Motivation and emotion/Book/2023/Flourishing in the elderly

Overview
Can you relate ...

Sarah, aged 85, begins her day in a house echoing with memories (see Figure 1). Faded photographs on the mantelpiece showcase her once pivotal role in the community. From hosting gatherings to being an active voice at the local council, she had always championed causes dear to her. But now, an overwhelming quietness envelops her heart, and she has lost touch with her sense of purpose.

Time has seen her closest friends move or pass away. Family visits, once frequent and filled with laughter, have become increasingly rare. This growing isolation weighs on Sarah, exacerbated by a society that seems to prioritise youth over experience. The fast-paced technological world further alienates her; smart devices and social media platforms feel foreign, exacerbating her deep-seated fear of irrelevance in a world that is rapidly evolving without her.

In a society increasingly centred on youth, how can seniors like Sarah reclaim their vitality and sense of meaning?



The ageing population represents an invaluable repository of wisdom, experience, and insight (see Figure 2). Yet, many elderly individuals, much like Sarah, face challenges related to purpose, meaning, and overall psychological well-being. This raises a question; can the elderly attain a state of psychological flourishing, even in the face of age-related adversities? The domain of positive psychology offers evidence-based strategies. Read on to explore what these strategies are and how they can be applied to support seniors in their journey toward a life filled with purpose, meaning, and joy.

Specifically, psychological flourishing in the elderly may be supported through a combination of the following four elements, especially when tailored to individual needs and preferences:


 * 1) Social engagement and meaningful activities such as community involvement or hobbies (Helliwell et al., 2013)
 * 2) Mental stimulation via cognitive training programs can sustain mental acuity and may delay cognitive decline (Ball et al., 2002)
 * 3) Physical activity using exercises tailored to the elderly improve mood and cognitive function (Colcombe & Kramer, 2003)
 * 4) Incorporating positive coping strategies from positive psychology techniques, such as gratitude exercises, builds resilience and satisfaction (Seligman et al., 2005)

Focus questions:
 * What is psychological flourishing?
 * Why is psychological flourishing important for the elderly?
 * How does positive psychology foster psychological flourishing?
 * What can seniors do to flourish?

What is psychological flourishing?
Psychological flourishing, a term frequently linked to positive psychology, has gained prominence over the years. For elderly individuals, understanding and achieving psychological flourishing is paramount, considering the myriad challenges they confront during this stage of life (Park et al., 2002). The concept of psychological flourishing and its significance, particularly in the context of ageing, will be explored in depth. Psychological theory, such as self-determination theory and resilience theory, combine with empirical evidence to underpin the suggested four-element model. It is also essential to define and distinguish psychological flourishing from broader notions of general flourishing and well-being. Through understanding this distinction, the unique facets of flourishing and its potential impact on the lives of older individuals become evident. Common misconceptions about psychological flourishing are also addressed, ensuring clarity in subsequent discussions.

Psychological flourishing, a concept closely associated with positive psychology, has gained prominence in recent years. For elderly individuals, comprehending and attaining psychological flourishing is crucial, given the diverse challenges encountered in this life stage (Park et al., 2002). The concept of psychological flourishing and its significance, particularly in the context of ageing, will be explored in depth. Psychological theories such as self-determination theory and resilience theory, as well as empirical evidence, will be used to establish a four-element model of psychological flourishing. Additionally, it is vital to delineate psychological flourishing from broader concepts of general flourishing and well-being. By grasping these distinctions, the unique facets of flourishing and their potential transformative impacts on the lives of older individuals become evident. Common misconceptions about psychological flourishing will also be addressed to ensure clarity in the discussions that follow.

Definitions and distinctions
Psychological flourishing, often simply termed "flourishing", signifies a pinnacle in human functioning. It represents a well-being state that extends beyond merely being free from distress or psychological issues. More than mere survival, flourishing connotes thriving, excelling, and feeling an intense sense of purpose and contentment (Seligman et al., 2005). This condition transcends mere happiness or the absence of mental illness (Sin & Lyubomirsky, 2009). Flourishing provides a holistic view, emphasising positive human functioning across various areas, from relationships to personal growth and purpose. It captures positive emotions, a sense of engagement, strong social connections, and a profound understanding of life's meaning. Distinct from general well-being, flourishing underscores not just feeling good but also functioning effectively, accentuating both hedonic (feelings about life) and eudaimonic (functioning in life) well-being facets (Keyes, 2007).

Positive psychology’s well-being theory, also known as the PERMA model, conceptualises well-being as a state of comfort, health, or happiness (Seligman, 2011). The model comprises five elements: positive emotion, engagement, positive relationships, meaning, and accomplishment (Seligman, 2011). However, psychological flourishing transcends the ‘feeling good’ aspect of well-being. It encompasses optimal functioning in daily life, incorporating the key principles of self-determination theory: autonomy, relatedness, and competence.

Importance in the context of ageing
Ageing often elicits feelings of apprehension and resignation, influenced by perceptions of decline or limitation, both physically and mentally. Nevertheless, research indicates that many elderly individuals experience periods of growth, insight, and enhanced well-being. For example, the Adult Development and Enrichment Project (ADEPT), conducted by researchers at Pennsylvania State University, underscored the potential for intellectual and emotional growth even in advanced age (Hultsch et al., 1999). Psychological flourishing becomes paramount in this context, assisting the elderly in navigating challenges, capitalising on opportunities, and making meaningful contributions to their communities and personal lives, thereby maintaining their autonomy, relatedness, and competence.

Psychological flourishing challenges these notions of decline or limitation, highlighting the profound possibilities for growth, enrichment, and depth in later life (Paterson & Warburton, 2010). Embracing flourishing can significantly transform the way elderly individuals perceive their later years, encouraging them to view this period as an opportunity for renewed purpose, deepened relationships, and the cultivation of new passions or interests. Furthermore, as elderly individuals inevitably face challenges, resilience theory provides a framework for developing a mindset rooted in flourishing (Southwick & Charney, 2012; Bonanno et al., 2004). Such a capacity and mindset act as a solid foundation, empowering seniors to approach obstacles with resilience and poise (Seligman et al., 2005).

Misconceptions
Several misconceptions exist regarding the concept of psychological flourishing. Contrary to common belief, it does not imply a perpetual state of happiness or a life devoid of adversity. Psychological flourishing is not about the absence of negative emotions or challenges. Instead, it focuses on cultivating psychological tools and strategies to navigate adversity, empowering individuals to thrive amidst difficulties (Carstensen et al., 1999). Clarifying these misconceptions paves the way for a deeper understanding of how older individuals can achieve and maintain psychological flourishing.

To truly grasp psychological flourishing in older adults, it is crucial to debunk prevalent myths about the ageing process. If left unchallenged, these misconceptions could deter the implementation of strategies promoting well-being in later life (Carstensen et al., 1999; Charles & Carstensen, 2010). Table 1 presents evidence-based counters to these myths, highlighting the potential for growth and vitality among the elderly.

Significance of psychological flourishing for the elderly
Psychological flourishing holds a special significance for the elderly (Seligman, 2011). As they navigate the complexities of ageing, fostering a sense of purpose, joy, and well-being is essential (Bonanno et al., 2004). The importance of psychological flourishing for older adults lies in its comprehensive contributions to their emotional, cognitive, and physical domains (Emmons & McCullough, 2003; Hultsch et al., 1999). Drawing upon current research, the following discussion explores the transformative effects of a flourishing mindset.

Emotional benefits
Ageing introduces challenges that can be emotionally strenuous. However, research such as that by Peterson et al. (2007) indicates that character strengths, including love, gratitude, and hope, can significantly enhance emotional well-being. A good sense of humour provides further enhancement to emotional well-being according to research conducted by Martin et al. (1993). Flourishing ensures that the elderly possess the emotional resilience required to confront challenges, nurturing feelings of contentment and fulfilment (Bonanno et al., 2004). A senior who flourishes, for instance, might derive profound joy from meaningful relationships or experience a deep sense of gratitude for life's journey. This emotional equilibrium not only improves overall life quality but also acts as a safeguard against stress, rendering the ageing experience more rewarding (Bengtson, 2001; Carstensen et al., 1999).

Cognitive benefits
Psychological flourishing has discernible effects on cognitive function. A flourishing mind is an active one, continuously engaged in stimulating activities. Various researchers have observed that aspects like mental stimulation and engagement in activities such as walking, cycling, and sports play a role in cognitive maintenance (Bonanno et al., 2004; Emmons & McCullough, 2003; Hultsch et al., 1999). Cross-sectional and retrospective studies, although lacking direct causation evidence, highlight the correlation between physical activity and cognitive function (Hultsch et al., 1999; Paterson & Warburton, 2010). Moreover, character strengths such as curiosity and zest, as pinpointed by Peterson et al. (2007), equip the elderly with a passion for learning, keeping their cognitive faculties sharp and agile. It is a proactive stance against cognitive decline, ensuring that the elderly remain mentally active and engaged.

Impact on physical health and longevity
The connection between the mind and body is profound, particularly in the context of ageing. Research consistently underscores the positive effects of physical activity on functional outcomes, with an emphasis on the benefits of aerobic activities and structured exercise programs (Greenfield & Marks, 2004; Paterson & Warburton, 2010). Notably, regular participation in these activities is linked to decreased risks of functional impairments. Beyond the immediate physical benefits, psychological flourishing, with its focus on positive behaviours and proactive approaches, may also enhance longevity (Bengtson, 2001; Peterson et al. 2007). For example, seniors who cultivate qualities such as gratitude, as identified in studies by Peterson et al. (2007), are likely to adopt more health-promoting behaviours. This symbiotic relationship between a flourishing mind and a healthy body underscores the importance of psychological well-being in the elderly.

{Imagine you are chatting with a friend about the advantages of psychological flourishing in older adults. Which of the following is NOT a benefit of psychological flourishing in the elderly? - Enhanced emotional resilience to confront challenges + Safeguard against financial issues - Improved overall life quality - Acts as a safeguard against stress
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{A senior with a flourishing mindset might derive profound joy from meaningful relationships and experience a deep sense of gratitude for life's journey. + True - False
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{Research indicates that seniors who cultivate qualities like gratitude are more likely to: - Avoid social interactions - Abstain from any form of physical activity + Adopt additional health-promoting behaviours - Experience rapid cognitive decline
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The role of positive psychology
Positive psychology represents a rapidly growing field, concentrating on the cultivation of individual strengths, virtues, and peak human functioning, as highlighted by Seligman (2011). For elderly individuals, this approach provides a comprehensive viewpoint, tackling the intrinsic challenges associated with ageing while actively encouraging a flourishing life that extends past mere existence. Southwick and Charney's (2012) influential research underscores resilience, an essential aspect of positive psychology's resilience theory, as crucial in managing stress and trauma. This section explores relevant core principles of positive psychology that, illustrate its substantial utility in supporting psychological flourishing among seniors.

Foundational principles and theories
Positive psychology fundamentally examines the conditions and processes essential for optimal functioning, as investigated by Southwick and Charney (2012). It transforms the traditional focus on deficits and disorders, advocating instead for the amplification of strengths, positive emotions, and resilience. These elements are crucial for seniors, offering invaluable guidance through the complexities of later life. Core theoretical frameworks within this field, including resilience theory, self-determination theory, and well-being theory, shed light on various avenues available for seniors to discover meaning, purpose, and an elevated sense of well-being, even amidst the challenges life presents.


 * Resilience theory in psychology delves into the complex processes that enable individuals to adapt positively in the face of adversity. Recognising resilience as a dynamic and developmental capacity, it encompasses both internal cognitive-affective mechanisms, such as emotion regulation and a robust sense of self-efficacy, and external factors like strong social support networks. This framework underscores the notion that resilience is not an innate trait; rather, it is a skill subject to cultivation. The theory also integrates the concept of post-traumatic growth, shedding light on how challenging experiences can contribute to personal development and a deeper sense of meaning in life. By considering individual differences and the developmental context, resilience theory provides a nuanced understanding of adaptive functioning, guiding interventions that aim to enhance resilience and promote positive psychological outcomes (Southwick & Charney, 2012; Bonanno et al., 2004).
 * Self-determination theory (SDT) stands as a prominent psychological framework elucidating the intrinsic and extrinsic factors driving human motivation and behaviour. Developed by Deci and Ryan, the theory posits that the fulfillment of three core psychological needs—autonomy, competence, and relatedness—is paramount for optimal functioning and well-being (Ryan & Deci, 2018). Autonomy pertains to the sense of volition and self-governance in one’s actions, competence encompasses the need to master tasks and learn, and relatedness refers to the desire for meaningful connections and belongingness. In the context of flourishing, particularly among seniors, SDT offers valuable insights into how supportive environments and interventions can be crafted to nurture these fundamental needs. By emphasising the integral role of internal motivation and the social context in psychological well-being, SDT provides a nuanced and comprehensive understanding of the pathways leading to enhanced flourishing and life satisfaction. This theory, therefore, serves as a pivotal guide in the quest to foster resilient, connected, and self-determined lives in the elderly population.
 * Well-being theory, conceptualised by Martin Seligman, represents a pivotal shift in psychological thought, extending the focus from the mere alleviation of distress to the active cultivation of optimal living. Seligman (2011) introduced the PERMA model, which encapsulates five integral components of well-being: positive emotion, engagement, positive relationships, meaning, and accomplishment. Positive emotion emphasises the value of fostering joy and contentment, while engagement stresses the importance of deep absorption in activities, invoking a state of flow. Positive relationships highlight the necessity of nurturing supportive and enriching connections. Meaning pertains to pursuing a purpose larger than oneself, and accomplishment encompasses striving for mastery and achievement. For the elderly, these dimensions provide a comprehensive blueprint for flourishing, guiding interventions and practices aimed at enhancing life quality and fulfilment. Well-being theory thus stands as a foundational pillar in positive psychology, offering a nuanced and holistic understanding of the factors that contribute to a life well-lived, irrespective of one’s age.

Psychological functioning and its role
Research conducted by Southwick and Charney (2012) underscores the integral role of psychological resilience in combatting depression—a condition prevalent among the elderly (16.1% of 65+-year-old Australians in 2020–21). Resilience does not merely denote bouncing back from adversity but signifies thriving amidst it. The elderly, with a lifetime of experiences, possess unique strengths and coping mechanisms. By harnessing these, and understanding neurobiological and psychosocial factors, there is an avenue for improved psychological functioning, ultimately contributing to enhanced flourishing.

The resilience connection
Several studies highlight that resilience is intricately linked to genetics, environment, neurobiology, and psychosocial factors (Helliwell & Sachs, 2013; Seligman, 2011; Southwick & Charney, 2012). For seniors, building resilience becomes a pivotal tool in managing age-related stressors and traumas. Embracing resilience does not mean avoiding challenges but rather developing a robust toolkit to face them head-on. With strategies encompassing positive emotions, social support, coping skills, and more, resilience offers a protective layer, allowing seniors to remain buoyant in the face of life's trials.

Proactive approaches and interventions
Promoting flourishing among the elderly necessitates actionable steps grounded in empirical evidence. Southwick and Charney (2012) advocate for interventions such as modifying the biological and psychosocial environment, strengthening social support networks, enhancing cognitive engagements, and boosting physical health through aerobic exercises. It is crucial to tailor these approaches to the distinct needs of seniors, taking into account their physiological, cognitive, and socio-emotional states. When informed by positive psychology, the amalgamation of these interventions paves the way for a life marked by heightened contentment, purpose, and joy in the latter years. Figure 3 illustrates how the integration of these supportive interventions correlates with increased levels of psychological flourishing among the elderly.



What can seniors do to flourish?
Psychological flourishing in seniors is essential for their well-being and quality of life. This section delves into practical, evidence-based strategies derived from positive psychology to foster flourishing among the elderly. It emphasises the importance of social engagement, mental stimulation, physical activity, and positive coping techniques. Tailored to individual needs, these approaches aim to enhance purpose, joy, and meaningful connections, addressing the unique challenges faced by seniors in their pursuit of a fulfilling life.

Social engagement and meaningful activities



 * Building social connections rejuvenates the spirit and enhances well-being.
 * Social relationships have been found to significantly influence mental and emotional well-being in the elderly. A strong social network can reduce feelings of loneliness and depression, thereby promoting psychological flourishing (Cacioppo et al., 2006).
 * Forming bonds across different age groups can be mutually beneficial and specifically aid the elderly in feeling more connected and less isolated (Bengtson, 2001).
 * Engaging in community activities or volunteering (see Figure 4) has been shown to provide a sense of purpose and improve mental health outcomes for seniors (Greenfield & Marks, 2004).



Mental stimulation

 * Continuous learning has been linked to cognitive vitality and emotional well-being (Park & Bischof, 2013).
 * Activities that require creativity, such as painting or music, not only stimulate the brain but also contribute to a greater sense of purpose and joy, enhancing the quality of life (Cohen et al., 2006).
 * Research indicates that lifelong learning and mental stimulation can help prevent cognitive decline and improve overall psychological well-being. Older adults who engage in mentally stimulating activities (see Figure 5) report higher levels of happiness and lower levels of depression (Hultsch et al., 1999).
 * More recent research underscores the notion that the ageing brain is capable of new neural connections when subjected to novel learning experiences, enhancing cognitive and emotional well-being (Park & Bischof, 2013).

Physical activity



 * Regular physical activity boosts mental health and protects against age-related ailments such as heart disease, osteoporosis, and sarcopenia (loss of muscle mass).
 * Several studies show that regular physical exercise can improve cognitive function, thereby supporting not only physical but also mental well-being (Colcombe & Kramer, 2003).
 * Group exercise activities like tai chi (see Figure 6) or water aerobics offer not only physical benefits but also social interaction, which can further contribute to psychological well-being (Liu & Latham, 2009).
 * Improved sleep through regular physical activity is correlated with better mood and mental health, providing another pathway to psychological flourishing (Reid et al., 2010).



Positive coping strategies

 * Develop resilience against challenges by adopting positive coping mechanisms such as meditation (see Figure 7), relaxation techniques, and engaging in spirituality.
 * Positive psychology interventions focus on strengths and virtues and have shown efficacy in improving well-being and reducing depressive symptoms in older adults (Seligman et al., 2005).
 * Incorporating gratitude into daily routines has been associated with positive emotional states, greater well-being, and better physical health in older adults (Emmons & McCullough, 2003).
 * Utilising humor is shown to not only uplift mood but also serve as an effective coping strategy for stress and life challenges. This is particularly relevant for elderly individuals who may face various forms of age-related adversity (Martin et al., 1993).

Can you relate ...

John, at 80, often sat in his armchair, lost in memories of youthful adventures. He believed his golden years had long passed, with each day echoing the sentiments of a vibrant past. Collecting his mail one day, a flyer for the local book club caught his attention, hinting at a promise of engaging discussions. Deciding to join, John discovered that the club was more than just about books; it was a community bridging generational gaps through shared stories.

A young woman from the group, impressed by John's vast life experiences, introduced him to a mentoring program hosted by the local APEX club. Through mentoring, John shared his life lessons, offering wisdom and guidance to the younger generation. This exchange rekindled his understanding of the value of his own journey. Far from feeling that his best years were behind him, the interactions brought about a renewed sense of purpose (see Figure 8). Through the book club and mentoring, John not only found a revived passion for literature but also tapped into a deeper zest for life, seeing his age not as a limitation but as a testament to a life rich with experiences.

Conclusion
Ageing, despite its inherent challenges, can still be a period rich in growth, connection, and profound meaning. By integrating the principles of positive psychology with tailored interventions, an environment conducive to psychological flourishing in the elderly can be cultivated. Foundational theories such as resilience theory, self-determination theory, and well-being theory offer a robust framework for understanding and nurturing the various facets of flourishing.

Translating these theories into practical strategies and interventions empowers seniors to gracefully navigate the complexities of ageing, maintaining resilience and a sustained sense of well-being. Supporting flourishing in the elderly necessitates a commitment to social engagement, enhancing emotional well-being; continuous mental stimulation, promoting cognitive vitality; regular physical activity, supporting both physical and mental health; and the adoption of positive coping strategies to foster resilience. These strategies not only enhance their quality of life but also contribute positively to the broader community, as the elderly impart their wisdom, experience, and emotional stability.

Furthermore, dispelling misconceptions surrounding ageing and psychological flourishing is paramount. Challenging societal stereotypes and adopting a holistic view of ageing is essential, acknowledging the potential for growth, development, and fulfilment in this life stage.

In conclusion, supporting psychological flourishing in the elderly is a multifaceted endeavour. It demands a collaborative effort from individuals, communities, and society at large, aiming to create environments that nurture the emotional, cognitive, and physical aspects of well-being. In doing so, the invaluable contributions of the elderly are honoured, fostering a culture of respect, appreciation, and comprehensive support, ensuring that the senior years are indeed filled with growth, connection, and a profound sense of purpose.