An estimated four to five million Canadians provide care for family members with long-term conditions. According to a new study, baby boomers are not interested in hands-on caregiving, and this approach poses new challenges for the health system.

Nancy Guberman of the University of Quebec and colleagues examined how Quebec baby boomers perceive caregiving and their expectations in regard to support services.

The study was based on 39 baby boomers, all in their 50s and 60s. The 31 women and eight men had family incomes that ranged from less than $20,000 to more than $60,000. Most of the caregivers cared for an older parent with a disability or a disabled spouse. Five of the women were caring for both a parent and a spouse or child.

The results of the study appeared online in The Gerontologist (January 31, 2012).

A caregiver . . . but not like my mother

The study found that respondents, in contrast to their parents’ generation, were reluctant to embrace caregiving at the expense of their other identities such as parent, worker, volunteer, friend or spouse. They juggled caregiving, career, family and other social commitments.

The daughter of one disabled parent explained:

But if my mother asks me to do her housework, to wash her fridge every week, to change her bedclothes, etc., I don’t want to deal with that, because . . . I just don’t want to do it! There are limits that I have to set and it is those limits that I need to negotiate with my mother because I am not ready to drop all my activities. That’s it. In that, I am a real baby boomer!

The study found the majority of interviewees refuse to put aside their professional activities to focus on caregiving. "We define ourselves by our work," one participant said. "So when you work at home taking care of someone, that means that you are not doing much of anything. Socially speaking, that was hard to take."

A new vision of care

In Canada, and particularly in Quebec, the post-war generation grew up with the welfare state, declining rates of religious practice, major changes in male-female relationships, high divorce rates, women’s integration into the labour force and very low fertility rates.

So it’s perhaps unsurprising that the new research found changing notions of family giving rise to a new vision of care.

As caregivers, baby boomers view their role as two-fold:

• guaranteeing quality of life for disabled person; and
• managing services.

In contrast to their parents’ generation, they are not interested in hands-on caregiving.

And to cope, they have high expectations of support from paid service workers. Respondents gave low grades to the services currently on offer.

As one respondent explained:

Monday she has singing class. Otherwise, during the week, there are the activities provided by the residence, but the activities . . . it’s cards, bingo, things like that. . . . We would like activities that will help them fight boredom, stimulate them, interest them. A service that provides leisure activities, travel, entertainment, that seems to be essential, and a service providing social integration.

More than half of the interviewees said caregivers should receive social support and financial compensation including, the possibility of a salary.

Someone who does not work, and then goes to help their parents, their expenses should be accounted for. Someone who is working and is obliged to leave their job then finds that they are having a hard time getting social assistance because they are caring for a parent, well they should probably get paid a salary.

Meanwhile, the majority of respondents said they have been forced to make adjustments to their personal and professional lives to care for aging parents. They were particularly concerned about the drain of care on their financial resources and its impact on their futures.

According to the study, the new approach faces major hurdles. For one thing, home-care services are seriously underfunded in Quebec. More importantly though, the new care-giving approach conflicts with current public policy that assumes family care as the cornerstone of long-term care.

Given the current economic situation, baby boomers may be compelled to rethink their expectations and take on elements of caregiving they no longer consider legitimate.

A new study shows that services for older men could be improved by paying more attention to their gender and to the impact of masculinity.

Tony Coles and Therese Vassarotti of the Australian Catholic University, Canberra, Australia, explored the affect of aging on men’s social identities. The researchers focused on the understanding of older men of themselves as male and masculine, and their connections and relationships with others. The research offers useful insights for those working with older men.

The findings appeared online in the Journal of Religion, Spirituality & Aging (January 10, 2012).

Dr. Coles is the National Executive Officer for the Australian Association of Gerontology. He was instrumental in establishing the National Alliance of Pastoral and Spiritual Care for Older People in Australia. His doctoral work focused on men’s health and aging issues.

AHB reached Dr. Coles in Melbourne, Australia.

Ruth Dempsey: Your research looks at how men negotiate their masculinity across the life course. How do you define masculinity?

Tony Coles: This is a difficult question. Countless books have been written on the subject and entire university courses dedicated to explaining men and masculinities, yet, there is no one definition. This is because the meaning of masculinity changes across cultures and over time, and it means different things to different people.

RD: These meanings are shaped by social and generational factors . . .

TC: That’s right. How men do masculinity is affected by a host of factors: class, ethnicity, health status, sexual orientation, geographical location, education and age.

But although men are influenced by their social environment, they are not passive agents. So, a combination of factors – structural and individual – shape men’s masculinities.

RD: What about dominant ideals of masculinity . . .

TC: In most western societies, the culturally dominant masculine ideal is one of men who are strong, youthful, able-bodied, and heterosexual. They are fearless, aggressive, and impervious to pain. They are rational, emotionally detached, and powerful.

Masculinity is personified by sports heroes and movie stars, and it is projected as the image of maleness to which all men are expected to aspire.

Of course, most men never meet these impossible standards. Instead, they negotiate what masculinity means for them in the context and circumstances of their own lives.

In my own research and interviews with men, I have never come across a gay man who felt as though he wasn’t masculine, even though the culturally dominant ideal of masculinity is one of heterosexual masculinity.

RD: As men age, lean muscular bodies become more difficult to maintain . . .

TC: You have hit on an aspect of my research that I have found particularly interesting: it deals with how men’s understanding of their masculinity – and what it means to them – shifts to accommodate change over time. In other words, the concept of masculinity has an elasticity that allows men to renegotiate what it means to them.

RD: So, some men said they still enjoyed going to the gym but they steered away from competitive sports. And others had become interested in intellectual pursuits.

TC: Yes. Instead of trying to fit the male body ideal, the men developed other strategies to compensate for their aging bodies.

Rather than seeing themselves as weak or vulnerable, traits characteristic of femininity, they saw their ability to draw on their wisdom and experience as strength; rather than viewing themselves as physically frail and passive, they saw themselves as intellectually active.

RD: You argue spirituality can be an important aspect of men’s identity. How so?

TC: We are all spiritual people. It is what makes us human. We ask ourselves: "Who am I?" "Why am I here?" "What is the meaning of my life?" These are human questions that challenge us to look deep within ourselves to understand our identity.

Spirituality is also about being able to connect with others and the external environment, including divinity, in search of enlightenment.

Yet the spirit is often a part of ourselves that we neglect. It only tends to be in times of crisis that we undertake soul searching to better understand ourselves and nurture our spirit.

For men, this may be further exacerbated by a cultural ideal that discourages men from reflecting on life or discussing their spiritual needs. In fact, it is precisely at times of vulnerability that men are expected to be stoic and self-reliant in order to get through the crisis.

RD: "Brian", a retiree in his early 70s talked about becoming more philosophical, more peace loving . . .

TC: There was a tendency amongst many of the older men in the study to reject standards of masculinity emphasizing stoicism and invulnerability and, instead, to negotiate what masculinity meant for them.

As Brian demonstrates, aging brings with it wisdom that allows one to reflect on life and develop a masculine sense of self that is more peaceful and reflective, and less aggressive and remonstrative.

RD: Services for older people have been dubbed "male unfriendly." Do you have any tips?

TC: I was at a conference recently where a presenter talked about men living in a residential aged-care facility and her attempts to engage them in conversational activities.

She introduced weekly talking sessions just for men (although facilitated by women). The group met informally over a cup of tea. To spark conversation, the facilitator would hold up a picture of an object, such as a tree or flower, and invite the men to share their thoughts and feelings on the subject.

Not surprisingly, the program wasn’t a huge success with the male residents. Just putting men together in the same room does not create a masculine environment. Men born around the time of the Great Depression do not regard conversations on subjects, such as flowers, while having a cup of tea as a particularly masculine activity – quite the reverse, in fact.

Some residential care facilities here in Australia have introduced a happy hour for men. At five o’clock in the afternoon, the men get together and have a beer and a chat before dinner. It has been hugely successful, and many of the men say that it is the highlight of their day.

Another program that has been extremely successful, particularly for older men, is "Men’s Sheds." The idea is that men like to talk shoulder-to-shoulder, not face-to-face. So providing a community shed for men to get together and work on projects (woodwork, metalwork, etc.,) provides a context for men to socialize and communicate in a way that is comfortable for men.

Some of the residential care facilities have built sheds on site for residents. At the same time, others prefer to take the men to sheds off site and get them actively participating in the community. Although the Men’s Shed movement started in Australia, the concept has gone international and there are now programs in Canada, too.

In Bag Lady or Powerhouse? A Roadmap for Midlife (Boomer) Women (Detselig Enterprises), gerontologist Lillian Zimmerman argues that midlife women have what it takes to reconfigure everyday meanings and experiences of growing old.

An octogenarian and mother of two boomer daughters, Zimmerman is a long-time associate of the Gerontology Research Centre at Simon Fraser University in Vancouver, B.C. She specializes in gender issues for older women.

AHB reached her in Vancouver.

Ruth Dempsey: So where did you grow up?

Lillian Zimmerman: I was born in Montreal, Quebec, and have no siblings. When I was 10, my parents decided to move to Vancouver. My parents were a stable and loving couple. It was during the Depression and times were hard.

RD: What sparked your interest in aging?

LZ: I got old. Also, I have been a lifelong feminist – well, since the 1960s. As I aged, I began to take notice of the way older women are mostly "invisible." I followed the data and reports, and I found single, older women to be among the country’s poorest (as are some men, too), but nobody seemed to pay much attention.

RD: Early on in your book, you describe the positive aspects of boomer women’s lives. What are these?

LZ: Boomer women grew up in such different times to mine. When they were young, they were part of the ’60s and ’70s student and other protest movements, especially the women’s movement, that of Afro-Americans and also Gay Pride. These have influenced many boomer women’s lives.

They are far more independent than we were – we married young, became housewives and had children. Now younger women are in the paid workforce, more educated, stay single longer, and when they do marry, or live common law, they have children later in life – and have fewer of them.

I am far from saying their lives are a bed of roses. In fact, I detail challenges facing boomer women in my book including, lower salaries, inadequate pensions, care giving responsibilities and ageist beliefs that target women in particular.

That said, when I was growing up, it was time to "move upwards’" building lifelong careers often in one job, trading up small houses for larger ones, having two cars and so on. I am describing how we made it into the middle class. Not everybody did, of course.

But in that era we saw the development of social welfare in Canada – medicare, public pensions and unemployment insurance. There was more of a collective ethos. A sense of people looking after each other was reflected in social policy. Now, sadly, these institutions are seriously threatened.

Still, I believe midlife women have what it takes to tackle problems today. At least, I feel it is within their grasp to level the playing field.

RD: You predict that senior centres will one day be replaced by "maturity centres" with libraries, exercise rooms, health-care staff and travel agents. Why wait?

LZ: Well, that’s up to the boomers now. I wrote that as a fantasy because I am so opposed to all the fear mongering about the crisis of "aging populations," and older persons draining the medical and pension coffers and threatening to bring down our entire economic system.

Also, it is time to get rid of the word "senior." It has the connotation that once a person becomes 65 they begin a downward slide. This, of course, is not true. I dreamed up the term maturity centres to counteract this.

RD: You make this point elsewhere. For instance, in your Globe and Mail article (September 19, 2011), you argue it’s time to recognize the positive contributions of older people . . .

Absolutely! Older people contribute to the economy. In fact, it’s been estimated that the time, energy and money that older Canadians contribute to the economy may reach $5 billion annually.

And, like everyone else, older people pay taxes. Large numbers work as volunteers and many give liberally to charities.

Many grandparents, especially grandmothers, help their adult children and grandchildren in important ways such as childminding. They reach out when they are in financial or other difficulties. They help them purchase homes. And, when they can, they give generously to their grandchildren for education, sports and other fees, and to buy things for themselves.

I want the contributions of grandparents to be recognized. I think that is now starting to happen.

RD: So, what advice do you have for women retiring today?

LZ: Above all, do not internalize the crisis mentality about the horrors of aging. And ignore the "decline regime" as the writer Margaret Gullette calls it.

In our youth oriented culture, we are made to feel useless, and urged to use "anti-aging products" and so on. Utter nonsense! See yourself as a capable, experienced person who has given much to your family and society and will continue to do so. Refuse to decline!

RD: You say one of the rewards of longevity is the company of your adult grandchildren. How so?

LZ: I have four grandchildren. They bring ways of understanding the younger generations, what interests them, what motivates them, so it teaches me a lot. It is really important to know the worlds of those younger than ourselves, and not to be scornful of what they do, as in "Well, in my day. . . ."

I have a humorous chapter about my grandkids and me in Shari Graydon’s book: I Like the Way My Hands Look.

RD: On turning 85, you told one interviewer that life is better now in some ways. How so?

LZ: I have far more confidence now than I ever had. I make decisions quite quickly, rather than back and forthing for ages trying to figure out what to do. I’m not always right, but most of the time I have done the right thing.

Also, I am hardly concerned with what others think of me, except for people I truly value. I also feel quite relieved that I no longer have to worry about furthering my career. I pretty well do what I want to do, as long as I feel responsible about my choices.

RD: What nourishes your spirit?

LZ: Darned if I know! I saw a film about five older women in England, aged 85 to 102. One of these remarkable women said it was anger that kept her going. She is the 102 year-old, and is shown heading a huge anti-war protest in London!

In my case, I know social injustice has fueled my flames. Also, I have been blessed with relatively good health, which has allowed me to remain engaged and keep on reading and writing – I published my book at age 82. I had never thought of anger as a life-enhancing asset, but it looks like we have a lot to learn about its positive effects.

WRITING A POEM HELPS ME TO LIVE GRATEFULLY: Born in 1912, Naomi Wingfield of Guelph, Ontario (Canada) began writing poetry in her early 80s.

At the age of 98, two years after moving to a retirement residence, Wingfield explained how writing poetry changed the tenor of daily life: “When I am screaming inside at not hearing in the dining room or not being able to read, the creativity of writing a poem helps me to live gratefully.”

Here are two of her poems:

Youth is a Flying Horse

Youth is a flying horse
age slows to a walk on sand
now I notice sea shells.

Change

My attic has changed.
For fifty years we stored our treasures there,
my mother’s wedding dress
great-grandfather’s solemn face in the ornate frame
love letters from high school days.

Change. My house is sold.
I return grandchildren’s drawings.
My brother’s wife cherishes letters from war-time years.
My daughter has my mother’s dress.

The attic is bare,
but my heart is full
of what has been.

The poems appeared in the Journal of Aging, Humanities, and the Arts (Vol.4, 2010).

 

TYZE NETWORK: BRIDGING FORMAL AND INFORMAL CARE: In 2011, the Financial Times listed Tyze among “the world’s most innovative aging projects.” The Vancouver-based company is a private, Facebook-style social network that allows older adults to share private information with their family, friends, caregivers and health providers. In 2010, founders Vickie Cammack and Al Etmanski were recipients of the Canadian Psychological Association’s Humanitarian Award.

 

CLIMATE CHANGE: AN ISSUE OF INTERGENERATIONAL JUSTICE: The director of the NASA Goddard Institute for Space Studies says that humanity is facing extreme weather events which would have disastrous effects for large areas of the planet.

“The situation we’re creating for young people and future generations is that we’re handing them a climate system which is potentially out of their control,” Jim Hansen told the Guardian during an April visit to the U.K. to receive the prestigious Edinburgh Medal for his contribution to science. “We’re in an emergency: you can see what’s on the horizon over the next few decades with the effects it will have on ecosystems, sea level and species extinction.”

Hansen said current generations have a moral duty to their children and grandchildren to take immediate action.

Meanwhile, Bill McKibben, author of The End of Nature and founder of 350.org, is urging people around the globe to unite for Climate Impacts Day on May 5, 2012. For details: www.climatedots.org.

 

ROBOT COMPANIONS SERVE THERAPEUTIC PURPOSE: Interest continues to grow in how robotics can enhance care. Preliminary findings by researchers at the University of Manitoba say robot companions may be valuable in improving communication and social interaction among older, agitated persons living with dementia in long-term care settings.

The first of its kind in Canada, the paper describes research in which Paro (a robotic baby harp seal) was used as part of a summer training program for students (Canadian Journal on Aging, March 2012).

The Interdisciplinary Summer Research Program provides an opportunity for students to work at Deer Lodge Centre, a 431-bed long-term care and rehabilitation facility in Winnipeg, Manitoba. See AHB Nov/Dec 2009 for the interview with Lorna Guse, the lead investigator.

What happens when residents of an assisted living facility and adolescents from the local school mix for crafts, exercise, spelling bees and sing-a-longs? Friendships blossom and age barriers fall away, says a new study.

The brainchild of an elementary school teacher, the Meadows School Project was launched in rural British Columbia in 2000. A Grade 6 teacher obtained permission to relocate her class to a nearby assisted living residence (Coldstream Meadows) for five weeks in October and November and three weeks in May. From Monday to Thursday, students took the short bus ride from the school to facility and back again at the end of the day.

Arlene Carson and colleagues from the University of Victoria (Victoria, B.C.) reported their findings online in the Journal of Intergenerational Relationships (December 12, 2011).

Learning about growing old

The Coldstream Meadows facility is ideally suited to an intergenerational program with spacious grounds and ample space for students to play during recess. An unused chapel near the residents’ lodge served as the students’ classroom.

The founding teacher organized the project in close collaboration with the facility owners and staff and the students and parents. As the program progressed, motivated residents helped to plan and lead some activities. Students volunteered to set lunch tables and serve tea to residents

As a component of the curriculum, the students learned:

• about the aging process;
• strategies for communicating with persons with hearing and speech impairments;
• common chronic conditions; and
• how to interact respectfully in social situations.

On-site activities

Twice daily, the residents and students worked in pairs or as part of a group at the facility.

Activities included:

• armchair fitness classes;
• seasonal craft projects (such as Halloween pumpkin carving);
• science fairs;
• spelling bees;
• sing-a-longs; and
• celebrations.

Connecting generations

The study found the program nurtured social bonds among participants through a variety of activities.

Here are some examples:

Physical activity: Residents and students engaged in fine and gross motor movements, including:

• armchair fitness classes led by the recreation coordinator; and
• walks around the grounds by one or two students paired with a resident.

Project experiences: One student described his favourite experiences: "The things that I enjoyed most were painting the pumpkins, sharing our science experiments with the residents, joining [residents] for tea, sharing our collections and just visiting."

Physical contact: Students provided residents with regular hand massages.

Door knocking: Students knocked on residents’ doors to invite them to participate in activities. "She [the resident] was so excited that we remembered to come and get her for an activity that she hugged me and thanked me for remembering her," one student said.

Mentorship: Both groups helped to mentor each other. "The kids have helped me a lot, just by giving me the gumption to bring my crochet work out and show it," one woman said. "And I know I was laughing and giggling and having a good old time."

The students helped dispel stereotypes about the younger generation. "I think that they [the residents] really enjoyed our company," one student explained. "And I think it totally made them realize that we’re not bad. We’re just kids."

Equal partners: Finally, the parents remarked on the egalitarian nature of the relationships forged between old and young: "They think that they [students and residents] just connected as people. I don’t think either party was condescending to the other," said the mother of one student. "And that was really awesome because people tend to be condescending to kids and seniors . . . and they were able to break through that."

Boost for residents

The project resulted in many positive outcomes for older adults.

As the former recreations activities director put it: "The residents are out of their rooms more. They have more energy. They’re more animated and talking. You don’t see so much sort of aimless wandering. There’s more purpose to where they’re going."

A current resident when asked whether the project had health benefits for her replied, "It did me a wonder, a wonder of good."

And finally, the daughter of a former resident said: "I think it helped her self-esteem. Because the children enjoyed hearing her stories and she enjoyed telling them."

Upside for students

The program also fostered understanding and friendship among the students and residents.

"I think the most surprising thing I learned is how much they love children, they love us so much," one student said. "I was really surprised to see how much fun they had with us."

"It was fun getting to know what it was like when they [residents] were younger . . . how they lived," another student noted.

"I learned that they [residents] can still learn a lot of stuff even though they are old," another remarked.

Asked what surprised him most about the project, one boy said, "The most surprising thing was about by buddy . . . she flew planes!"

Program wins hearts

The innovative project strengthened bonds between the old and young, promoting zest and community well-being. More broadly, researchers say the project offers a template for how a burgeoning older population can contribute to intergenerational partnerships and be valued for who they are.

 

In this March / April 2012 Issue

Interview: Why Looking Young is Becoming More Important

New Book: Rewarding Work After 50

Interview: Is Personality the Key to Aging Well?

Study: Finishing Up With No Regrets

 

Roundup:

• A Quilter Who Moves to an African Beat
• Men Feel Pressure Too
• Novel Conversations
• Books on Prescription

Women are bombarded every day by media advertisements that warn: you must not grow old. The toll this takes on women as they age is the subject of Laura Hurd Clarke’s bold and unsettling book Facing Age: Women Growing Older in Anti-Aging Culture (Rowman & Littlefield).

Drawing on data gathered over a 10-year period in interviews with older women, cosmetic surgeons and a study of women’s magazines, Hurd Clarke demonstrates that we all have a lot to lose by living in a society that attempts to render its older people invisible.

Dr. Hurd Clarke is an award-winning scholar and associate professor at the school of human kinetics at the University of British Columbia in Vancouver, BC.

AHB reached her in Vancouver.

Ruth Dempsey: So what drew you to this subject?

Laura Hurd Clarke: I began to think critically about the issue while I was doing course work for my PhD degree in 1996.

As a component of one of my courses, I was fortunate to spend four months studying the experiences of members of a seniors’ centre. What I learned from the men and women at the centre was that they did not consider themselves to be old, irrespective of their actual ages. They frequently told me things like "We’re not old!" or "We are young at heart!" I began to realize that "old" was something these adults equated with negative stereotypes of later life (such as senility or poor health), rather than chronological age per se.

However, there was one notable exception to the members’ sense of themselves as not being old – their appearances. The women in particular expressed dismay over how their aging appearances contradicted how they felt on the inside.

I was intrigued by this tension between chronological age and felt age. And when I looked around, I found few studies had explored the relationships between appearance, ageism, chronological age and identity. These questions became the focus of my doctoral work, and they sparked over a decade of research.

RD: Many participants seemed repulsed by the physical realities of later life. One 65-year-old woman said: "Everything kind of sags in spite of all the exercises and all that sort of thing. I must admit I look in the mirror and I really hate that look. I just hate it."

LHC: Yes, this remark points to the fact that women in their later years frequently feel that what they look like on the outside is not how they feel on the inside. Many women are disappointed with how their bodies change over time and some are scathing in their assessments of their aging appearances, preferring how they looked in their younger years.

Certainly, women are taught to be ruthless in their personal evaluations of their bodies and to aspire to look like the feminine ideal, which is young, toned, slim and wrinkle-free.

And of course, if you accept this definition of beauty, then getting older and looking aged can be personally devastating.

RD: Weight gain was a concern for many women . . .

LHC: Yes, this is very true. Indeed, there is a wealth of existing research that identifies body weight as a key source of dissatisfaction for women, whatever their age. Most women want to lose weight, even when they are at a normal and healthy weight.

Most of the women I have spoken to have wanted to lose weight, although some in their 90s have expressed a desire to gain weight so as to not appear "scrawny."

RD: Participants were torn on the use of beauty products. Many rejected the claims of cosmetic companies. They still bought the products.

LHC: You have identified an intriguing tension that all women face. Most of us are skeptical of the claims advertisers make about various products, and yet most of us buy at least some of these products.

Why is that? Some scholars have suggested that women engage in what I call "beauty work" because they find the practice pleasurable and the end result, a source of personal satisfaction.

Other scholars say it’s about socialization – we use beauty products because that is what feminine women do. In other words, beauty work is seen as a social requirement for women, who are perceived to have little or no agency.

Certainly, women are rewarded for looking attractive through the complements of others but also through the greater likelihood of finding partners, being promoted at work (which has been well documented in the research), and so on. The two explanations are not incompatible, in my view.

But I think many of us engage in beauty culture without ever really contemplating what we are doing or considering what the social implications of our actions are for ourselves and for others.

RD: With the onset of health problems personal attractiveness takes a backseat.

LHC: This makes a lot of sense to me. If I am in pain and finding it difficult to walk, for example, I may be less concerned with my appearance and more concerned with the potential loss of my mobility and my independence.

Still, few women ever fully lose their concern about their appearances. For example, I have heard stories of older women in the hospital receiving treatment for serious health issues but still insisting on wearing their lipstick, because it made them feel more like themselves.

And some women have said that they continued to attend to their appearance so that their families would see them as independent, socially engaged persons rather than as individuals needing extensive care, if not institutionalization.

RD: What about physicians involved in the beauty business? What did you learn from them?

LHC: I interviewed four cosmetic surgeons, two reconstructive plastic surgeons and two family doctors, all of whom were providing various non-surgical cosmetic procedures, including Botox. I wanted to know what they thought of the rise of non-surgical cosmetic procedures, as well as their role in the beauty business.

I learned that while the cosmetic surgeons had begun to provide non-surgical cosmetic procedures because of patient demand, they preferred the results they could achieve through surgery. They also liked using their surgical skills.

In contrast, the reconstructive surgeons and the family physicians talked about how their engagement in non-surgical cosmetic procedures gave them a chance to do more light-hearted medical treatments with healthier, less demanding and more pleasant patients.

The physicians were aware of the pressures on women to maintain a youthful appearance. However, they were relatively uncritical of the beauty business or how they themselves were reinforcing ageism.

For these physicians, looking old was a physical defect that warranted medical intervention rather than a natural and inevitable part of living.

RD: You see the approval of Botox Cosmetic for aesthetic purposes as a game changer. How so?

LHC: Well, Botox Cosmetic was the first injectable that was developed and approved for sale and it continues to be, by far, the most profitable. It was quickly followed by a myriad of other injectables and the expansion of these products continues at an incredible pace.

The development of Botox Cosmetic signaled an important change in both pharmaceutical companies, which moved quickly to develop and market non-surgical cosmetic procedures, and aesthetic medicine, which now had an alternative to face-lifts and could, therefore, reach a wider audience.

My research over the past decade reveals that women’s attitudes towards their wrinkles shifted dramatically in response to the development of these products. Sleek advertising campaigns by Botox Cosmetic have changed the way women see their faces and their wrinkles. It is becoming increasingly unacceptable to "look old."

RD: Even dentists are offering Botox injections today.

LHC: That’s right. My own dentist has a certificate hanging on his treatment room wall showing that he has been approved to provide the treatments.

I’ve also interviewed women who have told me that in addition to receiving the injections from cosmetic surgeons or dermatologists, they have been given Botox by family doctors, nurses, chiropractors and estheticians. I’m sure the range of people who sell Botox injections is even greater than that. There is a lot of money to be made in the beauty business!

RD: You also looked at women’s magazines . . .

LHC: I examined the print advertisements in five different women’s magazines over a one-year period. What I found was that most of the beauty products were marketed with anti-aging messages, which suggested that looking old was abhorrent and unnecessary.

Print ads urged women to use various creams, serums and beauty treatments to maintain their cultural worth by being as beautiful as possible.

In other interviews, I asked women to reflect on media messages about appearances and aging. Responses varied. On the one hand, most of the women rejected Hollywood ideals of beauty (particularly the emphasis on being ultra-skinny) and expressed anger at the negative ways older adults were portrayed in the media.

However, other women said they felt pressured to bend to media messages that equated youthfulness with beauty, particularly if they were still in the workforce or looking for a romantic partner.

RD: You see Facing Age as a call to tackle ageism?

LHC: Yes. Ageism affects us all, and we all have a lot to lose if we continue to live in a society that disparages the aged and the natural processes of growing older.

A record number of Canadians are approaching retirement. By 2020, the number of Canadians retiring each year will reach 425,000, according to Canada’s Urban Futures Institute.

But the over-50 crowd is not interested in the old-fashioned "full-stop" retirement, says Julia Moulden, a Toronto author and Huffington Post columnist. They are looking for new options and old and new ways to earn income, or, as Moulden puts it, new ways "to ripen."

If you are a 50-something and looking for a fresh start, Moulden provides a handy roadmap in RIPE: Rich, Rewarding Work After 50: Your Guide to the Next, Best Phase of Your Career.

The book has 12 chapters organized into a 12-week course. The course takes you on a journey of self-discovery, using stories of real people and reflective questions that make you think beneath the surface.

Masters and Pathfinders

Moulden, 55, stresses that the pursuit of rich, rewarding work after 50 is a personal journey. It’s about taking stock and taking charge.

She describes two kinds of ripe pioneers: masters and pathfinders.

MASTERS travel the same path, leveraging existing skills and discovering new passion for familiar work.

Consider the case of Marilyn Grist, a woman dedicated to social justice. She began her career as a worker in Lyndon Johnson’s campaign against poverty, moved to CARE, a leading humanitarian organization, where she worked for two decades, and then took time out to reinvent herself, as she thought. But, at 62, she is back as executive director of HelpAge U.S.A. "My work is my work," Grist says. "And it’s mine for a lifetime."

PATHFINDERS are interested in blazing new paths. Some feel burned out after long careers in large companies and institutions. Barbara Johnson left corporate life to become a social entrepreneur. She helped Pleasant Rowland to make the Superkids Reading Program in the United States a spectacular success.

In the world of ripe pioneers, masters outstrip pathfinders 10 to one.

RIPE provides a thoughtful framework for anyone seeking a more satisfying life. The author is especially good at mapping both the practical and emotional geography of life after 50. Throughout the book, Moulden keeps hammering home her key message: "Our most fulfilling years are ahead; we just need to grab hold of them."

Karen Hooker has been intrigued by the role of personality in life’s trajectory since her undergraduate days. Her passion to understand its impact on the aging process has only deepened over the past three decades.

Dr. Hooker is an award-winning scholar, a professor of human development and family sciences, as well as the Jo Anne Leonard Endowed director of the Center for Healthy Aging Research at Oregon State University.

AHB caught up with her in Corvallis, Oregon.

Ruth Dempsey: Your aging heroes include your grandmother and great grandfather. How did they inspire you?

Karen Hooker: They were strong individuals and were not frail or disabled. My great grandfather farmed well into his 90s. My grandmother – an absolutely beautiful woman at all ages of her life – played bridge and was active into her 90s. Both of them garnered a lot of respect and had power in my family.

Growing up, I never thought twice about how "old" these family members were. It was during my college years in the late 1970s that our culture and the media started paying attention to "aging" and portrayed older adults as a special group needing help and compassion. On the one hand, this was helpful in getting resources to those who did need services. On the other hand, it ignored the wide variation in how people age, and set the stage for some very insidious negative views of older adults that underlies the ageism in our culture to this day.

So, my grandmother and great grandfather were inspirational in that they caused me to challenge the "accepted view" of aging and to wonder why they seemed to have a vigorous old age when others were much more frail. Personally, of course, I also want to live my later years as they did – active and involved.

RD: Your work focuses on the importance of personality in optimal aging. How do you understand personality in this context? And what do you mean by optimal aging?

KH: Personality is a very broad construct that encompasses what a person is like, as well as processes that continually shape who and what we are. Most people know about trait aspects of personality, like the variation in how gregarious a person you are, or how stressed out you tend to get in pressure situations.

But personality is also much more than this. It includes our propensity to feel in control over certain situations and how likely it is that we will behave to enact our goals. It even includes our life story and how we remember and cognitively process events to tell our story.

I think personality is greatly overlooked in our models of optimal aging. One very influential model of optimal aging by Drs. Rowe and Kahn, which they termed "successful" aging, includes three components: preventing disability and disease, maintaining high cognitive and physical functioning, and engagement with life.

Personality is influential in all three of these spheres, particularly in the third sphere, engagement with life. What type of person you are, whether or not you can be counted on, and how you meet the goals you set are crucial for forming and maintaining relationships with others, as well as participating in productive activities – the keys to engagement with life.

RD: What about retirement? Does personality play a role in the transition?

KH: Yes, in several ways.

First, it likely influences the timing of retirement. We know that one’s financial health and social environment are crucial considerations in deciding when to retire. A person who is goal-oriented and takes the long view may be more likely to have financial resources to make retirement possible at a relatively young age.

Secondly, if one has satisfying social relations with others and leisure pursuits one wishes to pursue, this will also affect one’s retirement decisions.

Finally, the transition to retirement is becoming more "blurred" with increasing numbers of people working part-time instead of fully retiring and a significant number "retiring" from retirement as they head back into the workforce.

One example of how personality might influence the transition to retirement is contrasting the person who scores very high on the trait called "openness to experience," who might choose to move to another country in retirement. While a person low in openness would be more likely to stick with the tried and true.

I could speculate that this might even relate to cognitive health in later years, as research has shown that challenging the brain is important for keeping it healthy, and sticking to the tried and true might not be so great for maintaining mental sharpness as we age.

RD: You say goal setting is important for older adults. Why is this?

KH: Goal setting, whether we do it consciously or not, is important for adults of any age. It ties into what social scientists call "self-regulation," which refers to the ability of human beings to be self-directing – to align their goals, thoughts and actions.

My colleagues and I have studied how possible selves – images of self in the future – are related to activities to support these self-related goals.

By the time we reach old age, most of us have at least one health-related possible self. If you carry around a mental image of yourself as, for example, a 75-year-old equestrian cantering across the landscape, or an 80-year-old bicyclist pedaling your favourite parkway, you’re better able to cope with and fend off that scary possible self, the bedridden nursing-home resident.

So, if we can help people create concrete images of themselves in the future as healthy, this may be a strong motivating force in helping them achieve specific health goals.

RD: This brings us to healthy behaviours. Which three top your list?

KH: In terms of well being, there is a universal need for humans to feel loved as well as a universal need to feel productive. Therefore, I would say that at least one behavior to nurture connections as well as one behavior to make oneself useful to others would be important for overall health. Specifically, what those behaviors should be will depend on who you are and your social context.

I would also have to place exercise among the top three because of its pervasive and positive influence on both physical and mental health.

Editor’s note: This is a shortened version of the original interview, which appeared in AHB September/October 2007.