PLAN: Preparing and Living for Aging Now. A multi-methods study investigating older adults' readiness to plan for aging and frailty

Abstract

Despite the universality of aging, negative connotations and a denial of the inevitability of the aging process persist. Understanding aging through a holistic lens is essential to promote healthy aging in light of population aging and increased life expectancies that are often accompanied by the risk of chronic conditions, frailty, and disability. Planning for aging and frailty encompasses five domains that entail change as individuals age (communication/socialization, environmental, financial, physical care, cognitive status), and provides foci for a proactive approach to planning across life course. The aims of this research were to examine the stages of change, experiences (personal & experiences with others), and associations between contextual factors and stages of change for readiness to plan for aging and frailty. We also explored how adults (age 50+) perceive the concept of planning for aging and frailty, and identified the facilitators and barriers involved in the planning process. Using a multi-methods design (cross-sectional survey, semi-structured qualitative interviews), 252 community-dwelling adults (aged 50-80) completed a survey on planning for aging and frailty, and 20 adults were interviewed to explore lived experiences related to planning. The distribution of stages of change in readiness across domains of planning for aging and frailty were varied with highest levels of planning for action/maintenance stages in financial (68.7%), and lowest levels in cognitive status (28.2%). More participants reported having experiences with others in all domains as compared to having personal experiences. Factors most indicative of planning for aging and frailty across domains include: older age, marital status, living situation, increased social support, and increased vulnerability. Through a descriptive content analysis of qualitative data, categories of codes emerged for perceptions, facilitators, and barriers related to planning for aging and frailty. The depth of individuals’ self-identity, life experiences, and societal influences were illuminated with distinct levels (internal, external, systems, future-oriented). Planning for aging and frailty is an innovative concept that takes a comprehensive look at the aging process through the promotion of planning. Future study is needed to develop and test interventions that equip and encourage adults to consider their preparation and planning behaviors along a life course trajectory.