From an aging person to an elegant senior: a humanistic approach to viewing older adults

Abstract The continuing growth in the number of adults aged 60-plus has raised global alertness of population restructuring. This demographic change, on the one hand, reduces productivity and increases public expenditure due to aging, resulting in prejudice, bias, misrepresentation, and discrimination against them. On the other hand, it develops a specific consumer market segment and extends the availability and accessibility of the elderly through employment, volunteering, or grandparenting. This study argues against the stigmatization of this age group from a functional perspective that damages social cohesion. It advocates a humanistic view toward seniors to eradicate marginalization and promotes the manageability of the senior population. With the aid of advanced technology and health equity, senior adults can retain everyday competence for self-care with dignity, as well as gracefully attain physical and psychological health, autonomy, and well-being in their later life. All these considerations give medical and nursing professionals insight into how to take care of the elderly.


The myth of the demographic tsunami
Research reports the global presence of a structural population change, metaphorically depicting it as a demographic tsunami, "silver tsunami", 1 or "gray tsunami". 2 This analogy specifies the impacts of an unceasing rise of people who are aged ≥60 years. 3 The aging of the baby-boom generation , low fertility, increased life expectancy, and reduced old-age mortality have caused population aging, 4,5 with the result that 12% of the world population is now aged 60-plus and this segment is growing at a rate of 3.26% annually. 6 Such a faster growth of the proportion of older adults compared to other age groups creates a "demographic revolution" 7 that affects economical, political, and social dimensions. In particular, 22% of the aging population is in high-income countries, such as Japan (33% of its local population), Germany (28%), Italy (28%), and Finland (27%). 8 Many scholars are alarmed by the negative effects on human capital 9 and overall economic growth 10 due

Increasing medical costs
Aging erodes physical fitness and health, 36 with a high prevalence (25%-30%) of neurodegenerative diseases, 37 such as dementia 38 and Parkinsonian syndromes, 39 together with chronic illnesses, including cardiovascular diseases, 40 hypertension, 41 osteoporosis, 42 constipation, 43 memory loss, 44 vision and hearing impairments, 45 and poor oral health. 46 Additionally, malnutrition and obesity are not rare among this population. 47 These produce limitations, e.g., gait abnormality, 48 recurrent falls, 49 and swallowing difficulties. 50 Such age-related disabilities 51 not only weaken everyday competence, 52 but more importantly, they increase the risks of psychiatric problems, 53 including depression 54 and sleep disorders, 55 along with weaker emotion regulation due to an aging brain. 56 These factors restrict their social life. Therefore, heavy long-term care costs are incurred. 57-60 Reinhardt 61 argued that age-specific health-care spending is not necessarily the sole factor of public medical expenditure. Life-threatening illnesses occur in younger age groups as well, e.g., heart attack 62 and stroke. 63 Early-onset dementia 64 and Parkinson's disease affect the middle-aged. Medical expenses cover all ages. Medical specialists recommend health promotion in early life, 65 such as a good diet and a nonsmoking, nonalcoholic lifestyle. Such health-care planning and preventive measures 66 maintain good health fundamentally, especially for diminishing medical costs in lowincome or underdeveloped countries. 67

Reducing economic growth
Scholarly studies elucidate a negative correlation between the growth of population aging and the gross domestic product (GDP) per capita, pointing to a decrease of 5.5% in the GDP due to a 10% increase in 60-plus-year-old citizens. 68 This decrease is caused by a shrinking labor volume 69 and lower productivity, with a 0.2% yearly reduction over the following 2 decades, 70 directly mitigating national competitiveness. 71 Apart from demographic restructuring, age discrimination in the workplace 72 limits the employment and career promotion opportunities available to older people. Prejudices against the elderly stem from misunderstandings regarding them, e.g., poor job performance, low retraining ability, inflexibility, less adaptability, resistance to change, higher medical leave rates, and higher wages, 73 which result in excessive operational expenses and push them to retire involuntarily, 74 especially in the process of escalating economic development during urbanization. 75 to a contraction of the younger age groups and total population size. 11 In addition, misrepresentations of aging in the mass media 12,13 result in a phobia concerning aging, or gerontophobia, i.e., "the unreasonable fear and/or irrational hatred of old people by the society and by themselves". 14 The media magnify pessimistic perceptions, negative images, 15 and stigmatized attitudes toward the elderly 16 regarding their vulnerabilities in personal (e.g., stereotypic assumptions), institutional (such as compulsory retirement), intentional (for instance, elder abuse), and unintentional (such as insufficient aged care facilities) deficiencies. 17 They also belittle this group as being an inactive labor force. 18 Worse, they allude to genderbiased social representations 19 stemming from the loss of beauty and reproductive value in older women. 20 These contentious social perceptions 21 hinder social cohesion. Many older adults suffer from unfavorable housing conditions, income sources, social support, and civic participation. 22 Younger generations may be unwilling to involve themselves with this disadvantaged group. This not only engenders an insufficient healthcare workforce serving the elderly, 23 which hampers the medical system, but also causes negligence. Moreover, social exclusion worsens their physical and psychological health 24 : for instance, it can lead to disability, 25 cognitive underperformance, 26 anxiety, 27 and depression, 28 resulting in social disengagement. 29 Such a problem-directed discourse 30 toward the aged is controversial. Aging is an inevitable part of the life process, resulting from accumulated physiological changes 31 associated with illnesses and the natural deterioration of bodily systems 32 ; for instance, sensory (auditory, gustatory, olfactory, and visual) and kinesthetic dysfunctions lessen the quality of life among elderly people. Conversely, reframing the discourse on the aging population will enrich inclusiveness and social justice. 33,34 This study (1) analyzes the challenges and the opportunities in the context of population aging; and (2) subsequently highlights the paradigm shift from a biomedical to a humanistic perspective. It also suggests various measures to achieve a senior-respecting context.

Challenges of population aging
The fear of getting old 35 originates from the rejection of the natural life span leading up to death, which emphasizes the losses while neglecting the gains acquired in late life. These losses relate to health, economic capacity, status, and power, implying impotence and helplessness.

Augmenting retirement expenses
Despite the fact that social pensions and retirement schemes can improve the financial conditions, 76 health, 77 and well-being 78 of the elderly, the monetary amount provided by social security occupies a significant proportion of public expenditure. 79 However, the effects of wealth redistribution are debatable, 80,81 and the poverty rate among the elderly increases with age, 82 urging pension reforms. 83,84 Turner 85 refuted that age-driven economic burdens are probably overestimated or overstated.
Gerontologists warn that weak health, fiscal incapacity, and discrimination press the elderly to experience social withdrawal, 86 and vice versa, 87 which are connected to higher risks of suicide 88 and mortality. 89

Opportunities of population aging
The elderly deserve a graceful life, for which a holistic range of health ("a state of complete physical, mental, and social well-being") 90 is crucial to substantiate their abilities in developing a silver economy. This makes them capable of active aging, successful aging, productive aging, optimal aging, and vitality aging.

Energy maintenance
The postponement of functional declines 91 is a key strategy for aging care, which ameliorates self-efficacy for cognition performance and physical capability, 92 in addition to achieving a balanced emotional state. 93 This cultivates active aging among those who are ardent in personal, social, cultural, physical, mental, behavioral, financial, and civic affairs, 7,94 thus accomplishing social engagement and contribution by the elderly. 95 Active aging elicits successful aging for those who benefit from the dynamics related to "low probability of disease and disease-related disability, high cognitive and physical functional capacity, and active engagement with life". 96 This group of "third age" 97 pursues both individual and societal care, 98 including physical, mental, occupational, environmental, and social activities. 99 For instance, dancing 100 and physical exercise 101 improve their motor, sensory, and cognitive performance, health, 102 and social development, 103 enriching intra-and interpersonal relationships. 104 Their enthusiasm in personal growth 105 and social connection 106 reinforces their subjective self-satisfaction 107 and life fulfillment. 108

Silver economy
The misperception regarding the economic burdens induced by population aging has been disputed.
The elderly are eager to advance contributory opportunities to society, 109 which is known as productive aging. 110,111 Hence, a silver economy of older entrepreneurs and a white economy for medical services for the elderly population 112 have been developing. Silver economy refers broadly to "all types of goods and services for older adults and an aging population, including extending the working life, volunteerism, and active citizenship of older people". 113 With the aid of advanced technology, 114 the dimensions of elderly employability 115 and silver entrepreneurship 116 increase the involvement and potentiality of old adults in business ventures, gaining financial rewards, autonomy, self-attainment, and recognition in their later lives. This sets them forward as social assets and resources for expediting the use of social capital. 117 Meanwhile, the silver consumer market 118,119 is growing rapidly and profitably, 120 and attracts tremendous investment. 121 It expands product development and marketing expenses. 122 Aside from private medical services for the elderly, 123 community-based programs 124 and leisure products 125 -for instance, recreation centers, 126 spas 127 and senior tourism 128 -are also some of the major components in the silver industry.
Productive aging enhances their accessibility and availability in the family and society, 129 including in grandparenting 130 and volunteering. 131,132 Social engagement enhances subjective and objective health. 133 Simultaneously, their contributions push society in a positive direction toward this group of people. 134 In summary, the notion of optimal aging brings about a distinct domain pertaining to the wisdom and expertise of the elderly to assist other people, optimize capabilities, attain a meaningful life, and deal with death anxiety, 135 with an emphasis of vitality aging on independence, resilience, and an energetic quality of life. 136

From aging person to senior
This demographic trend is not necessarily a tsunami 137 when it is perceived under a proper lens. The Universal Declaration of Human Rights 138 affirms that "all human beings are born free and equal in dignity and rights", which values all age groups. In order to comply with this belief, the United Nations should take forward-looking leadership to advocate a humanistic approach toward the elderly and pioneer innovative methods.

Reframing the concept of the elderly
In accordance with the Oxford Learner's Dictionaries, 139 as a noun, "aging" refers to "the process of growing old", while as an adjective, it means to become "older and usually less useful, safe, and healthy", implying deterioration. Similarly, population aging is socially constructed as a group of feeble, lonely, unproductive, dependent people 140 who are poor of health and considered as "social other[s]". 141 In fact, age is not necessarily associated with negative consequences when such a functional-instrumental-biomedical model is reviewed.
Instead, the term senior represents adults or people either at a more advanced level or higher in rank or status. 142 Life exhibits a course of maturity within the continuum of a person's life span, 143 which is perceived differently in the light of cultural variations. 144 People affected by Asian cultures comparatively emphasize how they value the elderly. 145 For example, the Chinese respect senior members with filial piety. 146 They recognize the promising experiences, contributions, expertise, knowledge, wisdom, and autonomy 147 of these "golden years" 148 with dignity.
Elderly subjectification 149 views the senior as subjects, 150 increases awareness of this group, and promotes their values. 151 This empowerment 152 eliminates the dichotomous connotation between junior and senior, dismantling an age divide, and entitles the elegant senior to secure a social identity. 153 Without this divide, the elegant seniors are accepted by themselves and society, which increases self-actualization, self-achievement, and self-fulfillment, as well as facilitating better life enjoyment 154 and social integration. 155 This study suggests the development of a senior-respecting community built on an age-friendly society, 156,157 nourishing the well-being 158 of the senior.

Managing senior competence
Although aging is unavoidable, it is manageable, thereby boosting "age management" 159 effectively to nurture the smart senior through technology and flexibility.
Cyber technology positively affects the health and longevity of the elderly. 160 Extensive utilization of an e-medical system for physical health 161 and emotional care 162 is able to improve their physical and cognitive functions and, hence, increase social connections. 163 Recent bioengineering equipments 164 and three-dimensional printing have revolutionized medical applications. 165 These investments in health equity for seniors 166,167 enable their longevity while minimizing severe disabilities, 168 in spite of having functional physical limitations. Meanwhile, lowering health risks can strengthen psychological resilience, 169 forming "the life span diamond" 170 that interacts among relational resources, physical well-being, positive mental states, and engaging activity.
With the assistance of advanced technology, a smart home 171 provides automated convenience services, 172 senior-friendly furniture, and tailor-made facilities, 173 accommodating the specific needs of seniors while enhancing their quality of life.
Chronic stress escalates the senescence process among adults 174 physiologically and psychologically. 175 Thus, a flexible employment pattern and retirement behavior, 176 when prevalent among seniors, results in not only a reduction in stress but also in the retention of their knowledge and skills. 177 The use of their professionalism in the silver market, 178 in collaboration with available technology, elevates silver productivity. 179 Amazingly, senior entrepreneurship 180 fosters a novel work culture.
Studies signify an inverse relationship between education level and cognitive decline. 181 Cognitive performance in late life helps retain social connection, 182 as well as prevent disability and social isolation, 183 resulting in better life satisfaction. 184 Continuing education for seniors refines their sociopsychological adaptability 185,186 and personal development, 187 building stronger self-confidence, self-esteem, self-worth, and self-efficacy. 188

Conclusion
This study investigates the challenges and opportunities in the context of the growing senior population in order to de-stereotype the negative images regarding the elderly. Destigmatizing this group is critical for the demarginalization and sustainability of the elegant senior, who can then proceed toward a graceful ending with dignity in his/her life. A decent discourse concerning them is essential to providing the support of health equity and an age-barrier-free environment, to ensure the fulfillment of their psychological needs, a meaningful life, and wellness. This research reframes, with humanistic concerns, a population in which the number of seniors is continuously rising. Additionally, these shed insightful light on geriatric care for helping professionals, including medical and nursing teams.

Ethical approval
Ethical issues are not involved in this paper.

Conflicts of interest
There are no conflicts of interest.