‘Positive’ & ‘Successful’ Ageing
The way older people experience ageing is very dependent on the ways that physiological, psychological, economic and social factors are involved in supporting or mediating their ability to contribute to and be recognised as valued members of society.
The term used in gerontological literature for over 30 years. It is in contrast to the historical negative views of aging being associated with disability, cognitive deficits and loneliness. Successful ageing is considered as consisting of the avoidance of disease and disability, the maintenance of high physical and cognitive capacity in later years, and a continued active engagement with life.
‘Successful ageing’ implies that aging can be rewarding – the definition of rewarding can relative and value laden:
medically it could mean growing old without disease or deficits (biologically based definition)
psychologically it could mean growing old with contentment and satisfaction as perceived by the older person
sociologically it could mean growing old and still be integrated into society with social roles to play
in every day use ‘success’ usually refers to the attainment of financial wealth (materialistic definition) negative definition with the implications that lack of financial success “failed ageing”.
The value judgements associated with ‘successful’ ageing carries potential for ageist stereotypes.
Positive ageing is considered to be about :
• having an understanding about the ageing process and being older (implies that positive aging begins in youth)
• planning and preparing for the future while participating and contributing to society in the present
• individuals, families and communities beginning at an early age to share responsibility of achieving healthy, secure and fulfilling lives for themselves and those around them
• older members of society enjoying the respect and support of a caring community whose values, attitudes and behaviour they helped to shape and continue to influence by the contributions they make
• maintenance of a high quality of life.
Strawbridge et al (1996) followed 356 subjects aged 65-95 years for 6 years to investigate the predictors of successful ageing (which they defined as needing no assistance nor having difficulty on 13 activity/mobility measures plus little or no difficulty on 5 physical performance measures). Predictors of successful aging were income above the lower quintile, >12 years of education and white ethnicity. Behavioural and psychosocial predictors were the absence of depression, having close personal contacts and often going for walks or exercising.
Age Concern (New Zealand) as part of the Ageing is Living project suggests the following key factors for positive ageing:
• approaching older age with a vision of your needs and how to meet them
• having choices and feeling in control of your life
• being able to respond and adapt to change
• being physically and mentally active
• being involved
• continuing to learn
• feeling secure
• having healthy lifestyle habits
• having contact with family and friends
• gaining satisfaction in the things you do and your relationship with others
Bracewell et al refer to the three R’s that define tasks of ageing that are associated with successful old age:
1. accepting reality about one’s capacities in health, social and financial realms
2. fulfilling responsibilities – planning for the survivors and making best choices regarding the remainder of life
3. exercising rights – right to live life as an individual at one’s pace, right to privacy, right to respect, right to autonomy
The National Council for the Elderly (1994) in Ireland, list the following as indicators of what to promote and what to avoid in order to age positively:
Promote – acceptance of ageing, empowerment, individuality, physical activity, social contact/friendship, developing coping skills, valuing experience, knowledge etc
Avoid – denial of ageing, disempowerment, being stereotyped, sedentary lifestyle, social withdrawal, psychological stress, overvaluing paid work
The World Health Organisation has adopted the term ‘active ageing’ as being the process of optimising opportunities fro physical, social, and mental well-being throughout the life course, in order to extend healthy life expectancy, productivity and quality of life in older age.
To promote active ageing, health policies and programs need to be :
• reduce the burden of excess disabilities, especially in poor and marginalised populations
• reduce risk factors associated with the causes of major diseases and increases the factors that protect health and well being throughout the life course
• develop primary health care systems that emphasise health promotion, disease prevention and the provision of cot-effective, equitable and dignified long-term care
• advocate and collaborate with other sectors (such as education, housing and employment) to affect positive changes in the broad determinants of healthy active ageing