In recent years, there has been a shift in the perception of ageing from a negative to a positive perspective. Instead of a period of decline and ‘retirement’ from life, later life is increasingly seen as a period in which older people can continue to develop and to contribute their experience and knowledge to their communities. This view has informed the approach towards policy development in many countries and is central to the vision set out in the Irish National Positive Ageing Strategy (NPAS), published in 2013 (Government of Ireland, 2013). The Strategy arose from a commitment in the Programme for Government in early 2011 to complete and implement the NPAS so that ‘older people are recognised, supported and enabled to live independent full lives’ (pg. 56). In essence, the Government committed to enhancing and protecting people’s wellbeing and quality of life as they age.
The theoretical background for the NPAS is consistent with international developments in relation to ageing, and in particular the World Health Organisation’s (WHO) Active Ageing – A Policy Framework (World Health Organisation, 2002). This framework provides a roadmap for designing multi-sectoral active ageing policies. It encourages policy makers to recognise and address factors or ‘determinants’ that affect how people and populations age, to adopt a life-course perspective, and to promote intergenerational solidarity in developing policies to respond to population ageing. The WHO Active Ageing Framework calls for action on three fronts, by defining active ageing as a process of optimising opportunities for participation, health and security.
The implementation of the NPAS requires a ‘whole of government’ response, and must be framed within the implementation of Healthy Ireland - the national framework for action to improve the health and wellbeing of the population (Department of Health, 2013). Implementation of the NPAS is an essential part of the vision for creating a society in which “every individual and sector of society can play their part in achieving a healthy Ireland” (Healthy Ireland goal 4).
These two interlinked Government strategies have each committed to the development of indicators to monitor and evaluate progress in implementation. Indicators have been developed in many different policy areas and are regarded as playing a vital role in policy making. Indicators facilitate the identification of problems and trends, while contributing to the process of priority setting, policy formulation, and the evaluation and monitoring of progress (Nardo et al., 2008). Developing indicators to measure progress will be central to the successful implementation of the NPAS.
Development of an indicator set is a core aim of the Healthy and Positive Ageing Initiative (HaPAI). The indicator set will be primarily based around the goals and objectives of the NPAS, but also takes into account the use of indicators at international level. These indicators will be used to assess the level of progress being made through the implementation of the Strategy to improve the lives of older people over time, ideally benchmarked against other countries.
A preliminary report has been published detailing an initial long-list of indicators for each of the NPAS goals and objectives, drawing on currently available national and international data sources (Department of Health, 2015). The purpose of this review is to outline in more detail the background theory and evidence under-pinning the indicator development process.
The first section of this review will focus on definitions of ‘positive ageing’, health and wellbeing. It will also include a brief discussion of the life course approach, and what is meant by an indicator. The next section will examine current evidence for the relevance of various life domains for positive ageing, drawing on current research evidence and theory. The third section will discuss the international experience in relation to the development of indicators to measure wellbeing, particularly in the older population.
In summary this literature review aims to
Outline what is meant by Positive Ageing and define key relevant terms: Ageing, Healthy, Wellbeing and Quality of Life, Life course and Indicator
Identify key life domains related to healthy and positive ageing and outline current evidence for the contribution of each domain to positive ageing