The psychology of positive ageing

While the field of positive psychology was conceptually introduced in 2003 as a focus on wellbeing, it is only now emerging as an essential branch of psychology.  Traditionally, psychology emphasised identifying and treating mental illness and health problems in times of adversity.  Positive psychology, however, shifts this focus from clinical ill-health and instead, promotes wellbeing and a meaningful life.  Specifically, it is the study of the conditions and processes that contribute to the flourishing or optimal functioning of people, groups and institutions.

One particular area in which positive psychology has had a profound impact is ageing.  While many of us have come to accept that older adults are ‘past their prime’ and are no longer able to contribute to society, positive psychologists approach ageing from the perspective that people can (and do) continue to live purposeful and active lives, that are relatively disease-free for extended periods of time.   Positive, or successful ageing is a new area of research which challenges the notion that older adults are generally unwell, without purpose and are disengaged from society, and identifies a set of individual characteristics that promote ageing well.  These 7 characteristics, which are also thought to enhance wellbeing in dementia patients, include:

 1.     cognitive reserve – brain plasticity which maintains neural processes

2.     mastery – a sense of control over life and future

3.     self-efficacy – a belief in one’s value and ability to achieve

4.     wisdom – cognitive, affective and reflective experience

5.     resilience – maintaining subjective wellbeing through adversity

6.     spirituality – religiosity or search of existential meaning, and

7.     purposeful engagement – activities that maintain social roles and are meaningful to the individual

The most effective avenue through which people can maintain a positive life is with improvements in diet and physical activity, however psychologists can also intervene to facilitate positive ageing.  For instance, programs have been designed to maintain cognitive function and remediation such as games aimed to improve processing speed.  Creative exercises like play-acting can provide meaningful cognitive stimulation, and activities such as narrative writing and problem solving that include a social element can boost engagement. 

Further, psychologists can promote positive ageing with gratitude, forgiveness and altruism interventions that focus on reframing maladaptive thoughts, encouraging self-kindness and acceptance of environmental / natural circumstances, and providing a sense of meaning by giving back to the community.

However, psychologists can play a role in interventions designed to maintain cognitive function and cognitive remediation to improve declining elements of cognition. Strategies in these interventions include games aimed at processing speed, teaching compensatory behaviours (e.g. note taking, reducing distractions) and providing meaningful cognitive stimulation (e.g. acting) (Depp et al., 2012). There are also strategies that can be put in place so that structured, yet naturalistic activities are incorporated into the individuals' daily life (e.g. narrative writing, problem solving) and can involve a social element (Depp et al., 2012).

Other psychological interventions specifically designed to promote positive ageing include gratitude, forgiveness and altruism interventions.  Gratitude interventions are designed to reframe maladaptive thoughts and increase focus on positive elements of life, and while popular, have not been explicitly researched with older people (Hill, 2011). Forgiveness interventions can be used to help people dealing with loss and hurt, and are also useful when dealing with life transitions (e.g. loss of independence) (Hill, 2011). In such interventions forgiveness is broadly conceptualised and may be targeted towards self, others, and the environment/natural circumstances. Altruism interventions encourage volunteerism, and hence the sense of meaning and giving back to the broader community, however altruism interventions are most commonly applied to ambulant, cognitively intact adults, therefore there is scope to develop and evaluate whether such interventions also improve quality in life in older people who may be facing deficits (Hill, 2011). Finally, involvement in public education programs to address the influence of ageism is a broader way that psychologists can support people to age well (Depp et al., 2012). 

Positive ageing is not without it's critics, and indeed in a scathing article, Coyne and Tennan (2010) described positive psychology as "bad science, unwarranted claims and poor medicine."  Critics argue that concepts in the positive ageing field are difficult to operationally define and therefore measure, and that often, the scant evidence to support elements of positive work is interpreted as hard facts, when indeed it is simply the beginning of developing a substantial evidence base, that may or may not, be proven in the end (Bulow & Soderqvist, 2014; Coyne and Tennan, 2010). It is felt that often, in the rush to embrace positive change, psychologists can prematurely change practices without being aware of the possible implications of new techniques. Interventions such as gratitude and altruism described above are examples of strategies that need further evidence to support their routine use in care. There are also issues with terminology - for example if the goal is to age successfully, is an individual unsuccessful if they are diagnosed with a disabling illness? (Bulow & Soderqvist, 2014; Cartensen & Charles, 2003). Furthermore, Minkler (cited in Bulow & Soderqvist, 2014) aregues that if success is linked to modifiable factors, then the implication is that if someone is unsuccessful then they must in some way be responsible. In this way positive ageing does not address the structural elements that may contribute to poor outcomes in ageing (e.g. lack or services in socially disadvantaged areas, ageism) Bulow & Soderqvist, 2014). Therefore, it is recommended that a more balanced approach to ageing be explored, one that recognises that people will have both strengths and weaknesses (e.g. a 75 year old with terminal cancer may still feel that they are giving back by participating in a clinical trial and purpose by teaching their granddaughter to knit).

To challenge the negative view of ageing, positive psychology has explored the concept of positive or successful ageing, and that is what we turn our attention to as we finish this subject. According to Fernandez-Ballesteros (2003), there are two broad goals of the positive ageing perspective:

1. To develop and implement strategies that promote successful ageing by changing modifiable factors linked to illness, optimising capabilities, increasing social interactions and enhancing engagement in life, and

2. Explore psychological constructs linked to ageing well.

Watch: Research Update on Successful Aging and Mental Health (University of California)

Read: Depp, Vahia, & Jeste (2012); Fernandez-Ballesteros (2003), Jeste & Palmer (2013); von Humboldt (2016).