Martin Pinquart

The risk of needing help with household tasks or of requiring care in old age increases. Using semi-structured, qualitative interviews, beliefs about the usefulness versus uselessness of planning ahead for future care needs (FCN) were investigated in 23 East German, 10 U.S., and 10 Canadian elderly-community dwelling women ( S 65 years). Primary reasons in favor of planning for FCN were: gaining a feeling of security regarding the future, avoiding being a burden to potential helpers, and coping with one's present health conditions. Factors that prevent planning for FCN were: the difficulty foreseeing FCN, the lack of resources to plan, and low levels of perceived vulnerability. The women dealt with the contradictions between these factors that promote and prevent preparation by making general plans which could be adapted in the case of needing help by developing alternative plans or by avoidance of thinking about possible future health crises.

Preparation for one's death (e.g., having signed a will, having made preparations for one's funeral) and preparation for future care needs (e.g., having selected a source of support) were investigated in 593 United States and 582 German independently living seniors. The older adults reported higher levels of preparation for death than preparation for care. The lower level of preparation for care is interpreted as reflecting the uncertainty whether care needs will emerge in the future. Seniors who reported some preparation for death were more likely to report preparation for future care needs as well. Older, more educated, and more religious individuals were more likely to prepare for death. In addition, U.S. seniors were more likely to report some death preparation than German seniors. Limitations in activities of daily living did not predict levels of preparation for death. Implications for future research and for psychosocial interventions are discussed.

Age-associated changes of subjective health and associations of subjective health with physical health, functional health, and mental health were meta-analyzed in older adults (M age > 60 years). An age-associated decline of subjective health, which was stronger in old-old samples than in young-old samples, was found. Subjective health was correlated with the indicators of objective health, but the association with physical health was stronger than with functional health. Correlations of subjective health with physical health and functional health were lower in the old-old than in the young-old samples, whereas associations of subjective health with mental health were stronger in older samples. Furthermore, the size of the association between subjective and objective health varied by the method of assessment of objective health, showing highest associations with symptom checklists and results of medical examinations due to strict protocols.