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Introduction

"It is better to know some of the questions than all of the answers."

—James Thurber

LEARNING OUTCOMES

By the end of this chapter, readers will be able to:

  1. Discuss the importance of understanding various theories of aging.

  2. Describe biological theories of aging.

  3. Describe psychological theories of aging.

  4. Describe sociological theories of aging.

  5. Explain approaches to theory as guiding practice with older adults, emphasizing Dynamic Systems Theory of Motor Control (Shumway-Cook & Woollacott, 2012) and the Model of Human Occupation (Kielhofner, 2008).

Clinical Vignette

Mrs. Estelle Arthur is a 73-year-old widow who has the appearance of a wizened 90-year-old. Her hair is pure white, and her skin is wrinkled. Because of a long history of arthritis and a fear of falling, she walks slowly with feet wide apart. She spends most of her time in her apartment alone and she complains to family and her few surviving friends about how her life is not worth living. Over time, Mrs. Arthur has become skeptical about the intentions of others and no longer sees family and friends as much as she did in the past.

In contrast to Mrs. Arthur, Mr. Morales is a 76-year-old married man who appears much younger than his age. His hair retains some of its original dark color, and his skin has a relatively youthful look. Despite ongoing bilateral knee pain from overuse and old soccer injuries, he provides care for his infirm wife and helps one of his two adult sons as well. He enjoys the company of many friends and is busy much of the time playing pool, going to dominoes tournaments, and driving friends to the Hispanic Senior Center. He loves to dance, and he expresses enthusiasm for life.

  1. What makes these two stories so different?

  2. Why do some people seem to age well, while others spend their later years infirm and unhappy?

The questions posed in the case vignette raise more fundamental issues about the life course. Why do we age? What is the nature of senescence, and can its process be altered? How can we live healthier and more fulfilling lives? Why do some people age in a positive way and others don't? How can we better address the needs of elderly people through physical and occupational therapies to unleash their potentialities? These are important questions, and to answer them, scientific theory is required. Theory is an attempt to explain what we observe in empirical research or practice. Theories of aging are attempts to go beyond the what of symptoms or disabilities associated with aging to examine the why and how of changes related to age. The need for theory is most obvious in biomedical fields, where therapies represent the end of a sequence of laboratory research about causes and effects. But theory is equally important in psychology, sociology, and public policy. At the societal level, the rapid aging ...

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