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.
This is beautiful, Kathryn–Lovely writing and sensitive observations of the residents and the caregivers in the facility.
I don’t remember who did the research in nursing homes but another way to build PE is to have choices (when to get up, what to eat, what to wear, etc) and something to care for (a plant, for example).
Thanks for sharing this-
Thank you for the flower, Sherri. I remember that research as well. I’ll have to look for it and add it here.
Kathryn – I remember seeing research that suggested that lower energy positive emotions were more predictive of life satisfaction as we age ie contentment Similarly acceptance was also more predictive of aging well.
I think you are agreeing with me, that perhaps awareness of what brings contentment might be more helpful than awareness of what brings joy. Is that a fair reading of your comment? Do you remember where you saw the research?
kathryn, here are some articles
Hope these help
Can you publish something reliable about suitable indoor exercises and stretches for the elderly, please? Notes on duration and reps would be helpful too.
What a beautiful, heartfelt, and timely article, Kathryn! Thank you! In working with older adults (teaching group Dance/Fitness to people ranging from about 59-101 years) as part of my practice for the past 17 years, I believe your observations, research and questions are timely and spot on.
There is indeed a HUGE variation in the ranges of abilities of older adults I see. I notice a profound difference in older adults who engage in the available group fitness activities – aerobics dance-ex, strength training, yoga, t’ai chi, line dancing – at the Neptune Senior Center, versus those that come to the center for coffee and cake. I was shocked when I recently learned that one of my students is soon going to be 80; she dances, takes my yoga classes, and seems sort of ageless. She is a very attractive, youthful woman. I don’t consider her elderly at all. Might we need a better operational definition for active older adults?
T raises a very good question above, requesting “reliable and suitable indoor exercises and stretches for the elderly.” Before prescribing exercise, I think we need to know a little more. Here are some questions: Is there medical clearance? (although there is more risk in NOT exercising than in exercising safely); Are there any contraindications for which we need to be aware?; What are the exercise goals?; What activities might be most enjoyable so that the exercise can be maintained as a healthy habit?
Generally, in my practice with older adults, I offer a cardiovascular component (60-80%/maximum heart rate) for a duration ranging from 12 -35 minutes based on the fitness levels, a rhythmic strength training component, using very light weights to increase muscular strength and endurance, helping reduce the risk of osteopenia and osteoporosis (also building more cardiovascular power), a balance component, flexibility training and a mindfulness component. We build progression from there, My goal is to have my students leaving class feeling exhilarated, not exhausted. This clearly, along with promoting a positive social experience, helps build more positive emotion and exercise adherence. I would be happy to help address T’s question, if I can find out a little more.
Finally, lively, enjoyable music (and this is quite subjective to the individual or group) helps promote positive movement, positive emotion and complexity .
T and K, Here’s a slightly shorter answer to your question about indoor exercises for Elderly people. These are good for Beginner Exercisers and most anyone:
I like these 7 exercises to start because they help raise positive emotion and encourage well being. Most can be done seated or standing. Build to every day. Keep it safe, with good form, posture, proper execution of movement, feeling good.
1. Gently pound your chest and call like Tarzan. Breathe. Do it daily.
2. Give yourself a Hug. 8-10 times a day is recommended. Great stretch. Work it.
3. Belly laugh 8-10 times a day for optimal well-being. Smiling trains your orbicularis oris and lifts your mood. Also: The Duchenne smile: Emotional expression and brain physiology: II. Ekman, Paul; Davidson, Richard J.; Friesen, Wallace V. Journal of Personality and Social Psychology, Vol 58(2), Feb 1990, 342-353. doi: 10.1037/0022-35220.127.116.112
4. Shake out your arms and legs. Shake them out from the shoulders- gently high and low, right and left, front and back – 3 – 5 times a day for 4-20 reps.
5. Reach up overhead. “Reach for your best.” Climb up to the sky, stretch Right & Left aim for 3-5 sets a day, with 4-20 reps.
6. Tap your toes. This improves balance because it strengthens the shin area muscle (tibialus anterior), and stretches the calves (gastrocnemius).
Tapping toes also reduces stress. Do it for fun, mindfully. It passes the time if you are waiting,improves balance. Tap as much as you can. Toes up and down with good quality moves, building to 10 or more times a day 2 times every day.
7. Rhythmic Exercise to Music is a fun key to fitness, when the goal is boosting health and raising our mindful awareness, understanding of our body in space.
Practice your favorite dance moves. Learn new ones you might enjoy, seated or standing.
Enjoy, thanks for your consideration, and hope this is a good start!
T, Try Tai Chi