Gender Specifics of Healthy Ageing in Older Age as Seen by Women and Men (70+): A Focus Group Study
Abstract
:1. Introduction
- What opinions and attitudes exist about healthy ageing among women and men aged 70 and older?
- What gender-specific characteristics can be identified regarding healthy ageing in women and men aged 70 and older?
- What gender-specific and cross-gender recommendations for the promotion of healthy ageing can be derived?
2. Materials and Methods
2.1. Design
2.2. Study Sample
2.3. Implementation and Analysis
3. Results
3.1. Opinion and Attitude Differences
“I have a photo of my grandmother at home. On the back of the photo it says, ‘Grandma in her 63rd year.’ I’m 71 now (…) That’s two earlier generations and it’s a totally different image. (…) She was very old at 63. And that’s what I think is nice, that the people in this group right here, we are all different”.(female participant)
“Yeah, you’re certainly aware that in old age you will always have little aches and pains, sometimes maybe something worse too”.(male participant)
“I noticed with a friend that he became a bit frail and then began having difficulty walking. And then he stopped walking altogether and it continued in this way, and then he was dead. Yes, it happens very quickly at a certain age. And I think you should try to avoid that. Don’t give up, but fight. Fight every day”.(male participant)
“Of course, staying healthy is partly down to your genes. But I do think it’s important to take a lot of initiative yourself”.(female participant)
“Yeah, my husband always says, ‘my wife cooks and that’s why I’m healthy.’ He doesn’t take care of such things” (female participant). (“No, men don’t take care of such things.”).(another female participant)
“Intellectual activity is important, as I said. But in my experience, you shouldn’t be just killing time with it, so to speak. Whatever it is you do, it should serve some kind of purpose. You should have a task, as they say”.(male participant)
“Of course, the social environment is important. So many of us, I, in particular, sit at home alone all week without any contacts at all. There’s a nice saying: take time for your friends, otherwise time will take your friends”.(male participant)
“Well, there are big differences. We are simply socialized differently, we women. We are more communicative, we are more open. And the men, they withdraw”.(female participant)
“Yes, I am also a member in two exercise groups and we do a lot of things together. We often go on trips together or have dinner together. We play cards, things like that. We celebrate milestone birthdays”.(female participant)
“Until my heart attack about 20 years ago, I used to drive to the bakery. I didn’t get any exercise at all. I hated exercise. I still hate it, but I do it. I go to a cardio class once a week. I also go to the gym and exercise for half an hour”.(male participant)
“Our healthcare system is actually excellent, I would say. We really can’t complain about it. We live in luxury here” (female participant). “And I can’t complain at all. It’s all going well as far as medical care is concerned”.(male participant)
“Yes, because everything comes to an end at 70. No more gynecological checkups, nothing. You’ve taken advantage of all the preventive services. But that’s all gone”.(female participant)
“It is certainly important to make a difference between medication for older and younger people (…) In many cases it has been found to be wrong. And differentiating between medication for women and men, which is also not being done”.(male participant)
“Most often you’re caring for your spouse, or you’re having to deal with the fact that the end of your spouse’s life is not far off. That’s quite a challenge”.(female participant)
“You can read about it, it’s typical for men of retirement age. And as I said, I had a hard time coping. But thank God, with social support and also the help of my family, I’ve made it through so far”.(male participant)
“I moved to T. (…). And I’m really glad to have relocated at an older age. Let me tell you, the village life is not what it used to be. It’s so difficult to live in a village”.(female participant)
“People walk up the stairs and disappear into their flats. With some I even have the impression that should I open my door, they would quickly close theirs. That has changed a lot”.(female participant)
“And yes, well, I still like driving. But I would also be happy if public transportation were good enough to allow me to leave the car at home more often”.(male participant)
“But I play poker seriously. The first few years after my retirement, I took courses at the adult education center. A computer course and an English course and such”.(female participant)
“That’s what I was just about to say. You need some money if you want to keep busy three days a week”.(female participant)
“But what I’m trying to say is that something probably needs to be done because, on average, we men are being forgotten. There are a lot more opportunities and things for women. There’s this and there’s that. Men have other interests, generally speaking”.(male participant)
3.2. Recommendations
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A. Detailed Results According to Main Categories (MC)
Appendix A.1. MC1 Meaning of Ageing
Appendix A.2. MC2 Lifestyle and Health Behaviors
Appendix A.3. MC3 Own Actions to Promote Healthy Ageing
Appendix A.4. MC4 Influence of Personality Traits on Healthy Ageing
Appendix A.5. MC5 Role of Social Contacts
Appendix A.6. MC6 Social Framework Conditions
Appendix A.7. MC7 Life Incidents
Appendix A.8. MC8 Biological Factors
Appendix A.9. MC9 Medical History
Appendix A.10. MC10 Health Care and Public Health Promotion Services
Appendix A.11. MC11 Use of Public Services and Infrastructure
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Focus Group: Women | Focus Group: Men | |||
---|---|---|---|---|
N | 10 | 8 | ||
Age (Mean, (SD)) | 77.1 | (4.1) | 74.9 | (2.8) |
Education (n, (%)) a | ||||
Low | 2 | (20.0) | 0 | (0.0) |
Middle | 4 | (40.0) | 1 | (12.5) |
High | 4 | (40.0) | 7 | (87.5) |
Living situation (n, (%)) | ||||
Alone | 7 | (70.0) | 2 | (25.0) |
With partner | 3 | (30.0) | 6 | (75.0) |
Marital status (n, (%)) | ||||
Married | 2 | (20.0) | 6 | (75.0) |
Single | 0 | (0.0) | 0 | (0.0) |
Divorced | 3 | (30.0) | 1 | (12.5) |
Widowed | 5 | (50.0) | 1 | (12.5) |
MC1: Meaning of ageing | SC1: Healthy ageing | W: “Yes, I would say that life as you know it continues without diminishing, I would say.” M: “So the most important thing is just that you are physically fit, that you are mentally moderately fit and fit for quite a long time and then die—fast as lightning.” |
SC2: Ageing process | W: “I have a photo of my grandmother at home. On the back of the photo it says, ‘Grandma in her 63rd year.’ I’m 71 now (…) That’s two earlier generations and it’s a totally different image. (…) She was very old at 63. And that’s what I think is nice, that the people in this group right here, we are all different.” M: “Yeah, you’re certainly aware that in old age you will always have little aches and pains, sometimes maybe something worse too.” | |
MC2: Lifestyle and health behaviors | SC1: Hobbies | M: “In my opinion, you should somehow get a sense of accomplishment (…) That you can say, well, I did something useful, I didn’t just kill time.” |
SC2: Social activities | W: “You also get to know a lot of people there, but the most important thing for me is actually the friends I’ve had from a young age. And there, we are such a great community, who also/who not only celebrate together, but also help each other.” M: “So I just wanted to say that if you are lucky enough to have such contacts now with younger people, that is important. Not just ready to withdraw, as was said earlier (…). No, you have to get out into the world, of course.” | |
SC3: Nutrition | W: “I eat but, for example, I know that pork is not good for me. Of course, I don’t eat it anymore. But overall, I try not to eat fatty foods because our metabolism slows down a little bit now.” M: “I always say, you try to live in such a way that you can’t blame yourself, that you can say you live reasonably healthy. Everything in moderation. That’s/whether that’s alcohol, whether that’s exercise, whether that’s food.” | |
SC4: Risk behavior | W: “But for example, I have high blood pressure, but I’m not going to be dissuaded from drinking my little wine, right? I’ll decide that myself.” M: “I mean, what‘s harmful? Beer is healthy. Too much beer is unhealthy. Hard liquor is healthy. Too much hard liquor is unhealthy. Smoking, well, I never did.” | |
SC5: Healthy lifestyle | W: “How do I stay fit and how can I not become a burden to other people? I mean, other people help but I can’t give up on myself.” M: “I noticed with a friend that he became a bit frail and then began having difficulty walking. And then he stopped walking altogether and it continued in this way, and then he was dead. Yes, it happens very quickly at a certain age. And I think you should try to avoid that. Don’t give up, but fight. Fight every day.” | |
SC6: Differences women/men | W1: “Yeah, my husband always says, ‘my wife cooks and that’s why I’m healthy.’ He doesn’t take care of such things.” (W2: “No, men don’t take care of such things.”). M: “As I said, there are sports that are not really sports in the strict sense, that are primarily played by men.” | |
MC3: Own actions to promote healthy ageing | SC1: Social contacts | W: “Hiking, for example. So when I retired, I started a hiking group with female friends.” M: “Of course, the social environment is important. So many of us, I, in particular, sit at home alone all week without any contacts at all. There’s a nice saying: take time for your friends, otherwise time will take your friends.” |
SC2: Bodily fitness | W: “Yes, I live near this wonderful swimming center. So, that’s where I go. I can tell from the 10-times discount cards that I was there 62 times this past summer.” M: “Until my heart attack about 20 years ago, I used to drive to the bakery. I didn’t get any exercise at all. I hated exercise. I still hate it, but I do it. I go to a cardio class once a week. I also go to the gym and exercise for half an hour.” | |
SC3: Actions to stay mentally fit | W: “But I play poker seriously. The first few years after my retirement, I took courses at the adult education center. A computer course and an English course and such.” M: “Intellectual activity is important, as I said. But in my experience, you shouldn’t be just killing time with it, so to speak. Whatever it is you do, it should serve some kind of purpose. You should have a task, as they say.” | |
SC4: Actions for emotional well-being | W: “Yes, I am also a member in two exercise groups and we do a lot of things together. We often go on trips together or have dinner together. We play cards, things like that. We celebrate milestone birthdays.” M: “As I said, you have to create a hobby.” | |
SC5: Motivation | W: “Yes, well, you also have a certain personal responsibility for your life. And my aim has always been, I don’t want to be a burden on my daughter and grandchildren one day.” M: “Don’t stop, but fight. Fight every day.” | |
SC6: Differences women/men | W: “Well, there are big differences. We are simply socialized differently, we women. We are more communicative, we are more open. And the men, they withdraw.” M: “There are fewer sports groups for men. Besides, as I said, women have a longer life expectancy anyway. (…) It’s difficult to convince someone to do something that they don’t want to do.” | |
MC4: Influence of personality traits on healthy ageing | SC1: Personality traits | W: “Well, thank God, the good Lord has given me a sunny disposition. And I also have many aches and pains, but I bear them with a bit of humor.” M: “I’m more of a pessimist in some ways. But maybe that’s also due to Parkinson’s now. But it’s dragging me down. Optimism and attitude are important.” |
SC2: Differences women/men | W: “If I look at my husband, he’s one to/his glass is three-quarters empty.” M: “Women are more outgoing about that than men. In general. Women say, ‘Yeah, I don’t got it yet. Can you explain me that again?’ And a man says, ‘I can’t.’ It’s stupid.” | |
MC5: Role of social contacts | SC1: Social network | W: “That’s also where I go to exercise. I go to Pilates three times a week. You can get to know a lot of people there, too, but the most important thing for me is that I see friends that I’ve had since I was a young person.” M: “So, the other problem, you have a group of people that started at the same time, and then bringing in new ones, that’s not so easy.” |
SC2: Social support | W: “This is work. That’s exactly how it is. Like my friend, for example, whose husband is dying. I cook for her, then I drive her to the clinic. Today I am going shopping with her afterwards. That’s what friendship is all about. That’s what I mean by friendship.” M: “But thank God, with social support and also the help of my family, so far I have overcome everything.” | |
SC3: Differences women/men | W1: “Yes, you can see it, too, women traveling together. Women going out for walks together. But it’s almost impossible to see two men together.” (W2: “Village pub.”) “They no longer exist, where they used to sit together and chat. They sit at home and/” M: “And they (transcriptor’s note: women) look for friends then somehow. They were just bump into them. Men are (transcriptor’s note: incomprehensible), that they tell their life to a complete stranger (transcriptor’s note: incomprehensible). Men are different. But the women, they do that and/”. | |
MC6: Social framework conditions | SC1: Finance | W: “That’s what I was just about to say. You need some money if you want to keep busy three days a week.” M: “Are people doing something here (transcriptor’s note: volunteering) out of pure interest or are they doing it for financial reasons? And that’s where I think the commitment declines a lot.” |
SC2: Neighborhood (social integration) | W: “People walk up the stairs and disappear into their flats. With some I even have the impression that should I open my door, they would quickly close theirs. That has changed a lot.” | |
SC3: Urban/Rural | W: “I moved to T. (…). And I’m really glad to have relocated at an older age. Let me tell you, the village life is not what it used to be. It’s so difficult to live in a village.” | |
M: “Out in the countryside, the most important thing is a car. Without a car, you’re completely stuck out there.” | ||
SC4: Mobility | W: “And I then go by S-Bahn or by tram, because parking in the city center makes no sense.” M: “And yes, well, I still like driving. But I would also be happy if public transportation were good enough to allow me to leave the car at home more often.” | |
MC7: Life incidents | W: “Most often you’re caring for your spouse, or you’re having to deal with the fact that the end of your spouse’s life is not far off. That’s quite a challenge.” M: “You can read about it, it’s typical for men of retirement age. And as I said, I had a hard time coping. But thank God, with social support and also the help of my family, I’ve made it through so far.” | |
MC8: Biological factors | W: “Of course, staying healthy is partly down to your genes. But I do think it’s important to take a lot of initiative yourself.” M: “Women age better than men. I wonder why they age. Genetically. Genetic causes are primarily responsible.” | |
MC9: Medical history | W: “I had a lot of trouble at first, that one time. I don’t want to talk about that. So, I managed that situation with the help of my children—everything is resolved; I feel much more comfortable. Then I sorted out my circle of friends.” M: “If I forget to take my medication for half an hour—so I have to take it every four hours—I have a feeling of inner restlessness that I have to compensate for by movement. So I can’t rest either. (…). And that’s where I have my so-called activity.” | |
MC10: Health care and public health promotion services | SC1: Utilization | W: “Yes, I’ll get vaccinated (transcriptor’s note: flu vaccination). It won’t hurt.” M: “Yes. I think if you take advantage of the preventive care services, there’s nothing wrong with that, I think. But there are a lot of men who don’t go to the doctor at all, for example.” |
SC2: Desired support services | W: “But, what I would prefer would be to not go to the doctor for years, then to get a prescription for a short stay at a health resort.” M: “And when you say rehabilitation. I should have gone to an inpatient rehabilitation. And that was refused by my health insurance. You have to appeal the decision on your own.” | |
SC3: Need for improvement | W: “Yes, because everything comes to an end at 70. No more gynecological checkups, nothing. You’ve taken advantage of all the preventive services. But that’s all gone.” M: “It is certainly important to make a difference between medication for older and younger people (…) In many cases it has been found to be wrong. And differentiating between medication for women and men, which is also not being done.” | |
SC4: Access to treatment services | W: “But long waiting times for appointments with medical specialists is also a problem.” M: “And I’ve had two nose surgeries. After the first one, I immediately went to a rehabilitation center. And now in 2017, after the second one, I had to change otolaryngologists. And he said, ‘You’ve been my patient for such a short time. You won’t be able to go to a rehab center. So that was rejected. But that had been helpful for me the first time, rehab treatment. This time, I had no chance at all.” | |
SC5: Quality of health care | W: “Our healthcare system is actually excellent, I would say. We really can’t complain about it. We live in luxury here.” M: “And I can’t complain at all. It’s all going well as far as medical care is concerned.” | |
SC6: Differences women/men | W: “Yes, the men have to be pushed. The men have troubles keeping up.” (Transcriptor’s note: with preventive examinations) M: “But, after all, there are many men who don’t go to the doctor at all, for example.” | |
MC11: Use of public services and infrastructure | SC1: Education | W: “But I play poker seriously. The first few years after my retirement, I took courses at the adult education center. A computer course and an English course and such.” M: “Yes, and there are also offers in the community centers for senior citizens, yes, you can go there. And, yes, for us old people, I say, there we were taught how to use the device (transcriptor’s note: smartphone). You shouldn’t refuse, because it is really important and really okay. But I have to want it myself. If I don’t want/” |
SC2: Cultural offers | W: “So, for example, the city library organizes great free events. But in the evenings. Or ‘Haus des Buches’ (transcriptor’s note: local venue that offers readings). ‘Haus des Buches’ at ‘Gerichtsweg’ is also great. And that, yes, I think that also helps a bit to keep up.” M: “Or you go to the ‘Gewandhaus’ (transcriptor’s note: a local concert venue for classical music) once a month, even if that sometimes hurts a bit. But you can always have a beer afterwards if necessary. So art and cultural offerings. Men are certainly a bit behind in that respect. So according to my experience. They have a hard time with that.” | |
SC3: Sports | W1: “I always went to rehabilitation sports, I must say. And there it was nowhere near as full as there.” (W1: “Well, but you go to the group?”) “But yes.” (W1: “Once only?”) No, I go to three groups.” (W1: “That’s nice.”) “And so, three times, of that I do twice in a row and another day the third group, that I don’t have to go there three times a week. That would be too much. But going twice is fine.” M: “Regarding dancing in general, it’s usually the women who are best. In square dancing, it’s the men. Why is that? I was quite surprised when I took a closer look at this phenomenon, that in the beginning women predominate. And the better my own dancing became, the fewer women there were. Why? Square dancing is mathematics.” | |
SC4: Differences women/men | M: “But what I’m trying to say is that something probably needs to be done because, on average, we men are being forgotten. There are a lot more opportunities and things for women. There’s this and there’s that. Men have other interests, generally speaking.” |
Topic | Examples and Suggestions as Mentioned in Focus Groups | Recommendations Derived in a Qualitative Research Workshop | |
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Women | Men | ||
Nutrition |
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Sports and exercise |
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Social contacts/Social activities |
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Preventive health care |
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Lifelong learning |
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Meaningful activity |
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Cognitive skills training |
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Life events |
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Societal/structural conditions |
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Schladitz, K.; Förster, F.; Wagner, M.; Heser, K.; König, H.-H.; Hajek, A.; Wiese, B.; Pabst, A.; Riedel-Heller, S.G.; Löbner, M. Gender Specifics of Healthy Ageing in Older Age as Seen by Women and Men (70+): A Focus Group Study. Int. J. Environ. Res. Public Health 2022, 19, 3137. https://doi.org/10.3390/ijerph19053137
Schladitz K, Förster F, Wagner M, Heser K, König H-H, Hajek A, Wiese B, Pabst A, Riedel-Heller SG, Löbner M. Gender Specifics of Healthy Ageing in Older Age as Seen by Women and Men (70+): A Focus Group Study. International Journal of Environmental Research and Public Health. 2022; 19(5):3137. https://doi.org/10.3390/ijerph19053137
Chicago/Turabian StyleSchladitz, Katja, Franziska Förster, Michael Wagner, Kathrin Heser, Hans-Helmut König, André Hajek, Birgitt Wiese, Alexander Pabst, Steffi G. Riedel-Heller, and Margrit Löbner. 2022. "Gender Specifics of Healthy Ageing in Older Age as Seen by Women and Men (70+): A Focus Group Study" International Journal of Environmental Research and Public Health 19, no. 5: 3137. https://doi.org/10.3390/ijerph19053137
APA StyleSchladitz, K., Förster, F., Wagner, M., Heser, K., König, H. -H., Hajek, A., Wiese, B., Pabst, A., Riedel-Heller, S. G., & Löbner, M. (2022). Gender Specifics of Healthy Ageing in Older Age as Seen by Women and Men (70+): A Focus Group Study. International Journal of Environmental Research and Public Health, 19(5), 3137. https://doi.org/10.3390/ijerph19053137