At Arm’s Length

In the fall of 2010, I was well into my graduate thesis on the illness and recovery experiences of physically active middle-aged and older adults (Active Aging: Hiking, Health, and Healing). Two to three times a week I would hike and walk with three groups. During our walks and hikes, participants would talk about their overall health, illness, recovery, and physical activities. Several group members would talk about how physical activity had helped them recover from injury and illness and kept illness at bay. Some participants did suffer from chronic health problems and they would frequently tell me how their activities had helped them cope and improve their conditions. Furthermore, their group activities created a deep sense of community that contributed to their healing processes. Therefore, remaining active and social as we grow older might help us cope with illness. However, recent research out of Denmark suggests that, for some older adults, activity is a method used to avoid engaging with their diseases or keep their “disease at arm’s length.”

Aske Lassen, from the University of Copenhagen, researched 17 active older adults between the ages of 58 and 92 years (47 percent female) at two activity centres in Copenhagen, Denmark. Participants were included in the study if they were living independently, participated in the center’s activities at least twice a week, identified themselves as an “active older person,” and allowed for equal gender representation. Lassen collected participant data using the ethnographic techniques of participant observation and semi-structured interviews. Semi-structured interviews were conducted at participants’ homes or the activity centres. Interviews lasted between one and four hours and covered topics including physical activity, health, illness, and the importance of the activity centre to their lives. Furthermore, Lassen shadowed six participants during their daily routine.

Lassen used four vignettes to exemplify how several of the older adults in his study used activities provided by the centres to keep their diseases at a distance or, as Lassen refers to this behaviour, kept their disease at arm’s length. Valter, 73, is the activity centre’s manager and spends a lot of time walking when running errands for the centre. He considers this exercise, but he doesn’t value physical activity. Valter believes mental fitness is more important than physical activity and engages in activities that challenge him mentally. He finds the health and fitness advice he is subjected to intrusive, but he does enjoy the activities he engages in at the centre. His activities allow him to keep his disease at a distance. However, Valter had recently been diagnosed with chronic obstructive pulmonary disease, and he decided to leave his position as manager.

Daisy, 79, engages in several different types of activities provided by the centre from darts to activity planning. The activities provide her with much needed socialization to combat her loneliness and depression. Daisy has arthritis, back pain, type 2 diabetes, and an artificial wrist. Her activities help her keep her diseases at arm’s length, but her wrist does interfere with her activities and puts her “normal” life at risk – she fears she will slip back into a severe depression if she cannot remain active.

Karl, 78, has had two heart bypass surgeries and a heart-valve surgery. His doctor wants him to change his lifestyle, but Karl refuses. He wants to live his life on his own terms and not the terms dictated by biomedicine. It’s not his job to worry about his health. That’s the doctor’s job. Karl uses the centre to enjoy himself, engage in activities like pool, and socialize. Like Valt and Daisy, he uses his activities to distance himself from his disease.

Andrea, 75, suffers from cardiovascular disease, osteoporosis, gout, and she is a breast cancer survivor. She doesn’t like all the pills she has to take. It makes her feel unnatural. The activities she engages in at the centre allows her to separate herself from her disease while socializing with people her own age. It makes her feel proactive.

Keeping their diseases at arm’s length allowed participants to avoid the presence of their diseases. They didn’t think about their conditions until it directly encroached upon their daily life. For example, Daisy didn’t feel any different when she was diagnosed with diabetes and arthritis because they didn’t impact her daily activities. “Her condition becomes present when it impedes her from cleaning, not when her blood sugar and blood pressure is rising,” writes Lassen, “I regard this distancing as a health strategy. It is not an unhealthy negligence, but a way to continue an active life despite one’s diseases.”

The participants in Lassen’s research used the social and physical activities provided by the activity centres to keep their diseases at arm’s length. Some resented the constant reminder that they had to remain active as they aged, but they did engage in several different activities provided by the centres. This is the crux of engaging with an aging population: understanding the relationships between aging, physical activity, culture, community, and the experience of disease. It is a balance between providing support to those who need and request it and not infringing on the rights of those who choose to live their lives on their own terms.

Rodney Steadman 08 December 2014

Lassen, A (2014). Keeping disease at arm’s length – how older Danish people distance disease through active ageing. Ageing and Society, 1-20 DOI: 10.1017/S0144686X14000245

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