The dominant model of understanding ageing is a medical one, where the focus is on the bodily and mental decline of the individual, framing older people through a lens of illness and disability. This deficit model emphasises the dependency and frailty of older people – a failing body and mind – that can only be ‘fixed’ or ‘cured’ through medicine. This model encourages a pessimistic view of older age. We are taught to fear ageing and getting old, and older people can absorb these negative attitudes, leading to loss of confidence, withdrawal and invisibility. On the other hand, a whole ‘anti-ageing’ industry has built up to help people deny the reality of ageing.

What alternatives are there? Models of active, successful and productive ageing seek to provide a more positive attitude to older age, focusing on ageing ‘successfully’ through avoiding disease, functioning well, maintaining a healthy lifestyle and retaining independence. Whilst on the surface these models appear to be helpful, we have to be careful about what we mean by ‘successful’ ageing. Usually this means denying the reality of the deteriorating body and mind when someone who is frail and dependent can still be very fulfilled in their life, or be mentally active and creative.

We need a new concept of ageing that takes into account the diversity of experiences of older people, and does not define ageing in terms of ‘success’ or ‘deficit.’

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Living and ageing well