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Abstract

The aging process presents a complex interplay of physiological, psychological, and social transformations, shaping individual experiences in profound ways. This research protocol outlines a qualitative study exploring the intersection of purpose in later life, internalized ageism and other barriers to purpose, and psychological flexibility among older adults. Internalized ageism, encompassing negative stereotypes, prejudice, and self-discriminatory practices based on age, can significantly impact an individual’s sense of self and well-being. Simultaneously, the pursuit and maintenance of purpose, a driving force behind motivation and engagement, becomes particularly salient in later life as individuals navigate changing roles and responsibilities. Psychological flexibility, defined as the ability to adapt to changing circumstances and maintain goal-directed behavior, may play a crucial role in mitigating the negative effects of internalized ageism and fostering a sense of purpose in late life, although research is scarce. This study aims to delve into the lived experiences of older adults, examining how internalized ageism influences their sense of purpose and the role of psychological flexibility in navigating these challenges. By employing qualitative methods, we seek to identify potential markers of psychological in/flexibility in later life that could inform the development of assessment measures at this age stage.

Keywords

elderly ageism purpose in life psychological flexibility qualitative

Later life is a distinct stage of the life course, characterized by ongoing dynamic interactions between an individual and their environment. This stage encompasses a range of biological, physiological, psychosocial, and functional transformations that unfold gradually and exhibit significant inter-individual variability. It’s important to avoid generalizations and recognize the diverse experiences of individuals in later life.

The prevalence of this life stage is notably increasing. In Spain, 20.4% of the nation population is aged 65 and above, and the projections for 2055 anticipate a continued growth to up to 30.5% of the total population (National Statistics Institute [INE], 2024). Given this scenario, understanding well-being in older adults seems crucial to alleviate the potential impact on the healthcare system and the intergenerational social and family dynamics.

Research in recent decades has explored positive aging and related concepts like successful aging, aging well, healthy aging, productive aging and resilience (Zanjari et al., 2017). The term positive aging emerged in the literature relatively recently, coinciding with the rise of the positive psychology movement in the late 20th and early 21st centuries (Hill & Smith, 2015). Positive aging emphasizes the individual’s capacity to interpret life experiences, both positive and negative, in ways that maintain well-being. It involves accepting and reframing age-related challenges, such as declining physical and cognitive function, as opportunities for growth and continued well-being, hence prioritizing psychological resilience and adaptation. Indeed, the basic premise of positive aging is that by focusing on psychological adaptation and finding meaning in life’s transitions, individuals can maintain well-being even as they experience physical and cognitive changes.

One of the variables that enable individuals navigate life’s transitions and maintain wellbeing despite challenges is purpose in life. Defining purpose in life is complex as it is a subjective and multifaceted construct. However, several key elements are consistently highlighted in the literature: (1) meaning and significance, a belief that one’s existence matters and has value; (2) intentionality and goal-directedness, having goals and aspirations that guide one’s actions, provide a sense of direction and contribute to a feeling of forward momentum and engagement with life; (3) connection to something larger than oneself and contribution to something meaningful that can make a positive impact on the world; (4) personal growth and development through experiences, learning and self-discovery (Bronk et al., 2018).

McKnight and Kashdan (2009; see also Kashdan et al., 2024) propose a framework for understanding the development of purpose in life, suggesting it is a central, self-organizing life aim that shapes individual behavior and information processing. They distinguish purpose, an overarching and enduring pursuit of meaning, from specific, achievable goals. Their model outlines three developmental pathways to purpose: proactive development involving conscious cultivation over time; reactive development arising from transformative life events; and social learning through observation and modeling (Kashdan et al., 2024). These processes, they argue, are not mutually exclusive and can interact in shaping an individual’s evolving sense of purpose. Indeed, purpose is not a fixed endpoint, but rather a dynamic process that evolves and adapts over time. A life well-lived, according to the authors, is characterized by the pursuit of a self-organizing purpose, which provides direction and meaning even amidst adversity.

There is evidence that purpose in later life correlates with various physical and mental health outcomes, psychological resilience, cognitive function, social integration, overall life satisfaction (Dahl et al., 2020; Escura et al., 2019; Irving, 2024; Steptoe & Fancourt, 2019), and that it is a robust predictor of mortality (Martela et al., 2024).

Despite increasing recognition of its benefits, evidence on how older adults experience and define purpose in life, particularly within the context of changing life circumstances and societal expectations, is scarce. In her study, Irving (2024) revealed that older adults experience purpose through four main domains, namely, drive for life; roles and responsibilities; routine, activity and independence; and faith and spirituality. Flatt et al. (2015) found four main purposes in the social activities older adults tend to participate in, namely, enjoyment, relaxation, mental and social stimulation, and belongingness. And a recent review alert of the discrepancies between researchers and older adults in the role and the concept of purpose in this age stage (Pocock et al., 2023). Still, with few exceptions, the literature demonstrates that purpose declines with age, with older adults being at greater risk of losing their sources of purpose, potentially due to critical life events such as retirement, widowhood, and societal factors such as ageism and stereotypes about aging, which can negatively impact older adults’ opportunities and motivation to pursue meaningful activities (Irving, 2024; Irving et al., 2017).

Ageism is prejudice or discrimination against individuals or groups based on their age (Butler, 1969). While it can target people of any age, it most frequently affects older adults. Ageism is often rooted in stereotypes and assumptions about the capabilities, characteristics, and roles of individuals based on their age. These stereotypes can lead to negative attitudes, discriminatory behaviors, and systemic inequalities that limit opportunities and diminish the quality of life for older adults (Ben-Harush et al., 2016; Ribera-Casado, 2024). Ageism can manifest in various ways, from subtle, unintentional slights to overt acts of discrimination in employment, healthcare, and social interactions. Especially relevant to this study, ageism can be internalized, leading older adults to accept negative stereotypes about themselves as true statements and limit their own aspirations and actions (Kornadt & Rothermund, 2011; Levy & Banaji, 2002).

One way of overcoming internalized ageism is through psychological flexibility (PF), also known as psychological acceptance (Cherry et al., 2021; Ciarrochi et al., 2010; Doorley et al., 2020; Gloster et al., 2011; Hayes et al., 1999). Generally speaking, PF refers to the ability to notice a specific content (e.g., thought, emotion, memory, etc.) with perspective, that is, establishing a difference between the content and the person who has it, and choose a course of action aligned with the aspects that the person values. PF has been extensively related to an increase in optimism, more and better expression of positive emotions (less of the negative ones), closer relationships with others, less depressive symptomatology, and greater self-esteem and reported well-being (Kashdan & Rottenberg, 2010; for evidence on the negative associations of its counterpart, psychological inflexibility, with adaptation and wellbeing, see Bond et al., 2011; Levin et al., 2014; Monestès et al., 2018; Valdivia-Salas et al., 2017). Particularly in the case of older adults and internalized ageism, research on the benefits of promoting PF is incipient but is showing promising results (Hajatnia et al., 2023; Hajatpour & Haroon Rashidi, 2021; Lester & Murrell, 2022; Mahmoudpour et al., 2023; Murphy et al., 2023; Owen et al., 2021). Still, additional research is necessary to clarify the definition and the role of acceptance on well-being in later life (Pocock et al., 2023).

Currently, there are several measures of PF/PI in the general population (Cherry et al., 2021), which are categorized into three dimensions, namely, openness, awareness, and engagement. Openness refers to the acceptance of internal experiences such as thoughts, feelings, and bodily sensations, without trying to change them. Awareness refers to contact with the present moment and with the stable part of oneself that observes the internal experience moment by moment. Finally, engagement refers to clarity and connection with personal values, and the emission of behavior consistent with those personal values. In a recent review of the assessment of PF/PI in older adults, Plys et al. (2023) identified a total of 9 instruments measuring the Openness dimension; 6 measuring the Awareness dimension; and 2 measuring the Engagement dimension. The authors also noted that of the three dimensions, Engagement was the least explored in the older population, for instance, there was no evidence about age differences in Engagement, nor about its relationship with anxiety, depression, positive and negative affect, or well-being. Another issue relevant to the present investigation is that the most commonly used instrument to measure PF/PI, the Acceptance and Action Questionnaire (Bond et al., 2011), shows psychometric properties below recommended standards when applied to the older population (for similar poor results with other assessment instruments, see Adamowicz et at., 2022).

The purpose of the present study, hence, is to investigate, using qualitative methodology, aspects related to PF in older adults, including how purpose is experienced by older adults, to what extent they live by their purpose, and which are the barriers they typically find in their daily life to purpose-driven behaviors, among others, internalized ageism. All this with the final goal of informing the development of PF assessment measures, and specifically of the engagement component, that are more sensitive to the nuances of barriers to a purposeful life as perceived by older adults.

Methods

Study Design

This study will employ a qualitative design. Given the exploratory nature of the study, we will utilize the grounded theory approach (Strauss & Corbin, 1997). This approach allows for the development of a theory grounded in empirical data from qualitative interviews, revising preexisting theoretical frameworks, and creating knowledge that accurately reflects participants’ subjective experiences. There is a notable scarcity of research examining the relationship among psychological flexibility, internalized ageism and other barriers to purpose in life, and well-being in older adults, which limits the availability of established theoretical frameworks to guide inquiry in this area. Furthermore, the limited studies that do exist have predominantly relied on the AAQ to assess psychological flexibility; however, this instrument has demonstrated poor psychometric properties when applied to older populations, raising concerns about the validity and reliability of findings derived from its use. In light of these limitations, there is a pressing need for methodological approaches that do not depend on pre-existing theories or potentially inadequate measurement tools. Grounded theory is particularly well-suited to address these challenges, as it facilitates the generation of theory directly from participants’ lived experiences and narratives, thereby allowing for a more nuanced and contextually relevant understanding of psychological processes in later life. Using a constant comparative method across interviewees, data will be coded at multiple levels (open, axial, and selective) to identify patterns, relationships, and conceptual dimensions that describe how psychological flexibility/inflexibility is experienced and expressed in diverse social contexts under the influence of implicit ageism and other barriers to a purposeful life. By listening to older adults, we intend to gain in-depth understanding of how they perceive and construct purpose in their lives, to what extent they live by their purpose and which are the barriers they typically find.

Participants

We will first employ a convenience sampling approach, targeting older adults within the immediate environment who express willingness to participate. To broaden the sample and enhance representativeness, various associations and organizations dedicated to older adults will be contacted, extending informational flyers and invitations for participation. A snowball sampling method will further expand the reach, leveraging existing participant networks to identify and recruit additional eligible individuals. Eligible individuals will be those 60 years old and older; living in their community and also in assisted living facilities; fluent in Spanish; and giving written consent to participate. Those who present cognitive impairment as measured with the Short Portable Mental Status Questionnaire (SPMSQ; Pfeiffer, 1975) will be excluded from participation.

Data collection will cease upon reaching data saturation, which will occur when no new themes relating to the topics under investigation are identified in the interviews (Strauss & Corbin, 1997). The only researcher who will conduct the interviews will note the absence the new themes through an interim analysis. Two or three additional interviews will then be conducted and if no new themes emerge, then data collection will cease. From literature on the qualitative exploration of similar issues (e.g., Reichstadt et al., 2010; Rosenfeld et al., 2000), we anticipate data saturation will be reached after interviewing about 20 participants.

Data Collection

Complying with the United Nations recommendations to address potential shortcomings in the protection of the human rights of older persons (United Nations, 2024), we will conduct qualitative in-depth semi-structured interviews that will also adhere to APA’s guidelines for interviewing older adults (American Psychological Association, 2024). The interview will be informed by the PF model of wellbeing (Kashdan & McKnight, 2009), which poses special emphasis on meaning-driven behaviors that occur despite- and help overcome- adversity, and meaning-driven adaptations to the current circumstances. Specifically, the interview will explore sources of meaning, developmental ways to those, the presence of meaning in their daily life, experienced barriers to a meaning-based life, and past and current ways to overcoming such barriers (see Table 1 for an overview of the interview protocol).

Table 1.

Overview of the Interview Protocol

Section	Topics to explore
1. Ice breaking	Sociodemographics; daily routines.
2. Purpose in life	Sources of purpose; presence of; developmental ways to; changes over time; adaptations.
3. Barriers	Perception of old-age; self-aging; aspects of internalized ageism; physical, psychological, environmental barriers.
4. Inner resources	Experienced difficulties throughout life; coping strategies; perceived strengths of character.

Interviews will take place in a quiet place free of noise and other distractions, and where anonymity can be assured, at the participants’ choice. Based on a pilot experience, we estimated that each interview will last 60 to 90 min and will include opportunities for comfort breaks. The interviews will be audio-recorded and transcribed verbatim, including silences, gestures, or other nonverbal expressions of emotion that the interviewer will annotate in a field diary and that will help contextualize the information during data analysis.

Data Analysis

The content analysis of the transcripts will be performed with the aid of MAXQDA software (Kuckartz & Rädiker, 2019). We will first generate a coding system by using a hierarchical classification from the particular to the general. Specifically, two novice researchers in qualitative analysis will first perform a structural analysis with the identification of “topics” (by grouping the main ideas verbalized in the interviews), the creation of “subthemes” (by grouping the topics with common characteristics); and the establishment of the main “themes”, or higher order categories encompassing subthemes. The coding system will be developed through consensus (Cohen’s Kappa = 1), aiming for exhaustiveness, mutual exclusivity, and maximum informational coverage with the minimum number of categories (e.g., Qureshi & Ünlü, 2020). This initial approach by novice researchers (Phase 1 of analysis) aims to minimize theoretical bias.

Rigor will be ensured through adopting credibility, accuracy, and transferability measures. In order to guarantee data accuracy, notes taken in the field diary will be taken into account during the interviews and subsequent analyses, during their transcription, and when generating the hierarchy of themes. As for credibility, we will use triangulation across data, methods, and the analysis itself (Strauss & Corbin, 1997). The notes in the field diary and an expert criterion will serve to determine the final categories. Specifically, a supervisor expert in qualitative methods will conduct an independent analysis (Phase 2 of analysis) and the coding system generated by the novice researchers in Phase 1 of the analysis will be compared with that of the supervisor. Confrontation, refinement, and reorganization of discrepant codes will occur until consensus is reached. An inter-rater reliability analysis using Cohen’s Kappa coefficient will be performed between phases 1 and 2 to assess the degree of agreement in result extraction and coding system creation.

Finally, in order to guarantee data transferability, the methodology employed and the results obtained will be reported following the Consolidated Criteria for Reporting Qualitative Research Guidelines (COREQ; Tong et al., 2007).

Ethical Considerations

Ethical approval for this study has been obtained from Research Ethics Committee of the Autonomous Community of Aragón (CEICA, #PI24/554). Informed consent will be obtained from all participants prior to data collection. Participants will be informed that their voices will be recorded and of their right to withdraw from the study at any time. Confidentiality, anonymity and data protection will be secured throughout the study by using pseudonyms, encrypting data files, and storing data securely.

In alignment with the APA guidelines for psychological practice with older adults (American Psychological Association, 2024), our qualitative study is designed to uphold the highest standards of professional competence, respect for diversity, ethical rigor, and methodological adaptation. First, researchers possess specific training and expertise in aging, recognizing that working with older adults requires an understanding of the unique biopsychosocial processes, cultural backgrounds, and generational perspectives of this population. Second, the study will be intentionally sensitive to the considerable heterogeneity among older adults by recruiting a diverse sample and tailoring our research design to reflect differences in age, gender, ethnicity, socioeconomic status, health, and life trajectories, thereby avoiding homogenizing or stigmatizing approaches. Third, we will adopt a comprehensive biopsychosocial perspective, exploring physical, emotional, social, familial, and community dimensions relevant to well-being in later life. Fourth, our procedures will strictly adhere to ethical principles, ensuring truly informed consent, confidentiality, and respect for autonomy, with particular attention to possible cognitive or sensory limitations. Fifth, interviews will be adapted to the preferences and capacities of participants, using clear language, accessible environments, and flexible formats to facilitate meaningful engagement. Sixth, reflexivity will be a continuous process, as researchers will critically examine their own attitudes, beliefs, and potential biases regarding aging to ensure the integrity and inclusivity of data interpretation. Finally, the overarching aim of our study is to promote the well-being, dignity, and autonomy of older adults by centering their voices, fostering their active participation, and ensuring that their perspectives inform both research and practice.

Discussion

There is a notable gap in research focusing on how psychological flexibility could help older adults navigate through the challenges of this life stage. This scarcity extends to the development and validation of psychological flexibility quantitative assessment tools tailored to the unique characteristics and experiences of this population. In this sense, qualitative research offers a crucial lens for delving into the diverse perceptions, opinions, knowledge, and emotions of older individuals concerning aspects of psychological flexibility and purpose in life.

It is our tenet that there is a potential link between psychological flexibility and the ability to maintain purpose despite internalized ageism and other perceived barriers. In other words, older adults who demonstrate greater psychological flexibility, characterized by the ability to adapt to changing circumstances and maintain goal-directed behavior, are better equipped to navigate ageist challenges and preserve their sense of purpose. This hypothesis is supported by the literature on psychological flexibility as a protective factor against psychological distress (Plys et al., 2023).

Nonetheless, while numerous tailored measures of psychological flexibility exist for various age groups and specific challenges, a significant gap remains: the absence of instruments specifically adapted for older adults. Existing research, as highlighted by Plys et al. (2023), emphasizes the need for measures that are sensitive to the unique experiences and developmental context of older adults. Given that psychological flexibility is inherently explored in relation to personal barriers, our study seeks to qualitatively investigate how purpose in later life is experienced, what barriers older adults commonly encounter in pursuing a life with purpose, and what personal skills, if any, they find helpful in overcoming these obstacles.

We note that rather than external barriers, such as limited access to resources and social isolation (e.g., Goll et al., 2015); we are particularly interested in the internal barriers to a purposeful living, said another way, the way older adults elaborate on those and other perceived barriers. As Kashdan et al. (2024) pose it, they could be negative self-perceptions related to aging (e.g., “I can’t”, “what for”; “not worth it”; “who cares”, etc.), depressive mood, difficulties in managing emotions, and the like.

A significant contribution of this study protocol is its focus on the lived experiences of older adults, providing rich qualitative data that deepens our understanding of psychological flexibility during this life stage. By employing qualitative methods, we will be able to capture the nuances and individual variations in the experience of PF, which may be missed in quantitative studies. Future research will explore the development of assessment measures specifically designed to capture psychological flexibility in older adults, building on the insights gained from this qualitative exploration. This would allow for more rigorous quantitative investigations into the relationship between psychological flexibility and various aspects of well-being in later life, hence contributing to the eventual design of evidence-based prevention and intervention protocols.

Footnotes

ORCID iDs

Sonsoles Valdivia-Salas

Alejandra Chulián

Ethical Considerations

This study was approved by the Research Ethics Committee of the Autonomous Community of Aragón (CEICA) (approval #PI24/554) on February 5, 2025.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by Government of Aragon, Spain [grant # S62_23D].

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Internalized Ageism and Other Barriers to Purpose in Later Life: Protocol for a Qualitative Study

Abstract

Keywords

Methods

Study Design

Participants

Data Collection

Data Analysis

Ethical Considerations

Discussion

Footnotes

ORCID iDs

Ethical Considerations

Funding

Declaration of Conflicting Interests

References