The oldest old: Autonomy in the face of frailty

Abstract

Autonomy, a core American value, is routinely invoked as a goal in gerontological discussions of the aging process, yet frailty, another commonly used term in gerontology, suggests that functional losses may interfere with individuals' ability to maintain autonomy in everyday life. Older persons who are impaired are seldom asked how they view themselves with respect to autonomy and frailty, or what autonomy means. The meanings older persons attach to autonomy and decreases in physical abilities are explored through in-depth interviews with 28 persons age 80 or older. While autonomy encompassed a wide range of self-descriptions, respondents never used the word, frail, to describe themselves. I explore the potential of the construct of the lived body for a holistic approach to aging that values embodied knowledge and experiences of those who are old. I conclude that gerontological views of autonomy promote a cultural ideal that does not reflect elders' perspectives, and that the notion of frailty has the potential to stereotype elders, with negative effects on well being.