Living and ageing with long-term conditions
There is no internationally recognized definition of old age. Sixty years and above in developed countries is generally considered when older age commences but varies depending on employment and retirement policies. Older age in developing countries may begin at 50 years of age, for example in Africa, due to differing rates in morbidity, mortality and life expectancy and their impacts on health and ageing (WHO 2011). To promote health and well-being with increasing age, attention has focused on what constitutes successful and active ageing (Rowe & Kahn 1998, WHO 2011) and chronological age is not always accepted as an indicator of health status for individuals. As people are living longer, they are more likely to have one or more long-term chronic conditions (WHO 2005), and research has focused on the impact and burden on health services, care, individuals and families with emphasis on optimizing self-management and avoidance of unnecessary hospital admissions.
Living and ageing with existing long-term conditions is an important, novel and emerging area of research. The paper in this issue of JAN (pp. 181–190) by Roy and Giddings (2012) is a key example, building on earlier work (Giddings et al. 2007). They found that despite having a long-term condition, participants viewed ageing as a privilege and held positive views, although they felt their conditions accelerated ageing. They had already confronted issues associated with getting older and had developed strategies to make the most of every day and celebrate their age, which is indicative of positive and active ageing despite having a long-term condition. Of note were findings that health professionals’ practice assumes that symptoms and limited functions were due to age and not a consequence of long-term conditions. Such ageist attitudes remain to be challenged and more research on living and ageing with such conditions is needed to inform knowledge and practice. There is evidence of personal enrichment, enlightenment and growth as a consequence of age, even when living with a long-term condition, as evidenced by important contributions made to the arts and humanities in later life (O’Neill 2011).