New horizons in frailty: the contingent, the existential and the clinical.

In the past decade, frailty research has focused on refinement of biomedical tools and operationalisations, potentially introducing a reductionist approach. This article suggests that a new horizon in frailty lies in a more holistic approach to health and illness in old age. This would build on approaches that view healthy ageing in terms of functionality, in the sense of intrinsic capacity in interplay with social environment, whilst also emphasising positive attributes. Within this framework, frailty is conceptualised as originating as much in the social as in the biological domain; as co-existing with positive attributes and resilience, and as situated on a continuum with health and illness. Relatedly, social science-based studies involving interviews with, and observations of, frail, older people indicate that the social and biographical context in which frailty arises might be more impactful on the subsequent frailty trajectory than the health crisis which precipitates it. For these reasons, the article suggests that interpretive methodologies, derived from the social sciences and humanities, will be of particular use to the geriatrician in understanding health, illness and frailty from the perspective of the older person. These may be included in a toolkit with the purpose of identifying how biological and social factors jointly underpin the fluctuations of frailty and in designing interventions accordingly. Such an approach will bring clinical approaches closer to the views and experiences of older people who live with frailty, as well as to the holistic traditions of geriatric medicine itself.

Meaning Making in a Retirement Migrant Community: Religion, Spirituality, and Social Practices of Daily Lives.

Meaning in life has also been seen as crucial to well-being, and especially, in later life. This study focused on the social complexity of meaning making processes and the role of religion and spirituality in them, by finding out the following: (1) How are meaning-making practices connected with religion and spirituality for Finnish retirement migrants of the boomer generation? (2) What does the role of religion and spirituality in meaning-making practices teach us about the relationship between individual and social aspects of meaning making? This was done by examining a particular group of older persons: Finnish retirement migrants aged 60 or over in Costa del Sol, Spain. The material for this study consists of 58 texts (written correspondence, dataset 1, year 2009), 10 semi-structured interviews (dataset 2, year 2011), and 30 completed online surveys with open-ended questions (dataset 3, year 2019). Key findings include that religion and spirituality are present in the lives of our informants in a variety of ways, playing a significant role in their meaning making, and that they appear as intertwined and not so easy to separate. A variety of religious and non-religious forms of spirituality exist in this population, and all of these forms can be relevant factors in meaning making. Also, the engagement in meaning making, contrary to what has been suggested in some of the literature about meaning in later life, not only occurs in response to confrontations with health issues, death, or other major life events. Instead, we found that meaning making occurs as a process that is often inherent to daily activities which may seem "trivial," but in fact turn out to be important sources of purpose, values, and connectedness. Contrary to the dominant modern ideal of the authentic, self-sufficient human agent, which is based on a problematically atomistic and individualistic anthropology, for our respondents, their authentic subject position is embedded in the social practices of their daily lives, which nourish their individual spirituality and are vital to making meaning.

Aging and the Ethics of Authenticity.

This article aims to make a philosophical contribution to debates about meaningful sociocultural narratives about aging. It is argued that the moral-philosophical discourse of authenticity may provide valuable resources for counter narratives about later life that are capable of challenging the dominant stereotyping decline- and age-defying cultural narratives. The discussion will draw on classical and contemporary views of authenticity by Rousseau; existentialists such as Kierkegaard, Nietzsche, and Heidegger; and contemporary thinkers such as Taylor and Meyers. Authenticity discourse is argued to be capable of, on the one hand, acknowledging the positive potentials of growth and development that later life may harbor, while, on the other hand, providing support for recognizing and integrating the inevitable existential vulnerability and finitude that old age also confronts us with. Although authenticity is not a commonly used term in gerontology, some examples show how a language associated with this philosophical discourse has found its way into gerontological thought as well, supporting its relevance for the context of aging. The article concludes with a discussion of four aspects through which the authenticity discourse may contribute to viable cultural narratives about later life.

Virtuous aging and existential vulnerability.

In its efforts to overcome problematic views that associate aging with inevitable decline, contemporary gerontology shows a tendency to focus predominantly on age-related vulnerabilities that science may try to remedy and control. However, gerontology should also offer languages to address vulnerabilities that cannot be remedied because they intrinsically belong to the human condition. After all, these are increasingly radically encountered in later life and should therefore be reflected upon in the study of aging. Humanistic gerontology seems to be the most promising field to look for languages capable of contemplating such existential vulnerabilities. The potential contribution of philosophy in this field remains underdeveloped so far, however. This article therefore aims to introduce insights from the philosophical tradition to (humanistic) gerontology. More specifically, it focuses on the tradition of virtue ethics, arguing that virtue is a particularly relevant notion to explore in dealing with existential vulnerability in later life. The notion of virtue is clarified by discussing a selection of philosophical perspectives on this topic, by Aristotle, MacIntyre and Swanton. Next a brief overview will be given of some of the ways the notion of virtue has found its way into gerontological discourse so far. The article ends with an analysis of the merits of virtue-ethical discourse for the study of aging and later life, and pleads for more inclusion of philosophical ideas such as virtue in gerontology, as these can enrich our conceptual frameworks and help us relate to deep existential questions regarding the experience of aging.

Self-realization and cultural narratives about later life.

In late modern circumstances, aging individuals are confronted with the task of creating a meaningful individual life trajectory. However, these personal narratives are situated in the context of broader cultural narratives. It is argued that current cultural narratives about aging are often stereotyping and demeaning, being based on either a decline ideology or an age-defying ideology. This complicates the ascription of meaning to later life. We argue that narrative gerontology could profit from integrating a more cultural critical stance in its investigations. Dominant cultural narratives need to be challenged by viable counter narratives aimed at repairing and strengthening the moral agency of aging individuals. We discuss the criteria such counter narratives have to answer to and consider how the moral discourse on self-realization can provide an ideological foundation for meaning-generating cultural counter narratives on aging.