Background and Objectives

Successful aging is a mainstay of the gerontological literature, but it is not without criticism, including the often-limited way that it is studied and measured as well as the exclusion of older adults’ voices in its formulation and understanding. This study sought to address these issues through a qualitative investigation across multiple countries.

Research Design and Methods

This was a mixed-methods, cross-sectional, exploratory study, using an online survey. Nations that received the survey included Australia, New Zealand, the United Kingdom, Ireland, Canada, and the Unites States. Participants aged 65 and older were asked to describe what successful aging means to them in an open-ended survey item. Summative content analysis was utilized to examine the responses.

Results

Successful aging was defined by 1,994 participants, and six themes along with 20 subthemes were found. In contrast to conception that successful aging is solely or predominantly related to the absence of disease and decline, the most prominent theme in this study was “active, independent, and engaged” as the hallmark of success.

Discussion and Implications

While health and health maintenance were present in other themes, these findings support a multidimensional definition of successful aging that promotes the perspectives of older people. Future research should seek to further investigate the ways in which person-in-environment factors influence definitions of successful aging, including culture, gender and gender identity, race and ethnicity, and socioeconomic background.

Background

Studies of goal setting in later life tend to focus on health-related goal setting, are pre-determined by the researcher (i.e., tick box), and/or are focused on a specific geographical area (i.e., one country). This study sought to understand broader, long-term goals from the perspective of older adults (65 + years) from Australia, New Zealand (NZ), United Kingdom (UK), Ireland, Canada, and the United States of America (USA).

Methods

Through a cross-sectional, online survey (N = 1,551), this exploratory study examined the qualitative goal content of older adults. Thematic analysis was used to analyze the qualitative data, and bivariate analyses were used to compare thematic differences between regions and by participants’ sex.

Results

Over 60% of the participants reported setting goals, and participants from the Australia-NZ and Canada-USA regions were more likely to set goals than the UK-Ireland region. The following six overarching themes were identified from the 946 goals reported: health and well-being; social connections and engagement; activities and experiences; finance and employment; home and lifestyle; and attitude to life.

Conclusions

This study supports previous research that demonstrates that older adults can and do set personal goals that are wide ranging. These findings support the need for health professionals to consider different methods for elucidating this important information from older adults that builds rapport and focuses on aspects viewed as more important by the older adult and therefore potentially produces improved health outcomes.

Pandemics, such as the outbreak of the novel coronavirus (Covid-19) in March 2020, have a negative impact on older persons’ (60 years and older) physical and mental health. Research on the effects of Covid-19 on older persons’ experience of loneliness and self-reported social support has predominately originated from the Global North. Applying the strengths perspective, the present study aimed to determine and compare the loneliness and social support among South African older persons during a pandemic. A cross-sectional survey was operationalised to collect data from community-dwelling older persons (n = 139) and older persons residing in residential care facilities (n = 99) through purposive sampling across five South African provinces. A loneliness scale was used to measure the respondents’ overall loneliness, including emotional and social loneliness. A social support scale was used to measure the availability of social support across four domains. The survey focused on social contact, number of close friends/relatives, socio-demographics, and subjective physical and mental health, respectively. Independent samples t-tests were run to explore any statistically significant differences between the two groups. Community-dwelling older persons were found to present with marginally higher levels of loneliness. No statistically significant differences were identified between the two groups. Community-dwelling older persons measured higher on social support than their peers in residential care. Two domains of social support, namely, affectionate support and positive social interaction, were found to be significantly different (p < 0.01). Based on the study’s results, implications for strengths-based gerontological social work services in resource-constrained settings during a pandemic were delineated.

A scoping review framework was used to explore and synthesize the existing international research surrounding social workers’ application of theory into practice. The results indicated: (a) social workers report employing pragmatic approaches; (b) although some social workers struggle to explicitly identify the theories and methods they utilize, implicit theoretical application is evident; (c) time is the greatest barrier to theoretical application; and (d) some social workers are concerned with individual functioning rather than social justice. There is a need to integrate theory into education and future research to explore the link between theory and practice implemented by social workers internationally.

COVID-19 had a significant impact on older South Africans’ experience of social support. This cross-sectional study explored possible risk and protective factors of social support among community-dwelling older adults (N = 118). Social support pre- to during COVID-19 decreased significantly; however, overall social support was greater for those who were older, had more face-to-face contact, and had a greater number of friends or relatives. From a socio-ecological perspective on resilience, greater opportunities for older adults to create connections, such as classes or community events, are recommended to facilitate desired social supports, which in turn supports greater health and well-being.

The literature on the biopsychosocial effects of COVID-19 on older persons has originated predominately from the Global North, with a dearth of studies focusing on the loneliness of older persons in the developing world, such as South Africa. This cross-sectional study explored the loneliness of South African older persons (N = 118) before and during COVID-19 to inform gerontological social work. The survey incorporated a standardised scale of loneliness and items to assess the type and quantity of contact with others, physical health, mental health and socio-demographic variables. Bivariate and multivariate analyses explored the factors that contributed to overall loneliness, emotional loneliness and social loneliness. Results indicated a statistically significant increase in social, emotional and overall loneliness from pre- to during COVID-19. Considered from a socio-ecological resilience perspective, gerontological social work services are recommended for alleviating loneliness amongst South African older persons during a pandemic, such as COVID-19.

This phenomenological study explores the reintegrating experiences of nine prison torture survivors in the community of Gondar, Ethiopia. Data were collected through in-depth interviews and then thematically analyzed, revealing three major themes: the nature of reintegration, personal challenges of integration, and available supports for reintegration. The findings revealed prison torture survivors’ successful integration was based on their community social bonds. Poorly reintegrated prison torture survivors gradually become violent and committed other crimes. Providing community-based psychosocial support and well-organized social services is necessary for the well-being and sustainable reintegration of prison torture survivors into the community.

Within social work education, the literature on affective learning processes is, for the most part, poorly conceptualized and minimally researched. Affective processes that engage students’ values, beliefs, and emotions are valuable resources supporting students’ development of self-reflection skills, stamina for discomfort, and curiosity for people who hold identities that differ from their own. Using a nationwide sample of syllabi in the United States, this study measures the extent to which the Krathwohl and colleagues' affective domains are incorporated into MSW diversity-related social justice syllabi. Content analysis of 48 syllabi was used to analyze affective domains at the levels of (A1) Receiving, (A2) Responding, (A3) Valuing, (A4) Organization, and (A5) Characterization. Findings provide a model for differentiating the levels of affective learning and how they can be operationalized throughout the syllabus within diversity-related social justice.

This study examined social workers’ perceived use of theories and methods in practice through a questionnaire completed by social workers in New York City (N=105) followed by individual interviews (N=20). Social workers received approximately one to six courses on theory in their education that moderately influenced their current practice. The most commonly used theories in practice included Cognitive Behavioral Therapy, Strengths Perspective, and Trauma-Informed Care. Social workers either applied theory to practice in an intentional and systematic way or indicated their “practice was not that intentional.” Social work education was reported to provide a breadth but not depth of knowledge on theory. Recommendations for social work education to strengthen the link between theory and practice are provided.

The stress that the COVID pandemic has caused is immeasurable and is likely to impact people for many years to come. Service providers such as social workers are experiencing these impacts both personally and professionally. As new research emerges, a greater understanding of the emotional toll related to COVID can help to inform social work practice. To add to this gap in the literature, an online survey explored the factors that contribute to higher stress reactions among individuals in the general population (n = 412) and across the age spectrum. Bivariate analyses indicated a significant increase in stress from pre- to during-COVID for the entire sample and across the three age groups. Multivariate analysis revealed more conversations about COVID, more alcohol use, knowing someone who had tested positive, increased fear, greater avoidance of reading/watching information about COVID, decreased health status, and increased income contributed to stress during-COVID. Increased fear and decreased health status were significant when stress was examined separately among the three age groups. The results indicated the importance of understanding and responding to fear during public health crises and illustrate how interventions may shift for clinical social workers as they seek to address multi-layered concerns. Social workers can help manage the impact of the pandemic by providing clients with therapeutic services, psychoeducation, and case management.

The concept and act of “aging” can often carry a negative connotation in many Western societies; however, research suggests collective perceptions may be shifting as people are living longer lives. This cross-sectional study using survey methodology sought to understand how older people (N = 477) perceive their age by analyzing the responses of closed- and open-ended questions through summative content analysis. The mean age of participants was 63 years, and the average age that they felt was approximately 10 years younger. The seven themes for why individuals did not feel old ranged from maintaining an active and engaged lifestyle to “I don’t act or look old,” and the seven themes for why individuals felt old ranged from stopped or changed activities to nearing death. The findings illuminate how subjective age is shaped by perceptions of what it means to be old, and the ways in which these micronarratives are reflective of larger macronarratives surrounding age and aging.

Loneliness has a significant impact on the health and wellbeing of people. The COVID-19 pandemic has demanded individuals to socially distance, which has implications for loneliness and social isolation. This cross-sectional study explored the ways in which people in the United States (N = 412) are meeting their social needs in a time of social distancing, how these activities relate to levels of loneliness, and any differences among young, middle-aged, and older adults. Results indicated higher levels of loneliness and social isolation for the entire sample and across the three age groups from pre- to during COVID-19 with younger adults experiencing higher levels of emotional loneliness during COVID-19. The extent to which the activities were related to loneliness was only found among the young adults and older adults where outdoor meet-ups, talking on the phone, and texting was associated with lower levels of loneliness among the young adults, and engaging in social media and talking on the phone was associated with lower levels of loneliness among the older adults. The findings support social work and public health recommendations for addressing loneliness during times of social distancing under the COVID-19 pandemic and future public health crises.

Theory serves as a source of guiding knowledge in informing assessment and interventions in social work practice. Thus, social workers should be cognisant and analytical in applying theory to practice, particularly as their work moves forward the social work aims of social change and social justice under the current social and political climate. This exploratory, qualitative study sought to explore the use of theories by social workers in the United States, the underlying purposes of the social workers’ choice of theory, and whether the social workers’ practice had a focus on social change and social justice. Data from interviews with twenty social workers were analysed using a summative content analysis and revealed social workers to predominately apply theories to practice that have a purpose to problem solve on an individual level. Only one social worker applied theory with a purpose of empowerment and social change, and two social workers applied theory with a purpose of social change. The findings were considered against the global definition of social work, which promotes social change and social justice as key aims of social work. Social work practice in this study is found to reflect individualism, neoliberalism, and capitalism and recommendations are considered to redefine social work practice to be more widely committed to social change and social justice.

Ageism and internalized ageism have been found to impact older adults’ physical and mental health. Understanding the factors that can contribute to negative attitudes toward aging, and internalized ageism can assist in developing strategies to combat ageism at the individual and societal levels. This cross-sectional study sought to add to the literature on ageism and internalized ageism by investigating the role of death anxiety and hope in different types of aging attitudes (psychosocial loss, physical changes, psychological growth) amongst a group of community-dwelling older adults (N = 477). The survey incorporated standardized scales for death anxiety, hope, and attitudes toward aging along with items to assess loneliness, social isolation, physical health, cognitive health, age, and gender. Bivariate and multivariate analyses explored the factors that contributed to psychosocial loss, physical changes, and psychological growth with a specific focus on the unique contribution of death anxiety and hope. Results indicated death anxiety was negatively associated to the psychosocial loss of aging subscale while the agency element of hope was positively associated to the psychosocial loss, physical changes, and psychological growth to aging subscales. The findings highlight the unique contribution of hope to attitudes toward aging and point to programs that tackle ageism and foster hope among older individuals.

Loneliness has a significant impact on the health and well-being of older people, including an increased risk of mortality. This cross-sectional study explored possible risk and protective factors that can help explain loneliness and emotional and social loneliness in a sample of community-dwelling older adults (N = 477). The survey incorporated a standardized scale of loneliness and items to assess type and quality of contact with others, community support, social isolation, physical health, cognitive health, and functional ability. Bivariate and multivariate analyses explored the factors that contributed to loneliness, emotional loneliness, and social loneliness. Results indicated overall quality of contact with others, use of phone contact, and social isolation was significant in all three regressions; other significant variables were different for each analysis. The findings support social work and public health recommendations for addressing loneliness, particularly within the current climate of “social distancing” under the COVID-19 pandemic.

Older adults’ experiences and perspectives have been missing in the quest to develop a unified definition of successful aging. Through an online survey using convenience sampling, respondents (N = 477) were asked to report how important 25 specific attributes of successful aging, originating from published literature that examined successful aging from the perspective of older adults, were to them as they age. Over 90% of respondents reported 11 attributes as important or very important to them as they age, which included “remaining free of chronic diseases” and “feeling good about myself.” A factor analysis (N = 462) resulted in four dimensions explaining 57.06% of the variance: Adaptation and Coping; Being Healthy; Self-Determination; and Social Relationships and Interactions. The findings revealed older adults’ definition of what is important to them as they age is multidimensional, with having access to affordable health care and remaining alert and mentally active as critical elements followed by elements of self-determination, coping, and physical and social health. Future research should replicate the study with diverse populations to continue to refine a definition of successful aging that could influence program development and intervention approaches in health and social services.

Successful aging is a prominent theory that describes the aging process and the expected activities and behaviors older adults should engage in or exhibit to age successfully. Although this theory is used to gauge the extent to which older adults are aging successfully, older adults’ experiences and perspectives of what successful aging means to them are missing from the theory. A five-step scoping review framework was used to explore and synthesize the existing research that investigated older adults’ perspectives on successful aging. Twelve main themes were found and ranged from the importance of social relationships and interactions to having a good death. Findings indicated older adults do not define successful aging as strictly as is found in the literature. Old age and the aging process from the views of older adults provide future directions for theory development and research.