Positive Aging
Ageing
Life expectancy has improved considerably during the past few decades, and increasingly, more people look forward to twenty years or more of life after retirement. However, the growing number of older adults and the rising proportion of them to a younger population provide both challenges and opportunities for society (Merriam & Kee, 2014). So, it is crucial to explore the attitudes toward, understand and plan for this period of our lives.
The potential benefits of such explorations extend beyond the welfare of the individuals, their beloved families and the society they live in (Fowler & Christakis, 2009). After all, older adults who are happy and relatively healthy become assets for their families and society (Allen, 2008).
But how old can be considered old? This has wide variations, but the World Health Organisation (WHO) has recognised 60+ as a satisfactory threshold (World Health Organisation, 2015).
The Negative Image of Ageing
I was 68 (at the time of writing) and physically much less agile than twenty years earlier. My strides are slower, and climbing a flight of steps is becoming more and more demanding. But I enjoy having years of added knowledge and skills, feel more confident in what I do for work and every year, I appreciate the beauty of seasons more than the last.
I feel somewhat uncomfortable that ageing is blamed for many problems in our society and is considered a burden on the community and the younger generation (Angus & Reeve, 2006). I think ageing should not be introduced in such a grim and divisive manner.
Unfortunately, we are living in an increasingly divided society. Here in London, where I work and live, the dividing line is not just about attitudes toward race, religion, immigration, and politics but also concerning age. Mass media is full of clips that constantly place younger and older people against each other. Below are a few examples;
Older people block the beds in our hospitals and are bankrupting our healthcare system.
Older people enjoy pensions and state benefits that the younger generation cannot afford.
Older people keep youngsters out of work by insisting on staying in their jobs for longer than expected.
Some even question whether older people should be voting at all, claiming that the future only belongs to younger people.
Generally, older people are portrayed as a ticking demographic time bomb, a burden society cannot afford, and a generation that refuses to hand the baton in time. Even worse, in line with this attitude, some older people feel useless, shameful and vexing to society.
Levy et al. (2002) studied the effect of internalising negative stereotypes of ageing (i.e., negative self-perceptions of ageing) and discovered that it reduced the life expectancy of older adults by more than seven years. Moreover, they showed that such beliefs had a more significant impact on survival and longevity than gender, socioeconomic status, loneliness, and functional health.
However, most negative ideas about ageing are based on the ideological analysis of politicians who try to justify their failed policies. They result from years of mismanagement and wrong approaches to healthcare and the community's well-being, often involving exclusions and inequalities in later life.
To refute such negative ideas, Zweifel, Felder and Werblow (2004) successfully argued that population ageing could not considerably impact healthcare expenditure. Later, Rechel et al. (2009) reinforced this positive view in their report for the World Health Organisation (WHO) by iterating that while spending on long-term care is sure to increase with the ageing of the population, its effect on healthcare expenditure is doubtful or insignificant. They showed that if appropriate measures are implemented in time, population ageing does not necessarily lead to higher healthcare expenditure.
Living longer is excellent, and I agree with many scientists (K Zweifel, Felder & Werblow, 2004; Doyle et al., 2009; Kendig & Browning, 2016) who have shown we can afford our ageing population. They have questioned the claim that the ageing population fundamentally threatens the sustainability of welfare states and argued that we could adopt policies that accommodate ageing populations without abandoning the existing social solidarity.
They also established that developing better social and health strategies will improve our ageing population's mental and physical capacities. This requires a little imagination and a positive approach, as reflected by the International Federation on Ageing (IFA) mission, which envisions a world with healthier older people whose rights and choices are protected and respected.
IFA is an international non-governmental organization (NGO) with a membership base that includes governments, other NGOs, industry, academia, and individuals in 70 countries. IFA is the global point of connection and network of experts who try to influence and shape age-related policies that improve the lives of older people.
Positive Psychology and Ageing
Some people dread thinking about old age, and rightly so. Many examples exist of people who face severe hardship, sickness, idleness, rejection, and loneliness after retirement. Even the thought of these issues makes us flinch when we reflect on getting old.
Although the potential pitfalls of old age cannot be entirely averted, and obviously, there are challenges ahead (Vita et al., 1998), there are new possibilities, too, that can make our lives worthwhile, exciting and productive throughout our older years.
Geriatrics, a well-known branch of medicine and social science, focuses on the adverse effects of ageing and the unique needs of older people. However, many researchers believe that while lots of effort has understandably been spent on the negative aspects of ageing, the positive sides of ageing, which are sources of vitality and happiness, have been overlooked. They have explored successful scenarios concentrated on the positive attributes of ageing and highlighted the techniques and policies that can help us develop more resilience, strength and a sense of fulfilment and control despite the challenges associated with old age (Bowling, 1993; Ranzijn, 2002).
Collectively, these techniques are referred to as Positive Ageing (ageing well, healthy ageing, or successful ageing), a concept promoted by the World Health Organisation (2015). Positive ageing signifies better choices we can make for the later period of our lives and allows us to live our old age happily, productively and delightfully. It is a constructive view of growing old, which accepts ageing as a continuous and expected process of life for everyone (Kendig & Browning, 2016).
Positive ageing is an essential goal for health organisations, healthcare professionals, and older people. The concept has grown into a multidisciplinary approach which includes social factors that emphasise societal opportunities and public responses that allow older adults to experience a better life (Kendig & Browning, 2016).
In short, the positive ageing movement strives to create a society for all ages. It prepares for and celebrates the ageing process. It supports people of all ages in achieving their full potential and respects older adults’ engagement in economic, social, cultural, and family life. It fosters better solidarity between generations to create a society where all people's rights, independence, participation, care, self-actualisation and dignity are the prime objectives.
It's important to note that there is a difference between normal ageing changes and illnesses with different medical causes that may become more serious because of old age. Normal ageing is a gradual process and brings changes that are not necessarily painful or dangerous. These may include thinning and greying our hair, stiffness of our joints, or a slight decline in cognitive speed and memory performance (Christensen et al., 2001). But if changes are quick, unexpected, and painful, they could have causes other than ageing.
Well-being and Older Adults
Well-being is mostly a subjective appraisal of how people experience their lives (Huppert & Cooper, 2014). As a positive psychological concept, well-being is not just the absence of disorder or disease but a condition conducive to flourishing and growth (Huppert & Cooper, 2014).
In this respect, flourishing is a state of optimum functioning and enduring satisfaction where people experience positivity, fitness, resilience and growth. In contrast, languishing is a situation where someone’s life is wrecked by negativity, poor health, deterioration and emptiness (Keyes, 2002; Ekman et al., 2005; Fredrickson & Losada, 2005).
However, when we discuss ageing, the critical point is the perception of older adults themselves about their well-being. A concept that Ryff's (1989) studies revealed is that positive relationships, self-efficacy, self-compassion, self-awareness, accepting change, and having a sense of humour are among the most preferred criteria for successful ageing.
Actions on Positive Ageing
Researchers and organisations who particularly respect older people’s views about their welfare have championed evidence and ideas on ageing well. Research has suggested many priorities and recommended societal actions for achieving positive ageing. Such actions should be viewed as an essential investment in an ageing community and could be implemented at the level of individuals, organisations or societies.
Individuals are advised to keep a positive attitude, stay active and connected, have a healthy diet, and avoid smoking (Haveman‐Nies, de Groot & van Staveren, 2003). However, despite positive rhetoric, policy-making and practical actions at organisational and societal levels have been relatively limited.
Nonetheless, the designation of 2012 as the European Year of Active Ageing offered a potential focus for renewed policy and increased action on positive ageing in Europe. Since then, there has been more interest in age-friendly communities, and more organisations consider ageing a positive process. This new discourse on ageing has redirected policy discussions from economic or welfare issues to social inclusion, engagement and community development (Lui et al., 2009; Walker & Maltby, 2012).
Brain Plasticity and Ageing
Fortunately, many scientific discoveries support positive approaches to ageing. One important finding is the discovery of brain plasticity in adults (the brain's ability to change and adapt to new circumstances), which has been successfully used (among other things) to overcome the symptoms of sensory-motor disorders and brain injuries.
Plasticity is the quality or the capacity to be shaped or moulded. In biology, plasticity is the flexibility of an organism to change and adjust to its environment or the long-term circumstances of its life.
Brain plasticity, or neuroplasticity, describes changes to the brain throughout our lives. This contrasts with the earlier belief that the brain only develops in childhood and remains relatively unchanged. Research has shown that many aspects of the brain are plastic, i.e., they can be altered even into adulthood (Rakic, 2002; Pascual-Leone et al., 2005).
Our brains are not hard-wired with fixed neuronal circuits. Instead, brain circuits rewire, often in response to lifestyle, training or injury. There is also strong evidence that neurogenesis (or the birth of brain cells) occurs in adults and can continue well into old age. One principle underlying neuroplasticity is that neural connections are constantly being removed or constructed, mainly due to the nature of the activities of the neurons (or what we do).
Brain plasticity has been used to alleviate chronic pain and enable patients to use prosthetic devices as an extension of their bodies (including artificial hearing and vision devices). There is promising evidence that older adults can also benefit from brain plasticity to reduce age-related cognitive decline through education, leisure activities, intellectual engagements and learning new skills (Kramer et al., 2004; Vance et al., 2008).
References
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