Nirvana Live In Brazil 1993
Umbelina Baublitz
This article focuses on different conceptions of successful aging, emphasizing the process of aging as a heterogeneous experience that implies different strategies for achieving wellbeing and quality of life. Studies valuing the aging process as part of the course of human life and the role of subjectivity and health self-perception, as key concepts for understanding wellbeing and health in old age, were selected. Data in the literature suggest that the experience of successful aging values elderly people's own perceptions: they are the protagonists of interventions and possess judgment about wellbeing and quality of life. Even in the presence of comorbidities and diminished functional ability, it is possible to identify elderly people who report high levels of satisfaction and good quality of life. We propose questions that seek to improve investigations and elaborate this construct within gerontology, bearing in mind the size and complexity of this topic.
Este artigo enfoca diferentes concepes de envelhecimento bem-sucedido, enfatizando o processo de envelhecimento como uma experincia heterognea, que implica diferentes estratgias para a obteno de bem-estar e qualidade de vida. Foram selecionados estudos que valorizam o processo de envelhecimento como parte do curso de vida humano, o papel da subjetividade e a auto-avaliao em sade, como conceitos-chave para compreender o bem-estar e sade na velhice. Os dados da literatura sugerem que a experincia do envelhecimento bem-sucedido valoriza a percepo dos prprios idosos, protagonistas de intervenes e dotados de julgamentos sobre bem-estar e qualidade de vida. Mesmo na presena de co-morbidades e diminuio da funcionalidade possvel identificar idosos que referem altos nveis de satisfao e boa qualidade de vida. Propomos questes que buscam aprimorar investigaes e a elaborao deste constructo em gerontologia, tendo em vista a amplitude e complexidade do tema.
Este artculo aborda diferentes concepciones de envejecimiento bien llevado, enfatizando el proceso como una experiencia heterognea que implica diferentes estrategias para la obtencin del bienestar y calidad de vida; seleccionando estudios que evalan el proceso de envejecimiento como parte del curso de vida humana, el papel de la subjetividad y la auto-evaluacin en salud como conceptos clave para abarcar el bienestar y la salud en la vejez. Los datos obtenidos sugieren que este proceso resalta la percepcin de los ancianos protagonistas de intervenciones. Proponemos cuestiones que tratan de perfeccionar investigaciones y la elaboracin de este constructo en Gerontologa.
Successful aging is one of the broadly disseminated themes in the means of communication, services, research and texts that inform laws and public policies in the field of gerontology. In this area, it is believed that active life should be added to chronological time, a need identified as the product of efforts undertaken in the last years, largely related to an increase in science production, technology and healthcare practices to the elderly. It is desirable that aging occurs with quality and maintenance of the elderly individuals' autonomy, in an effort to preserve their participation in society, and to minimize the possibilities of social exclusion (Teixeira, Neri, 2008; Lima, 2005, 2003; Holstein, Minkler, 2003; Kahn, 2003; Paschoal, 2002).
In the present discussion, we view old age and the aging process as two complementary and inseparable spheres. It is worth mentioning that we consider aging as a process that, in the individual level, implies multiple life trajectories and, in the collective level, is constructed under different sociocultural influences, such as: access to educational opportunities, adoption of health care, and the undertaking of actions throughout the life course, extending into the late phases of life, like old age. In this sense, while aging is defined as a multifaceted sociovital process that happens along the entire life course, old age denotes the state of "being old", a condition that results from the aging process that generations have experienced and experience within diverse social, political and individual contexts. In other words, these terms refer to specific aspects of the vital human cycle, in such a way that moving between the notions of "old age" and "aging process" becomes fundamental to develop the theoretical-conceptual reflection that we present below, concerning aging, successful old age and elderly individuals' well-being.
In European countries, data presented by Baltes, Smith (2006) show that individuals older than 85 years have higher risk of presenting multiple chronic-degenerative diseases and other pathologies. For example, the results obtained by these authors indicate that 50% of the individuals aged 90 years or older suffer from Alzheimer's Disease, a neurodegenerative illness that is associated with dementia, progressive loss of cognitive and functional abilities and high health costs. In addition, Baltes, Smith (2006) present evidences according to which very old individuals spend the end of their lives with high indexes of functional disability, dependence and loneliness. The authors believe that investing in the multiple factors involved in the aging process and in more actions to promote social inclusion may have positive influences on successive cohorts of elderly people.
In the scope of old age, resources and interventions are hardly justified if they are not targeted at the well-being and quality of life of the individuals who age. These principles are becoming more and more relevant in the context of the well-known accelerated growth of the Brazilian population (Camarano, 2006; Kalache et al., 1987).
Well-established estimates indicate that, up to the year 2025, the number of Brazilian elderlies will exceed thirty million, with different types of old age, that is, constructed by means of diverse trajectories, sometimes with high levels of comorbidities and chronic diseases, sometimes with health and well-being (Lima, 2003; Debert, 1999; Berqu, 1996).
On the other hand, the discussion about successful aging is relatively new. The first gerontological studies were developed in the 1950s and 1960s by researchers from European countries, because, at that time, it was already possible to find a large proportion of healthy elderly individuals in those communities (Teixeira, Neri, 2008; Glass, 2003; Neri, 2001). The most positive beliefs about the aging process allowed many theoretical lines to participate in this discussion, demystifying the inevitable paradigm, valid at the time, of growth, stability and contraction, regarding the vital human cycle (Neri, 2001). In other words, gerontological investigations enabled to modify the notion according to which aging is directly associated with the organism's deterioration. It could begin to be seen as a stage of the vital cycle, as important as any other, with its virtues and challenges (Masoro apud Groisman, 2002; Uchoa, Firmo, Lima-Costa, 2002; Debert, 1999; Erikson, 1998).
In short, based on the scientific and empirical knowledge that has been accumulated up to the present moment, we are entitled to state that aging is not synonymous with disease, inactivity and general contraction in development although the negative beliefs and attitudes regarding old age are still hegemonic in some cultural contexts, mainly among the Western societies, and possibly, among some contemporary Eastern societies. Thus, there are new values and concepts under construction which are disseminated in different contexts of the world, with an ever-growing globalized economy (Neri, 2006; Bosi, 2005; Beauvoir, 1990). In the scope of attitudes and stereotypes, considering that all elderly people are wise or that all are incapable is equally negative (Neri, 2006; Debert, 1999). In the gerontological literature, aging is considered a progressive and multifactorial event, and old age, a potentially successful experience, but also a heterogeneous one, experienced with less or more quality of life.
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