Understanding age and ageing

‘You know you’re getting old when the candles cost more than the cake.’ BOB HOPE, American comedian and actor

Before we start you might like to answer the following questions:

• How old do you feel you are?

• How old would you like to be?

• What age do you consider old age to begin?

We will come back to consider your answers later.

Surprisingly, there is no simple answer to the question, ‘What is ageing?’ It can be very misleading to think of ageing as simply a chronological progression of the number of years we have lived. That approach fails to recognise that someone who is 60 can look and behave like a 40-year-old, and another person who is 40 can look and feel like a 60-year-old. Chronological age doesn’t give a clear picture of our ageing process.

‘Ageing is not just a physiological process but also a psychological, intellectual, social and cultural process. Our bodies change but at the same time we mature. Ageing is therefore less about the old and more about the new.’ ANNE KARPF • columnist and writer

Let’s look at three other ways of understanding ageing – biological, cultural and psychological.

BIOLOGICAL

Ageing brings physical changes in the body, most obviously wrinkles and grey hair. But these can give a misleading or partial view because some people can get wrinkles and grey hair at much younger or older ages than others. Not only is it impossible to tell someone’s age from any particular physical feature or specific internal process, but there is no medical test to determine how old someone is. If you didn’t know what age you were, no doctor could give you the answer!

There is a lot of scientific work on biological ageing and we know a lot more about the biological processes and their complexities than ever before. For our purposes, the process is probably best described by one of the country’s leading experts on ageing, Professor Tom Kirkwood, who says:

‘Ageing appears to be a lifelong accumulation of faults at the cellular and molecular level, each a random occurrence insignificant in itself, combining to overwhelm the body’s ability to keep its systems running. The random nature of these faults is what makes us each age so individually, and it is this individuality and the underlying complexity which makes the ageing process such an intriguing scientific challenge.’

Scientific research into ageing is very important, as it can help discover ways of treating or preventing conditions which disable, cause pain or shorten normal lifespans. However, it is also important to be wary of the eternal human aspiration of finding the elixir of youth. First, as we shall see later, it is very dubious whether achieving eternal life would actually turn out to be something we really wanted. Second, we have already achieved almost magical increases in longevity. In 1900 life expectancy at birth for men was 48.5 years and for women 52.4 years; by 2017 life expectancy had

shot up to 79.6 years for men and 83.2 years for women – a massive increase of over 30 years!

CULTURAL

Society has a big part to play in how we define age. First, society promotes some very powerful images and ideas about ageing which can significantly affect our sense of how old we are. Not only that, the cosmetics industry appears to have one main aim – to emphasise that looking old is bad and should be avoided at all costs. This is all based on the idea that youthful looks are positive and attractive and that looking old is distasteful. Underpinning this are the predominantly unrealistic images of older people which are portrayed in the media: at one extreme there is the image of the frail and rather miserable lonely older person (hugely promoted by age charities and some of the large corporate businesses at Christmas time) and at the other, there is the growth of the stereotype-busting ‘superhero’, like the 100-year-old marathon runner or 90-year-old parachute jumper. Neither is truly representative and both fail to validate who older people really are. We need more varied and nuanced images of older people in the media.

Second, society establishes numerous rules and entitlements based on chronological age. For example, an older person is commonly thought of as ‘a pensioner’, but when this is depends on current legislation because the state pension age changes. (It is interesting to note that when pensions were first introduced in 1908, the age of entitlement was 70! – it is due to reach 66 in 2020 – by which time life expectancy at pension age will have doubled since pensions were introduced.) Even though society sets out these rules and norms there is actually very little agreement about when someone can be said to be ‘old’. In a report for the respected Centre for Ageing Better, researchers found that people had very different ideas about this, depending on how old they were themselves! Those who were in the 16–24 age bracket thought that old age is reached at 61; whereas those in the 35–44 age bracket thought it was 67; and finally the 55–64-year-olds thought that old age didn’t start

The Ten Steps of Positive Ageing until 72. In other words, the older you are yourself, the more likely you are to think that old age comes later in life. And interestingly there are inter-cultural differences across the world. Whereas the average UK estimate is 66, in Spain one is considered to be old at 74 and in Saudi Arabia it is 55.

‘Getting old is a fascinating thing. The older you get, the older you want to get!’ KEITH RICHARDS • guitarist and songwriter with the Rolling Stones

PSYCHOLOGICAL

The psychological understanding of ageing is very limited in popular culture – something I hope this book will change. The only recognition of the inner world of older people tends to revolve around two negative assertions – changes in personality (becoming grumpy) and memory (becoming more forgetful). It’s worth knowing that there is no research evidence that links later life with becoming grumpy nor the inevitable loss of significant mental functioning. There are, however, a number of psychological and emotional aspects to ageing, and I’ll outline what they are and how to approach them in a way which generates the most positive outcomes in later life. Let’s now look at how we perceive our own age and how major life transitions might be a better way of looking at our ageing process.

SUBJECTIVE AGE Most of us are familiar with the adage ‘you are only as old as you feel’. It’s true that some of the research on the psychology of ageing supports this claim. There is a good body of evidence to back up the idea that most of us actually feel ourselves to be a different age from our chronological age. In other words, we have a ‘subjective’ age as well as the one determined by our birth certificate. In general, it appears that older people’s subjective age is usually younger than their chronological one. Some studies estimate that after the age of 40, people maintain a subjective age that is on average 20 per cent younger, whereas other

research suggests that actual age influences subjective age. In other words, the gap between these two is wider among older groups rather than younger ones. This is echoed in an interesting recent study which found that among people over 50, almost three-quarters (72 per cent) do not think of themselves as old, and perhaps most surprisingly (but pleasantly so), even among 80–89-year-olds, 63 per cent per cent do not think of themselves as old. So age is not really just a number – it is actually just any number you feel!

‘I will never be old. Old age will always be 15 years older than I am.’ SIR FRANCIS BACON • philosopher and statesman

The idea of subjective age is not just an idle curiosity; it has actually been found to have an important connection with our health. People who feel younger than their actual age tend to rate their own health as much better than those who feel older than their actual age. For example, researchers examined the data from three longitudinal studies which together tracked more than 17,000 participants. Most felt younger than their actual age, but some felt older, and the consequences for them were serious. Feeling between 8 and 13 years older than their actual age resulted in an 18–25 per cent greater risk of death during the studies. The effect goes wider than just health status. Other studies have shown that those who report feeling older than they are, experience fewer positive emotions, report lower life satisfaction, and display higher pessimism about ageing. It appears that our subjective age can better predict our health and wellbeing than the date on our birth certificates.

You might now like to have a look back at the answers you gave to the questions at the beginning of this section (see page 5). Do they provide you with any new insights about how you understand or feel about your age?

TRANSITIONS IN LATER LIFE Given the complexities of viewing age as just a number, it can be much more useful to understand ageing instead as a stage in life with

The Ten Steps of Positive Ageing a number of key life transitions. One of the defining characteristics of ageing is that most people experience at least one or usually more major life events, such as:

• retirement;

• moving home/downsizing;

• becoming a grandparent;

• relationship breakdown/divorce;

• becoming a carer;

• bereavement;

• becoming ill.

Each one of these events tends to have a major psychological and emotional impact on us. They bring about some quite dramatic changes in how we see ourselves and how we are seen by other people, and this process is commonly referred to as a ‘major transition’ in later life. The impact of a transition is experienced over time, as outlined below:

Selfesteem 1 Immobilisation 2 Minimisation

3 Depression 7 Internalisation

6 Searching for meanin g 5 Testing

Beginning of transition 4 Acceptance of reality Letting go Time

Source: Hopson & Adams, 1976

This model usefully illustrates how feelings are likely to change as we go through any major life change. Our self-esteem and confidence tend to vary across these phases and appear to follow a general pattern, although, as we all know, people seldom move in a progressive and orderly fashion; depending on the meaning of the transition, we may move both forward and backward. You might like to recall one of the life transitions that you have experienced and

then read through the following stages and think about whether any of them resonate with you.

1Immobilisation. There is a sense of numbness and shock; of being overwhelmed and unable to act. 2 Minimisation. As a way of coping with the change, it is common to deny that it is happening. This is a frequent reaction to a crisis which is too difficult to face. 3 Depression. People often experience self-doubt and get depressed when they face up to the implications of change. 4 Accepting reality. At this point the person begins to let go of their old state of being, accepting the reality of what is happening to them. 5 Testing. Having begun to accept the situation, it then becomes possible to test out new behaviours to cope with the situation. 6 Seeking meanings. This is a reflective stage where people try to work out how and why things are different. 7 Internalisation. Finally, understandings of the situation and new meanings become internalised and accepted. They then become part of the person’s behaviour.

Whilst helpful, this model is not an outline of how a transition should be experienced. We will all experience different feelings to different degrees and probably in a different order. The important learning point is that a transition is a process, and we will experience different feelings along the way. It has a beginning, and, although it doesn’t have a definable ‘end’, we will (in most cases) emerge at some point having come to terms with our new situation.

It can be helpful to have some understanding of how a major life transition can affect us emotionally and psychologically so that we can have a bit more control over how we respond to these situations when they arise. The following framework was developed by Robert Dilts and shows how a major life transition can impact on our inner world. It is likely to cause some important changes to our:

• Sense of purpose and meaning in life;

• Identity and how we feel about our role and place in society;

• Beliefs about what is true or important in life;

our feelings about what we can do or achieve;

• Day-to-day behaviour – the sort of things we spend our time on;

• Living arrangements or the environment where we carry out our

daily lives.

To illustrate how this framework can help us understand and address the impact of a life transition, let us consider the example of retirement. Retirement can affect all aspects of people’s lives.

SENSE OF PURPOSE Work provides many of us with a significant element of what makes our lives meaningful. For most people it is second only to family in defining their sense of purpose in life. The end of work can therefore cause significant psychological disruption about what gives our lives meaning.

IDENTITY This is hugely affected. Retirement is generally seen as when one becomes ‘a pensioner’. It is the gateway from being an ‘adult’ to becoming an ‘older person’, with all that entails. Abandoning the role we might have had in our work life can cause a lot of soul searching about who we are now and what role we play in our community.

BELIEFS Although perhaps not affected as much as other elements, some of our beliefs might need to be looked at in the light of our new identity and how retirement might have changed how we make sense of ourselves and our place in the world.

CAPABILITIES Our skills and talents can be hugely affected. Abilities and the experience that we used to routinely deploy in the workplace can become redundant. This is not necessarily negative, as it can allow us the space to learn new skills and other activities which we have always been interested in.

BEHAVIOUR This usually changes significantly, most obviously because former work activities (such as commuting) become redundant and other behaviours usually replace them.

ENVIRONMENT The workplace is substituted with another environment for the person to spend their time in – we might be at home more, for instance.

Each of the transitions we are likely to experience in later life (whether this is retirement, illness or bereavement) will have a different impact on our lives, and how we react to them will come to dominate how we experience our later years. And unfortunately, these events don’t tend to occur sequentially; we can often find ourselves dealing with two or more major life transitions at any one time. Looking at later life as a period when we are likely to have to deal with a variety of major life transitions provides a much more useful and realistic way of thinking about our later years, rather than getting caught up in the number of birthdays we have or will have had by the time we die. It is how we journey through these later years which makes up the reality of our ageing process.