug-testing regulations which ignore the needs of older female competitors (Burger et al. 1996). There is also an interesting paradox in the sociology of aging. While older women are more visible as a result of their greater longevity, gender has been traditionally neglected as a focus for analysis (Arber and Ginn 1991). Certainly early gerontology had a ‘masculine bias’ (Russell 2007) focusing on the problems men encountered far more than their female counterparts. Notably, the British Heart Foundation recently also identified men as a priority target group on the basis that they have earlier mortality and do not use health services frequently as compared to women (Laventure 2007). An examination of policy documents and media reports indicates a seemingly unquestioning acceptance of the need for an increasingly aging population to engage in ‘active aging,’ a key theme in the United Nations, World Health Organization and European Commission as well as national and local policies, despite common perceptions of the frailty of the aging female body (European Commission 1999; World Health Organization 2002, 2005). This has also influenced research agendas. For example, in 2009 the combined Research Council U.K. identified aging, lifelong health and well-being as priority research areas. These policies and agendas encompass a variety of ways of maintaining active citizenship and contributing to society in later life, but invariably promote physical activity and exercise as having health and social benefits. These include perceived benefits for physiological functions most notably improved flexibility, balance and muscle tone. The dominant message is that exercise may help to prevent falls, which are the major cause of disability among older people (World Health Organization 2005). In addition, it is argued that exercise improves psychological well-being, addresses social isolation and enables the maintenance of independence in later life, particularly for older women who live longer and often alone (Cattan 2001; Kluge 2002; Department of Health 2004). However, activity statistics demonstrate that involvement in exercise in most developed nations decreases with age, and that women are less active than men throughout the life course (DCMS/Strategy Unit 2002). 

 

An additional concern is that, while it is generally accepted that an active lifestyle will reduce certain diseases (and, therefore, related medical costs) among some population subgroups, there is not sufficient information about the aging process or age-related diseases to be certain of the benefits to women of exercise in its various manifestations (Clements, 2006). Weinert and Timiras identify 15 different theories of what causes aging, and they conclude that despite advances in knowledge “the ultimate causes of aging remain unknown” (2003). Since the underlying causes of age-related frailty are not well understood, there is at best inconclusive evidence that exercise prescription will prevent falls or improve functional competence (Fair 2006 in Tulle 2008). Indeed, Coalter (2007) even suggests that evidence of health benefits which are based on one single variable (physical activity) are crude, limited, may contain substantial margins of error, and are often based on theoretically informed judgments rather than empirical evidence. Regardless a plethora of official policy documents, public health messages and increasingly business enterprises continue to draw from this research to promote the physical, psychological, and social benefits of exercise in specific forms and for specific populations. In a survey of the ‘position stands’ presented in sports science literature, Tulle (2008) identified an acceptance that exercise is at the forefront of the fight against disease and aging, especially the ability to reduce falls in later life. The resulting anti-aging science agenda claims that symptoms can be alleviated, life expectancy and lifespan extended, and aging delayed and/or reversed. The relationship between exercise and the prevention of aging is stated as a ‘truth,’ it is given substance by ‘scientific discovery,’ and supports the use of exercise as ‘prevention’ against disease and aging. These are then applied to the aging population with claims of ‘morbidity compression’ which means attempts to increase the health span rather than the life span, lengthening the period of active retirement, commonly termed the Third Age, while reducing the Fourth Age period of decline, dependency and ill-health. The rhetoric surrounding the compression of morbidity makes assumptions that it is possible to decouple age and disease. However, it is known that normal aging and age-related diseases share common causes and are directly connected. Therefore, it is impossible to compress morbidity unless we can control the rate of aging (Kirkwood 2001). Against this backdrop of broad policy recommendations grounded in inadequate understanding of the aging process, I examined the lived experiences of older women who negotiated the terrain of expected and acceptable ways of aging.

 

Method And Theoretical Framework

old-couple-happy-in-sunny-dayThe research presented in this article draws on participant observation, interviews and the written stories of British women over the age of 60. This is the current age of retirement in the U.K., and a life stage which is regarded as significant in its impact on lifestyle, access to regular social networks, physical activity and mental stimulation. These women were recruited from a variety of exercise settings: some regularly took part in exercise classes including Masters swimming clubs and a Scottish dancing group, some had been referred to an exercise program for particular health benefits (specifically cardiac rehabilitation and diabetes), others were engaged through a process of snowball sampling as people known to the researcher or other participants. The participant observation was undertaken by the author over a period of two years by participating in Masters swimming training sessions. Unstructured conversational interviews (Amis 2005) were initiated by the author indicating a general interest in the changing role of exercise in participants’ lives as they aged, and then examined emergent themes via prompt questions during the course of the conversation. The interviews lasted between 30 to 120 minutes, were recorded on a Dictaphone, transcribed and coded by systematic thematic analysis. Some women were prepared to write down their experiences in addition to face-to-face contact with the author. Others who were not available for interviews were provided with a questionnaire which, after some initial biographical data, simply encouraged them to write freely about their experiences of the aging process, how they felt about their bodies as they grew older, and the role that exercise had played in their lives through the life course. The level of engagement in the research project was varied from those who were interviewed several times, wrote detailed stories of their lives and were regularly observed, to those with whom there were informal conversations or who sent brief notes to the researcher. The choice of methods and analysis of these women’s experiences is informed by the work of Erving Goffman. In particular, this follows the critique that social gerontology and studies of exercise and aging have tended to be dominated by positivist and survey-style approaches (Grant and O’Brien Cousins 2001; Markula et al. 2001)This is important because the longer a woman lives, the greater the array of life experiences that she has had, making older populations increasingly heterogeneous and less easy to categorize in any meaningful way (Nilsson et al. 2000; Thompson 1992). This article, therefore, takes as its point de depart a need to avoid generalizing the experience of aging and understand individual differences and the ways that older adults interpret their social worlds through qualitative methods of enquiry (Grant and O’Brien Cousins 2001). Specifically the research responds to concerns that there remains limited examination of the meaning and significance of women’s involvement in exercise in later life (Langley and Knight 1999; Roper et al. 2003). Furthermore, it will be identified in what follows that an understanding of corporeality is central to the understanding of aging and exercise, and that this is particularly relevant to older women (Wahidin and Powell 2003). In drawing on the work of Goffman, I take on board the criticisms of his work including his lack of an explicit macro-perspective and what some regard as his failure to appreciate the gendered basis of people’s experiences. Goffman was interested almost exclusively in the subtle nuances and minutiae of human speech and activities that underpin human interaction and which he termed “face work” (Goffman 1967). Throughout his writings, he also demonstrates an awareness of how gender, specifically in the case of women, may be interactionally consequential, and a concern with the consequences of gendered practices for the production of gender as a social institution (see Smith 2006). 

 

The ‘Agender’

old-woman-smilingIt has long been argued that age may exacerbate other existing social inequalities, in particular gender, and this may be experienced as a ‘double jeopardy’ of discriminatory practice (de Beauvoir 1972). Furthermore, older women’s exercise promotion, often grounded in medical discourse, rarely seems to take into account what may be meaningful to the women themselves. I use the term the ‘AGEnder’ to explore the nexus where age and gender are key to the experience of the agenda of the exercise policy makers. Clarke and Warren have argued that the “active healthy aging” agenda is “typically framed by policy makers, researchers and service planners, who tend to define activity from middle-aged or youthful perspectives that may not be congruent with older people’s experiences” and “seldom is the focus on what older people themselves desire, and more often on ‘what you think we need’ (Joseph Rowntree Foundation 2004)” (2007). Sam (2003) and Sam and Jackson (2004) further observe that while policies frame social problems and reflect public values and the demands of interest groups, they also shape public expectations in defining the issue and setting the agenda through best practice guidelines for future plans and actions. This in turn can change, exacerbate and create further problems. The policy makers have adopted a view of aging as a period of frailty and decline which needs addressing through a counter-discourse of positive/active/healthy aging. Governmental anti-aging campaigns, medical and social care experts, thus, aim to keep people healthy and independent of the need for socioeconomic support (see Dionigi 2006; Dionigi and O’Flynn 2007). This is illustrative of what Katz (1996) has termed an ensconcement in the gerontological web, and was experienced by women in this study:  "I am definitely more aware now about the benefits of regular exercise. The publicity is all around, and I am inundated with junk mail, charity begging letters, etc. all telling me the benefits. Our local council runs promotions and now government is giving healthy living more exposure."

The consequences of this good/bad, normal/natural binary determines people’s experiences of aging depending on the choices that they make. Refusal to engage in anti-aging is seen as irresponsible because the person remains a threat to social values. In turn, this contributes to differential power relations—if you do not exercise you are a bad person—which further stigmatizes those who are less able or willing to exercise. It is important to note that older women, and those with less economic capital, are particularly ‘othered’ by this process. For example, several women in this study indicated that gender-defined domestic responsibilities continue to constrain exercise choices in later life. This demonstrates that gender remains an organizing and potentially limiting element in the experience of aging. For example, one woman explained: "I thought when I retired that I would increase swimming sessions . . . but so far have been too busy with looking after garden, granddaughter, mother, husband et al. In spite of loving some aspects of ‘retirement’ I am almost resentful that I do not have the time for myself that I thought I would have." 

Goffman describes such techniques as a means by which the ‘socially dead’ (i.e., the old and usually female) are “sorted but not segregated and continue to walk among the living,” enabled to continue to co-exist with those deemed ‘successful’ (in other words, the young and usually male) who, in this case, are those with relative privilege in being able to make socially valued active lifestyle choices (1952). Furthermore, these policies and practices have contributed to a commodification of aging by business enterprises targeting a “blossoming consumer market” (Neilson 2006): those who wish to continue to appear young. The older population becomes regulated by a complex network of health and beauty industries, particularly older women for whom aging is more problematic than men. It is often assumed that beauty work is grounded in definitions of femininity which are narrower than those of masculinity within patriarchal, ageist societies. Davis (2003) argues that while this many be true, women often demonstrate agency. They are frequently critical of the dominant definition of femininity as illustrated in the following quotations from women in this study who were also discouraged from exercise: "I don’t think I should be more active. I’m fortunate not to have any creaking joints. I have no guilt feelings about the lack of exercise in my life at all and tend to think the current obsession with going to gym and engaging personal trainers . . . both boring and pointless. Yes, I’m heavier than I used to be. But I enjoy life and I’m not cutting down on life’s pleasures (wine, for example) or changing my lifestyle to look as someone else thinks I should. I never read women’s magazines or take any notice of adverts so I’m pretty immune to the dictates of fashion (when it comes to size and shape). My life is too full to think too much about it."

 

Public Aging

public-agingGoffman (1963) distinguished between a person’s social identity—how people are identified and categorized by others—and their personal identity constituted of those dimensions which make people distinctive from others. The social identity may be initially virtual based on the anticipations of a person on first appearance. It then develops into an actual identity when the attributes of a person become known. A discrepancy between the virtual and actual social identity which downgrades the initial anticipation creates what Goffman calls a stigma. Stigma may be discredited (visible) or discreditable (invisible) but, according to Goffman, everyone will experience stigma “if for no other reason than oncoming agedness” (1963). A key dimension of the discredited, or public, stigma is that one’s external appearance is seen to say something about one’s identity. One woman described her lack of exercise as “a failure of character” and something that needed to be addressed: “I should be more active”. As older women negotiate the stigma of aging, they may make comparisons between self and others to assess how ‘well’ they are aging. This is judged largely on the basis of the public, visible features of the aging process. For example, one woman explained how “I regard swimming as of vital importance, especially as at my age I see so many of my peers who do not exercise becoming old, overweight and mentally lethargic”. Here, she is able to reduce her perceived self-stigmatization by distancing herself from those who do not conform to the dominant ideas of the ‘good,’ ‘normal’ way to age. Aging, unlike other discredited stigmas which are visible at birth, is one that has to be adjusted to throughout the life course. This presents a specific challenge for women, who simultaneously have to negotiate ageism and sexism. Hurd Clarke and Griffin explain: "The loss of a youthful appearance is particularly damaging to women, who are socialized to be more concerned with their appearances than their male counterparts (Bartky 1990; Bordo 1993). Indeed, women are harshly judged on the basis of their ability to achieve and maintain the cultural ideal of female beauty, namely a young, thin, toned, yet shapely body (Bartky 1990; Bordo 1993; Cortese 2004; Gimlin 2002; Wolf 1991)."  In this study, women repeated a concern with weight gain and changes in their body attributed specifically to the aging process. This has become the focus for policies, and also for the ways that people (and particularly women) judge themselves and others. Ironically, in some cases negative perceptions of, and a subsequent desire to hide, the excess weight served as a factor to reduce the amount of physical activity undertaken: “The extra stone that has crept on, is disheartening . . . I can’t think what would help me to get motivated (to exercise) once more”. 

 

An added dimension of the experience of aging is that people often look at same-sex older people, especially those within their own family, and are worried for their own futures. This may exacerbate negative perceptions of self-aging, and can support ageist attitudes and undermine relationships between younger and older people. Previous research in this area has focused on younger women in their twenties, whose concerns centred on age-related changes to the appearance of their bodies including weight gain following childbearing and giving birth (see Phoenix and Sparkes 2006). In contrast to young men, these women experienced a contradiction between their perceptions of older women and their idealized future selves, with negative views of older age focused on loss of mobility and muscle tone, and the development of wrinkles and greying hair. Within my own research, women in their sixties continued to draw on their perceptions of their older female relatives as a key factor in determining whether to engage in exercise. These decisions were framed as negative choices within an anti-aging discourse—to exercise was to avoid/delay aging: "I am lucky to be fit and pain-free at the moment—though my hip gets stiff sometimes. I then do a cycling exercise on my back and eventually it goes away. My mother had osteoporosis so I take preventative medication and try to take load bearing exercise daily—but could do more—I set great store by my morning yoga type exercise, about 7 to 10 minutes as I dress, so I am bendy and supple but do not have much stamina." The experience of the visible discredited stigma may lead to a person engaging in impression management to ‘cover’ the signs of aging and ‘pass’ as younger (Goffman, 1963). The role of cosmetics and choice of clothing were identified as particularly significant in this process, as illustrated in the words of one woman: "I don’t feel differently about my body or appearance than when I was younger because I colour my hair brown and my weight is only 7lbs more than in my teens so I can wear fashionable sports clothes, combat trousers and t-shirts, etc." 

 

Twigg (2007) identifies the ways in which sport and leisure clothing allow women’s body movement and body spread in later life, while simultaneously integrating age-related changes with a youthful appearance via a sporting style. However, some also talked of how their desire to cover their body negatively impacted on the choice of exercise participation: "I am embarrassed about the veins in my legs and no longer wear short skirts. I feel ashamed of showing bare feet, as I now have bunions, and try to hide them! This manifests itself in swimming pools, showers, and walking barefoot when other people are around." Such choices are illustrative of what Goffman (1963) called the ego or felt identity, which relates to the feelings people have about their identity. Many of the women in this study were negotiating in-group/out-group alignments, torn between identifying with their stigmatized peer group and those who Goffman termed the “normals” (in this case, the youthful) in society. Such “politics of identity” (Goffman 1963) was illustrated in the words of two women who disassociated from their own age group. In contrast to the findings of Dumas et al. (2005), none of the women in this study demonstrated an age habitus whereby they were able to re-evaluate standards of beauty and embrace different norms of appearance as they grew older. Instead, the emphasis was very much on “keeping slim and ‘defying’ old age”. Furthermore, while the examples presented in this section are of visible and public signs of aging, many of the women also talked of other non-observable, but highly significant, dimensions of aging which impacted on their exercise choices. These will be discussed in the following section. 

 

Private Aging

old-couple-huggingMany of the women talked of more private aspects of the aging process, akin to what Goffman (1963) termed the discreditable or invisible stigma. Some described changes in their musculo-skeletal structure: "If you let your muscles degenerate you never get them back when you’re older because they won’t regenerate . . . I’m quite old now you know . . . it all went miserably downhill . . . I’ve got arthritis in my knee . . . Everyone at my age has osteopenia because it’s a degeneration of the bones." Others spoke of a more general sense that “age is slowing me down” (66); or more specifically that “reactions are slower . . . it takes longer for the message to reach the feet! Vision has deteriorated . . . Stamina has lessened”. In each case, the women demonstrated negative comparisons to, and a sense of nostalgia for, their younger selves, to the extent that one woman stated that as she wrote her story for this research: “I am in tears now thinking about the things I can’t do anymore” (71). Some of the more private aspects of aging also were explicitly gendered, with women describing the effects of the menopause or having borne children. For example, one specifically explained how she would not exercise because “running makes me wee—we were not taught pelvic floor exercises in the ’60s!”. The significance of many of the aspects of private aging is that, unlike public aging, there is little opportunity to cover or alter the changes to the body. The private dimensions of aging were experienced as confirmation of the aging process, and the best that the women could do was to try to control the flow of information which threatened the presentation of a youthful identity, even if this meant not engaging in exercise. As one woman explained, the current (public) exercise provision available to her merely ensured her absence: “Definitely do not do enough exercise . . . Would never go to a gym”. Indeed, evidence from these women’s stories suggest that the emphasis on youthfulness in policy discourse and promotional materials appears to have the unintended consequence of creating the impression that “You have to be young to do sport”, with many women choosing not to engage in activities which appear inappropriate to their presentation and sense of (an aging) self.

 

However, following Goffman, it is important to understand the experience of aging, as with other stigmatized groups, as context specific: “a language of relationships, not attributes” (1963). How a person feels about growing older is likely to vary depending on where the person is. Consequently in certain situations, it is possible for the aging person to interact with those Goffman termed the ‘normals’ (i.e., the young). One woman said that she “might consider a small, friendlier women’s-only organization”. A woman interviewed by Hurd Clarke and Griffin embraced the opportunity to experience her age ‘privately,’ explaining: "I don’t mind being invisible. I quite enjoy that. Like when I go to the gym with all these gorgeous young things around me, I can just look anyway I want and just be peddling away and do whatever I want. No one is paying any attention to me and it’s really nice. I really enjoy that." Unlike previous research, my findings question the idea of the aging body as a ‘mask’ whereby the outer shell merely disguises the belief in a youthful self beneath (Featherstone and Hepworth 1991). In my research, women found it impossible to disguise aging through strategies of masquerade (Biggs 1993) or a masquerade of youth (Woodward 1991) and continue a lifestyle consistent with an ‘inner’ youthful self. In the case of most women in this study, it was not only the visible aspects of aging which were problematic but also dimensions of the aging process which were not immediately obvious to others. The challenge and experience of aging extends beyond merely maintaining the public image (Ballard et al. 2009). 

 

Conclusion

old-people-thumbs-upThe findings from this study indicate that exercise has multiple and contradictory meanings for older women: while it offers empowerment in developing strength and mobility for independent living, most of the women continue to be oppressed by the impossible body ideals privileging youth and traditional norms of femininity. Furthermore, Dumas et al. (2005) have argued that older women from affluent backgrounds experience the ‘loss’ of age-related changes more than working-class women who are more used to hardship and marginalization. It should be acknowledged that majority of the stories in this study were from women who appeared to lead a life of relative privilege with respect to physical and cultural capital. For example, most women enjoyed membership of leisure clubs, overseas travel and home ownership. Upper- and middleclass women are more likely to have the time and resources to work on a ‘body project’ (Shilling 2005), and often demonstrate greater concern with the presentation of their corporeal self. The stories presented here, therefore, need to be read with the caveat that they are unlikely to be fully representative of the experiences of women from less privileged social groups. However for most women, growing older is experienced within a framework of age fundamentalism which is reinforced by subsequent policy documents based on incomplete scientific knowledge. Youthfulness becomes a totalizing ideology from which there is little chance of escape. Tulle (2008) has argued that recommendations for older women to exercise are framed in an anti-aging remit—exercise eliminates aging—rather than emphasizing how aging women can find ways to increase physical capital and also restore social and cultural capital. Aging is particularly problematic for older women who often live on the margins of society isolated, in some cases, by widowhood and perceptions of appropriate gendered norms of behaviour and appearance. As women age, choices seem to be taken away through processes of stereotyping, overprotection, and poor and inappropriate policies, planning and provision. There is a clear need for policy makers to be aware that investment in exercise programs for older women is also an investment for the current younger generation, most of whom will also grow old. Perhaps a far greater challenge is to modify the current exercise ‘AGEnder’ and enhance the celebration of life, experience, and character as it is written on the older woman’s body and appreciate the beauty therein.

 


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