AGEING AS FUTURE 2nd CONFERENCE, 26th to 28th of July 2022

The End of Life: New Directions in Theory, Research and Policy

Over the past century, death has transitioned from a sudden and unexpected event, perceived as beyond human control, to a protracted, anticipated, and partially controllable transition that follows a chronic illness diagnosis, usually in very old age. Historical changes in when, where, and from what causes people die have set the stage for the emergence of a new life course stage: the end of life. For most older adults, the end of life, or the prolonged period between the onset of major illness and death, encompasses experiences that include physical discomfort, difficulty breathing (dyspnea), reliance on life-extending but often intrusive technologies, waning mental acuity, and existential questions about one’s purpose and legacy. Family members must grapple with exhausting caregiving responsibilities, distress from watching a loved one suffer, and anxiety regarding medical decisions. In this presentation, I show how the end of life is a uniquely contemporary social construction, reflecting historical, technological, institutional, and cultural contexts. Yet the end of life differs from other established life course stages in that it lacks a definitive or agreed-upon starting point. I identify challenges and ambiguities in identifying when an individual enters the end of life, describe key components of well-being among dying patients and their families, and highlight racial and socioeconomic disparities therein. I show how two practices in the U.S., advance care planning (ACP) and hospice use, can enhance well-being at the end of life. I suggest new avenues for theory, research, and policy innovations.

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Narrative and Well-Being in Later Life: How eScience Technologies Contribute to Methodological Advances

It is a well-established research finding that older adults maintain their well-being despite a more negative balance between losses and gains in later life. Narratives are important developmental devices in this process as they support people in attributing meaning to their past, present, and future. They thereby contribute to their mental health and well-being. This is further corroborated by the increasing evidence that narrative interventions, like life review therapy, support the well-being and mental health of older adults who have difficulty in finding meaning in their lives. The field of e-science, i.e., the use of digital technologies in research, poses interesting possibilities to advance our insights in these processes. This will be demonstrated in two applications. First, the use of natural language processing will be discussed to analyze therapeutic change processes in life review therapy: which patterns of language use by clients and counselors are related to therapeutic adherence and success? Second, the use of affective computing will be discussed in detecting emotions in stories about personal memories: which (non)verbal, multimodal aspects of emotional expression are related to qualities of personal memories like valence and vividness? It is concluded that digital tools cannot be merely applied to data, but raise substantial theoretical questions about processes of storytelling and well-being in ageing persons.

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Views on Aging From a Daily Diary Perspective

Views on aging are important correlates of health and well-being, but our understanding of short-term variability and relevant contextual antecedents and consequences is in its infancy. I will begin by describing previous theoretical and empirical foundations that have guided recent daily diary studies in my lab. Studies in my lab examine daily fluctuations in subjective age and awareness of age-related change, two indicators of views on aging. Across two daily diary studies of older adults in the U.S. (Study 1: 8 consecutive days of 116 participants, M age = 64.71, range 60-90; Study 2: 14 consecutive days of 428 participants M age = 63.51, range 50-85), we have evidence that they do vary significantly from day-to-day. Additionally, we know that contextual factors such as daily stressors, control beliefs, health, and affect co-vary with daily fluctuations in subjective age. Daily fluctuations in awareness of age-related change are predicted by daily fluctuations in physical health, but individual differences matter as well. Older adults with lower control beliefs are more vulnerable to daily increases in appraised threats to future plans on days with stressors with respect to awareness of age-related change losses, compared to older adults with stronger control beliefs. Awareness of age-related change predicts fluctuations in control beliefs as well as cognitive interference and cognitive performance, highlighting the importance of future work pushing to translate daily variability in views on aging to optimal functioning.

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