The results of this study were divided into two general themes: The view of the middle-aged with respect to healthy aging and the strategies to achieve it.
Elderly interviewees provided various views on healthy aging but four main themes were obtained: having good physical and mental health, having financial well-being, having social support. The themes are interlinked and explain the middle-aged peoples’ view of aging.
The most common health dimension is physical health, which can be more easily evaluated than other aspects of health. In the present study, participants reported being in good physical health having no chronic illnesses and functional independence as one of the first signs of healthy aging.
1-1-1. Lack of chronic disease
Aging is also a period when the elderly are exposed to potential threats such as increased risk of chronic diseases. Many middle-aged people also considered the absence of chronic disease as healthy aging, as one participant said
“Being healthy means getting old and not having a disease, for example, not having hypertension, not being fat or suffering from diabetes. or very dangerous diseases such as cancer which can be seen, but I look around and most of them have various diseases …” (46 years old woman).
1-1-2. Functional independence
With the increase in age in the aging period, due to functional impairments, one's dependence on others for carrying out daily tasks increases. In this regard, participants in this study stated that being independent and being able to see to one’s daily affairs and routine activities is an essential part of healthy aging. As one of the middle-aged women said
“A healthy elderly person is one that can afford to look after themselves and does not need the help of others.; can see to her own things and be healthy as it’ is hard to get old and need the help of your child ...” (52 years old woman)
1–2. Having Good Mental Health:
The mental health of the elderly is as important as their physical health and has a significant effect on the health of the individual and society. Having good mental health from the point of view of the middle-aged person falls into two categories of lack of mental discomfort and enjoyment of life.
1-2-1. Lack of mental discomfort
From a middle-aged outlook, the lack of psychological problems such as depression, anxiety, and stress about life in old age indicates that this period is healthy as these problems are seen in most elderly people and can endanger one’s health in old age.
“A healthy elderly person is one who has a healthy spirit, and is not depressed. Depression itself brings sickness. When there is no anxiety and stress, well, elderly people are healthier” (48 years old woman).
1-2-2. Enjoying life
From a middle-aged perspective, a healthy elderly person is one who enjoys life and is happy. The elderly people do not seem to be satisfied with their lives and old age in general and do not enjoy a good life. In this regard a middle-aged person stated that
“A healthy old man is someone who, although aged, is happy inside and is not sad and is still able to chat, laugh, and have fun …... In fact, aging is a chance to enjoy life” (56 years old man).
1–3. Having Financial Well-being:
One of the biggest misfortunes facing the elderly, and perhaps the most important is poverty. From the perspective of the middle-aged participants in this study, having enough money and wealth is a sign of health and an important factor for health in old age. Middle-aged people consider capitalists as healthy and stated that having money is a basic need for one to be healthy. This concept consists of two sub-categories of having sufficient financial resources and having financial independence.
1-3-1. Having adequate financial resources
Elderly people with adequate capital and savings during t old age are certainly less likely to have financial problems and better healthcare. Here is an example of a quote from participants in this regard
“For elderly people to be healthy they need money, they need capital and savings; if you have money, everyone’s around you. When you have money, you have mental peace as well as a healthy body” (53 years old man).
1-3-2. Having financial independence
Middle-aged people believe that those who work and have financial independence have a healthier life in old age. One participant stated
“An elderly person who makes a living and has an income and has no financial need of anyone is certainly healthier and has good spirits. I see some old men walking in the park aimlessly..........” (50 years old woman)
1–4. Having Social Support:
Social support plays a very important role in maintaining the health of the elderly in such a way that those with higher social support have a better health status. In the present study, social support was expressed in the form of emotional support from the family as well as instrumental support from those around the health components of aging.
1-4-1. Emotional Support
Aging can become difficult time for some people due to illness and families can help ease many of these problems by providing a loving and nurturing environment at home. The example that follows is from a middle-aged man;
“You know it's good to be old when you’re healthy, not physically, but because of one’s family support as it is the most important factor; to have a warm and affectionate family, considerate and loving” (55 years old man).
1-4-2. Instrumental support
Elderly people need the support of those around them. Participants stated that being alone in adversity reduces the health of the elderly. In this regard one middle-aged person commented
“Health means not be alone during hardships in life when you get old; there is always someone to help or visit you every now and then ...” (55 years old woman)
2. Strategies for achieving healthy aging:
Many common problems in old age can be prevented. Appropriate solutions must be taken before reaching old age to ensure good health. Participants have identified several strategies for achieving healthy aging that are generally broken down into 5 sections: Future financial planning, promoting physical health, promoting psychological health, maintaining and improving communication are essential strategies for achieving healthy aging from the perspective of the middle-aged.
2 − 1. Financial Planning For The Future
Participants place greater emphasis on economic factors and believe that “everything depends on money, even health, depends on money”. Wealth is the most important provider of healthy aging. Participants believe that having money is a prerequisite for health, and not having money is the biggest obstacle to good health and healthy aging. Financial planning and forecasting financial needs for the future are essential for healthy aging. To have healthy aging, you need to save money and invest wisely beforehand.
Middle-aged people believe that for aging to be an opportunity to rest, one must think about earning money and save for one’s old age. One middle-aged man's opinion about saving for old age is as follows
“Work while you are young and save money so that you have saved up enough for your old age and do not need anyone because you cannot always work and will not always be strong and young and have to have a source of income and capital...” (45 years old man).
Middle-aged participants in the study cited having a job and a steady income will help to improve the quality of life in old age and put one’s mind at rest. The following example reinforces this
“If you don’t have an income, you won’t have a good life, and you may not remain healthy, which will reduce your quality of life; many are looking for a job to make a living, if you have a good job, you’ll have financial independence, motivation and goals….” (49 years old woman).
2–2. Physical Health Promotion
To have healthy aging the most important and most basic aspect of health is promoting physical health. Middle-aged people in the present study stated that those who had more physical activity and a healthier nutritious diet when younger would certainly experience a healthy aging.
2-2-1. Healthy nutrition
Physical development and health are directly linked to healthy nutrition. Obviously, aging cannot be prevented, but it is possible to maintain good physical and mental health when aging by adhering to the principles of proper nutrition throughout life. One of these views is as follows
A 50 years old woman commented: “Someone who is well fed from youth, although it may not be luxurious food but good enough, and consistent, nutritious, when they get old, will be healthier than others” (58 years old man).
Middle-aged people believe that exercise has been a part of some elderly peoples’ lives from their youth; they’ve kept their bodies active and healthy. The views of the participants are as follows
“Exercise should be a priority in life for sure. There is no need for heavy exercise light exercise like walking is very effective for the health of the elderly.” (47 year old woman).
2–3. Promoting Psychological Health
One of the most important issues faced by the elderly is psychological health problems, so paying attention to these issues before reaching told age and preventing the damage caused by them is important. From a middle-aged perspective, promoting mental health through kindness, positive thinking, happiness, and spiritual connection are effective strategies for health in aging:
One of the most important consequences of being kind and spreading kindness in the society is the effect it has on the overall health of the body in individuals. As one participant stated
“Be kind to other human beings because we believe that the more kindness we show to other creatures, human or animals, and the more we live together in peace and friendship, the greater it will affect our own mental health” (50 years old man).
2-3-2. Positive Thinking
Positive thinking leads to a healthier lifestyle. Middle-aged people said that it is easier to solve problems and to endure problems when viewed with a positive outlook. You have to think about good things. A middle-aged man's point of view on this
“If we strengthen our imagination and positive thinking as capable human beings and experience the positive aspects of our life in the universe, we must also realize that we must remain healthy, sound, energetic ...” (47 years old man).
Happiness is one of the positive emotions that is in opposition to negative emotions such as depression, anxiety and despair. In fact, happiness can play a protective role against mental health problems that are a particular challenge for the elderly; for example, a 56 years old man stated
People must be happy and care for themselves. The more a man cares for himself and is happy, the better he feels. It’s very good to be happy, it’s very effective. Those who live happily, live longer.
2-3-4. Spiritual relationship
Faith in God gives peace to man, and when he has peace it will be easier to accept truths. Participants also believe that spirituality and religious practices can play a protective role against aging problems and challenges. One participant stated
“Belief in God is very important to a person. He must believe that aging is not the end and death is not the end of life. Aging is a good opportunity for self-knowledge and ultimately knowing God.” (56 years old woman).
2–4. Maintaining And Expanding Communications
From the perspective of middle-aged people in the study, communicating with others and not being alone are effective in promoting healthy aging. Communication with those around in aging can lead to good mental health and, in some cases, improve physical health, so maintaining and expanding relationships are of the essential strategies for achieving healthy aging.
2-4-1. Having a companion and not being alone
Middle-aged people believe that being alone and not having a partner and spouse will be a big problem in their old age, and in this regard a bachelor stated
“In old age, you should be accompanied by your loved one a, your companion and not be alone, being alone makes a man feel depressed and not care about his health, neither his mental health, nor his physical health. If one is mentally healthy, their body will be healthy.” (48 years old man).
2-4-2Keeping people satisfied: Participants believed that we should not push others away from us, as having relationships and maintaining them with those around during aging is effective on health. Keeping people satisfied by being kind to them and helping others can be a supporting factor for healthy aging. A 59 years old woman says: “If you are kind, everyone will want to stay with you, but if you are sharp and bother others, when you get old, everyone will leave you….”