Part I: The Context of Aging

The number of older adults across the globe continues to grow dramatically, while the number of births, especially in northern hemisphere countries, declines (World Health Organization [WHO], 2023). This inversion has important implications for aging, society, and healthcare. The context of aging takes into consideration social policy, medical and social service access, and housing and transportation options. In addition, social shifts in embracing diversity in identity, ethnicity, family constellations, and culture influence how older adults engage in life’s meaningful occupations. Recognizing these intersections of person and society, occupational therapists help older adults, their families, and communities adapt and find meaning in change.

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 of 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 from how younger people do, they are still quite capable of acquiring new skills and abilities, and through wisdom, 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 and how these experiences are shaped by current sociocultural and historical contexts.

Part I of this book provides an overview of the aging experience, the meanings of occupation in later life, and the social and cultural environment in which aging occurs. In addition, the section offers an introduction to biological and psychosocial theories of aging and legal and ethical considerations around aging. These chapters offer a framework in which the experience of growing old in contemporary society can be understood. To ensure the best care, providers must understand the individual, including their identity, relationships, history, needs, and wishes. It is also essential to think of the individual in context, not as separate from life experiences and community. Context includes those in the older adult’s immediate surroundings: the built environment, social networks, neighborhood characteristics, and local and national 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 aging occurs and the experiences of individuals and populations as they age.