
As a psychology Ph.D. student, most of my time is spent tucked away in a lab doing research. The lab is a curious place: at once beguiling, like a Siren, the complexities of the natural world while also keeping them cautiously at bay—controlled, compartmentalized.
But it is life’s laboratory that nourishes the stuff of the books and nooks and notes that live in our labs. The most interesting psychological questions are not those that we cautiously contrive, but those with which the natural world indiscriminately confronts us.
I did not always know or trust this.
Around the same time I’d submitted my first manuscript for publication, my sixty-something father had undergone rotator cuff surgery. Two things preoccupied me: (1) what question(s) would my next publication address, and (2) would my father be okay?
In the days following his surgery—between hours of frenetic note taking and reading—I’d call to check in with him. Our conversations usually went like this:
Me: “How ya doing, Dad? How are you feeling today?”
Dad (in full Brooklynese): “Ay, sweetie! I’m feeling great. In pain, but doing some exercises to feel better.”
Me (incredulously): “Exercises? Already? You weren’t even operated on 48 hours ago.”
Dad (jokingly): “I’m an important guy—people need me! Like your crazy motha (pronounced: muh-tha)! Gotta make myself useful around here.”
And suddenly, I found myself plopped unapologetically in the middle of life’s laboratory. I repeated his words to myself: people need me. People need me. I wondered: was my father’s perceived responsibility his proximal social world—my mother, me, his friends—in some way, influencing how he coped with his pain? Was he feeling needed by and useful to his friends and family, in part, motivating an exercise regime that Jane Fonda herself would envy?
My research interests—united in their attempts to understand associations of chronic illness (e.g. osteoarthritis, HIV/AIDS, obesity) with psychological health in older adults—emerge from this question. More specifically, it asks: “How do feelings of usefulness to others in later life influence the selection and application of adaptive health behaviors?”
And why am I asking it? Because, all too often in this culture of ours, if you’re old, you’re simply not useful anymore. And really, what’s the use of a culture like that?
I’ve begun — under the mentorship and support of Dr. Patricia A. Parmelee— slowly but surely, to answer this question using her samples of older adults with knee osteoarthritis (KOA)—an incurable, chronically painful joint disorder.
In the United States, osteoarthritis ranks among the top three health conditions causing disability and is estimated to affect 26.9 million adults. It also represents the most common source of chronic pain in older adults—with more than half over the age of 65 reporting KOA-related pain and about 80 percent reporting some degree of disability or movement limitation. And because KOA cannot be cured, adults learn to cope with the pain either actively—by attempting more or less directly to control it—or passively, through relinquishing control of it. Research across rheumatic diseases (e.g. rheumatoid arthritis) has linked active coping strategies— like direct problem solving— with less pain, functional disability, depression, and greater quality of life than passive approaches.
So, what exactly determines how we cope?
Deciding to cope actively or passively with knee pain—and pain in general—illustrates a psychologically interesting and complex question because beliefs, values, and goals are heavily involved in that decision. For example, if you believe you meaningfully contribute to, and are needed by a community, might you be motivated to be more active in your approach to coping with pain?
Gerontological theories of activity and continuity hold that, to age successfully, older adults aim to maintain the activities and relationships of their earlier years of life. Accordingly, decrements in social and economic participation notwithstanding, older adults desire to remain active, useful, and generative. It stands to reason that feeling useful to others in later life may, in part, motivate the selection of pain management strategies that reinforce and maintain feelings of usefulness, particularly with disabilities like KOA.
Indeed, using a sample of 199 persons with physician-confirmed knee osteoarthritis, preliminary results from our ongoing research suggest older adults who endorse feeling more useful— that is—who have relationships that offer opportunities for helping others and who feel validated for their interpersonal worth—are more likely to use active coping strategies to manage their knee pain than those who feel less useful. While further research is needed, our results provide preliminary support for the possibility that feelings of usefulness may motivate the selection of adaptive health behaviors, like active pain coping, that promote the maintenance of social engagement and function with disability.
This raises interesting implications for clinical care—specifically, the importance of recommending a broader range of interventions to persons with KOA aimed at both social and physical activity. Further research clarifying the psychological role of perceived usefulness in promoting health behavior is needed, but will continue to gain relevance as the population ages, rates of chronic disabilities like KOA continue to grow, and contributory roles of older adults as mentors, volunteers, and productive citizens increase.
And so while my mother may make my father crazy, at least she makes him feel useful.
What does usefulness mean to you?
Hello, I’m an AGNG 320 student at the Erickson School of Aging. I think that this feeling or usefulness resonates with more than just people having to decide to endure something as opposed to taking the easy road. In the context of your blog post, this is in regards to elderly people and choosing active coping strategies as opposed to passive ones. This same behaviour is reflected in a lot of different aspects of peoples’ lives. For example, an individual whose working on a project with a group of other people might put in extra effort to complete their part because they know their project will have a large impact on society. That’s a weak example, but I think it reflects the idea that people who know that others are dependent on them will exert more effort due to social pressures.
Hello, I am an AGNG 320 student at the Erickson School of Aging. I enjoyed reading your blog because you kind of shine light on the topic of “healthy aging.” I personally would like to pursue a career in healthcare and I find it interesting how the human body functions especially as we age. I agree with your stance that being useful (remaining active) can be used as a mechanism to cope with pain. As human beings it’s easier to accomplish any task given there is an incentive, therefore it should be natural for older adults to continue daily activity if they feel their needed versus those who are not. One of the healthy people 2020 objectives is to “Reduce the proportion of older adults who have moderate to severe functional limitations.” An excellent way to accomplish this objective is for many older adults to follow your dads approach and just continue remaining useful and active.
Hello, I am an AGNG 320 student at the Erickson School of Aging. The personal aspect of your post really caught my attention. I believe that the thought of being useful is a very important aspect in motivation. Being useful, or just the fact that someone out there needs you and only you, could really push a person to strive to be healthy in order to live a longer life. I feel once a person gets to certain age, many of them live for other people. Parents start to live for the sake of their children, Grandparents for their grandchildren, or maybe even a pet owner living for their pets. They want to live because they want to see the continuous lives of their loved ones, which ultimately may be the number one motivator to push someone in being healthy.
I am an AGNG 200 student at the Erickson School of Aging. Your article resonates with me due to it’s personal perspective and message. It is also an important aspect of aging to consider. Usefulness is in a way the fountain of youth. It is very important to encourage the elderly to still be active in decisions pertaining to their well being and the well being of others, this gives them a sense of vitality and purpose. Based on the research conducted, being useful is a form of therapy and coping mechanism for an older individual going through some kind of health issue. Family members should view their elderly as a team member, although they are higher in age they are not so fragile to the extent of exclusion. incorporating their ideas and feelings keeps them content and healthy.
I am an AGNG 200 student at the Erickson School of Aging an AGNG 200 student at the Erickson School of Aging. The article is a great confirmation about the positive effects of living with the feeling of use-fulness. Chronic pains can cause depression due to uncomfortable feeling and limiting people of all ages from their favorite activities. In the case of older adults, it is more challenged for them to cope with chronic pains and physical/intellectual decline at the same time. Living a meaningful life reproduces positive thinking that helps elders go over pains to enjoy life. According to the research about Education Participation Among Older Adults of U.S. Department of Education, 2005, while younger adults participate in professional institutes such as Degree/Diploma Programs, most of older ones like to take personal interest courses. From the research, we can see that elders love to focus on and take part in real life as much as possible to have the feeling of living actively. This article also makes me think about how to recognize and motivate elders’ motivation since usefulness has different meanings to different individuals. Without this kind of motivation, older adults would focus too much in body decline that causes extra pain and sickness.
As a person who has lived with pain since my 20’s I agree with this article. I pursed 2 Master’s Degrees and served in the ministry until retiring at 64. A year later I started small business which is entering its 8th year. I am unable to do some of the things I enjoy such as kayaking but find meaning in serving seniors and providing work for my staff.
I think it is important. Having several long lived high functioning members of my family (and now myself) who were useful and felt needed, they (and I) took extra effort to stay healthy. For years now I have thought a good research group would be entertainers (except rock band members, maybe). They can continue to provide a happy experience to people well into old age. A friend who just recently died performed his magic act before hundreds on his 100th birthday. I have been a full time performer still in demand since retiring so I feel useful and I feel the need to control my pain and to watch my health.
Ray Thompson, MS Counseling