Professor Claire Donnellan

Professor of Nursing Research, Edith Cowan University, Perth, Western Australia
Adjunct Associate Professor, Trinity College Dublin, Ireland

Population ageing was one of the most distinctive demographic events of the 20th century and refers to the process by which older individuals become a proportionally larger share of the total population. Longevity figures globally not only show us that more individuals are surviving to old age but once there, they tend to live longer, meaning there are expected relative gains in life expectancy. We know life expectancy tells us about the status of population health because it captures mortality along the entire life course and the average age of death in a population. This dramatic rise in life expectancy has resulted in increasing interest in promoting healthier ageing and the study of how people actually age successfully. Despite it being proposed as a field of great interest in gerontological research and as a challenge for the design of health and social policy and practice, the concept of healthy ageing still needs to be incorporated into healthcare provision and for healthcare professionals to actively promote it as part of their practice.  

Healthy ageing as a concept is primarily concerned with increasing the quantity and quality of life of older adults. It also implies a focus on the maintenance of health, often through lifestyle choices and preventive measures. Havighurst wrote back in 1963 that it was essential for gerontology to have a theory of successful ageing. He defined this as a statement of the conditions of individual and social life under which the individual person gets a maximum of satisfaction and happiness, and society maintains an appropriate balance among satisfactions for the various groups which make it up—old, middle-aged, and young, men and women. [1]

Rowe and Kahn (1987, 1997) reintroduced the concept and defined successful ageing as multidimensional, encompassing the avoidance of disease and disability, the maintenance of high physical and cognitive function and sustained engagement in social and productive activities. [2, 3] In 2015, WHO’s World report on ageing and health outlined a policy framework for healthy ageing that centres on the notion of functional ability. [4] It refers to healthy ageing as a combination of the intrinsic capacity of the individual, relevant environmental characteristics and the interactions between the individual and these characteristics.

Because many older adults see themselves as active and healthy, (including older Australians aged 65 and older who indicated their health as good, very good or excellent in the 2017-18 National Health Survey [5]), it is important to focus on promoting and maintaining these healthy states in an ageing population. In our research work, we have devised a program of care called REsources And LIfe Strategy Management (REALISM) based on a theory of successful ageing [6-9] that aims to support older adults engage with healthy behaviours.  

Havighurst referred to ‘adding life to the years.’ WHO has reworded this phrase as ‘adding health to the years’ because promoting healthy ageing involves influencing and encouraging older adults to make better decisions related to diet, exercise and managing their overall health and wellbeing while also enjoying all life has to offer.

*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health and Aged Care.

Anna Lions

Communications Coordinator, Southern Cross Care (SA, NT & VIC) Inc

The Government-funded Short Term Restorative Care (STRC) programme helps older Australians to maintain their independence and keep living at home, but what happens when the eight-week program is over? Well, the answer right now, in many cases, is not enough.

A recent research grant funded by the Aged Care Research & Industry Innovation Australia (ARIIA) aims to help STRC participants continue to manage their health after the program ends. The grant is funding the development and trialling of a self-management workbook, My Health in My Hands, which participants will be guided through by Southern Cross Care allied health professionals.

The workbook includes evidence-based activities for setting health goals and learning about healthy activities, with a focus on the ongoing self-management of their health. Once the program has ended, participants can use the workbook for guidance on eating healthily, exercising, and looking after their wellbeing in a way that is both simple and the most beneficial to them.

The development of the workbook has included research into best practice methods, such as positive goal setting, and co-design with older people who have completed the STRC program. One co-design participant who is enthusiastic to see the workbook used is Peter Johnson. He completed the STRC program a few months ago and said he struggled without ongoing support and encouragement.

‘[The STRC program] gave me more confidence and encouragement as well as, and because of, my improved physical abilities,’ Mr Johnson said. ‘The team answered a lot of my questions during the program but I probably didn’t ask all the questions I needed to and at the end of the program I thought, “what happens now?”’ Mr Johnson said the workbook would have helped him to ‘design, plan and prepare’ for the gap between the end of the STRC program and the beginning of his home care services, in order to keep up his progress.

The workbook development is being overseen by healthy ageing expert Dr Tim Henwood, Group Manager Health & Wellness at Southern Cross Care (SA, NT & VIC) Inc. Dr Henwood is excited by the possibilities that this new workbook offers STRC program participants. ‘The workbook will offer all providers of short-term allied health and therapy programs a tool that clients can reference to learn and be more proactive about their own health,’ said Dr Henwood. ‘While we are trialling it in STRC, we hope it can play a key role in the forthcoming Government Support at Home reform by supporting older clients entering restorative pathways, to graduate from them with enhanced knowledge of how to best self-manage their health.’

The research partners are Justin Koegh, Associate Prof, Faculty of Health Sciences and Medicine at Bond University, and Dr Paul Swinton, Associate Prof at Robert Gordon University.

The first of the workbooks have now reached STRC participants. From here, the team will assess the impact of the workbook on participants’ health knowledge, wellbeing and allied health participation during and following their STRC program.

*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health and Aged Care.