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Decline should not be seen as a sign of failure


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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2 Responses to Decline should not be seen as a sign of failure

  1. Caroline June 14, 2018 at 4:35 pm #

    Felicity, while recently at uni, I looked at ageing with addictions among a group of people who are definitely in a spiral of decline but continue to live at home, often with minimal support. I argued that counselling provided an opportunity to support them living at home no matter the choice. Declining but not necessarily a failure!!

    Your opinion piece resonates well with the idea that decline needs to be viewed within the context of a life course (as does ageing with addictions). There is too much emphasis on independence, wellness, happiness, images of happy retired people, etc. and I would argue, isolation and loneliness as something to rescue people from. YES, we need a new paradigm of ageing with decline (inc ageing with addictions!) where the focus remains on supporting people who are ageing whatever the decline, natural or otherwise. I thought that was the purpose of home care packages, for example. I’m also critical of the concept of independence as we are naturally people who live in interdependent relationships particularly as we age and need someone else to support us no matter how determined or resilient we are about letting in help.

    The reality of ageing with decline needs to embraced and celebrated! That decline is associated with the physical, social and mental health of a person. That’s reality! We can never be the person we once were but we can be someone who is still ageing and living the best possible life, no matter what!

    My dissertation attempted to look at the concept and policy of positive ageing from the position of older people with addictions. It was a struggle to find any literature, let alone any discussion about ageing with addictions.

    YES to ageing well even in decline!

  2. Judy Smith June 17, 2018 at 11:31 pm #

    Hi. Thanks for writing this so eloquently. The message resonates with me on so many levels. I’m nearly 70. I still work part time. My aim is for quality of life not quantity. I really want to be “at peace” with myself as I age. I don’t want to hate my body and what it’s doing I want to maintain a loving relationship with it. I find myself increasingly resenting health professionals who seem to think they have a right to tell me how to live my life. Statements like you need to learn to live with your pain incense me. My message to all of this health professionals is work with me – walk beside me as I age but you have no right to tell me how to age or how I should feel about ageing. It’s my body and my health .

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