Rather than stigmatised, decline needs to be recognised as part of a life-course approach to ageing well, writes Felicity Chapman.
Much of the discourse around ‘ageing well’ resists depictions of decline or frailty because it is seen to feed into a negative view about ageing and fuel ageist attitudes. Instead, positive views about age are promoted that encourage people to believe in their strengths and assert their right to health and wellbeing no matter what their age.
I am not suggesting a move away from empowering older adults to feel good about themselves and be as healthy as possible. But I caution against an approach that leaves little room for reality and implies we can prevent decline.
We need a paradigm that more strongly incorporates ageing well with experiences where people can no longer be as active as they want to be and are for all intents and purposes frail and highly dependant. What do we do when after adjusting and treating as much as possible we simply can’t live the type of life that we want to?
I am concerned at how an overemphasis on health and prevention might rob us of peace of mind in our latter days.
Medical science – as good as it is – can seduce us into thinking that we can control and prevent everything. And our youth focused society fuels a fear about ‘old age’ and natural decline.
It’s perfectly normal to want health and independence and we should seek that – at any age. But the fact is that from the moment we are born we are ageing and at some point, if it is a natural process, our bodies will deteriorate to the point of death. How can this process not be one related to decline?
Ageing well is about holding onto health and independence but it is also about knowing when and how to let it go. If we cling to it at all costs it can subtract from our quality of life and how we feel about ourselves.
Eastern philosophies have a lot to teach us about letting go, and mindfulness-based interventions are now widely used in psychology, but I find that the current group of over 85 year olds have their own wisdom to share.
My observation is that collectively this group has a very refreshing take on the realities of life and death. They appear to have this mix of gratitude, pragmatism, steely resilience and acceptance that I find humbling and instructive because of how it seems to cultivate contentment. It truly is an honour to hear their stories and facilitate dignity and peace in their final days.
I’m not suggesting that we pretend that losing our health and ultimately life is okay with us. This process is often one that admits to fear and allows for grief. I am simply saying that the path toward death, that we are all on, means that most of us will decline to the point of frailty and ageing well needs to account for this trajectory.
If we don’t encourage people to embrace the reality that ageing does in fact relate to decline then we actually set people up to see themselves as a failure when decline becomes obvious. This can make us more susceptible to internalised ageism, depressive symptoms and flies in the face of the tenets of positive ageing.
There is nothing more important to mental health than the way we appraise ourselves and our situation. At its core, ageing well should be about having a positive self-image and being able to find quality and meaning in life right to the very end. Our identity does not have to be attached to what we can and can’t do.
The freshly established national anti-ageism campaign EveryAGE Counts from the Benevolent Society has a slogan: “Stop discriminating against our future selves,” which can equally be applied to our understanding of ageing well.
We need to make sure that the well-meaning tenets of positive ageing don’t entrap us into resisting and preventing decline at every turn. This is likely to fuel a sense of negativity in relation to age and be a road block to peace of mind.
It’s about fostering a sense of value, purpose and choice no matter what age you are. Ageing well is a state of mind more than one of body and promoting this sense of value even with the presence of decline is a social responsibility.
Valuing older adults and being senior friendly is also ensuring that words and concepts are inclusive and empowering. Let’s renovate our understanding of ageing well to include decline – for the sake of the current group of over 85 year olds and for our future selves.
Felicity Chapman is a clinical social worker and the author of Counselling and Psychotherapy with Older People in Care: A Support Guide, which was published earlier this year.
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