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Introduction

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Life expectancy has increased dramatically worldwide in the late 20th and early 21st centuries (Centers for Disease Control and Prevention, 2013). This increase is the result of reductions in deaths from infectious diseases such as polio and measles, as well as improved health-related habits including smoking cessation and the use of seat belts. At the same time, modern innovations like fast food and suburban living have led to poor eating and limited exercise, with associated increases in chronic diseases such as diabetes. The positive changes in health care provide reason for optimism about late life, but at the same time, the more negative behaviors are worrying. Beyond the obvious increase in longevity, it is somewhat difficult to project whether later life will be characterized primarily by good health and function or by increased disease and disability (Crimmins, 2015; Crimmins & Beltrán-Sánchez, 2010); indeed, each of these descriptions may fit a segment of the older population.

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The vast majority of older adults, even those with physical or cognitive limitations, live in the community and adapt well to the changes that are an inevitable part aging. Many continue to participate in meaningful occupations that contribute to quality of life. Individuals find ways to manage the typical decrements in physical and cognitive skills that often occur in later life. These differences are not all negative. Individuals may have to adjust to reduced vision or hearing, but they also have life experience and knowledge that can help them cope. For example, as can be seen in this text, although older adults may learn differently than younger people do, they are still quite capable of acquiring new skills and abilities, and may offer valuable insights and observations to younger people as well. It is essential to understand both the universal aspects of aging and the individual experience, because "although there are universal age-related changes, the process of aging for each individual is unique" (Martin & Gillin, 2013, p. 53).

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Part I of this book provides an overview of the aging experience and an introduction to biological and psychosocial theories of aging, the meanings of occupation in later life, and the social, cultural, and political environment in which aging occurs. These chapters offer a framework in which the experience of growing old can be understood. To ensure the best care, providers must understand the individual, including his or her history, needs, and wishes. It is also essential to think of the individual in context, not as separate from life experiences and community. In understanding contexts, it is important to recognize that these include those in the older adult's immediate surroundings: the built environment, social networks, neighborhood characteristics, and local policies. But they also include the more global contexts: societal attitudes toward aging, cultural values in the society, public policy affecting later life, and many other factors. This section of the book is designed to provide an understanding of the context in which ...

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