Well-being in older age calls for collective cultural change

Our society has achieved increased longevity and is ageing more and more. The proportion of older people is constantly growing: global life expectancy rose by more than eight years between 1990 and 2020, to 72 years. It is estimated that the number of over-60s around the world will increase from 1.1 billion to 1.4 billion by 2030.

Initiatives for active ageing 

This major demographic change calls for plans, policies and a widespread culture that will give each and every one of us the opportunity to age well. This has been recommended by the United Nations, which has dedicated the 2021-2030 decade to healthy ageing, to ensure that older people hold an equitable position in society.  

In this vein, and as part of its ongoing commitment to research and promoting science, IBSA Foundation for scientific research is devoting itself to conducting and disseminating studies, recommendations and a culture to promote active ageing.  Recent examples of this journey are ‘Culture and Longevity’, a conference on the beneficial link between culture and longevity, which took place in Zurich in 2023, ‘New Frontiers in biological and environmental determinants of aging’, an event presented in Bellinzona in the same year, and ‘New Frontiers in cancer and healthy aging’, a forum held earlier this year in Naples.  

The challenge issued by WHO  

This issue is a public health priority, with social and economic impacts that call for cultural change. The World Health Organization (WHO) has been insisting on the need to promote active and healthy ageing since the turn of the millennium, stressing, incidentally, that this isn’t the same as living longer. It has issued a challenge to optimise ‘opportunities for health, participation and security in order to enhance quality of life as people age’ .  

In 2020, WHO clarified the concepts and methods for measuring healthy ageing with the Decade of healthy ageing: baseline report. Geneva: World Health Organization, 2020. These were then endorsed by all the United Nations member states, proposing the following definitions:  

• healthy ageing is the process of developing and maintaining the functional ability that enables well-being in older age;  

• functional ability means health-related attributes that enable people to be and to do what they value. These aspects include the intrinsic capacities of the individual, the relevant characteristics of their environment and how the person interacts with these characteristics;  

• intrinsic capacity means the sum total of an individual’s physical and mental capacities;   

• the environment comprises all the factors that form the context of an individual’s life. It includes places, assistive devices and products, the home, communities and the broader society. 

Considering these definitions, WHO published an update on the progress of the decade late last year. With the Progress report on the United Nations Decade of Healthy Ageing, 2021-2023. Geneva: World Health Organization, 2023, it recommended a few courses of action that are needed to promote healthy ageing in the population. These were summarised by Annalisa Cicerchia and Martina Caroleo in an article (in Italian only) published on the non-profit association Etica e Economia’s website.  

1. Action area 1 concerns the need to promote projects and measures aimed at changing how each of us thinks, feels and acts towards age and ageing, in particular by combating ageism, which is so entrenched that it even occurs among older people themselves. In Finland, for example, an Ombudsman for older people has been established for the first time, tasked with monitoring the effects of political decisions on older people, focusing in particular on preventing isolation and discrimination of older adults. 
2. Action area 2 is needed to ensure that communities take charge of and nurture the abilities of older people, for example by creating environments with appropriate physical and sensory accessibility. A prime example of this is the establishment in the Philippines of the National Commission of Senior Citizens, which, in partnership with the Department of Health and with support from the WHO Regional Office for the Western Pacific, has developed a specific 2023-2028 national plan of action for the creation of age-friendly environments.  
3. Action area 3 involves the need to deliver person-centred, integrated care and primary health services that cater to the requirements of older people, according to the integrated approach to caring for older people proposed by WHO. To implement this, health workers will need to be trained appropriately so that they become increasingly capable of integrating clinical practices with useful strategies to address stigmatisation and discrimination. 
4. The final action area concerns the need to provide long-term care for older people, who all too often rely on care by family members, who not everyone has by their side. The ultimate goal is to create long-term care centres where the older people themselves are involved in managing and providing services.

Older age: activities to combat social isolation 

Projects that encourage older people to participate in cultural and artistic activities are a valuable resource for leveraging their skills. They open up opportunities for expression, involvement and social relations, thus combating isolation, the number-one crippling factor. More and more studies, conferences and initiatives are shedding light on the possibilities of active involvement in artistic and creative activities for healthy ageing, first and foremost from a neurocognitive viewpoint, and secondly to promote an active way of perceiving and experiencing older age. Promoting cultural activities dedicated to older people in care and community settings is one of the recommendations of the CultureforHealth Report, the preparatory action for the policies of the European Commission’s Work Plan 2023-2026. The report states that these activities can cut health costs significantly, especially through social prescribing, which mobilises community resources, enabling a longer period of quality of life and giving relief to parents and caregivers.  

European Commission-backed research and action projects are in progress that tackle the causes and consequences of ageism, i.e. discrimination and violence towards older people, by mobilising communities through practical activities to build new narratives, thus paving the way for collective cultural change with regard to older people and ageing. 

‘Age Against The Machine’ (AATM) is an intergenerational project being developed as part of the CERV Network of Towns programme to create an international solidarity network of six towns that will publicly support the fight against ageism. Discriminatory practices existing against older citizens in various areas of social life will be explored, presented and reassessed through a combination of different participatory theatre techniques, zeroing in on older women in particular. The general objective is to increase awareness, knowledge and interest among citizens and European policymakers with regard to ageing and the equitable position of older people in society, through artistic theatrical expression and community theatre in particular.  

As Cicerchia and Caroleo suggest in their article, it is vital to create a network of the many existing and future initiatives, making them scalable and implementing them across increasingly extensive areas. 

By Catterina Seia (Presidente CCW – Cultural Welfare Centre) and Marta Reichlin (PhD, Cultural Welfare Center (CCW), Research Area)