Understanding the meaning of past, present and future in advanced age : very old persons’ experiences of ageing

The overall aim of the thesis was to understand elderly people's lived experiences of ageing and their life situation in very old age. The participating persons have been involved in and followed through all studies in the thesis. In study I some characteristics of quality of life in old age were illustrated by means of empirical data and Allardt's definition of the concept. To the elderly people investigated, quality of life meant contentment and a peaceful life, independence and health as a resource for this, personal integrity in terms of moral quality and a caring attitude. A phenomenological hermeneutic approach was utilised in the subsequent studies. In study II 30 of the participants were followed up and interviewed in depth about their lived experiences related to quality of life in old age. Different patterns of life in old age appeared depending on the meaning that the participants ascribed to their experiences of quality of life: successful ageing, good old age, a comparatively good life in old age, bad ageing and a miserable life in old age.

Data for studies III-V was collected in the form of thematic life story interviews with 15 participants. Study III illuminated eight participants' experiences of feeling old in advanced age. The understanding was that the very old persons who also felt old were in a phase of transition. The distinguishing qualities of those that felt old were also found to be in line with the dystonic dominance in the ninth stage designated by Joan Erikson and added to the previously described life cycle. Study IV aimed at identifying and revealing the meaning of central themes in very old people's life stories. The results showed that the interviewees by means of the central life themes communicated personal and functional meanings that were understood as influencing very old persons' experience of their everyday life in a positive way. Study V highlighted the very old persons' view of their future from the perspective of philosophy of life. The participants were found to view their future in ways that ranged from a tangible positive approach via a wait-and-see policy to a negative approach. Positive approaches were related to hope and feelings of purpose and meaning.

The comprehensive understanding of the thesis was that the challenge in very old age will be to live a life as good as possible notwithstanding changes in health and in environment. In the process of ageing positive tendencies in balancing the developmental crises as described by EH Erikson will contribute to positive experiences of life.

List of scientific papers

I. Nilsson M, Ekman SL, Ericsson K, Winblad B (1996). "Some characteristics of the quality of life in old age illustrated by means of Allardt´s concept" Scand J Caring Sci 10(2): 116-121
https://pubmed.ncbi.nlm.nih.gov/96361213

II. Nilsson M, Ekman SL, Sarvimäki A (1998). "Ageing with joy or resigning to old age: older people´s experiences of their quality of life" Health care in later life 3(2): 94-110

III. Nilsson M, Sarvimäki A, Ekman SL (2000). "Feeling old: being in a phase of transition in later life" Nurs Inq 7(1): 41-49
https://pubmed.ncbi.nlm.nih.gov/20477150

IV. Nilsson M, Sarvimäki A, Ekman SL (2000). "Central life themes and their meaning in very old people´s life stories" (Submitted)

V. Nilsson M, Sarvimäki A, Ekman SL (2000). "Looking forward in very old age" (Submitted)