Exploring the Perceptions of the Ageing Experience in Singaporean Older Adults: a Qualitative Study.

Understanding older adults perceptions of health and adaptation processes to ageing can allow for more culturally aligned services and better targeted care. The aim of this exploratory qualitative study was to examine older adults perceptions of physical, psychological and social health and further understand the processes of adaptation and self-management of these health perceptions. Semi-structured in depth interviews (IDI) were conducted with ethnically diverse older adults in Singapore, aged 60 and above. Participants were asked open ended questions about their physical health, psychological health and their current social health and relationships. They were also asked methods of adaptation to these age related changes. In total, forty participants were interviewed. A thematic analysis identified five main themes when exploring perceptions of physical, psychological and social health. These included; 1) Slowing down 2) Relationship harmony 3) Financial harmony 4) Social connectedness and 5) Eating together. Adaptation and self-management of these health perceptions included six additional themes; 1) Keep moving 2) Keep learning; where continued self-determination and resilience was a key method in adapting to negative thoughts about declining physical health 3) Adopting avoidant coping behaviours 4) 'It feels good to do good'; where finding meaning in life was to help others 5) 'Power of Prayer'; which highlighted how older adults relegated responsibilities to a higher spiritual power 6) Social participation; which included engaging in community and religious social activities that all contributed to self-management of older adults psychological health and social health. In conclusion, our study highlighted specific cultural nuances in older adults perceptions of health, particularly psychological and social health. These findings can help develop more targeted intervention programmes and better methods of measuring older adults health, which can assist with the global ageing phenomena.

Mental health and resilience at older ages: bouncing back after adversity in the British Household Panel Survey.

BACKGROUND: Resilience is having good outcomes despite adversity and risk and could be described in terms of preserving the same level of the outcome or rebounding back to that level after an initial set back. Using the latter definition, resilience as "bouncing back", this paper aims (1) to identify those members of a panel survey who demonstrated resilience, and (2) to identify the characteristics of the resilient individuals and the predictors of their resilience. METHODS: The study subjects were the 3581 participants in the British Household Panel Survey, selected from waves 1-14, who satisfied three requirements: exposure to an adversity; availability of consecutive General Health Questionnaire (GHQ)-12 scores; aged 50 or more years. The primary outcome variable was resilience, operationalised as a GHQ-12 score that increased after exposure to adversity and returned to its pre-exposure level in the next (after 1 year) wave of the survey. The adversities were: functional limitation; bereavement or marital separation; poverty. RESULTS: The prevalence of resilience, as defined, was 14.5%. After adjusting for regression to the mean, the GHQ-12 score of the resilient dropped by a mean of 3.6 points in the post-adversity period. Women predominated among the resilient, with this gender difference stronger among older women than younger women. The resilient were more likely to have high social support than the non-resilient, but otherwise were not different socioeconomically. High social support pre-adversity and during adversity increased the likelihood of resilience by 40-60% compared with those with low social support. CONCLUSIONS: Resilience is relatively rare and favours older women. It is fostered by high levels of social support existing before exposure to adversity.