Attitudes of the middle-aged towards ageing in Estonia

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Virve-Ines Laidmäe MA
Researcher of the Institute of Social Work, Tallinn University, Tallinn

Address:

Taimi Tulva PhD
Professor of Social Work, Institute of Social Work Tallinn University, Tallinn

Address:

Milvi Sepp MA
Social official of Rõuge rural municipality

Address:

Citation: V. Laidmäe, T. Tulva & M. Sepp : Attitudes of the middle-aged towards ageing in Estonia. The Internet Journal of Geriatrics and Gerontology. 2009 Volume 5 Number 1

Keywords: successful ageing | the middle-aged | attitude towards elderly | preparation for ageing | health assessments | gender aspect

Abstract

Objective: The goal of the current article is to elucidate and characterize the attitudes of the middle-aged towards aging.Methods: The data of the article is based on questionnaire survey of 210 middle-aged persons from one of the Estonian rural municipalities.Results: The attitudes of the middle-aged towards ageing and the condition of elderly in society are mostly positive, although not very strongly. At the same time the opinions of women towards ageing are somewhat more positive than the opinions of men. Contradictory attitudes towards life were visible – On one hand elderly are active members of society and can influence society – and on other hand elderly are a burden for society, old age causes poverty and exclusion. The middle-aged know in principle that it is important to prepare oneself for ageing, but this knowledge is not always used in their lives. Conclusion: In order to age successfully and cope in an old age, it requires re-evaluation of the present attitudes and the way of thinking. Important result that indicates work not done is that the respondents do not trust the state, the local government, as helper.

Introduction

The approach to ageing is especially important from the standpoint of the position of elderly as conceptions of ageing influence the meaning given to old people, how ideal ageing is depicted, in which cases it is possible to take into account the opinions voiced by elderly and which are their rights and duties (1, 2, 3). The overall approach to ageing influences the understanding of ageing at the level of state and local government (4). It is necessary to pay more and more attention to elderly people and social and health-care services offered to them, so that they could cope as long as possible in safe home environment.

Ageing concerns the middle-aged more than other age groups as they see their future in old people. Relationship to ageing chances with person’s own ageing (5). The middle-aged could change together with the elderly the attitudes and opinions about ageing in society more positive. The middle-aged could get interested in ageing also due to the question: whether the system of social services for elderly and the quality of specific services is by the time they reach old age at the level that would satisfy their expectations and needs. Since developing and implementing different services takes time it is important to know in addition to the opinions of the elderly also what the middle-aged think, in order to plan these services.

The theoretical premises of research were based on two conceptions – successful ageing of postmodern society and life-span approach.

Successful ageing. Ageing is a life-long process that contains biological, psychological and social changes, whereas the processes of ageing concern children, youth and middle-aged (6). The approach to ageing dominating in modern industrial society has been complemented by a new type of approach to ageing of postmodern society (1, 2, 7, 8, 9). Finnish social scientists have characterised successful ageing as follows: central is the psycho-social and socio-cultural ageing model; old age is viewed in the context of social integration and activeness; ageing is a unique phase of life with its developmental tasks and crises; old age is separated from retirement; old people are a heterogeneous group; old people are viewed as a resource in society and they can influence the society; ageing is influenced by the generation the person belongs to as different generations have different needs and wishes (10). Socio-cultural approach views ageing as positive historic, cultural and social phenomenon (4). It is important which the society is where a person ages and how younger generations (incl also the middle-aged) relate to ageing members of society. In the framework of new, successful ageing policy, the questions of how to satisfy the needs and wishes of the growing number of elderly had to be re-evaluated (11). The new conception of ageing views old people as a resource and emphasises their independence and individuality (ibid.).

Life-span. The current study is based on the division of life-span into phases according to Levinson (12): middle-aged people are 40/45 years up to 60/65 years and elderly since 60/65 years until death. In 2008 there were 166 642 middle-aged men and 194 652 women aged 40-60 years in Estonia, this is about 27% of the population. The ratio of men and women in this age cohort is equal to the Estonian average (ca 46% of men and 54% of women) (13).

Social scientists who have studied the life-span have found that the life-span of human being is influenced by the quality of human relationships throughout the life (14). Developmental change is taking place throughout the life-span, concerning psychological, social and physiological areas. Therefore, in order to understand one person’s life, it is necessary to analyse the comprehensive context of his/ her past and present situation (ibid.). In the life-span of human being several crises can be brought out, most attention has been paid to the transfer to middle age or mid-life crises. The main developmental purpose of this crisis is to cope with successes and failures associated with dreams; it is necessary to cope with the fact whether one has achieved one’s goals or not (15). During middle-age life becomes more controllable as many important decisions of previous years (having children, starting a family, finding a job) have been made. Children have become more independent and relay less on their parents. People have also more financial possibilities in these years. During these years many every-day activities stop being compulsory (e.g. looking after children) and become more loose (16). With retirement one of the most important tasks of human’s life – going to work – can end and free-time activities can change. Presuming good health and reasonable financial income, retirement can bring even more flexibility and freedom when compared to middle-age (ibid.). It has been stated that in today’s ageing process an elderly person lives longer, more healthily and financially better off. Sigelman & Shaffer (17) contradict the negative stereotypes of retiring persons as „useless, old, boring, annoying, sick, and unsatisfied with life”. The authors list among reasons why people are satisfied with life in an old age the disappearance or decrease of previous stressors. Older person is now more devoted to domestic life, lives more healthily, whereas new activities compensate for losses when aging. Old age is not viewed in terms of shortcomings, but emphasis is on achieving new quality of life. This all helps to understand why many old people are enthusiastic about their lives and their satisfaction with life is as high as in case of young adults (17, 18).

When growing old people become more dependent on their social network, they use in every-day life more behavioural patterns that have developed throughout their lives and show less interest for changes and new trials. This confirms that conservative values (traditions, comfort, and safety) become more important in time and openness to changes decreases (19). The life-span used to be earlier more clearly divided according to age and life-years: childhood, youth, working age and pension age. Nowadays these phases are not so distinct from each other. A person in pension age, who has reached the so called third phase of life, can work at the same time, as adult learner he can be simultaneously employee and student and he can also be carer for relatives and for grand-children. Many things and roles interact simultaneously, in an integrated and smooth way (5). The emphasis is on the need to learn in middle-age and later life (20) and also on the fact that elderly who follow active life-style and use learning opportunities offered to them have much higher self-confidence and self-evaluation, higher motivation for knowledge and learning, stronger life-force and better health than more passive people of the same age (21).

In most studies focusing on ageing the object of research is the satisfaction of life of the elderly. The novelty of the current study lies in the fact that ageing was studied on the basis of subjective opinions and evaluations of the middle-aged.

The research objective was:

• Analyse the attitudes of the middle-aged in relation to main indicators of the conception of successful ageing;
• Characterise the attitudes of the middle-aged towards elderly parents and taking care of them;
• Study to what extent have the middle-aged made preparations for adjusting to ageing.

Study material and research methods

Research process

The survey of the middle-aged was carried out by Milvi Sepp who has a master’s degree from the Tallinn University, Institute of Social Work, in spring 2008 in Puhja rural municipality, which is an average municipality in Estonia in terms of its size and number of residents (2413 persons 01.01.2008).

Gathering data

Questionnaire survey was used in order to gather research data. In Puhja rural municipality there are 326 men and 336 women between ages 40-60. Since the objective was to retain the ratio of men and women as it actually was among the residents of the municipality, then the sample was formed in case of men and women according to age-defined list, by including in the sample every third person, starting counting from the third person on the list. The sample included 112 women and 108 men. The questionnaires (220) were given personally by the researcher to the respondent, giving at the same time an overview of the research objective, clarifying requirements for fulfilling the questionnaire and answering questions. The respondents fulfilled the questionnaires at a time suitable for them and brought them to a previously specified place (municipality government, libraries, local shop). The number of returned questionnaires was 210: from 107 women and 103 men. The participation in the research was voluntary; the respondents were informed about the confidentiality of their personal data and of using the research results only for scientific purposes.

Two hypotheses were raised for the research.

• First hypothesis – the attitudes of the middle-aged towards ageing and old age are mostly negative and have not been replaced by the conception of successful ageing – is negation of Marin’s (2) statement that “old age is being re-evaluated as part of the life-span: it is no longer seen as a hopeless phase of life, but instead negative attitude towards ageing and old age has been replaced by the conception of successful ageing”.
• Second hypothesis – the middle-aged know that preparation for ageing should start early, but some of them have made no conscious efforts for that – is based on Taimi Tulva’s idea that “it is reasonable that preparations for ageing start already in early age, but this way of thinking is not yet wide-spread in Estonia” (22).

Schema of analysis and choice of indicators

Figure 1. Schema of analysis: attitudes of the middle-aged and preparations for ageing

The attitudes and every-day life of the middle-aged depend in large extent on the gender aspect. Therefore the entire research data is analysed in terms of men and women, trying to emphasise the gender differences of ageing. The data has been coded: woman – 1; man – 2.

Middle-age can bring with it special condition for the person, which has been called the sandwich generation phenomenon, i.e. where people have been pressed between requirements coming from two generations. On one hand, children need support and help and, on the other hand, elderly parents (23, 24). In the current research we concentrate on one direction of this triple relationship – the attitudes of the middle-aged towards their elderly parents, characterised by agreement with the following statements: adult child is duty-bound to support his parent who is unable to work; elderly people cope with their lives independently in their homes, and what action is taken when it is necessary to nurse an elderly person.

The health and mental state of the middle-aged is evaluated using the following indicators: 1. Evaluation of one’s health condition (from very good to very bad); 2. Evaluation of one’s state of mind (from very happy to unhappy); 3. Evaluation of deterioration of health when ageing (yes, no, don’t know); 4. First emotions when thinking about own ageing (fear, emptiness, sadness, indifference, etc (no, yes)) and death (angst, sadness or fear (no, yes)).

The problem of the middle-aged is the nearing old age. What the future will be like, depends on one hand on attitudes in middle-age, on the other hand to what degree a person is prepared for old age. And thirdly – whom to rely on in an old age.

These three aspects are analysed in our work using for this different opinions and evaluations, with which the respondents agreed or not.

Sentiments and opinions about ageing: questionnaire contains 8 statements that characterise successful ageing (old age is normal and natural state in a person’s life; old people are ill and infirm; elderly person is active member of society; old age causes poverty and exclusion; old age begins with retirement; elderly people have the same needs; elderly can influence society; elderly are a burden for younger because of the need to take care of them). Preparation for ageing: economic preparation (making a life insurance contract or testament; gathering monetary savings; joining pension insurance), health conscious preparation (giving up alcohol or smoking; going to medical check-ups, going on a diet to normalise body weight; practising sports; staying outdoors for a long time), constructional preparation. Whom the middle-aged would rely on in an old age, whom would they turn to: (children; spouse; sisters/brothers; other relatives; friends/relatives; care-giving institution, state).

When developing the system of successful ageing we relied on the ideas of Koskinen, Aalto, Hakonen, Päivarinta (10). In order to assess the strength of statements the Likert scale was used. Every statement was accompanied by a 5-point scale that began with “agree very much”, progressed with “don’t know” and ended with “do not agree at all” at the other end of the scale. Likert scale was used for the reason as it can give information about both the strength and content of the statement. Questions that characterised preparation for ageing and whom to rely on in an old age were accompanied mainly by no- don’t know - yes answers.

The quantitative data was analysed by using comparative frequency distribution (the answers of men and women were compared). In order to find differences between the two parts of the sample, the opinions of men and women, the Pearson correlation coefficient was used. In order to study different types of opinions towards ageing, correlation analysis was used. In order to see to what extent different evaluations or situations can influence the chance in mental balance (i.e. if one feels happy or not), ANOVA analysis was used.

Results

The description of the sample. 107 women and 103 men aged 40-60 years participated in the study. The average age of men was 49.8 and for women 50.8 years. More than three-quarters (76%) of middle-aged people were married or lived in cohabitation. One-third were single people, widow(er)s and divorced people, whereas there were more single men and widowed and divorced women. Most participants were Estonian (85%), the rest were Russian or from another nationality.

Opinions about successful ageing

There were 8 statements about the conception of successful ageing in the questionnaire: three positive and five negative. The evaluations of men and women about these eight statements about successful ageing are depicted in table 1.

Table 1. Answers of middle-age men and women about the statements of the conception of successful ageing, %, R and p, 2008.

On the bases of the general division it can be concluded that the attitude of the middle-aged towards ageing is positive, although not very strongly. The answers to the first statement “old age is normal and natural stage in person’s life” show strong agreement. Also to the other two positive statements every second respondent answered with yes. Most of the respondents disagreed with all of the five negative statements. The negative statement that respondents agreed with most was that “elderly are a burden to take care of for younger people” (34%) and that “elderly are ill and infirm” (41%).

Table 1 gives also an overview of the differences of attitudes for men and women. The statement “old age is normal and natural stage in person’s life” was evaluated by women and men most highly. Men and women agree also that elderly are a burden to take care of for younger people. But there are several attitudes in terms of which women are more positive. Among women there are less those who think that elderly are ill and infirm, and those who find that old age causes poverty and exclusion; at the same time there are more those respondents who think that an elderly person is an active member of society. We see that women agreed with positive statements to the same extent or somewhat more than men. In case of negative statements it becomes apparent that they are somewhat less widespread among women. On the bases of these results we venture to conclude that women have more positive attitude towards old age than men.

In order to emphasise contradictory types of attitudes, we concluded correlation analysis of the inside connections of opinions on the basis of Pearson’s R. The results are presented in table 2. Only strong correlations have been presented, i.e. where p=0.000.

Table 2. Correlation tree of opinions (Pearson’s R)

Table 2 shows clearly two contradictory attitudes. On one hand the different statements grouped around „ Elderly person is active member of society”. This statement has positive correlations with statements elderly can influence society and old age is normal and natural stage in person’s life. At the same time there were negative correlations with statements that elderly are a burden for society, that elderly are ill and infirm, that old age causes poverty and exclusion and that old age begins with retirement.

Another attitude that had a lot of correlations with different statements was ,elderly are a burden to take care of for younger people “. The respondents who agree with this statement tend to agree also with the statements that old age causes poverty and exclusion, that elderly are ill and infirm and that old age begins with retirement. And on the contrary – they don’t agree with statements that old age is normal and natural stage in person’s life, that elderly person is active member of society and that elderly can influence society.

Person’s point of view is an important factor as agreeing either with positive or negative statements about ageing reflects the overall state of mind and approach to life. Among the respondents with positive attitude there are more happy people (r=0.23, p=0.001) and those who don’t worry that their health deteriorates in the future (r=0.20, p=0.004). It became also apparent that agreement with statement that elderly person is active member of society was more frequent in the group with higher educational level (r=-0.14, p<0.04). On the other hand the statement that elderly are a burden to take care of for younger people is more frequent among respondents with lower educational level (r=0.18, p=0.01). People with this attitude tend to feel more unhappy (r=-0.16, p=0.01) and complain about their health (r=-0.17, p=0.01).

The middle-aged and their elderly parents

The independent coping of elderly through the eyes of the middle-aged was studied with a statement “elderly usually cope themselves with their independent lives at their homes”. This statement brought positive reactions from both men and women, among women 73% agreed, among men 65%. The respondents could answer the question who should be responsible for elderly receiving assistance for every-day activities if necessary, by choosing in the questionnaire up to three answers among the following (state, local government, spouse, children and heirs). The middle-aged thought that the responsible parties should be in the first place local government and children (71% of all respondents). There was a notable difference between the answers of men and women in terms of children’s responsibility (p=0.03). Children were considered to be responsible by 78% of women and by 64% of men. One woman explained the responsibility of local government with the opinion that “since a person has worked for 30-40 years and his income tax has been allocated to local government, then the municipality should help the person when he grows old”.

91% of the middle-aged had children or grand-children. The middle-aged have to take care of their children and help them enter independent life, but assist also their parents who need help. 58% of respondents had elderly parents who needed help, for whom they are ready and willing to care (90%). In terms of caring for parents there were differences among men and women: almost all women were ready to assist (96%), but 83% of men (r=0.23, p=0.000). Helping was seen in very different activities: house-keeping tasks, gardening and farming, storing fire-wood, taking to a doctor, bringing medicine, going to shop, visiting graveyard, doing repairs, using the internet, mowing lawn, with transport, financially, just by giving advice and help, in everything where help is needed and which the elderly cannot do alone. But only women stated that they would help in doing laundry, preparing food, cleaning the house, washing in sauna and nursing an elderly in bed. As one man said: “I’m ready to help my parents, but not to nurse them”. Women add: “I help parents in everything that is necessary and the opposite would be unthinkable”. 10% of the middle-aged answered that they are not ready to take care of their parents who need help. The reasons given were long distance, own bad health and poor economic situation.

There was in the questionnaire also a task consisting solving a situation: how would you act when your elderly parent has to stay in bed and needs long-time nursing. The respondents had to choose one suitable behaviour. Women were more ready than men to nurse their parent either at their home or at parent’s house. Men were more willing to pay for nursing or find if necessary a place for their parent in a nursing home. 11% of respondents didn’t know what to do in order to solve the situation.

When answering the statement “adult child is obliged to support his parent who needs help and is unable to work (Family law §64)” there was a difference between men and women (table 3). Female respondents elaborated their agreement as: “this parent raised me”. It is partly unexpected outcome that respondents thought that children do not have to support their elderly parents who are unable to work and need help. Among women as much as 27% stated so. One of the women explained: “Family and children/grandchildren – of course they help their parents, but this cannot be made an obligation! The economic and medical condition has to be taken into account, also the need to take care of children who go to school”.

Table 3. Evaluations of statement: adult child is obliged to support his parent who needs help and is unable to work, %, 2008

Ageing from the point of view of the middle-aged: preparation, attitudes and fears

When thinking about their own ageing the middle-aged men and women felt different emotions (p=0.01): 44% of women referred to such feelings as fear, emptiness or sadness. Men stated firstly indifference (34%), women noted also an open answer “something else”, which was complemented by the following statements: “feeling of inevitability”; “ageing is a natural process”; “calm”; “god won’t leave me”; “glad expectation as with the new experience come grandchildren”; “natural time for oneself and the family”; “mixed feelings”; “there is time to do what you want, so I don’t see any negative emotions”. In addition we asked about feelings that were experienced when thinking about death. Among men and women 64% stated angst, sadness or fear.

The middle-aged were asked which worries or scares them most in terms of ageing. The answers are presented in figure 2.

Figure 2. Fears of the middle-aged when thinking about ageing (summarised frequency of three choices), %

Most often, almost every second respondent was worried about deterioration of his health. Women were almost two times more scared of developing dementia in an old age. Women were also more afraid of remaining alone. Men were more afraid than women of becoming economically dependent on someone, becoming powerless and needing help in everyday activities.

General opinion about preparation for ageing was studied with a statement “preparation for ageing should start already in youth in order to avoid crises related to ageing”. 65% of women and 58% of men “agreed” or “agreed very much”, so the middle-aged are aware that you need to prepare for ageing. Preparations for ageing can be done in many ways. In the survey the questions were about economic, health and construction related preparations for ageing that the middle-aged had made. Results are presented in table 4.

Table 4. Preparations of the middle-aged for ageing, %, 2008.

In terms of economic preparations most middle-aged had joined the pillar II of pension insurance (40%), whereas twice as many women had joined it than men. Men had on the other hand made a testament more often. Only fifth (24%) had made construction related preparations, whereas the answers stated mostly renovations at home. Men gave such examples as: “I lost the door blocks”, “we built the house with only one story”, “we made one bedroom also on the ground floor”. In terms of health preserving preparations both men and women had most often went to the doctor during the previous year. Women had been more than men on a diet to normalise weight and done sports. Men stated more than women giving up alcohol and smoking. This can be explained by one woman’s statement: “I have never smoked and drink only little alcohol”. Those who had done no preparations were very few (one woman and seven men).

People consider health as one of the most important values. Big part of the middle-aged found their health to be satisfactory (table 5). Almost half of middle-aged women thought their health was good or very good, one-third of men gave the same evaluation. It follows that middle-aged women evaluated their health more highly than men (r=0.14, p<0.04). 60% of respondents gave their evaluation how they thought their health would change when ageing, the others answered to this with “don’t know”. Biggest part (90%) of those who gave an evaluation thought that their health will certainly deteriorate with age. Men and women had different opinions about how their health would change when ageing: men were more pessimistic than women. Health deterioration was noted by 61% of men and by 47% of women.

Table 5. Evaluation of the middle-aged about their health, %, 2008

A person always wishes to cope independently. When it is impossible to cope on our own in an old age, there is need for outside assistance. Two-third (66%) of the middle-aged wish to spend their old age at their home. Men rely more than women on people close to them. 18% of respondents would like to live in a home for elderly. When the respondents chose home for elderly as their answer, then the justification was: “Wouldn’t want to be an extra burden for children who need to go to work and raise their own children”. So one motive for choosing a home for elderly was the wish not to be a burden for children.

Figure 3. The opinion of the middle-aged whom they would firstly rely on in an old age in case their health worsens, %, 2008

As the figure 3 shows women rely in an old age firstly on their children or grandchildren, whereas men rely on their children two times less. In terms of this question there was the biggest difference between the answers of men and women.

Men rely in an old age mostly on their wives; there are two times less women who rely on their husbands. They are reluctant to rely on children as illustrated by one man that “there should be decent old age pension so that there is no need to depend on children or grandchildren. I have worked for that during my entire life”. Women think that it is difficult to rely on husband. Relatively fewer respondents rely on sisters/ brothers, relatives, friends and also on local government.

There was a big difference between men and women in terms whether the middle-aged person will take up new hobby or participate in the activities of some society/ association. Women answered both of these two questions more positively. Three-fourth (76%) of women but less than half (45%) of men would take up a new hobby (r=0.32, p=0.000). Among middle-aged women every second considers it necessary to participate in an old age in the work of some society, association or hobby circle, among men only 15% think this way, this is three times less (r=0.29, p=0.000). When a person reaches the pension age, s/he can decide whether to keep on working or stay at home. 42% of the middle-aged planned to work and 26% to stay at home. Third did not know how they would act.

ANOVA analysis

More than half (55%) of the middle-aged thought that they were rather or very happy. There is notable difference between women and men: among women 64% and men 46% (r=0.18, p<0.01). Thinking about the future state of mind every tenth said that ageing should not make him/ her unhappy; at the same time 40% of respondents noted that they would become happier with age or stay in the same state as now. Using ANOVA method we analysed which attitudes and activities increase or decrease the happiness of a middle-aged person (see table 6).

Table 6. ANOVA analysis about the impact of different statements for the mental balance, feeling of happiness, of men and women, F, p

• The analysis shows that the statements of successful ageing influence the person’s mental balance in a considerable way, among women in the extent of 25% and among men 26%. The changes in the feeling of happiness are influenced most, in the extent of 26%, by the conviction that old age causes poverty and exclusion (for women, F=13.08, p=0.000; for men, F=15.40, p=0.000).
• The feeling of happiness is also influenced by the fact whether the middle-aged are prepared to help their elderly parents, if this is not considered a heavy task. Women think it is natural to take care of parents and this does not disturb them emotionally or they refuse straight away by referring to difficulties in their own families. This influence is bigger (8%) for men , F=4.27, p<0.04
• The influence of higher emotionality and anxiety was apparent in several ways. When the first reaction when thinking about ageing is fear, emptiness or sadness then this attitude inhibits the development of the feeling of happiness to the extent of 10%, firstly for women (F=10.56, p=0.002). Women’s feeling of happiness is also influenced negatively, although to a lesser extent (4%), when they feel already at middle-age angst, sadness or fear when thinking about death (F=3.89, p<0.05).
• The state of health is also an influencing factor. Also here the influence for women’s well-being is stronger than for men. Women’s state of mind is influenced by satisfaction with health (F=28.79, p=0.000) and by conviction that health will worsen with age (F=16.55, p=0.000). For the first statement the influence was 24%, for the second 15%.
• When thinking about ageing women are upset by the thought (in the extent of 7%), that there could be situations in an old age when outside help is needed for every-day activities (F=7.37, p=0.008).
• State-of-mind is influenced also if preparations have been made for ageing. In case of women 13% are affected by the fact whether health related preparations have been made, whereas especially important for the development of feeling of happiness is the success of dieting to normalise weight (F=4.87, p<0.04). In terms of economic preparations 7% are influenced by the fact whether they have joined pillar II of pension insurance (F=4.02, p<0.04). For men constructional preparations are important (in the extent of 6%) (F=5.64, p<0.02).
• When thinking about ageing for women free time activities and self-fulfilment are important: having hobbies (F=6.45, p<0.01) and participating in the activities of some society, association or hobby circle (F=6.96, p<0.01). The sum influence of these factors for women’s feeling of happiness is 7%.

We can conclude that the middle-aged women have circumstances that contribute to or inhibit the development of their feeling of happiness much more than is the case for men. Men were firstly characterised by attitude that old age causes poverty and exclusion (26%) and satisfaction with health (17%). Well-being is also influenced by the fact whether one is prepared to help elderly parents (F=4.27, p<0.04) and whether constructional preparations have been made for ageing (F=5.64, p<0.02). The impact of last two situations for the feeling of happiness is 6-8%.

Discussion

Old and young, old age and youth – there is contradiction in these words. The word “old” carries with it many negative connotations, because many people assume that old age is accompanied by troubles and problems. Ageism conveys negative attitudes, which are prejudicial as they are based only on age (15). These prejudicial attitudes are widespread also nowadays (7). Nevertheless, we can state on the basis of the research results that the overall attitude of the middle-aged towards ageing is positive. This corresponds to Marin’s (2) view that old age as part of life span is being re-evaluated: this is no longer seen as bleak phase of life, but instead negative attitude towards ageing and old age has been replaced by the conception of successful ageing. Different results were yielded by Kiik’s study (25), where the answers of the middle-aged reflected a negative attitude towards the elderly. One of the most widespread myths about ageing is that the elderly are frail, senile, powerless and have no sex-life (6). The fact that two-fifth of the middle-aged agreed also in the current study with part of this prejudicial statement, i.e. “elderly are ill and infirm” shows the negative side of attitudes towards the elderly. Elderly have also been seen as a group which is a burden for society and needs to be cared for (7) and there is a fear that the elderly will bankrupt the society with increased cost of their health care (26).

As a result of the study more than half of the middle-aged thought that the elderly are active members of society and can influence society. But there are also different opinions. According to 2008 Integration monitoring 71% of the middle-aged thought that they themselves have no possibility to influence the society. Alienation correlates strongly with age, among people aged 60-75 about 80% says that they have no possibility to influence the society (27).

In the current research the attitudes of the middle-aged towards the conception of successful ageing were studied with eight statements and the answers given to them were as a whole positive, somewhat more for women. Correlation analysis indicated two contradictory attitudes. On one hand, if a person views ageing positively, then s/he also thinks that the elderly are active members of society, that they can influence society and that old age is normal and natural stage in a person’s life. The other view is that the elderly are a burden to take care of for younger, they are ill and infirm and that old age causes poverty and exclusion.

We assume that the middle-aged are aware that preparation for ageing should start early and 62% of respondents agreed with it. People are aware of it and yet part of the respondents have made no conscious preparations to adjust to ageing. In Estonia 46-52% of people are worried about securing old age (28), but on the basis of current study almost every third man and fifth woman had made no economic preparations for ageing.

The middle-aged thought that the elderly can usually cope themselves with their independent lives at home. But when an elderly person needs help, then children and local government should be responsible for that. It is characteristic to our culture that parents take care of their children and children look after their elderly parents. When asking about the support of adult child for a parent incapable of work, then two-thirds of the middle-aged agreed with that, but over fourth of women were against it referring to economic and medical situation and the need to care for their children who go to school. The authors agree with these women and think that adult children could (and they want to) take care of their parents, but this should not be an obligation. The situation and means of a family have to be taken into account. Furthermore – as Estonian researchers have found, the ratio of people in Estonia has increased who are worried about the necessity to take care of their parents and relatives (28).

Although most (90%) of the middle-aged women and men were ready to assist their parents, then women were more prepared to help their parents in different activities than men. Our results coincide with the data of other researchers. For example Chrisholm (29) has shown that there are big differences in the content of help given by men and women to elderly parents. Men help the older generation more materially, in practical works and organise support services (cooking, cleaning, etc). Women do all the above, but engage more themselves and give also emotional support.

The emotions of the middle-aged when thinking of ageing were in 44% of cases negative (fear, emptiness or sadness). 32% of respondents noted an answer “some other” with comments. Ageing was associated firstly with inevitability, calm, relaxation, etc, it was thought that old age is time when there is more time for oneself and family, there was joyful expectation as grandchildren would come. More than half of the middle-aged thought that they are rather or very happy. The middle-aged do not have the attitude that a person should definitely become unhappy with ageing. This corresponds to Dottie Billington’s (30) view that happiness has no connection with age.

Gender differences were in the current work most apparent in the answers of the middle-aged to the question: on whose help can you rely in case your health worsens in an old age. Women rely in an old age mostly on their children and grandchildren, but men rely on their wives. This corresponds with Kiik’s (25) conclusion, in whose study women deliberated when thinking about the future in terms of – me and children, but for men the prevailing idea was – me and my wife. The authors of the article think that one reason why women are afraid of relying on their husbands is the fact that Estonian men live 11 years less than women, one of the biggest differences in the world: life expectancy for men at the moment of birth is 67 and for women 78 years (13). It is therefore understandable like the study showed that women are afraid to stay alone in an old age. The middle-aged wish “not to have to depend on children or grandchildren” and “not to be a burden for children” in an old age. But, nevertheless, most women rely in an old age firstly on children. The authors find that there is a contradiction in the wishes and hopes of the middle-aged, especially for women. It can be concluded from these opinions that the middle-aged are afraid of relying on assistance offered by the public sector.

When analysing satisfaction with life and changes in the level of stress at different stages of the life span, the researchers have received different results. Some have found that the feeling of happiness increases with age (31), others think the correlation is U-shaped, whereas the breaking point is around 40th year (32, 33). Also studies conducted in Estonia have shown that the level of stress is highest in youth and old age and what is most important from the point of view of our work – women’s level of stress is considerably higher than the same indicators for men (34, 35). Also in the current study the ANOVA analysis showed that middle-aged women have much more areas than men that can cause strong stress and decrease their mental balance. The feeling of happiness is especially strongly influenced by negative emotions and fears (thought that old age causes poverty and exclusion; when first reaction when thinking about ageing is fear, emptiness or sadness; when people are afraid that health worsens with age; that there could be a need for outside help in an old age to cope with everyday activities, etc). At the same time women are not affected when they have to take care of their elderly parents. Since they find that it is their duty as children, then this need does not disturb their balance. But this became apparent for men, who are prepared to assist (financially and by looking for necessary services), but not do something by themselves. Women have thought also more about what they will do in an old age. This is natural as they have more years to live than men. And so they plan to take up self-fulfilling and creative hobbies and participate in the activities of some society, association or hobby circle. It is important to associate in an old age with peers, receive support, advice and help from them. Especially if there is no husband any more.

It seems that men’s mental balance is not so much influenced by negative emotions, but the state of their health. They also do not plan self-fulfilling activities for the future or participation in the activities of societies or associations. At the moment they have made economic, health preserving and constructional preparations (e.g. made a will, given up alcohol and smoking or renovated apartment or house) for the old age.

There is no one answer how to age as people’s attitudes and understandings of life are different. Individuality is the thing to be appreciated. The attitude of society towards ageing and old age reflects the maturity and level of ethics of society (22). All people, especially elderly and middle-aged have the task to improve the reputation of ageing and take favourable stance towards their own ageing.

Conclusion

Life demands answers to new questions, the making of new decisions when old age approaches. How to age successfully and cope as an elderly person requires re-evaluation of present attitudes and way of thinking. Ageing is not a problematic time, but natural process in person’s life span. It is reasonable that preparations for ageing begin already in youth as then old age becomes phase of life where next to the inevitable there are things that the persons can influence themselves.

According to the objective set for the study and analysis of questionnaires it is possible to make the following conclusions about the attitudes of the middle-aged

The middle-aged have varying attitudes towards ageing, both positive and negative. The general attitude towards successful ageing is positive, but not very strongly, whereas the women’s assessments about ageing are somewhat more positive than men’s. Old age is considered to be normal and natural part of human’s life span. The middle-aged think that elderly cope themselves with their independent lives at home. When thinking about ageing the emotions of the middle-aged are mostly not negative, but they sense the inevitability of time and find that old age is period, where there is more time for oneself and family. Respondents generally think that children should take care of their parents within the limits of their means. Nursing is considered mostly a task for women, women were willing to help their parents who needed assistance more and in different activities than men. The middle-aged do not want to be a burden for their children in an old age, this was one of the reasons why they preferred to live in old people’s home. The middle-aged do not feel that a person should become unhappy when ageing. Middle-aged women thought their health was better than middle-aged men. The middle-aged have an attitude that health worsens with age and this is stronger for men. At the same time women are almost twice more scared to develop dementia in an old age than men. The middle-aged are aware of the necessity to prepare for ageing, but this knowledge is not always used in their own lives. There are middle-aged people who have made relatively few or no preparations for ageing. There are notable differences in the attitudes of middle-aged women and men. The biggest difference was that women rely in an old age mostly on their children or grandchildren, whereas two times less men rely on their children. Men rely in an old age firstly on their wives, but women rely on their husbands two times less. Men and women have different attitudes in terms of hobby activities in an old age or belonging to a society or association. Three-fourth of middle-aged women would take up a new hobby, but less than half of the men. Half of the middle-aged women considered it necessary to participate as elderly in the activities of some society, association or hobby circle, but only 15% of men, which is more than three times less. 42% of the middle-aged plan to work when reaching the pension age.

Taking into account the results and conclusions of the study the authors make the following suggestions and recommendations:

• For local government: develop services for the elderly; find a way to pay partly for general nursing home even if elderly have children/ grandchildren; support training, information days, gatherings and other possibilities of communication for elderly, incl pay attention to free time spending possibilities that interest middle-aged men; find ways for the elderly to be and feel useful in their home municipality or town.
• For middle-aged people to ensure preparedness for ageing: maintain positive attitude to life, be informed about fast-changing life; maintain relations with one’s family, close ones, communicate more with relatives; follow balanced healthy way of life: eat properly in order to have normal weight, have regular physical activities (sport, long walks, staying in nature), sleep every night seven-eight hours, not to smoke; pay attention to health, in case of health problems go to the doctor in time; not only work, but take time for hobbies and free time activities; know and plan that it is possible to work part-time in pension age; or make when reaching pension age positive and psychologically prepared decision to stay at home.

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