Conclusions: Participants' multidimensional views of successful ageing were broader than Rowe and Kahn's model and included the need to have a degree of autonomy over the place and manner of the last phase of life and final days (successful dying).Key words: older women, spirituality, successful ageing.
IntroductionThe protean concept of 'successful ageing' emerged in the middle of the twentieth century [1] and more recently evolved with the work of Rowe and Kahn [2,3] to encompass a more socially engaged and higher functioning state of being than was previously considered to be the typical or 'usual' way of ageing. Historically, old age has often been viewed as a process of decline that concluded with disengagement from the world soon after an individual's working life had come to an end. Such views gave rise to ageist stereotypes that continue to be pervasive today and that impact negatively on the lives of older people [4]. It has also been argued that the combination of being old and female creates a situation of double jeopardy [5], such that women experience disadvantage from the combined effects of sexist and ageist stereotyping.Rowe and Kahn's model [2,3] is arguably the most widely recognised and accepted approach to understanding successful ageing [6,7]. This model is functionally orientated, incorporating three principles of successful ageing: (i) maintaining high levels of physical and mental functioning; (ii) an absence of risk for disease and disease-related disabilities; and (iii) being actively engaged with life through involvement with other people and/or paid or unpaid activities that are of economic benefit to the community. According to Rowe and Kahn [3], the loss of any one of these three factors means that the person moves out of successful ageing to 'usual' (at risk of ill health) or to various kinds of impaired ageing. In their view, the key to regaining a state of successful ageing centres on the concept of personal resilience. They argue that resilience can be enhanced when people make healthy lifestyle choices that promote a successful ageing process.Despite a number of positive elements, there have been recent criticisms of Rowe and Kahn's model. For example, Bowling [8] described their 'biomedicalisation' approach to the ageing process as too narrowly focussed and lacking input from older people. In addition, their model has been criticised because it has been seen as carrying an element of implied blame towards individuals who are not able meet the functionally based criteria for ageing successfully [7,9]. For example, there is no acknowledgement of the impact of socioeconomic status on diet, education and other life opportunities and hence state of health in later years. Holstein and Minkler [7] argue that this omission can act to marginalise and discriminate against social groups who are already socially disadvantaged (e.g. those who are old, poor, female or from non-mainstream ethnic groups). Indeed, Riley accused Rowe and Kahn's model of failing to incorporate developments to ad...