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Critical Investigations of Age and Aging in the United States
By Sarah E Lamb
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American Anthropologist. Washington: Dec 2005
©Copyright University of California Press Dec 2005
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The three books under review here -- (1) Critical Investigations of Age and Aging in the
United States Aged by Culture, (2) Breaking the Watch: The Meanings of Retirement in America
and (3) My Mother's Hip: Lessons from the World of Eldercare -- critically explore the diverse
ways that age and aging are managed and given and stripped of meaning in the
contemporary United States.
Critical Investigations of Age and Aging in the United States Aged by Culture by
Margaret Morganroth Gullette. Chicago: University of Chicago Press, 2004. 267 pp.
Breaking the Watch: The Meanings of Retirement in America by Joel S. Savishinsky.
Ithaca, NY: Cornell University Press, 2000. 281 pp.
My Mother's Hip: Lessons from the World of Eldercare by Luisa Margolies. Philadelphia:
Temple University Press, 2004. 339 pp.
1
Age is a fundamental dimension of human life and yet, interestingly, something that
many in the United States find difficult to confront. The three books under review here critically
explore the diverse ways that age and aging are managed and given (and stripped of) meaning
in the contemporary United States. Together, they make the case that to understand aging is to
illuminate principal features of our society as a whole.
2
Margaret Gullette is not formally an anthropologist but, rather, a writer and cultural critic.
However, she presents her work as "anthropological" in that her project is to critically scrutinize
the ways that age and aging are culturally constructed in the contemporary United States,
arguing, in general, that human beings are "aged by culture" far more profoundly than they are
by nature or the body. Breaking the Watch focuses on the meanings of retirement in the United
States, which, as the U.S. population ages, has become a significantly longer and more
prevalent-although still strikingly ill defined-life phase. My Mother's Hip explores the social,
moral, and medical dilemmas surrounding care of the chronically ill elderly, by narrating the
intensely personal story of the author's own mother's decline.
3
Of the three books, Aged by Culture has the most far-reaching theoretical and political
implications. Gullette's central argument is that age is culturally constructed, and it is a highly
significant cultural construction at that: "No other construction concerns every one, or concerns
each one so nearly" (p. 97). Like race, class, gender, and sexuality, age is a powerful form of
difference and identity. But just as scholars and activists have done for race and gender, we
need now to "unmake an essentialized body-based ideology" surrounding age, to "drag aging . .
. away from nature and toward culture" (p. 102), and, thus, to realize that our particular
dominant narratives of aging are just some of many possibilities.
4
Such arguments may seem commonplace to some anthropologists, but in making her
case, Gullette presents a rich and incisive exposé of some of the most salient and pernicious
ideologies of age in our society. Her main peeve is with U.S. culture's master narrative of aging
as decline (here, she builds on her earlier book, Declining to Decline 1997). Popular as well as
scholarly discourses present the life course as a story of "progress" in youth, building toward a
"peak" in early midlife or young adulthood, followed by "decline" (p. 130). No one stays long in
the "good" stages, and "aging" becomes the "social name for bad alterations" (p. 130). One of
many arenas in which such ideologies are realized and perpetuated is the burgeoning
commercial anti-aging market, which pushes "solutions" to aging and "the midlife crisis," from
botox parties to Buddhism, cosmetic surgery, and "rejuvenating" toothpaste. Gullette reflects:
"Using prosthetic youtheners to defy aging as early as midlife proves that youthfulness is
symbolic capital" and how "deeply [we] internalize the meaning of time passing as the loss of
our capital" (p. 22). (Why, instead, can we not imagine younger people tattooing wrinkles on
their bodies or highlighting their hair with gray?)
5
Gullette draws her material from her own life experiences as well as analyses of U.S.
media, fiction, poetry, museum exhibits, work life patterns, sexual and family relations,
economic systems, and so forth. The book's ultimate aim is to promote a "revolution in age
consciousness" (p. 78) and a society in which we can "feel at home in the life course at every
age" (p. 20). Gullette is stronger, though, in critiquing existing models than in offering
alternatives. Here is where cross-cultural data could be illuminating-for other non-decline
narratives of aging do exist cross-culturally, as do narratives in which decline and loss in late life
have richly complex and often positive meanings, as I have found in my work with Bengalis.
6
Breaking the Watch and My Mother's Hip are both more centrally ethnographic, focused
on particular people's lives. Neither have the sweeping theoretical implications of GuIlette's
work, but they each offer illuminating, intimate portraits of the everyday lives of real people as
they work out their own and others' aging. In some senses, both books grapple with the theme
of decline that Gullette is so critical of. Breaking the Watch explores how older U.S. citizens
manage the loss of their work lives and identities after retirement, and My Mother's Hip explores
how we deal with chronic illness, elder care, and dying. Both books together could be said to
make the argument (as several of the books' informants articulately express) that, to some
extent, decline and loss are indeed a central part of late life for many-a part that we, and they,
might not wish to deny. Maybe, then, the problem is not so much that U.S. citizens have
constructed narratives of late-life decline, but, rather, that we have not made these narratives
meaningful.
7
To produce Breaking the Watch, anthropologist Joel Savishinsky conducted fieldwork
over several years with 26 men and women of an upstate New York community, all of whom
were planning for and then entered retirement. He examines the intricate ways that these
persons work self-consciously to create meaningful lives for themselves, when the post-work life
phase initially strikes them as permeated by an "aura of nothingness" (p. 54).
8
Retirement in the United States is relatively new as a distinct life phase. A confluence of
economic, demographic, and social-cultural factors-including the establishment of Social
security in 1935, the increased longevity of the post-World War II "baby boomers," and modern
ideas about workplace efficiency and social justice-has meant that U.S. citizens now generally
expect to spend their last one, two, or three decades, often about one-quarter of their lives, in
post-work "retirement." Notably, however, the retirement phase in the United States is still
relatively void of precise meanings and expectations. There are no special figures of speech,
rites, or mythologies to indicate precisely what retirement is for. Savishinsky observes that
"going through retirement strips people of a long-held identity and bestows nothing concrete to
replace it" (p. 54). To situate his U.S. ethnography in a broader context, the author glimpses at
practices in regions such as India, Africa, and China, finding that in many non-Western settings,
old age-like earlier life stages-is marked by clear rituals and purposes. In the United States, it is
"this undefined nature, this cultural lightness of retirement," which makes it very often "so
personally heavy to bear" (p. 55). One problem is that because U.S. citizens have so
emphasized work and productivity as the foundations of moral worth, it is difficult to feel
"valuable" without working. One informant poignantly narrates his experiences filling out his
income tax forms after retiring: "On the front sheet it asks occupation. So-what do I put? Once it
was 'chemist,' then 'health educator.' Now? I wanted to write 'bum'" (p. 248).
9
The heart of the book focuses on the diverse ways Breaking the Watch's informants selfconsciously take such a void and actively work to make retirement meaningful, productive, and
enjoyable. In this endeavor, the main project seems to become replacing the "work ethic" with
the "busy ethic" (p. 16). Retirees structure their days around organizing the house, planting a
garden, care giving (for parents, grandchildren, and ailing spouses), volunteer work, travel,
second part-time jobs, courses at senior centers, exercise, reading, writing letters, golf, boating,
ballroom dancing, tai chi, and introspection ("What is the meaning of life?" or "What is the
meaning of my life?"). Although their success in crafting retirement as a meaningful life phase
varies (along with degrees of health, financial security, and supportive social ties), the bulk of
Savishinsky's informants do appear to come to value at least many facets of retirement.
10
Savishinsky and some of his informants are, nonetheless, critical of what can be viewed
as an overemphasis on busyness and fitness, or "successful aging," in the United States-for
such models "overlook the fact that an old age free of worry and illness is ideal, not real" (p.
240). According to Savishinsky, many older persons wish to talk about, and incorporate into
their senses of self, the experiences of loss that aging (in their minds) inevitably entails, and
some, for instance, are expressly critical of children and others who are unwilling to talk with
them about death.
11
My Mother's Hip is even much more so a rumination on loss and decline in late life. In
My Mother's Hip, medical anthropologist Luisa Margolies offers both the personal narrative of
her experiences caring for her chronically ill mother and a critical presentation of medical,
institutional, and social-cultural issues related to elder care in the United States. After her
mother's double hip fracture, Margolies immersed herself in identifying and coordinating the
services and institutions needed to provide critical care for an elderly person. She dropped
almost everything else in her life-her son, husband, and work in Venezuela-and spent the better
part of five months in Florida negotiating care with physicians, hospital workers, nursing home
administrators, the Medicare bureaucracy, home care providers, her brother, and her parents.
She quickly found that neither the U.S. medical system nor the family is currently prepared to
deal effectively with the elderly's long-term care needs, although new demographic realities and
an "epidemic growth of age-related diseases" (p. 3) are creating an enormous dependent aged
population. (Margolies suggests that "the majority of American elders can now expect to die
protracted deaths from chronic conditions" [p. 225].) Although the bulk of the book centers on
the intimately detailed story of "Mother's" final months of life, Margolies also inserts critical and
practical "lessons" on elder care, speaking to ethical dilemmas surrounding the prolonging of
life, the institutionalization of the elderly, and the emotional toll paid by adult children caring for
aging parents.
12
One of the book's messages is one that other medical anthropologists, and many in our
society, widely acknowledge: that "advanced" medical technologies are not unequivocally
beneficial. Although Margolies desperately wants her mother to continue living and pushes for
every available medical intervention, she emerges profoundly ambivalent. She reflects, "A
lifesaving procedure may do just that [lifesave], or it may consign a person to a living death" (p.
93). "A . . . serious consequence of technological brinkmanship is the deterioration in the quality
of our lives that it brings about as the end approaches. It insures that our final years will be
characterized by debilities and our final days by pain and suffering" (p. 231).
13
Margolies is also piercingly critical of the quality and prevalence of institutional care for
the elderly, which is transparent from lesson titles such as "Nursing Homes Are Dangerous to
Your Health: The Medical Model for Housing the Elderly" (pp. 176-196). Her mother spent the
last 147 days of her life in seven different medical facilities, where she faced bureaucratization,
standardization, unpalatable food, indifference, neglect, and indignity. However, because aging
U.S. parents refuse to be a "burden on their children" (p. 180) and children do not feel able or
willing to care for their parents on their own, nursing homes have now become "ubiquitous," and
the chances of ending up in one "nearly one in two" (p. 179). Margolies reflects disparagingly,
"Seniors are actually geared to spend their final days in nursing homes, an alternative just as
viable today as living with one's children was in the past" (p. 180).
14
However, although Margolies believes that "hired hands and institutions cannot replace
the warmth of one's own family" (author interview, www.temple.edu/tempress/
authors/1721_qa.html), and although she gives so much of herself to her parents during their
final months, she finds that our lives are simply not set up to care for chronically ill older parents
in the home. Adult children regularly are dispersed nationally and transnationally (Margolies's
home is in Venezuela and her only sibling is in Chicago), have pressing work lives, and are not
competent to deal with complex medical needs. When Margolies attempts for a period to take
over her mother's care, her physician brother feels that she is completely overdoing it, arguing
that this is the purpose of nursing homes and Medicare. Further, Margolies's mother "didn't think
it was appropriate for a daughter to be involved in such intimate care" as bodily functions and
bathing (p. 105). Over the phone, Margolies's husband quotes a telling proverb from his native
northern Italy: "When the parents give to their child, the parents laugh and the child laughs, but
when the child gives to the parents, the child cries and the parents cry" (p. 80). The book's data
reveal powerful Euro-American cultural models of in/dependence and intergenerational
relations: Parents provide intimate care for their children when the children are young, but as
adults both generations aspire to live as independently as possible.
15
As an ethnography, the book works more as raw (illuminating and poignant) data than as
anthropological analysis. Throughout most of the text, the author is still too close to the material
to be able to (or to wish to) develop broad theoretical analyses or explore alternative
perspectives other than her own. For instance, Margolies presents numerous intriguing
accounts of her clashes with other caregivers, such as her brother, her parents' longtime
domestic helper (Marisa), and various nursing home staff. However, rather than attempting to
pursue what would likely be very interesting and revealing counter-narratives, Margolies tends
simply to close the tales with insular, reductive assertions such as "Marisa was wrong and I was
right" (p. 109), "I had lost it again, but [my brother] deserved it" (p. 266), or the staff "should
have realized they were dealing with an acutely ill and demoralized woman" rather than a
"chronic complainer" (pp. 159-160). And Margolies does not seem to be able to acknowledge,
until the very end of the text, that her mother clearly wants to die.
16
Complementing all three books would be cross-cultural data, enabling us to better
realize alternative perspectives and our own unrecognized assumptions. There has, in fact,
been for several decades now-as the authors acknowledge and at times engage with-a growing
anthropological literature on age, maturation, and aging as social-cultural phenomena, in this
and other societies. Margaret Gullette ambitiously recommends that we take this body of
literature, as well as feminist, historical, psychosocial, literary, political, and economic
perspectives, and develop "Age Studies" as a new interdisciplinary field, one aimed at
producing more complex, challenging, and satisfying accounts of cultures and ideologies of age
(pp. 115-116). It is important to point out that age here would not refer primarily or exclusively to
old age. In a reconceptualized age studies, Gullette envisions that "'aging' will no longer be
either a euphemism for old age or a process that begins at an undecidable period in middle age.
. . . Age studies will not be synonymous with gerontology" (pp. 106-107).
17
I close by returning to the theme of decline running in different ways through each work,
focusing on the issue of death. In arguing fervently against decline as an ideology of aging,
Gullette's arguments feel at times like one of the antiaging commercial products she critiques:
Either one must stay the same, or experience positive change, but cultural models of negative
change or loss are oppressive and unacceptable. Striking here is Gullette's refusal to accept
death as part of age studies. Gullette argues that "aging discourse slides into dying discourse
without critique," that the age-death connection is "ageist," and that "age theory must in general
tear up the death card" (pp. 107-108). True, aging and dying are not inevitably or naturally
linked: In societies (including the pre-1900s United States) in which infant and child mortality is
very high, death can be viewed as heavily attached not to the old but to the very young. But, the
blanket argument that it is ageist and wrong to entertain dying as a possible component of
meaningful discourses of later life seems rather peculiarly tied to a broad U.S. cultural
discomfort with death, meriting critical examination. On a much more personal level, Luisa
Margolies, too, fights death throughout My Mother's Hip: striving to force Mother to eat, pushing
for life-support technologies, refusing to acknowledge her mother's announcements that she
does not want to eat because she is ready to die, and that she is angry that she had not been
allowed to die earlier. In different ways, then, both Gullette and Margolies somewhat uncritically
espouse our culture's prevalent notions that death is ultimately bad, constitutes an end to
personhood, and should not be discussed. In contrast, Savishinsky finds through fieldwork with
older individuals that "retirees were generally not reluctant to talk about the deaths of others or
their own mortality, and they were often quite critical of friends and family, including their own
children, who continued to deny, avoid, or taboo the whole subject" (p. 233). Further, reflecting
on their own and other people's frailties and mortality became a "stone against which to sharpen
the keenness of appreciation for the life one had left" and, in fact, became "part of what made
retirement a liberation for Alan, Alice, Zoe, and Sandra" (pp. 233-234).
18
Taking off from Savishinsky's informants' insights, I suggest that we strive to accept that
aging is not inevitably or naturally a story of decline. However, we should not also move to
argue that any models of aging that foreground decline or dying are untenable. One could
contemplate, for instance, a Buddhist or Hindu perspective: Life fundamentally entails decline
and transience-not only in old age but also as an essential feature of the human, material
condition. Coming to realize this transience, many Buddhists and Hindus say, can be a positive
and enlightening move, potentially making both aging and dying meaningful.
19
The books together reveal powerfully that studies of age and aging provide an
illuminating lens into complex and important features of U.S. society, surrounding cultural-moral
values, social relationships, and visions of personhood. All three books-each highly readable,
enlightening, and provocative-could be very fruitfully used in graduate and undergraduate
courses on age or aging, medical anthropology (Margolies), the body (Gullette), family and
kinship (Margolies), and U.S. society and culture.