The shift from old age to very old age: an analysis of the perception of aging among older people

Abstract Background The oldest-old (individuals over 90 years) are a fast-growing population. Understanding the perceptions of older people about very old age is the first step towards developing optimal geriatric care for an aging population. This study aimed to explore the potential shift from old age to very old age through the exploration of older people’s perception of aging. Methods Qualitative study conducted through individual interviews in the homes of older people. We voluntarily chose to include persons a decade under and above 90 years old to explore other factors than age that could participate in the shift from old age to very old age. The sampling was theoretical. We carried out the analyses using an inductive approach based on the phases of grounded theory. The researchers used triangulation. Collection was concluded when theoretical saturation was reached. Results Fourteen participants were interviewed. The shift from old age to very old age was not based on age but occurred when participants became conscious of the irreversibility of aging and its effects, and when they started living day-by-day, renouncing to any plan in a near future. The transition to very old age seemed to be preceded by a progressive disengagement from non-essentials activities. Participants reported a sensation of progressive social exclusion due to the loss of contemporaries or spouse, the difficulty to connect with younger generations or the absence of relationships in their neighborhood. The last step of life was feared, not because of the idea of death itself but because of the associated suffering and loss of autonomy. Conclusion Precipitating and slowing factors of the shift to very old age were identified to help general practitioners support older patients throughout their life trajectories.

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Bereavement in Very Old Age: Impact on Health and Relationships of the Loss of a Spouse, a Child, a Sibling, or a Close Friend

OMEGA - Journal of Death and Dying ◽

10.2190/om.60.4.a ◽

2010 ◽

Vol 60 (4) ◽

pp. 301-325 ◽

Cited By ~ 28

Author(s):

Christian J. Lalive d'Epinay ◽

Stefano Cavalli ◽

Luc A. Guillet

Keyword(s):

Depressive Symptoms ◽

Functional Status ◽

Old Age ◽

Oldest Old ◽

Great Majority ◽

Close Friend ◽

Short Term ◽

Very Old ◽

Very Old Age

This article deals with the following two questions: In very old age, which are the main sources of bereavement? And what are the consequences of such losses on health and on relationships? The findings are based on the complete set of data compiled in the course of the Swiss Interdisciplinary Longitudinal Study on the Oldest Old (SWILSOO), which provided a 10-year follow-up of a first cohort (1994–2004) and a 5-year follow-up of a second (1999–2004). The data revealed that, in very old age, the great majority of the dear ones who died were either siblings or close friends. Taken as a whole, the bereaved suffered a marked and lasting increase in depressive symptoms, together with a short-term deterioration in their functional status; those bereft of a spouse or a child saw their functional status worsen and exhibited enduring depressive symptoms but they also benefited from support in the form of increased interaction; those bereft of siblings only suffered from a mild, short-term deterioration in functional status; those who had lost a close friend suffered a very significant increase in depressive symptoms. In the medium term, most of these effects disappeared, lending weight to the claim that the survivors manage to cope with the misfortunes of life.

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Loneliness and Social Isolation Among Centenarians and Near-Centenarians: Results From the Fordham Centenarian Study

Innovation in Aging ◽

10.1093/geroni/igab046.416 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 110-110

Author(s):

Daniele Zaccaria ◽

Stefano Cavalli ◽

Barbara Masotti ◽

Daniela Jopp

Keyword(s):

Older People ◽

Old Age ◽

Social Isolation ◽

Very Old ◽

Self Rated Health ◽

Loneliness Scale ◽

Social Risks ◽

Very Old Age

Abstract Although loneliness and social isolation are often discussed together, they are mainly examined separately. The few studies examining both concepts simultaneously focus usually on the wider category of older people (65+), with no or little attention to very old age. Our main aim was to investigate loneliness and social isolation in combination among near-centenarians and centenarians. Analyzing data from the Fordham Centenarian Study (N=94; MAge=99.2; range=95-107), we found no or very weak associations between loneliness and social isolation. Combining measures of loneliness (UCLA Loneliness scale) and social isolation (Lubben Scale) we built a typology with four different groups (Not lonely or isolated; Lonely and isolated; Lonely but not isolated; Isolated but not lonely). The factors that most strongly predicted the distribution among these four groups were gender, widowhood, education, and self-rated health. Findings highlight the importance of jointly studying both concepts to better understand social risks in very old age.

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How are Temporal and Social Comparisons Related to Appraisals of Self-Rated Health During Very Old Age?

Swiss Journal of Psychology ◽

10.1024/1421-0185.66.2.79 ◽

2007 ◽

Vol 66 (2) ◽

pp. 79-89 ◽

Cited By ~ 8

Author(s):

Dario Spini ◽

Alain Clémence ◽

Paolo Ghisletta

Keyword(s):

Old Age ◽

Oldest Old ◽

Time Lag ◽

Social Comparisons ◽

Relative Importance ◽

Very Old ◽

Self Rated Health ◽

Direction Of Effects ◽

Very Old Age ◽

Positive Effect

This study investigated the direction of effects of temporal and downward social comparisons on self-rated health in very old age. Conversely, self-rated health can either reinforce or hinder comparison processes. In the framework of the Swiss Interdisciplinary Longitudinal Study on the Oldest Old, individuals aged 80 to 84 at baseline were interviewed and followed longitudinally for 5 years. Multilevel analyses were used to test the relative importance of temporal and social comparisons on self-rated health evaluations synchronically and diachronically (with a time lag of 12 to 18 months) as well as the direction of these relative influences. Results indicate that (a) at the synchronic level, continuity temporal comparisons have more impact than downward social comparisons on self-rated health; (b) both types of comparison had an independent and positive effect on self-rated health at the diachronic level; (c) self-rated health has an independent synchronic effect on both types of comparison and an independent diachronic effect in temporal comparison.

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The experience of transitions in care in very old age: implications for general practice

Family Practice ◽

10.1093/fampra/cmz014 ◽

2019 ◽

Vol 36 (6) ◽

pp. 778-784

Author(s):

Fiona Scheibl ◽

Jane Fleming ◽

Jackie Buck ◽

Stephen Barclay ◽

Carol Brayne ◽

...

Keyword(s):

Old Age ◽

Family Relationships ◽

Oldest Old ◽

Population Based ◽

Old Patients ◽

Very Old ◽

Complex Process ◽

Community Ties ◽

Very Old Age

Abstract Background It can be challenging for general practitioners to support their oldest old patients through the complex process of relocation. Objective To provide a typology of the experiences of moving in very old age that is clinically useful for practitioners navigating very old people’s relocation. Methods Qualitative analysis of data from a mixed-methods UK population-based longitudinal study, Cambridge City over-75s Cohort (CC75C), from Year 21 follow-up onwards. Interviews with participants aged ≥95 years old and proxy informants (Year 21: 44/48, 92%, subsequent attrition all deaths). Thematic analysis of qualitative data available from 26/32 participants who moved before they died. Results Individuals who moved voluntarily in with family experienced gratitude, and those who moved into sheltered house or care homes voluntarily had no regrets. One voluntary move into care was experienced with regret, loss and increased isolation as it severed life-long community ties. Regret and loss were key experiences for those making involuntary moves into care, but acceptance, relief and appreciation of increased company were also observed. The key experience of family members was trauma. Establishing connections with people or place ahead of moving, for example through previous respite care, eased moving. A checklist for practitioners based on the resulting typology of relocation is proposed. Conclusions Most of the sample moved into residential care. This study highlights the importance of connections to locality, people and place along with good family relationships as the key facilitators of a healthy transition into care for the oldest old. The proposed checklist may have clinical utility.

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