Discrepancies between subjective importance and actual everyday practice among very old adults and the consequences for autonomy.

BACKGROUND: An individual's everyday practice in very old age is based on stable dispositions and on the living conditions associated with the person's stage of life. Age-associated changes in living conditions can cause discrepancies between the person's dispositions and actual everyday practice that have consequences for the quality of life. OBJECTIVE: The aim of this paper is to look more closely at such discrepancies and their associations with living conditions in very old age (long-term care needs, multimorbidity, care tasks) as well as with the feeling of autonomy as an aspect of quality of life. METHODS: A cross-sectional analysis was conducted using data from the first wave of the NRW80+-study on the quality of life of people aged 80 years and over. Data on the subjective importance of five areas of everyday practice and on the frequency of translating these dispositions into practice were used. The analysis focuses on the occurrence of large discrepancies that arise if the subjective importance of an everyday practice deviates considerably from the frequency of performing it. RESULTS: Among the very old population surveyed, solitary activities are considered the most important, and they are carried out most often. Multimorbidity, long-term care needs, and private care responsibilities are significantly associated with the experience of large discrepancies. Finally, very old adults with large discrepancies report feelings of reduced autonomy. CONCLUSION: These initial results show that age-associated changes in living conditions can be accompanied by difficulties for very old adults to put their dispositions into practice. Attention should be paid to such discrepancies to avoid negative consequences for quality of life.

Stereotypes about very old people and perceived societal appreciation in very old age.

BACKGROUND: People in very old age (VOA) are expected to be confronted with particularly negative stereotypes. These influence societally shared behavior towards and judgements about them. Such external evaluations of individuals' lives are considered a crucial part of their quality of life (QoL). OBJECTIVE: The present study elaborated a) the societal appreciation perceived by people in VOA and b) the stereotypes about people in VOA held by stakeholders from key societal areas. The aim was to discuss possible connections between these external standards and individual life results. MATERIAL AND METHODS: A parallel mixed methods design was employed. Cross-sectional data from a representative survey of people aged 80 years and older (n = 1863) were analyzed by means of χ2-tests and Kruskal-Wallis tests to examine differences in perceived societal appreciation (PSA) by characteristics of the person, their biography, and current lifestyle. Linear regression models were used to investigate the impact of these characteristics on PSA. Regarding stereotypes about people in VOA, semi-structured interviews with stakeholders from key societal areas (n = 22) were analyzed using qualitative content analysis. The quantitative and qualitative findings were juxtaposed for comparison. RESULTS: PSA was predicted by health-related variables and productive activities. Several societal stakeholders highlighted that age-related losses pose challenges on very old individuals, their families, and society, whereas remaining potentials in VOA can and should be used for the benefit of others; however, stakeholders' perceptions differed by the extent of their professional contact with (very) old people. Different pathways were proposed through which the observed stereotypes and determinants of PSA might be connected (e.g., stereotype internalization). CONCLUSION: Our study illustrates the relevance of external standards for individual QoL and highlights the need for a normative perspective in the discussion about QoL and its enhancement.

Quality of life of the very old : Survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+).

BACKGROUND: In Germany, the very old are the most rapidly growing proportion of the population. A comprehensive investigation of the conditions for a good quality of life in this group is relevant for both society and politics. OBJECTIVE: The project "Quality of life and subjective well-being of the very old in North Rhine-Westphalia" (NRW80+) at the University of Cologne surveys quality of life of the very old. Taking into account many specific methodological and theoretical challenges, it aims at setting up a specific theoretical framework and methodological approach. METHODS: Existing studies on quality of life in old age in Germany and abroad as well as models on quality of life are reviewed with respect to their relevance for the very old and their specific living conditions, needs and interests. A theoretical framework of quality of life in very old age is developed. The NRW80+ study combines three levels: the empirical level of description of life situations and conditions, the explanative level of evaluating models of quality of life and the normative level of societal and ethical standards and norms. RESULTS: Considering results of recently conducted studies with the very old, an integrative conceptual model for studying quality of life of very old persons is introduced. In the model of challenges and potentials (CHAPO), environmental and individual factors as well as life chances and life results are thereby taken into consideration from a subjective as well as an objective point of view, supplemented by the concept of successful life conduct. CONCLUSION: Starting from the CHAPO model of quality of life, the representative study NRW80+ aims at challenging methodological standards for the inclusion of the very old in social research thus providing the basis for further research as well as for sustainable social politics especially for the very old.

Old-age lifestyles: Patterns of participation in leisure activities and their associations with different forms of capital.

As an important dimension of lifestyle, participation in leisure activities can enhance people's quality of life. Thus, pursuing an engaged lifestyle has become an assumed requirement of ageing successfully. People's opportunities to pursue an engaged lifestyle are influenced by their social positions, which are defined by their access to economic, cultural, and social capital. However, lifestyles in very old age and the significance of these forms of capital have not been sufficiently investigated. Against this background, we examined the questions of what lifestyles people pursue in very old age, and how these lifestyles are associated with their access to different forms of capital. Representative data from the NRW80+ study in North Rhine-Westphalia, Germany, were used. The sample comprised 1863 respondents aged 80 and older, and was carried out in 2017. First, the respondents' patterns of participation in leisure activities, which were used to measure their lifestyles, were identified by applying latent class analysis. Second, the associations between lifestyles and indicators of economic, cultural, and social capital were analysed separately for community- and institutional-dwelling very old adults using logistic regression. Three patterns of leisure activity participation were identified: a digital (16.5%), a sociable (41.0%), and a withdrawn (42.4%) lifestyle. For community-dwelling very old adults with low or medium education and those with low occupational prestige in their last job, the odds of having a withdrawn lifestyle were increased. For both community- and institutional-dwelling individuals, larger social networks were associated with decreased odds of pursuing a withdrawn lifestyle. We conclude that the different forms of capital continue to be related to the lifestyle opportunities of very old adults, but lose their importance for institutional-dwelling individuals. A life course perspective on social inequalities in lifestyle is therefore needed.