Indian Journal of Health Social Work
The ancient times have often described old age as second childhood. Just like a child an elderly is dependent on the caregivers to help them with activities (Almeida, 2012). This stage represents the final period of lifespan, a time where the individual reflects on life, ponders over his past accomplishments and begins to plan the closure. Aging is a process of becoming older. It is an accumulation of changes in an organism over time referring to a multidimensional process of physical, psychological and social change (Ryan et al., 2011). As individuals get older the problems associated with health and functioning rise up. Most of elderly people have at least one chronic condition and may also suffer from multiple chronic diseases (Hoffman, Rice & Sung, 1996). A lot of elder contribute to their environment quite consistent with Eriksonian theory of development. However, they often face challenges related to physical health, disability resulting in issues such as decreased sense of self and capacity and wellbeing. These often bring associated conditions along such as compromised mobility, biological changes, physical deterioration, empty nest syndrome, retirement, financial constraints or death of spouse and friends. According to World Health Organisation (2016) almost every country, the number of people aged over 60 is growing faster than any other age group. While the traditional approaches of healthcare a im on reduc ing human suf fer ing, psychopathology, positive psychology seeks to help produce happiness, well-being and positive mental health in individuals. The approach can be applied across the life span. Researches have highlighted its application in elderly population also. Hence, it can be used a resource to promote wellbeing, promote positive mental health and successful aging.
FACTORS CONTRIBUTING TO AGING
It is important to understand what make old age a challenging phase of life span. There are some major factors contributing to aging:
Failing health due to advancing age happens because of a lot of reasons such as non-availability or in accessibility of health care services especially in the developing countries or lack of awareness and knowledge and high cost of disease management making caring for ailing health a burden to the person as well as the caregiver, this picture worsens for the elderlies from lower socio economic status. The elderly perceive their health as inadequate. In a national level survey almost 55% elderly were finding their health
unsatisfactory. This figure is quite large compared to those 17% reported by WHO for general population as reported by (Pilania et
Elderly often feel economically insecure due to lack the opportunity and capacity to be as productive as they used to be. Rajan (2006) in a survey stated that 76% respondents reported no financial assets in their name. The financial difficulties get compounded by the fact that aging reduces physical and mental capacities limiting their access to resources. O’Rand (2001) stated that developed countries, major demographic and structural changes have generated persistent social inequalities and shifts away from social welfare policies and strategies toward market centred ways for health, lifestyle and income maintenance. The growing social and economic inequalities within populations form the prime social condition that yields negative outcomes on health and well-being O’Rand (2001).
Increased life expectancy with advancement in health care has helped us to win over debilitating medical conditions. This has also led to a disfigured population graph with ever increasing proportion of graying population. Elderly loneliness is becoming an alarming reality for many countries. In a report by WHO (2016) there will be rise in the number of elders in senior homes which will be almost double by the year 2030, onethird of whom will have some disability or illness. This implies that in the next twentyfive years, there will be about 72 million seniors in elderly care communities. Living arrangements and life satisfaction were also found to be important aspects. In a study conducted by Mehrot ra et al ., (2018) significant positive relationship between family and home wi th over all increased life satisfaction was found. Males who had families and had an access to recreational activities were more satisfied with life than their female counterparts. Individuals with middle-lower socioeconomic status had greater life satisfaction than upper-middle and upper-lower socioeconomic status.
Neglect & Abuse:
Elderly having failing health, dependency need support and care the most. Most of the care givers perceive it to be natural for their age and therefore consider it normal leading to neglect and abuse because of isolation they may also become victim of criminal activities. Demanding jobs, nuclear families, changing lifestyles are often the prime reasons for neglect of elderly. This clearly highlights social roots of loneliness rather than an individual phenomenon (Gupta et al ., 2014) .There have been several instances reporting elderly living in abusive relationships, many times in a quite dependent way. There is a need to address the issue of social negligence of elderly from family members and society (Kumar, Das & Rautela, 2011).
Various models have attempted describing the process of aging and factors affecting it. The important approaches include:
According to Biomedical Theories Successful Ageing can be defined in terms of optimisation of life expectancy while minimising physical and mental deterioration and disability. In this definition they highlight that successful ageing encompasses: the absence of chronic disease and of risk factors for disease; good health; and high levels of independent physical functioning, performance, mobility, and cognitive functioning.
This approach states that life satisfaction, social participation and functioning, and psychological resources, including personal growth are the keys to ageing successfully. It includes happiness, relationships between desired and achieved goals, self-concept, morale, zest, resolution and fortitude, mood, and overall wellbeing. Continued social functioning is another commonly proposed domain of successful ageing as per psychosocial theory of ageing. It highlights the importance of high levels of ability in social role functioning, positive interactions or relationships with others, social integration, and reciprocal participat ion in society (Havighurst, Neugarten & Tobin, 1968). For example, when some activities are curtailed (say, because of ill health) strategies need to be activated to find new activities and to maximise one’s reserves (Baltes & Baltes, 1990) . Successful ageing is seen as a dynamic process, as the outcome of one’s development over the life course, and as the ability to grow and learn by using past experiences to cope with present circumstances while maintaining a realistic sense of self (Ryff, 1989). Satisfaction with one’s past and present life has been the most commonly proposed definition of successful ageing, and is also the most commonly investigated (Havighurst, 1963).
Psychosocial models have also culminated in the positive psychology movement, with its proponents of the benefits of learnt optimism (Seligman, 2004). It has been postulated that happy outlook is a skill that can be cultivated in people and they can learn to see “a bottle half full” instead of “a bottle half empty”.However, irrespective of the likelihood of genetic influences, getting people to “cheer up” is not always easy in real life.
A simple categorization of “diseased” and “norma l ” fails to recognise the large heterogeneity within elderly. It is commonly
assumed that a person will age successfully if they are healthy, high functioning, and socially engaged. However, it is more than
that. It involves what is optimal in later life. This opened the doors for researchers to highlight what encompass successful aging
and what can we do, as individuals and as a society, to foster optimal or successful aging. Rowe and Kahn (1997) presented the elements
that are involved in successful ageing:
1. Avoidance of physical illness and disability,
2. Maintenance of high physical and cognitive function
3. Continued engagement in productive and social activities. A few investigations were made into older people’s views of what is successful ageing (Phelan et al., 2004). The common themes identified were mental , psychological , physical, and social health; functioning and resources; life satisfaction; having a sense of purpose; financial security; learning new things; accomplishments; productivity; contribution to life; sense of humour ; spirituality and physical appearance.
SUCCESSFUL AGING AND POSITIVE MENTAL HEALTH
Positive Psychology was identified as a major area of Psychology, the great philosophers such as Socrates, Plato, Aristotle and psychological thinkers such as Freud, Jung, Adler, Frankl, Rogers, Maslow have articulated theories of the good life, pleasure, wholeness, purpose, health, and actualization. There is a considerable difference between the normal aging and successful aging. Normal aging is a gradual process and it includes changes that are not necessarily painful or dangerous such as thinning and greying of our hair, the stiffness in joints, or a slight decline in cognitive processes and memory (Christensen, 2001). Successful aging doesn’t merely mean absence of physical or psychological morbidity rather it means experiencing aging as an optimal process. Positive psychology aims to provide a direction for discussing the concept of a flourishing life and optimum well-being. Whether a person is flourishing depends largely on their subjective well-being. Seligman (2002) differentiated subjective well-being into three “lives” or levels. These are: The “pleasant life” which is the pursuit of hedonically satisfying and engaging in pleasurable experiences such as enjoying food, music or sex. The second one being “good life” which is when individuals are aware of their unique strengths and keep themselves engaged in activities which allow them to experience active engagement in relationships, work or leisure. The third one being the “meaningful life ” in which individual’s apply their unique strengths towards a greater purpose. Even though flourishing should involve all three levels of subjective well-being, the emphasis should be on promoting the “meaningful life” as it impacts well-being for the greatest and the longest period of time.
ISSN: 2582-1393 (Online)