A New Look at Successful Aging: Exploring a Mid-Range Nursing Theory among Older Adults in a Low-Income Retirement Community
McCarthy, Valerie Lander, Journal of Theory Construction and Testing
The current view of successful aging excludes elders with disease or disability, limits the potential for success among disadvantaged populations, and fails to consider older adults' own criteria for success, especially in the existential or spiritual domain. This cross-sectional study was a preliminary investigation of a mid-range nursing theory (Flood, 2005) of successful aging. A random, stratified sample (N= 112) was used. Questionnaires were administered to small groups of non-demented older adults. Relationships among study variables were examined using hierarchical multiple regression. Adaptation and transcendence explained 45.4% of the variance in successful aging, independent of age, income, function, and health. Transcendence accounted for 2.5 times the effect of adaptation.
Key Words: adaptation, lifespan devehpment, health disparities, successful aging, transcendence
The current view of successful aging as freedom from disease and disability (Rowe & Kahn, 1998) excludes older adults with any degree of chronic disease; focuses on behavioral determinants of health rather than social and environmental factors, thus limiting the potential for success among low-income and minority groups; and fails to consider older adults' own criteria for successful aging, especially in the existential or spiritual domain. A new way of looking at successful aging defines success, not by the absence of disease or disability, but by an individual's personal satisfaction with the ability to adapt to change over time, while maintaining a sense of connectedness, meaning, and purpose in life (Flood, 2005). Flood's mid-range nursing Theory of Successful Aging proposes that adaptation and transcendence are the primary predictors of this new view of successful aging.
The dual purposes of this study were to investigate relationships among adaptation, transcendence, and successful aging (Flood, 2005) and to explore the usefulness of successful aging as a guide to a richer, more meaningful old age for all older adults, regardless of disease, disability, and disadvantages. The study focused on successful aging among older adults dealing with chronic disease, functional limitations, and racial or socioeconomic disadvantages rather than healthy, high functioning older adults. Social and environmental factors were considered along with behavioral determinants of health.
The concept of successful aging commonly focuses on population-based epidemiological studies aimed at understanding genetic, biochemical, and behavioral factors influencing the incidence of disease and disability in late fife (Rowe & Kahn, 1987, 1997). Within psychosocial disciplines, successful aging focuses on such constructs as adaptation, specifically coping strategies older adults use to adapt to the changes, challenges, and opportunities of aging (Aspinwall & Taylor, 1997; Baltes & Baltes, 1990; Kahana & Kahana, 1996; Schwarzer & Taubert, 2002). Spiritual or existential aspects of successful aging, such as transcendence, have received some attention in philosophical and theoretical literature but scant empirical investigation (Erikson & Erikson, 1997; Maslow, 1969, 1971;Tornstam, 1989, 2005; Reed, 1991a, 2003, 2009). Literature about these components of Flood's (2005) mid-range theory - successful aging, adaptation, and transcendence - is discussed below.
Successful aging was the most common term used to indicate a positive old age (Peel, Bartlett, & McClure, 2004), perhaps due to its use in several large aging studies, e.g., the MacArthur Successful Aging Studies (Rowe & Kahn, 1987, 1997), the Harvard Study of Adult Development (Vaillant & Mukamal, 2001), the Alameda County Study (Strawbridge, Cohen, Shema, & Kaplan, 1996) and the Berlin Aging Studies (Baltes & Baltes, 1990). The predominant view of successful aging as freedom from disease and disability with active social engagement gained popularity with the lay public as a result of Rowe & Kahns 1998 book, Successful Aging. …