researching with centenarians

ORIGINAL ARTICLE

Researching with centenarians

Tina Koch PhD, RN

Professor of Nursing (Older Person Care), School of Nursing and Midwifery, Faculty of Health, The University of Newcastle,

Callaghan, Newcastle, NSW, Australia

Charmaine Power PhD, RN

Senior Lecturer, School of Nursing and Midwifery, Flinders University, Adelaide, SA, Australia

Debbie Kralik PhD, RN

Director, RDNS Research Unit, Royal District Nursing Service, Adelaide, SA, Australia

Submitted for publication: 10 February 2006

Accepted for publication: 19 July 2006

Correspondence:

Tina Koch

Professor of Nursing (Older Person Care)

School of Nursing and Midwifery

Faculty of Health

The University of Newcastle

University Drive

Callaghan

Newcastle, NSW 2308

Australia

Telephone þ6(0) 24921 6144

E-mail: [email protected]

KOCH T., POWER C. & KRALIK D. (2007)KOCH T., POWER C. & KRALIK D. (2007) International Journal of Older People

Nursing 2, 52–61


Aims and objectives. The objectives were shaped by ways in which to best engage

the readers’ curiosity about being 100 years old.

Background. In the effort to reverse negative stereotyping associated with older

people, the aim was to produce a book of individual stories for public readership

that had the power to combat ageism and to present alternative constructions.

Methods. Twenty-four centenarians were interviewed. Each person was asked to

retell, using their own words, something about themselves and the social context

that had shaped their lives. Centenarians could select whatever was foremost in their

minds; an aspect of their lives that they wanted to share. We asked a few standard

questions: What is it like to have lived one hundred years? What, in your opinion,

has contributed to longevity? What matters today? A conversational approach to

interviewing was adopted with the use of prompts to encourage story telling.

Results. Centenarians privileged talking about their early years, childhood, going to

school and first employment. Although most people could relate to a country

upbringing and fewer years at school, subsequent life experiences and opportunities

were diverse. Advice to others who desired a long life was keeping active, leading a

simple life, eating well, working hard, maintaining an interest in events and sur-

roundings, helping others and being moderate in all things. Maintaining a sense of

humour was thought to be important. Loss of eyesight, mostly in the last few years,

had been a profound disruption in the lives, creating new dependencies. Extensive

family cohesion and frequent contact with others who cared was a profound feature.

There appears to be a matter of fact appraisal of difficulties, losses and sadness but

these were considered to be part of life and not particularly extraordinary. It seemed

that these people had made a successful transition to living beyond 100 years old by

leaving stress behind and moving on. Embedded in the stories of centenarians was a

sense of self that was strong and resilient.

Conclusions. The book containing 24 separate stories was published by Penguin.

Sharing the stories of centenarians provided an opportunity to engage with the

public readership and help shape wider social perceptions of older people as worth

listening to.

52 � 2007 The Authors. Journal compilation � 2007 Blackwell Publishing Ltd

Relevance to clinical practice. In this paper, alternatives to dominant stories about

ageing are presented and challenge the negative stereotyping of older people and its

associated notions of decline, dementia, decay and death. Its relevance to clinical

practice is precisely to show that older people are worth listening to. Moreover their

ordinary lives make interesting, popular readership. Although the stories were

primed to reach a wide public audience, we argue that its health promotion message

and our creative effort to combat negative stereotypes can filter to healthcare

delivery.

Key words: ageism, centenarian, stereotyping, story telling, transition

Introduction

Several years ago Koch (1993) explored the experiences of

older people admitted to the acute care sector. The broad

scheme of stories told by older people was that ‘care’ made

them feel worthless. The PhD thesis was that ageism played a

large role in their depersonalization. Ageism, or the process

of systematic stereotyping of and discrimination against

people because they are older, was an attitude held by some

healthcare workers, but also reinforced and perpetuated in

the wider community. Three of the most pervasive aspects of

the stereotype of ageing were that older people were believed

to be physically incapable, mentally incapable and intellec-

tually frail. In this PhD inquiry the stereotyping of older

persons profoundly affected the way they were perceived and

consequently treated in the acute healthcare systems.

Many years later, it is still evident that depersonalization

and negative stereotyping of older people continues (Visentin

& Koch, 2003; T. Koch, University of Newcastle, Newcastle,

NSW, unpublished report) with dire consequences for recip-

ients in the healthcare delivery web. Ageism, kept alive

through negative stereotyping, denies a person’s self-identity.

Exploring the way to reverse some of these negative attitudes

has been the purpose of generating stories with older people.

Stories, when well crafted, are spurs to the imagination,

and through our readings, may advance understandings to

embrace personhood, i.e. to see the person behind the patient.

Recognizing that ageism is a wider social construction, the

way we have sought to reverse negative stereotyping is to take

the stories of older people into the public forum. We had a

unique opportunity to research with 24 older people, most

of them high-profile Australians, and published two books

containing their experiences of ageing (Koch et al., 1999a,b).

These publications had wide exposure, two print runs, and

resulted in wide media coverage including television and

radio exposure of the interviewees and the authors. The point

here is that sharing alternative stories of ageing with the

larger public challenged the negative myths around ageing.

Encouraged by the success of the 1999 book series, we

were keen to continue creating alternative stories of ageing

for the public domain. Whilst we had expertise in story tell-

ing methodologies, we had the additional concern about a

market for subsequent books. In 1999 the marketing of the

books was assisted by the focus of International Year of the

Older Person. Most importantly, we had selected ‘celebrities’

as interviewees. A large readership was the result.

The idea to generate stories with centenarians was appeal-

ing as readership was almost guaranteed. It was argued that

people who are 100 years and older have made successful

transitions on life, and as the concept of transition underpins

our current theorizing in chronic illness experience, we had

an additional quest for knowledge. Sharing the stories of

centenarians would give another opportunity to engage with

the public readership and help shape wider social perceptions

of older people as worth listening to and to be heard as

interesting individuals. Moving away from the problem focus

of ageing, we wanted to expose the strengths of living beyond

100 years. Although primed to reach a wide public audience,

we argue that its health promotion message will filter to

healthcare delivery.

Let us listen to centenarians. A proposal made its way

through funding, book publishers and ethics committees, and

soon we were able to undertake interviews with centenarians.

In our favour was that we are strong advocates of ‘narrative

nursing’; indeed story telling is central to our research

practice (Koch, 1998; Koch & Kralik, 2006). Based on our

previous story telling experience, between April and May

2004, we had consent, talked with 24 people, generated and

transcribed interview data, developed individual story lines,

and signed off on the agreed version for publication with

participants. The book was published (Koch et al. 2006),

presenting 24 separate stories accounts of making it to

100 years and beyond. In this paper we share some of the

commonalities talk about the common and diverse aspects

and situations of this group of individuals that were not

published as part of the book.


� 2007 The Authors. Journal compilation � 2007 Blackwell Publishing Ltd 53

Background

Reaching 100 years of age is becoming increasingly common.

During the next few years there will be one centenarian per

10 000 people in most industrialized countries (Okinawa

Centenarian Study, 2000). The increase in centenarians has

been related to fewer childhood deaths, advances in health care

including the development of vaccines and medications, safe

water supplies and better public health. A New England

Centenarian Study (Perls et al., 1999) found a sizeable group of

people aged more than 100 years who were functioning well,

both mentally and physically. In terms of gender balance,

clearly women do get the upper hand on the men at extreme old

age, 85% women and 15% men (Perls et al., 1999).

Generally, we can expect to live longer. The anticipated

boom will occur with people who were born during the

1920s when public health measures were put into action

(Perls et al., 1999). Another expected rise in life span is

expected to occur with the baby boomers around the year

2050 (Perls et al., 1999). We can anticipate a dramatic

increase in the number of centenarians. This increase will

present new opportunities for nurses to be innovative in the

provision of age appropriate health promotion.

There are a few centenarian studies currently underway

which are aim to question the notion of healthy ageing and

explore what factors contribute to longevity? Despite the

rapid increase in the centenarian demographic, there is a

paucity of research with centenarians, particularly in Austra-

lia. International centenarian research has tended to focus on

the biomedical aspects of ageing. One notable exception to

this is the ongoing New England Centenarian Study (Perls

et al., 1999). Whilst these researchers have focused on genetic

research with centenarians, they have also studied their

medical, functional and cognitive capacities with the aim of

determining what made centenarians healthier than the

general population. Significant findings included that 21%

of centenarian participants were cognitively intact (Perls

et al., 1999). This dispels the myth that people who live to

extreme old age will inevitably develop dementia. The study

found that many participants were active and independent

into their early 90s and if illness was experienced, it had been

during the last 5 years of life (Hitt et al., 1999). Significantly

these people had lived the vast majority of their lives in good

health and often escaped the diseases normally associated

with ageing. In other words ‘the older you get, the healthier

you’ve been’ (Hitt et al., 1999).

The other characteristic identified was that centenarians

appeared to shed emotional stress very well (Perls et al.,

1999). Their stress-shedding personalities and the familial

support they received contributed as stress-reducing mecha-

nisms. Reportedly the centenarians did not ignore stress;

rather they were very good at handling stress and losses. They

seemed to accept their losses, grieve and then move on.

The Japanese Okinawan Centenarian Study (Suzuki et al.,

2004) is another notable exception to the focus on biomed-

ical ageing. This research looks at ‘successful ageing’, i.e.

longevity accompanied by excellent health. In their research,

to be considered ‘successful ageing’ a person ‘should have

enjoyed a high quality of life throughout the life course up to

and including a ‘‘super-elderly’’ stage’ (Suzuki et al., 2004, p.

180). These people have, to some extent, spent their long lives

ageing naturally. This study commenced in 1976, and since

then over 600 centenarians have participated, and while their

evidence shows that hereditary factors are significant for

longevity, environmental factors seem to be more important

(Suzuki et al., 2004). The researchers have developed and

published ‘The Okinawa Program’ which is based on the

traditional Okinawan way of life.

In Australia, McCormack (2001) researched the quality of

life (QoL) with 35 centenarians using a six-item QoL tool.

Items studied were the common indicators of QoL such as

health, memory, social relationships, ability to do things for

oneself, overall life satisfaction and rating the experience of

living to 100. These centenarians viewed living to 100 years

as positive and social relations were reported as good.

Given the limited experiential knowledge about this

population, and the increasing numbers of centenarians, it

is important to listen to the stories of centenarians as they

talk about how they have lived their lives, what they believe

has contributed to their longevity and how they understand

the ways they have managed stressful events in their lives. As

discussed, these stories have been published in a book titled

‘100 years old: 24 Australian Centenarians tell their story’.

In the published book we did not provide a profile of the

centenarians. The Penguin editor took the decision that the

readers would be interested only in the ‘ordinary voices’ of

the centenarians. Excluded were the socio-economic, political

and cultural information that accompanied the introduction

to some of the centenarian’s stories because they were

considered as relevant to all of the centenarians, indeed to

most people who are living a long life. So we relied on

centenarians themselves to provide enough detail in their own

reminiscing and story telling to shape the century in which

they had lived. However, we did bring some of the profile

data together for this paper.

Aims and objectives

In the effort to reverse negative stereotyping associated with

older people, the aim was to produce a book of individual

T. Koch et al.


stories for public readership that had the power to present

alternative constructions.

The objectives were shaped by ways to engage the readers’

curiosity about being 100 years old, and to further our

theoretical understanding of transition. What are the com-

mon traits of people who live to be 100? What are the

‘secrets’? What is it like to have lived one hundred years?

What, in the opinion of centenarians, has contributed to their

longevity? Is it important to manage stress well in order to

live a long time? Does being able to transition through or

move on from stressful events provide a strong link with

longevity?

However, the main objective was to generate individual

stories. The interviewee was asked to talk about an aspect of

their life and ageing they wanted to share, understanding that

what they chose to tell would be available for public

readership.

Methodology

Recruitment

During February 2004 a press release was issued through the

university’s media programme requesting volunteers to par-

ticipate in the study. Inclusion criteria were that participants

be aged more than 100 years old, willing to participate and

be able to tell their story. Within a few days Australia’s Radio

National and many local Australian Broadcasting Commis-

sion radio stations made contact with us, wanting to air our

proposal. Media attention was remarkable, and we were

inundated with people phoning to say that they knew

someone, friend or family, who was 100 years old and who

may wish to be interviewed. Within a fortnight we had

gathered more than 40 names of centenarians from across

Australia. A research coordinator made initial contact by

telephone, and asked the contact person several questions to

gather demographic details. These data included where the

person was born, family composition, the centenarian’s

ability to tell his/her own story, memory status, level of

independence or dependence on others for activities of daily

living, social and other supports received. We then asked the

contact person (who was sometimes the centenarian him or

herself) for a short biography. Some centenarians were to

provide a written chronology later. A short biography was an

important resource because one hundred years is a vast span

to cover in an interview. We selected the first 24 people who

were willing to be involved and were able to tell their story.

The study was approved by a formally constituted Ethics

Committee. Before the interview commenced, written con-

sent was obtained including permission to use the story

should the person die. Permission was granted to use actual

names.

Interviews

We conducted a trial interview with Ben Obst (born 1899).

There were five people present at the interview, the first and

second authors, Ben, his daughter and a friend. This made us

realize that the interview process was most likely to be a

family event. We also recognized that not every person would

be a storyteller. Ben was laconic and although his responses

were astute and penetrating, we had to encourage conversa-

tion. The interview was taped and transcribed verbatim. Even

when actual talk was sparse, we were determined to use his

voice as much as possible. It was our task to write the story,

weaving centenarians’ own speech into it, and to further

shape their account by inclusion of social and historical

context. Family and friends, in receipt of the story, made

changes to actual dates and place names, otherwise there

were few alterations in the final version.

Twenty-four centenarians, 16 women and eight men, were

interviewed. Interviews always included interested friends or

relatives. Each person was asked to retell, using their own

words, something about themselves and the social context

that had shaped their lives. There were some standard

questions, but many chose to talk about aspects of their life

that was foremost in their minds. Their stories ran to several

thousand words. Each interview is woven into their story,

and validated by the centenarian. Together these stories

comprise a social history of ordinary lives lived during the

20th century. We shared the doing of the 24 interviews

geographically, as demanded by the tyranny of distance,

covering North, South, East and West Australia.

Each centenarian was asked to retell, using their own

words, something about themselves and the social context

that had shaped their lives. We asked a few standard

questions: What is it like to have lived one hundred years?

What, in your opinion, has contributed to longevity? What

matters today? Centenarians could select whatever was

foremost in their minds; an aspect of their lives that they

wanted to share. In addition to telling a general life story, we

asked the centenarian to describe a key stressful event in their

lives. A conversational approach to interviewing was adopted

with the use of prompts to encourage story telling.

Gaining insight into a segment of a person’s life, as

experienced, understood, explained and justified by that

person was the purpose. Interviews lasted between 2 and

4 hours. Whilst some participants showed great stamina,

others found the interview process tiring so the interview

length was often not determined by the story telling capacity



of participants but rather by their own physical limitations.

The interviews were conducted in the person’s own home and

often with a friend or family member present to support the

participant. Most of the interviews were audio-taped and

transcribed but notes were also taken if a person was softly

spoken.

Centenarians could select whatever was foremost in their

minds; an aspect of their lives that they wanted to share.

Through taking time and being interested in the storied

lives of centenarians, we built collaborative relationships. A

common refrain expressed by centenarians was ‘I’ve’ never

thought about this, but now that you ask….’ As these older

people narrated their stories they started to hear their life

anew through hearing and prompts made by the others. Of

course, stories are not accounts describing the real world ‘out

there’; rather they are constructed, and creatively authored.

Individual interpretations vary as people develop impressions

based on aspects of life with which they are comfortable and

familiar. Having lived 100 plus years you could surmise that

selecting just a few excerpts of life would be difficult. Yet was

remarkable that few centenarians hesitated about which

aspect of their lives they wanted to share. We were drawn

into their stories and laughter in their telling. The experience

of interviewing was always interesting, often funny, concern-

ing, surprising but overall we felt we were in very good

company with people who enjoyed the company of other

people.

Analysis

We have developed the story telling analysis process over

many years and it is beyond the scope of this paper to dwell

with the analysis process, rather we point to publications in

Koch and Kralik (2006). However to summarize, we inter-

viewed and recorded the stories from 24 people. The

researcher undertaking the interview was responsible extract-

ing for significant statements, creating the story line from the

words, and taking the adapted version back to the participant

and/or family (for instance if the person was visually

impaired) for their comment and changes. The second and

third author read each transcript, significant statements

extracted and the story line and at subsequent research

meetings, discussed analysis. Whilst the three researchers

provided an independent thematic analysis of each story, a

systematic process was developed through immersion in the

text, intensive re-reading of the transcript and documenting

evidence to support each interpretive claim.

The weekly research team meetings were filled with

exciting and stimulating discussion. We were eager to share

our experiences, the interesting people we had interviewed,

relatives and friends who had made us welcome and what we

had learned. We explored the interview transcripts together.

Whilst we sought commonalities in the stories we were

continually surprised that few were apparent. On occasions

we had a lead: Was being raised in the countryside one of the

most common experiences? Then one of us would talk with a

person who had lived in the city all of their lives and dispel

the hunch. So what did we learn?

What do we know about the centenarians?

Centenarians comprised a diverse group. The average age

was 103 while ages ranged from 100 to 109. We noted that

the number of men who participated was higher than the

15% of male centenarians in the population quoted from the

Perls (1999) study. They comprise a wide range of socio-

economic status, a few had privileged upbringing with

servants to attend to their needs, whilst others battled

financially throughout their lives.

One common finding was that 15 people had received only

primary schooling, many leaving school at age 11 or

12 years. Long distances were endured to travel to school

in the country, indeed many recalled walking miles, and

distance was often cited as the reason given for early school

leavers. Two people attended secondary school for a few

years, and seven women had further education at teacher’s

college, Business College or nursing training.

Another common feature was that 14 centenarians were

devout Christians, and that belonging to a church community

was important. Others may have attended church and Sunday

school in their youth but had dismissed religion as important

in their lives. What does this tell us? Perhaps having a strong

belief that offers clear guidelines for living may reduce some

of the agonising when people search for meaning outside

religion. Again this is speculation.

The institution of marriage was also significant. All except

one person had married, often waiting until they were in their

late 20s or early 30s to do so. Marrying later in life was partly

a consequence of poor economic circumstances and the Great

Depression. One woman had separated from her husband,

but her decision to leave was possible because she had a

teaching career that provided financial independence. The

average number of children was two per unit. The mortality

rate of children was higher during the 1930s when most

offspring were born and loosing one’s child at infancy was

not uncommon. Several women were widowed when aged in

their 50s and they had lived solo lives since the death of their

spouse. Although it had been 50 years since her husband had

died, Ada March continued to miss her ‘Alby’. Two people

had remarried. Gilbert Bennion had refused two marriage

T. Koch et al.


offers following the death of his first wife but eventually

remarried when he was aged 90.

The men had occupations in farming, small business, as a

baker or a carpenter and one man was a Park Ranger and

continues his interest in conservation. The Second World War

and their involvement in the war effort changed the employ-

ment path for several men. Indeed the war years present as a

significant life event and some men chose to talk about the

years 1940–1945 almost exclusively.

Although seven women had ‘careers’, these were aban-

doned once they had married. Relinquishing paid employ-

ment when married was an expectation for women that

lasted well into the 1960s. Several women found themselves

back in the work force. Irene White had worked all of her

life, but was paid a salary for the first time when she was aged

in her 60s. Alice Oxley, as the only unmarried centenarian,

had several ‘careers’ including nursing and property man-

agement. Centenarians reported the Great Depression as a

significant time in their lives, and these accounts were

conveyed in their stories. Centenarians recalled that although

there was not much to eat, they were ‘never hungry’.

Homemaking was the social expectation for women, and

many household tasks were laborious, and recalled without

nostalgia. Nevertheless homemaking, baking and sewing

were highly developed skills. Often women provided addi-

tional labour on the farm and recalled milking cows, making

butter and keeping the ‘chooks’. Working hard is what these

centenarians have in common.

Charlie Booth, Maude Young and Jack Aitken continued

to live alone in their own homes. There was another group

that lived with family; Hannah Stevenson, Milka Butorac and

Gilbert Bennion live with a son or daughter. Seven centenar-

ians lived independently in a unit or hostel room as part of an

aged care complex or retirement village. These people were

independent in activities of daily living. Eleven people lived in

the nursing home section of an aged care complex. The

average age of this group of centenarians was 103. It had only

been during the previous 5 years or so of their lives that they

had experienced illness and had become more dependent.

Their minds were lucid and they disliked being inactive.

Boredom as a result of being confined to their nursing home

bed, was a constant issue. Two people were convinced that

they were in a nursing home prematurely. Only one woman

shared her nursing home room with others but most had their

own space.

What are the commonalities?

What do centenarians have in common other than their

extreme age? Class, economic, education and occupational

differences are observed. Although most people can relate to

a country upbringing and fewer years at school, subsequent

life experiences and opportunities were diverse.

Most (18) centenarians were raised in farming communi-

ties. This included one woman who was born in a small

village in the former Yugoslavia. What does this tell us about

longevity and country life? We can speculate about fresh air,

hard work and home-grown food, but is it possible to be

certain? We learned what it was like to be raised in a farming

community.

Raised in a farming community

The oldest person began her life in 1895. Jean Lawson grew

up in the country on a station near Bombala, in New South

Wales. Her father was a station hand and her mother had

worked in the homestead of a nearby station. At this time

they had a farm with dairy cows and other livestock. Jean

recalled that ‘this was a very hard life’. Jean remembered

walking barefoot to school across a creek.

Ben Obst was born in 1899 to descendants of German

immigrants, in the wheat farming community of Brownlow,

100 km north of Adelaide. German was spoken at his father’s

farm and he learned English on his arrival at the local school

when 8 years of age. ‘As a child I walked five miles to

school… it was a long way on my own’.

Max Folland, who was born in 1901, lived in Williams,

then an outback community in Western Australia, in a small

house built among the red gums. The house was ‘a building

24 ft wide by 10 ft wide, two windows, a door on one side,

open fire place the other end, iron roof, no veranda’. His

father made a hard surface inside the dwelling out of termite

nests which were broken up and spread over the floor, and

with some water to moisten it, it was ‘rammed down hard’. In

the attempt to give some privacy, the room was divided by a

hessian curtain. Wheat bags were used as carpet or mats and

‘kerosene packing cases, made of pine’ were used as chairs. ‘I

slept in a single bed in the same room as Mum and Dad, with

Jean and Vern on a couch in the kitchen’.

The farm routine of hard work had shaped their lives. One

woman said that when growing up: ‘I loved the farm life, it

was simple and we had very hard times… mother would do

the baking and make the bread… that was a real luxury’. At

the centre of farm life were the simple pleasures involving

family and community. Many of the women became ‘farm

wives’ and were responsible for the dairy, the chickens and

when the water situation allowed, the vegetable and fruits.

Men had controlled and managed the property, produced

marketable crops, tended the farm stock, cleared and

ploughed the land, built and repaired fences.



Several men recounted stories of work in the ‘outback’ of

Australia. Corresponding with these economic realities and

work relationships, married women were decreed to be

helping wives and loving mothers while men were productive

farmers, protective husbands and fathers. In their capacity as

the head of the household in a patriarchal society, men

enjoyed communication in the wider social world whilst the

strongest and most significant social connections for farm

women were same sex domestic groupings that were vital for

support. The help and support that women provided each

other was intrinsic to their lifestyle. Church activities were

central to socialization in these small communities.

A few centenarians were raised in the main cities, but even

these were provincial places during the early 20th century.

Being raised in the country was the most dominant finding,

but many centenarians had moved to towns and major cities

when they married, found employment, careers and much

later, aged care accommodation, or to be close to their adult

children.

What is it like to have lived one hundred years?

It was noticeable that most centenarians privileged talking

about their early years, childhood, going to school and first

employment. The Saturday night dance was recalled with

great joy. Men often neglected to talk about their marriage

unless we prompted through questioning. Centenarians have

experienced and moved through an astonishing range of life

experiences. How have they done this? What can we learn

from these collective stories?

When asked what it meant to have reached the age of 100

most people replied that they had not planned to live this

long. Until we questioned why they thought they had lived so

long, it had not been given much thought. Mostly people did

not think about their ‘old’ age and they were not able to give

a particular theory of ageing well. Most centenarians thought

that they had simply been lucky. Celebrations when turning

100 were occasions recalled with pride. Comments like ‘it’s

amazing’ and ‘I’m flattered about the attention’ and ‘it gives

me satisfaction’ were common. While not everyone was

happy with this particular stage of their long life, most people

were pleased that they had reached an extreme age.

What, in the opinion of centenarians, has contributed to

their longevity?

We asked people what advice they would give to others who

were seeking to live to 100. Keeping active, leading a simple

life, eating well, working hard, maintaining an interest in

events and surroundings, helping others and being moderate

in all things were common responses. Avoidance of excesses

was stressed, whether food or alcohol, most people preferring

to live simple. We were told that eating good food was

important. Usually this meant fresh food that was simply

prepared. In the earlier years this food was often grown in

potage gardens, organically produced.

Significantly most people talked about the contribution

that hard work had made to their longevity. Being active was

still valued in their current lives. These older people spoke

about experiencing frustration and boredom when their

physical abilities have limited their capacity for activity.

Maintaining a sense of humour was thought to be important.

Laughter was an essential ingredient. Indeed the interviews

were interspersed with laughter.

A few people thought that their genetic inheritance played

a significant part in living a long life as did being mentally

and physically active throughout their lives. Heredity may

not be as powerful an influence on longevity as previously

assumed. Research suggests that as we age, genetic inherit-

ance becomes less of a factor and environment and lifestyle

may become more important. It may be that how we live and

where we live can have a profound impact on the way in

which we age.

What matters today?

Predictably, the focus of peoples’ concerns were for their own

health, the health of their family, a desire to keep busy,

maintaining a level of comfort and striving for contentment.

There was a high level of satisfaction amongst these people

with the life they have led. There was a strong feeling among

these centenarians that they had lived a fortunate and a good

life. Not surprisingly, some people felt that they were ready to

‘go to sleep’.

Health and well-being characteristics of longevity

What about their health? Loss of eyesight had been a

profound disruption on the lives of many centenarians. For

those who had enjoyed reading or watching television, the

loss of vision affected their QoL. Apart from a few people

with hearing loss the other senses were less problematic.

Again and again we heard that losing eyesight was the most

significant disability experienced. Twelve centenarians had

impaired vision. Max Folland said:

Six months after I turned 100 and my eye went on me… I can only

just see your face; you’re a cloud to me. My life has changed. I’d been

known to read the paper, read anything… now I turn the wireless on

most of the days.

T. Koch et al.


Resonating here is that losing vision has the potential to

change one’s life completely. Hearing loss was resolved by

aids and the use of modern technology, whereas loss of

eyesight has few remedies. Six centenarians had fallen and

had fractured a hip during the previous decade. Even though

most had made a good recovery, walking with a frame helped

them feel more secure. Very few medications were taken by

this group. Arthritis was a common condition.

A comparison of these stories with the factors identified in

the New England Centenarian Study ‘Life Expectancy Cal-

culator’ revealed that this group of centenarians has many of

the health and well-being characteristics that promote

longevity. They were not overweight, have generally not

smoked, have not taken alcohol at all or with extreme

moderation and have eaten a very plain diet.

Many of these people spoke of eating three meals a day,

beginning with porridge for breakfast and meat and vegeta-

bles for dinner. Dinner would often include a home-made

‘pudding’ and bread was usually home-baked, as were cakes

and biscuits. Butter and cream were also made at home and

consumed in moderation. Fruit was an essential food, again

often self-grown. Eating was not given special meaning;

people felt that they had not ever done anything special.

Significantly these people consumed virtually no processed

food for the first 50–60 years of their lives.

Dental care was very different during their growing years;

toothbrushes had not been ‘discovered’. Certainly daily

flossing is a very recent initiative to protect against gum

disease and associated bacterial and inflammatory damage.

Dental prosthesis or false teeth were common in this group of

people.

Extensive family cohesion and frequent contact was a

profound feature of the lives of these centenarians. Many

talked about the strong sense of family life often with

treasured memories of family gatherings. These connections

with others tended to extend to neighbours and the broader

community.

The lives of centenarians had been guided by the rule to

give to others with no thought for anything in return. All

participants talked about this and continued to deeply value

this principle. Other researchers (Griffith, 2004) have noted

that people who do not belong to cohesive families have

fewer coping resources and experience increased level of

social and psychological stress.

Transition

Other centenarian studies have indicated that the way people

cope with stress may be a factor in longevity (Perls et al.,

1999). The predominant responses to this issue indicate that

although these people have lived through difficult situations

and hard times, most revealed that they did not view their

lives as being particularly stressful. There seemed to be a

matter of fact appraisal of difficulties, losses and sadness but

these were considered to be part of life and not particularly

extraordinary. With hindsight, a perspective of accepting

whatever life brings appeared to prevail. Attitudes of ‘don’t

worry about the past’, ‘take each day as it comes’, ‘accept

things’, ‘do what you can to make things better and then

forget it’ and ‘give it time, wait for things to change’ were

common responses. It seemed that these people had made a

successful transition to living beyond 100 years old by

leaving stress behind and moving on.

The capacity to manage stress has been considered to be a

significant factor in longevity (Perls et al., 1999). The

centenarians in this study had experienced many highly

stressful events throughout their lives, both personal and

social. Living through and experiencing the loss of family

members, sometimes their own babies and adult children,

spouses and other family members were prevalent aspects of

their lives. These centenarians had endured the social and

economic consequences of two world wars and one severe

depression, however the key aspect in relation to these major

events was that ‘you do what you can, then move on’. They

had considered there had been ‘no point in dwelling on

things’.

Ageing is not experienced in the short term, but as a

transitional process. People learn ways to incorporate the

consequences of significant events into their lives. How do

people live through the profound grief of losing a partner of

60 years or a child? How do people rebuild their lives

following significant life crisis such as a war or depression?

What has emerged strongly from the stories is that aging is

a complex process, and it is neither a medical concern nor a

psychological problem, but it is a combination of life events

and personal characteristics. One’s physical health, social and

economic circumstances, and attitudes towards aging all

seem to have an important part to play.

Centenarians often said they were surprised that they

had lived to an extreme age. The taken for grantedness of

our everyday lives means they often perceived themselves

to be ageless. There was an identity that maintained

continuity throughout their lifetime that drew meaning

from the past so as to provide courage for the future. Some

people came to realize they have aged by watching their

children and grandchildren reach adulthood. Several cente-

narians spoke of the profound grief they experienced when

their parents died. Death of their parents brought the

realization that they were the oldest generation in their

families.



Embedded in the stories of centenarians was a sense of self

that was strong and resilient. Structures and boundaries

shaped their lives – family units, community, and religion

helped to define their self-identity. Strong discipline imposed

by family and religion, strict moral codes and hard work

created a sense of order and control. Is helping and

connecting with others a means by which people maintain a

sense of self and a sense of meaning and purpose in their

lives?

Family life provides many roles for older people such as

spouse, sibling, in-law, grandparent, and great grandparent.

Longevity creates multiple and changing roles for older

members of our community however these roles although

important, are often devalued. Older adults may experience

great difficulties in adjusting to the reality of the death of a

spouse. Profound change was forced upon them as they learnt

to live with loss and adapt to the role of widow or widower.

Many centenarians had wished for the return of their

deceased partner. Most people talked about losing their

contemporaries and the shared stories that were lost with

those lives.

Centenarians were living in a wide range of accommoda-

tion including hostels, where they maintained a large degree

of independence. There were also those who were living at

home, sometimes with a family member. Jack lived with his

wife, and others such as Maude lived independently and

alone. Not all centenarians however were able to choose

where they lived or how their day could be spent.

It was notable that family and friends of the centenarians

actively worked to counter boredom by focusing on what

they could do. This group of people all said that they have led

active lives. They were accustomed to being busy and not at

all comfortable with having nothing to do. There were some

situations, either due to the personal loss of faculty or

because their accommodation limits access to interesting

activity, that centenarians expressed intense boredom and

lack of stimulation. This was not because people were

disinterested but that the opportunities were not presented.

Some aged care institutions did not ensure that people were

provided with opportunities to exercise their intellect.

There was diversity in the socio-economic status of these

people, and again stereotyping was not possible. It was

significant that the majority of people had little formal

education, often achieving primary school level. Distance to

travel to school was often the obstruction for further

education. Despite this there was a strong work ethic evident

in the stories and even during times of extreme hardship, such

as during the Great Depression, work was found.

Religion was very important to the majority. Church

attendance was less regular when centenarians’ mobility was

reduced or transport not available. The values and strength of

a religious life however remained significant and many people

revealed an enduring, strong belief in Christianity.

Conclusions

We have to agree that centenarians have made a successful

transition in life. Whilst social roles and institutions tended to

be prescriptive, it did mean that agonizing about what to do

with one’s life was minimized. Centenarians seemed to share

the characteristic of resilience. They recovered quickly from

crisis and illness events. This quality may have implications

for longevity, as people revealed the capacity for adaptability,

and successful incorporation of change into their lives. These

people were able to bounce back from crisis and hardship,

and to adapt to change. Connections with others and the

ability to laugh were important commonalities.

It was our aim to dispel the negative stereotyping

surrounding older people and we have selected the centen-

arian group to secure an audience with which to share this

health promotion. In this study, myths have been disrupted;

misconceptions and stereotypes commonly held about older

people are challenged. None of the centenarians who

participated in this study were intellectually frail. Some

people did experience lapses in memory that were related to

the recall of dates and the sequence of events, which is not

surprising given the time frame over which events occurred.

There exists a tension that comes from being older and living

in a society that values youth, speed and productivity. There

is an opportunity however, as our population ages, for us to

begin to focus on the value of the older person rather than on

disability, the disease or illness state. While physical strength

declines with age it had only been relatively recent that

centenarians had experienced this. Some people had de-

creased mobility and experienced tiredness and diminished

stamina. A few people were notable exceptions and contin-

ued to exercise regularly. Intellectually sharp, stories revealed

that centenarians thrived on laughter and joy in their lives.

While a few people thought that they were ready to ‘go to

sleep’ this had usually been a recent feeling. Most people

revealed a continued pleasure with their life. It is our

observation that people shared a common characteristic of

wanting to connect with others. We suggest this is vitally

important regardless setting, but how do we proceed?

Implications for practice

As advocates of ‘narrative nursing’, story telling practice is

rewarding in research and in practice. However in practice,

nurses in particular, need to be given the permission to

T. Koch et al.


engage with older people. This is not to say that biographical

approaches, utilizing photos, personal documents and mem-

ories have not been part of routine nursing practice in

residential type facilities but it is far from acceptable in acute

care health settings to engage with older people in this way.

Yet if time was granted and sanctions were lifted, deperson-

alization might become past tense. Valuing older people is

displayed through listening and responding. Stories challenge

providers of care to examine their own assumptions. Through

listening, it would become obvious that being older does not

equate with negative stereotypes. The complex and continu-

ous process of ageing expressed by older people themselves is

a powerful way to counter negative stereotypes.

We believe that listening to the stories of older people has

the potential to confront people’s thinking about ageing. In

this paper alternatives to dominant stories about ageing are

presented and in so doing, challenge the negative stereotyp-

ing of older people and its associated notions of decline,

dementia, decay and death. In this way we view our work as

health promotion in the wider community. It is creative

because we have selected a variety of ways, including radio,

television and popular press media, to disseminate the

outcomes of story telling research.

Acknowledgements

This study was funded by a grant from the Foundation Board

of the Royal District Nursing Service (RDNS), South

Australia. We appreciate the work of Natalie Howard and

Lois Dennes, RDNS Research Unit, for coordination, inter-

view transcription and administrative support.

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