Uncertainty and successful ageing: the perspective from Malaysian middle-aged adults using constructivist grounded theory
Background: Studying the perspectives of middle-aged adults in relation to successful ageing is essential because of significant concern about the growing size of the ‘young old’ population in Malaysia. Growing evidence has highlighted the need to review middle-aged adults’ preparedness for later life, yet research has only been focused on the biographical experiences of ageing selves in older age. Early models of successful ageing (SA) were developed five decades ago and concentrated strongly on diseases and disabilities. Subsequent developments included the importance of psychological, functional, environmental and spiritual elements. However, little attention has been paid to the lay perspective of ageing successfully among middle-aged adults and Eastern populations. Aim and Objectives: This study explores the concept of ‘ageing successfully’ from the perspective of people in middle age, in order to understand the richness and complexity of people’s ‘ageing self’ and how these shapes their understanding of successful ageing in later life. Specifically, this study aims to gain an understanding of the attitudes, normative beliefs and subjective norms that influence one’s intention with regard to successful ageing in the future, and the implications of this for intended behavioural change. This study also focused on the priorities and supports needed to cope with uncertainty that impacts on the ageing experience among the participants. Method: A qualitative study using Constructivist Grounded Theory (CGT) methodology. The data were collected through in-depth interviews with 16 middle-aged adults between 40 and 60 years of age living in Malaysia. These participants met the inclusion criteria of the study and were able to articulate their views about ageing. Heterogeneity of the interviews was maintained in terms of the participants’ gender and marital and health status. The data analysis identified core categories and built a theoretical perspective of ageing successfully that is related to Malaysian adults – leading to the development of the Conceptual Model of Successful Ageing and Uncertainty. The analysis method was consistent with the CGT approach. Results: Uncertainty posed by ‘disruptive events’ in middle age is the key interrupter to achieving successful ageing. Such disruptive events were identified through the primary experiences and incidents encountered by the participants themselves, and also indirectly through the secondary awareness gained through the experiences of other people. The sources of disruptive events are encountered around biomedical factors, personal factors and pressures from socio-economic expectations. The dimensions of uncertainty were influenced by the nature of the disruptive events (e.g. The severity of the impacts, unfulfilled normative expectations and etc.), the knowledge and resources available, assessment by the individual and the input of time. These factors played a significant role in decreasing or increasing the level of uncertainty. The research participants tended to construct their ‘ageing selves’ in the face of adversity, and the coping strategies of ‘being resilient’, ‘building interdependence’, ‘creating balance’ and ‘modifying lifestyles and behaviours’ were developed instinctively to ensure their well-being in older age. Conclusion: The lay views of Malaysian middle-aged adults with regard to ageing successfully are multidimensional and include attainment of certainty in terms of physical and psychological health, spiritual fulfilment, family relationship, independence, financial freedom and having a meaningful life. Resilience through familial and religious understanding is demonstrated to be a key influence on individual behaviour in the face of adversity. There is a need for studies to be conducted in these areas in the future to ensure that middle-aged adults, irrespective of their health status, are exposed to an encouraging environment and are prepared for later life.