Rethinking the Aging Transition, 1st ed. 2021
Psychological, Health, and Social Principles to Guide Aging Well

The current book is not only a discussion of the transition of life events of older adults but also a transition of views from a physician's perspective to a gerontologist's on addressing aging from a unique and distinct vantage point. This introductory chapter discusses the factors influencing the author's trajectory. Probably, the most powerful impact on the trajectory is that the author's grandmother suffered from Alzheimer's disease, and the author's mother is also showing the clinical manifestations of that disorder. The author has witnessed the disease process not only as a clinician but also as a family member and care partner. The chapters tie various disparate themes together focusing on the period of transition between late middle age and early old age (discussed in the chapter on aging and retirement), emphasizing an analysis of the differences between Eastern and Western cultures (the central aspect in the chapters on aging and spirituality, aging and diversity, and aging and caregiving), and promoting a person-centered holistic biopsychosocial approach to aging that maximizes their quality of life while living with different chronic disorders (the key element in the chapters on aging and physician, aging and longevity, aging and mental health, and aging and dementia).

Keywords: Transition, Gerontology, Alzheimer’s disease, India, United States.

2.            Aging and Physicians.

The latest advancements in medicine have increased longevity across the globe. However, how are the current quality of lives in those gained extra days due to blessings of medicalization? How honest are the clinicians, in this respect, while taking care of the diseased? A psychological bonding is essential for both doctor and patient to maintain a trustworthy relationship. Reaching beyond medical model treatments, clinicians should upgrade their responsibility by embracing person-centered care that includes medical care but focuses on individuals' quality of life and wellbeing. Humanity should be our priority. To be a change agent, every clinician must raise their hands against the overwhelming harmful effects of medicalization. Though, this is very frustrating to see that the situation of older adults is not much different in a so-called developed country compared to that of a so-called developing country. Still, the recent COVID-19 pandemic has reminded the entire world that physicians are always the last hope through their leadership roles, humanity, and invincible determination. This chapter discusses physicians' moral role to act as the change agent in the world of caregiving.

Keywords: Clinicians, medical care, medicalization, change agent, moral role.

3.            Aging and Retirement.

As the population is “graying” throughout the globe, the term “retirement’ is gaining importance day by day from different newer perspectives. It is probably one of the inevitable destinations of every human adult, regulates an intergenerational social cycle that operates the status of the economic development of a country. The transition from working life to apparent workless life controls the wellbeing of the concerned person remarkably economically, physically, and psychologically. However, the subtle idea of retirement should not be tied only to the transition from pre-older adults to older adults on a specific day; instead, the transitioning is in every day, every moment, even beyond that age. In later life, all these issues have a collective and profound impact on the morbidity and life span of the individual. However, with the progression of time, today’s aging population has many more options regarding retirement planning from work, which were never present before. Retirement is a milestone in an individual’s life, and this chapter discusses how everyone should feel about retirement; this is retirement from work, not from life. Finally, a relation of ageism with retirement is addressed in the context of a proposed theory, the "Complementary theory of aging."

Keywords: Retirement, work, aging population, theory.

4.            Healthy Aging.

Aging is an unavoidable part of the normal life course of every human being. Only in the last century, the global average human life expectancy has more than doubled. However, are all these older adults experiencing healthy aging, especially those suffering from one or more chronic disorders? How are they passing their days within families or in different institutional environments, such as assisted living facilities, nursing homes, or hospitals? How social relationships contribute to maintaining their dignity? Unfortunately, older adults, particularly those who are having chronic diseases, in our present socioeconomic structures, are sometimes perceived as a burden to their family members and are particularly vulnerable to abuse, even by their close ones. They found themselves very lonely in their surrounding world. On the other hand, it has also been found that education and a disciplined lifestyle are necessary to achieve healthy aging. It can also be stated that aging will be healthy if the older adults sacrifice properly in later years; the expectation of a huge outcome from later life is not wise. This chapter discusses how different determinants influence the outcome of aging in our life course.

Keywords: Healthy aging, chronic disorders, abuse, outcome of aging.

A large number of older adults are waiting with a critical demand for healthy aging, but there are only a limited number of professionals in the field of caregiving. Older adults are often forced to live alone and are exposed to various helpless situations, such as lack of physical, social, emotional, and financial support. While the Americans with Disabilities Act, assuring equal protections, extended its coverage to all persons with disabilities in the US, the Maintenance and Welfare of Parents and Senior Citizens Act made it a legal obligation for children and heirs to provide care to older adults in India, at least by providing a monthly allowance. However, everywhere, the practical scenario is different. Both in-home and institutional care, such as nursing home care, for older adults should be accessible, equitable, inclusive, safe, secure, and supportive. Is this available? The current pandemic has further compounded these challenges, both for caregivers and care-recipients. It is essential to generate awareness in the general population and implement strict monitoring of the existing laws to protect older adults living within or outside families. This chapter discusses different facets of caregiving, whether it is health care or regular care for basic activities or to provide emotional and financial care.

Keywords: Older adults, caregiving, support, awareness, families.

6.            Aging and Mental Health.

Various mental health conditions may be associated with impaired physical functioning and increased dependence among adults in later life. The conditions may be further responsible for the gradual rise in stress levels among older adults. Psychological issues, such as adjustment problems, helplessness due to cognitive decline, spousal caregiving, bereavement, and social role transitions, such as retirement and loss of mastery or family leadership, further aggravate the stress. These all have a conglomerate negative impact on the individual's health and functional status that directly affect quality of life. Furthermore, these age-related biopsychosocial complexities have a strong negative feedback effect on psychiatric morbidity, making diagnosing mental health issues and their management further difficult. This chapter discusses various aspects of mental health conditions, including types, causes, and whether various therapies available for mental illnesses are truly effective in their capacity to help older adults to age better.

7.            Aging and Dementia.

As we are passing through an era of demographic shift, we are now having millions of older citizens around us. Growing old is not easy, either on bodies or minds. As we grow, our knowledge grows, our experience grows, but at the same time, we have to lose so many things with our progression towards elderhood. Our general cognitive ability tends to decline throughout adulthood, and as an obvious consequence, the number of dementia patients is increasing in every part of the globe. Dementia, which is considered as the progressive deterioration of cognitive function of an individual, is currently one of the leading causes of death worldwide. Dementia is probably the most unrecognized and undertreated chronic condition in the present world. As there is no definitive curative management available, this is one of the significant public health concerns. This chapter discusses various aspects of dementia, including types, causes, and management, including the virtual dementia tour.

Keywords: Elder-hood, dementia, cognitive function, management.

8.            Aging and Diversity.

For obvious reasons, as the population is becoming more diverse, some of the unique psychological, health, and social challenges and issues like successful aging and death are emerging gradually as matters of concern. Most of these are particularly critical for different minority populations and ultimately aids in shaping their long-term care experiences. Early disadvantages impact as a negative risk factor across the stages of life, and the differences generated from the initial disadvantages are intensified over time. Aging is now considered not just a segregated process; instead, a continuous process that starts from even before birth; the factors associated with health, i.e., physical, psychological, social, environmental, and spiritual wellbeing, influence people to maintain their intra-individual variability. The association between socioeconomic inequality and health is bidirectional and cumulative, both affecting and being affected at the individual, societal, and country levels. Everyone needs to be a change agent to minimize the existing gap in this bidirectional relationship towards equality. This chapter highlights how population diversity challenges different psychological, health, and social issues of older adults globally.

Keywords: Diversity, challenges, minority population, quality of life.

9.            Aging and Longevity. 

Keywords: India, longevity, quality of life, Yoga, social relationships.

10.          Aging and Technology.

Keywords: Technology, biological machine, health promotion, world of orphans.

11.          Aging and Death.

Keywords: Death, death-related events, palliative care, hospice.

12.          Aging and Spirituality.

Kallol Kumar Bhattacharyya, MBBS, MA, PhD (Candidate) is a physician gerontologist with a general interest in providing older adults with more holistic health care that maximizes their quality of life. He worked as a family physician in India for nearly two decades. As a mid-life career changer, he completed his master's degree in Gerontology from Georgia State University, USA. Dr. Bhattacharyya is currently researching dementia at the School of Aging Studies, University of South Florida (Tampa), USA, where he is a doctoral candidate and undergraduate instructor. He expects to complete his PhD in Spring 2022. His research interests include mindfulness activities to improve the quality of life of persons with dementia, improvement of health policy for older adults, longevity, and healthy aging. Dr. Bhattacharyya is particularly focused on some alternative therapeutic interventions for Alzheimer’s disease and related dementia. He is also working on the individualized care provided in institutional settings, especially nursing homes, and is interested in investigating how residents’ satisfaction levels and subsequent complaints (if any) help identify flaws in the care delivery system.

Elucidates fundamental relation of aging with health and socioeconomic factors, incorporating theoretical perspectives

Uniquely features the late middle-age and early old-age transitional periods and East-West comparisons

Serves as a bridge for a smooth transition with caregiving in the context of the challenges posed by COVID-19