AGING INDEPENDENTLY: LIVING ARRANGEMENTS AND MOBILITY K. Warner Schaie, Hans-Werner Wahl, Heidrum Mollenkopf, and Frank Oswald (Eds.) New York: Springer Publishing Company, 2003, 408pp., $52.95 (hardcover).
This multi-authored volume is a product of the conference Aging in the Community: Living Arrangements and Mobility, which brought together professionals from Germany and the United States in 2001. Via 22 thematically organized essays, this book explores the implications of the physical environment, particularly the home and means of transportation, for persons aging independently. It consists of five sections: (1) Setting the Field; (2) The Aging Individual and the Environment: Basic Considerations; (3) Aging Independently "Indoors": Living Arrangements; (4) Aging Independently "Outdoors": Mobility; and (5) Future Perspectives of Aging Independently: Combining Perspectives of Aging Inside and Outside the Home. Although the volume covers a great deal of ground, articles vary considerably in their quality. Whereas most successfully convey their significance to an improved understanding of aging independently, some are convoluted or present findings of little apparent import. This review first examines two essays that reflect the aforementioned aspects of Aging Independently and then presents more general comments on the book's contents.
"History, Habit, Heart, and Hearth: On Making Spaces into Places," by Graham D. Rowles and John F. Watkins, draws in a novel manner upon anthropological and psychological perspectives to examine aging in place. The authors identify four "interwoven elements" involved in the "skill" of "making spaces into places": history, habit, heart, and hearth (p. 79). History is roughly characterized as previous relocating experiences that may contribute to the development of successful relocation strategies. Habit consists of daily routines whereby people become familiar with their surroundings. Heart refers to emotional bonding with items and places because they are reminders of moments or people of emotional significance. Hearth refers to the innate desire for physically familiar surroundings and the psychological well-being that comes from occupying such a place. The authors also identify three mechanisms involved in the transformation of places into spaces: conscious memory, which allows the active reconstruction of spaces in ways that reflect one's identity and past; implicit memory, which allows the subconscious configuration or ordering of household items in a manner similar to one's previous residence; and the "selective transfer of possessions to each new environment" (p. 83). These three mechanisms are then illustrated through a five-paragraph case study of an 82-year-old widow who moved to a continuing care retirement community. The aforementioned concepts and case study are then loosely related to a "life course model of environmental experience" that seeks to unify myriad aspects of people's relationships to their residential environment (pp. 86-90).
"History, Habit, Heart, and Hearth" is often insightful, presents an abundance of information, and is a praiseworthy attempt to integrate a vast body of knowledge on the subject of aging in place; yet overall it lacks clarity. The "skills" involved in relocation share little more in common than the first letter "h." Whereas history refers to the vague acquisition of relocation skills, habit, heart, and hearth are apparently reasons people prefer to age in place. The life course model, visually depicted as a bar chart and a line chart, is similarly incomprehensible (e.g., Why does total "life experience" increase over time before slightly decreasing toward the end of the chart? Does this indicate that during the latest part of life persons experience a minor loss of both subconscious and conscious memory? What does the unexplained subdivision between "Event A" and "Event B" represent?). Moreover, the relationships among the various "mechanisms" and "elements," the case study, and the model are poorly articulated. This is not to say the model is entirely devoid of merit. Rather, clarification and modification are needed for it to serve as a tool for understanding the differences between positive and negative relocation experiences and ultimately assist in the development of more effective "relocation preparation and adjustment strategies" (p. 92), as the authors intended.
Compared to "History, Habit, Heart, and Hearth," Paul P. Jovanis's "Macrointerventions: Roads, Transportation Systems, Traffic Calming, and Vehicle Design" is far less theory oriented. Jovanis's goal "is to develop an appreciation for the process of transportation engineering design and the implications of several elements of the transportation system for elderly mobility" (p. 234). This goal is achieved in part through a discussion of safety audits. These audits utilize "information from nontransportation sources, such as health and human service agencies and department[s] of aging" (p. 236), to evaluate problems in the use of specific segments of transportation systems. The evaluations serve as a basis for further analysis of the costs and benefits of modifications to improve the safety of travel. The process may result, for example, in the decision to construct "a raised median and high-contrast raised pavement markings" to alert drivers to their "position on the roadway and within the lane" (p. 237). Advances in intelligent transportation systems, traffic calming, and vehicle design are also explained in a concise manner that highlights both their limitations and potential value to enhance the transportation experiences of the elderly.
Collectively, the articles comprising Aging Independently make evident the fact that human capabilities are not predetermined by aging, but are a function of the interplay of physical health, behavior, and the environment. Just as advances "in medicine have created possibilities for men and women to experience aging more positively, the ostensibly more mundane physical settings of daily life shape life in ways that are often unexamined. Anns Independently is a powerful lens for reexamining one's surroundings. This lens allows the reader to view the world as a product of choices with concrete, although not necessarily unambiguous, implications for how aging occurs. Transportation and housing policy are shown to affect intergenerational equity, and even home modifications can raise ethical concerns: How will technologies distributed by the marketplace, yet offering to shape the way later stages of life are experienced, influence income-based inequities? This is but one of the questions I found myself pondering as I read. Aging Independently overviews of technological and social issues and their implications for the possibilities and realities of aging independently are sure to be a source of insight as well as inquiry for other readers as well.
[Author Affiliation]
Reviewer: Scott Bucher, MA
Saint Vincent's Hospital
New York, NY
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