Early this year, I spent a week visiting my mother in a supported living facility. I lived there, sleeping on a cot in her room and taking meals with her in the communal dining room. The staff have established a culture of respectful “just-enough” caring. They help when help is needed, and let people manage on their own when it isn’t. My mother can go out for afternoon walks by herself, so long as she remembers to take her walker.They also care about the residents emotionally. While I was there, a resident played the piano on Thursday afternoon for the pleasure of other residents, as was her habit. Then, she had a stroke on Friday and died on Saturday morning, aged 104. Friday afternoon, staff who could be spared gathered around her and sang hymns. They helped her die with the music she loved.
I spent a lot of time observing people in their 80’s, 90’s, and older. There is a great deal of difference in what people can still do. There is also a big difference in the way they respond emotionally to the kind of life they now live. Some struggle to find a reason to still be alive. Others see a benefit to having a time of life when little is expected of them and others care for their needs. That is, little is expected of them, except for the emotional role they still play in their families. I wasn’t the only offspring to come by during the week. Others came to take their parents out to the doctor or to church or to have a meal. In fact, two came to participate in the monthly floor meeting where their father was the featured resident of the month. They brought pictures of the family and newspaper articles about their father, and they told stories about his life.
What can positive psychology offer to people who live in such facilities as well as the people who care for them? What happens to our emotional lives as we age?
Positive Emotion and Health Differences as We Age
from Cornell University recently published a review article exploring research by a number of scientists on the connection between positive emotion and health as we age. Both trait positive emotion (a personal tendency to experience positive emotions frequently) and state positive emotion (transitory positive experiences that can be intentionally induced) make a difference. He found four pathways linking positive emotions to health in later life: Professor Anthony Ong
- Maintaining good health behaviors: Trait positive emotion is associated with a tendency to initiate and maintain good health behaviors, such as healthy diet, physical exercise, not smoking, and getting enough sleep.
- Having stronger physiological systems: Trait positive emotion may dampen the vulnerability to disease that comes with advancing age. He cites two empirical studies that show a connection between trait positive emotion and physiological markers including lower stress hormones, lower heart rate, and greater immune competence.
Reducing risk from stressors: There are many stressors associated with aging, including pain, inflammation, and disability. There is evidence that trait positive emotion is associated with slightly reduced risk of these stressors, making the risk of frailty, for example, slightly lower. The mechanism behind this pathway is as yet unknown.
- Reacting less and recovering more quickly from stress (Stress Undoing): State positive emotion may reduce or even undo the effects of acute stress. It can make people less reactive to particular stressors, and it can help them recover more quickly from the arousal they experience. This one is particularly interesting to me because other people can induce state positive emotions. I can’t change my mother’s overall tendency to experience positive emotion, but I can certainly look for ways to induce positive states.
How can we use this information? Perhaps it helps us understand why some people maintain greater physical well-being, even in the face of the inevitable losses of old age. Perhaps we can all benefit by building habits that yield positive emotions, such as frequently performing acts of kindness for others or expressing gratitude.
Understanding the value of state positive emotion in the face of acute stress may suggest things that family and staff can do to help older people deal with stressful situations. Sometimes people need to be reminded that it’s ok to feel positive emotions in times of loss. It’s also helpful to know the particular triggers of positive emotion for particular people. For my mother, flowers, visits, a room with a view, and an occasional mocha after a walk outdoors create positive emotional states. For others, perhaps funny movies are helpful, or music, as Elaine O’Brien recently suggested.
Emotional ComplexityOne quality that appears to increase as we get older is emotional complexity. That means both the ability to experience positive and negative emotions at the same time and awareness of what we are experiencing. Sometimes the word poignancy is associated with complexity — a sharpness and intensity, an awareness of feelings that may not seem like they fit together, like eating sweet and sour at the same time.
In work that they published in 2004, Anthony Ong and Cindy Bergeman explored the emotional experiences of 40 adults from 60 to 85 years old. They asked them to keep diaries of their emotional experiences for 30 days, identifying experienced emotions and their intensities. They found that the people who are most vulnerable to stress tended to be unidimensional in their experience of emotions, that is, they experienced emotions on a single continuum from good to bad.
They also looked at individuals who test high for resilience, and found that they can have positive emotions and negative emotions at the same time, even while experiencing personally significant stress. They were also better able to differentiate their emotions. This reminded me of Todd Kashdan’s observations that young people who are better able to differentiate their emotions are less likely to abuse alcohol.
When people are in their 80’s and 90’s, something stressful is often happening, for example, a change for the worse in health, a new source of pain, a new loss of capability. When people can feel positive emotions at the same time that they feel negative emotions, they are less vulnerable to the effects of stress.
“What gives you joy?”When my mother entered the place where she lives, one of the questions they asked her was, “What gives you joy?” It’s a great question, but my mother found it rather hard to go beyond the expected answers, “Family…” Joy is such a big emotion.
What seems more relevant, day to day, are the little things that evoke small pleasures — having waffles with syrup on Monday mornings, the aide that helps a resident dress in a colorful shirt and put on earrings so that she feels pretty, bringing coffee refills with just the right amount of cream, serving meals on hot plates (my mother always checks, and she gets a pleasurable buzz when they remember her preference), seating wheelchair residents at their preferred places at the table, remembering who likes to get the floor newspaper to fill out the crossword, adjusting exercises so that people can do them safely seated in their wheelchairs, having art on the walls and flower arrangements in the corners. I especially remember Elizabeth who made people laugh by doing little dances as she delivered food — and then she laughed along with them.
If we’re lucky enough to live long enough, we’ll all get old some day. Collecting self-knowledge about what gives us little daily pleasures is one way to store up psychological capital for future needs.
Kashdan, T. B., Ferssizidis, P., Collins, R. L., & Muraven, M. (2010). Emotion differentiation as resilience against excessive alcohol use: An ecological momentary assessment in underage social drinkers. Psychological Science, 21, 1341-1347.
Ong, A. N. (2010). Pathways Linking Positive Emotion and Health in Later Life. Current Directions in Psychological Science, 19(6), 358-362.
Ong, A. N., Bergeman, C. S., Bisconti, T. L. & Wallace, K. A. (2006). Psychological resilience, positive emotions, and successful adaptation to stress in later life. Journal of Personality and Social Psychology, 91 (4), 730–749
Ong, A. N. & Bergeman, C. S. (2004). The Complexity of Emotions in Later Life. Journal of Gerontology, 59B (3), 117–122.