Review of Wellbeing Indicators

Conceptual Framework: definition of terms

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Conceptual Framework: definition of terms

A range of terms have been used in the literature to refer to positive outcomes in later life: “Positive Ageing” (Gergen & Gergen, 2001); “Ageing well” (Fries, 1989); “Healthy Ageing” (SNIPH, 2007), “Successful Ageing” (M. Baltes & Carstensen, 1996; Rowe & Kahn, 1997), “Productive Ageing” (Butler, 1996; Kaye, Butler, & Webster, 2003) and “Active Ageing” (World Health Organisation, 2002).

Initially, the emphasis was on the physical and mental health of older adults, with ‘Healthy’ ageing identified as an aim by the WHO as early as 1980. In the 1990s the emphasis shifted towards ‘active and productive’ ageing, accompanied by an increasing focus on the economic implications of population ageing (Bass, Caro, & Chen, 1993). ‘Productive ageing’ views older people as a resource and emphasises the importance of their economic participation in society (OECD, 1998). The concept of ‘Active ageing’, was proposed by the United Nations in 1999, and argues that the old stereotype of older people as frail and dependent will change as active older people became more visible and better integrated into society.

Concepts of ‘successful’ and ‘positive’ ageing emphasise a broad range of factors that contribute to wellbeing - physical, intellectual, emotional and spiritual - and suggest that psychological adjustment and autonomy are central to the achievement of good quality of life. Physical health is only one aspect of positive ageing, and a high level of physical function may not be necessary for a person to consider themselves “successfully aged” (Depp & Jeste, 2006). For example, one study of adults aged 60 and over in the US found that 92% of the sample considered themselves "successfully aged", despite the fact that 85% had chronic conditions, and 78% had at least some functional impairment (Montross et al., 2006).

The NPAS uses a definition of positive ageing put forward by the Office of an Ageing Australia as

an individual, community, public and private sector approach to ageing that aims to maintain and improve the physical, emotional and mental wellbeing of older people. It extends beyond the health and community service sectors, as the wellbeing of older people is affected by many different factors including socio-economic status, family and broader social interactions, employment, housing and transport. Social attitudes and perceptions of ageing can also strongly influence the wellbeing of older people, whether through direct discrimination or through negative attitudes and images”.

This definition acknowledges that positive outcomes in later life cannot be reduced to physical health and function, or to productivity. The positive ageing approach involves recognition that a broad range of supportive societal and external environmental factors play a role in improving general wellbeing and quality of life. Some of the key terms related to positive ageing – ageing, health, wellbeing and quality of life, are defined below.

Ageing occurs throughout the life course and although there are commonly used definitions of old age, there is no general agreement on the age at which a person becomes old. Based on the most common age of retirement or qualification for a pension benefit, the World Health Organisation states that most developed world countries have accepted the age of 65 years as a definition of an 'elderly' or older person1. The United Nations generally uses the cut-off of 60+ years to refer to the older population.

However, when examining positive ageing it is also useful to include research with the population aged 50-64, as this is the time of life leading up to retirement, and is also when many people experience the initial onset of chronic conditions. Large-scale ageing surveys, such as the Irish Longitudinal Study of Ageing (TILDA) and the Survey of Health, Ageing and Retirement in Europe (SHARE) collect data from adults aged 50 and over.

Health is described in Healthy Ireland as meaning “…everyone achieving his or her potential to enjoy complete physical, mental and social wellbeing”. As per the WHO definition, the concept is broadly defined as being “more than an absence of disease or disability” (Department of Health 2013. p.9).

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