“They want you to know who they really are inside of the old visage” - biographical storytelling as a methodological tool to explore emotional challenges in old age

doi:10.21203/rs.3.rs-2117438/v1

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Research Article

“They want you to know who they really are inside of the old visage” - biographical storytelling as a methodological tool to explore emotional challenges in old age

https://doi.org/10.21203/rs.3.rs-2117438/v1

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Journal Publication

published 23 Jun, 2023

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Background: Older people are at risk of confronting emotional challenges, including loneliness, depression, anxiety and low-levels of wellbeing, as a result of varied ageing-related changes. These emotional challenges may further give rise to socio-health issues and even increased mortality, presenting a pressing public health issue in the context of population ageing. By employing a biographical lens, we aim to introduce storytelling as a methodological tool to more holistically explore the construction of their emotional challenges within the context of their life histories.

Methods: Building upon theoretical understandings about the social construction of the life course, we draw on a qualitative study about older people’s loneliness to showcase the methodological value and feasibility of implementing biographical storytelling, to better understand the nuanced and sometimes painful emotional experiences facing people alongside their ageing.

Results: Findings from the qualitative study we showcase highlight that not only older people’s emotional pains but also their (in)ability to deal with such are deeply rooted in their earlier lives. The biographical nature of these findings further illustrates the methodological merit of biographical storytelling, integrating meaningful narratives from across different life stages to more holistically understand and support people’s emotional challenges and wellbeing in old age.

Conclusion: We argue that biographical storytelling is a particularly useful research methodology to explore the experiences and needs of older people, who have often accumulated rich life stories and who may be at increased risk of facing changes and challenges following bodily deterioration and other ageing-related losses. This methodological development can empower older people to reconstruct their ageing lives in the context of their biography as an ongoing construction. The development also lies in an insightful analytical lens to explore how older people’s earlier life experiences may be carried forward and confronted to shape their emotional stability in the present and future stages of their ageing lives.

biography

storytelling

older people

ageing

emotional challenges

qualitative methods

Ageing can have a profound impact on shaping people’s physical activeness, social relationships, family dynamics, and more deeply, their sense of meaning and being¹. It is widely acknowledged that growing older is not necessarily connected to negative emotional experiences, but conversely, it is more likely to be associated with resilience, contentedness and inner growth². Despite this, older people are still at risk of confronting emotional challenges, including loneliness, depression and anxiety, and low-levels of wellbeing, as a result of varied and even drastic ageing-related changes (e.g., bodily deterioration, diminished sociability and bereavement)³,⁴,^5,6. These emotional challenges may further give rise to socio-health issues and even increased mortality, presenting a pressing public health issue in the context of population ageing⁷. The complexity of the disruptions to emotional lives in old age can be further compounded by broader socio-cultural environments, such as healthcare and social support systems, public attitudes to ageing and/or mental health and cultural values^1,2.

The emotional challenges facing older people are not fragmented experiences unique in the ageing process, but rather are often rooted in their lived lives. Ageing, in its broadest sense, begins with birth and continues throughout the life cycle - how people live and feel in old age is constantly building upon, shaped and even restricted by experiences accumulated in their earlier life histories⁸,⁹. Therefore, it is of a particular benefit to understand older people’s emotional challenges in the context of their biography. This biographical approach can afford an integrative and retrospective lens, interpreting how older people’s experiences of emotional challenges as rich and complex composites are interwoven by not only their present ageing but also individual life histories, personal meanings and broader socio-historical contexts¹⁰,¹¹.

Qualitative research methods have long been interested in the multifaceted aspects of the ageing process and older people’s lived experiences. The current methodological literature has largely focused on ‘involving’ and ‘empowering’ older people in research design, ranging from traditional interviews and focus groups to more participatory and creative methods, such as photovoice¹²,^13,14. Storytelling has emerged as a scientifically insightful and emotionally meaningful tool that empowers older people to draw on socially accessible discourses (e.g., language, multimedia materials) to vividly reconstruct their lived lives with researchers, and to further make sense of their experiences and promote wellbeing¹⁵,^16,17. More particularly, a study by Brotman, Ferrer and Koehn¹⁸ on ageing immigrants has illuminated the implications of storytelling on later life, highlighting that talking about life histories can

“capture the complex and intersecting identities of older adults and expose the often-invisible institutional structures and relationships of power that mark older adults’ interactions with family, community, and the state in their everyday lives” (p.480).

To build upon the above understandings, we argue that the methodological value of biographical storytelling can be further extended, from being an interventional tool to facilitate older people’s wellbeing and from solely researching 'marginalised older people. Drawing on a large qualitative project (as a showcase) that investigated the emotional lives of 80 older people in the UK and Australia, we aim to demonstrate this approach’s value as a methodological tool, which can help us begin to more holistically understand older people’s emotional challenges. This approach can also help to further to situate such experiences within their biographical contexts and through the lens/meanings that they ascribe to those experiences. This biographical storytelling method can uniquely allow the implications of these experiences on their ongoing later life to be ascertained by researchers.

Understanding biographical storytelling as a methodology in the context of ageing

Research has long argued for storytelling as an authentic methodological tool to capture enriched life encounters as experienced by individuals and intersected with wider socio-historical contexts^,. The value of storytelling in research lies not only in generating rich, in-depth data in the form of stories to inform research outputs; but it is also closely connected to and reinforced by the storytelling process per se that enables both the storyteller and the researcher to co-construct, compare and contrast their varied interpretations of how experiences are created and given meaning. In a classic debate on the power of language, sociologist C. Wright Mills asserted that language provides speakers with a means of accessing available linguistic and cultural discourses to ‘tell’ (more accurately, interpret and justify) their experiences, and how they negotiate these within their unique situational contexts (e.g., with listeners, in socio-historical environments). The meaning-making processes of storytelling was also captured in the “Life Story Interview”, both as a research method and an intervention model, highlighting the benefits that revisiting lived experiences can have on constructing coherent narratives of self over time^11,.

The power of storytelling can be particularly evident when exploring older people’s lived experiences. Humans are natural storytellers, they can draw upon their past experiences and knowledge to present themselves to others and to retain their sense of identity. For older people, their long-lived lives can provide a rich source of material for storytelling. Gerontological research has captured the benefits of enabling older people to tell/share their stories to empower their voices and to restore their resilience in facing loss and other ageing-related transitions/challenges. Biographical storytelling in the context of ageing has thus far been largely approached from interventional and therapeutic perspectives, such as Westerhof’s “life-story work” model¹⁷ to encourage people to reflexively recollect, evaluate and ascribe meaning to memories as a means of promoting mental health and wellbeing (particularly in old age and during times of changes). Similarly, Bluck has argued the powerful functions of autobiographical memories for older people in creating a sense of continuity and purpose to enhance cognitive abilities and emotional status.

While the above functional approaches of biographical storytelling are valuable for improving older people’s wellbeing, it is also important to develop storytelling as methodological tool for research to explore the ‘hidden’ meaning of ageing experiences rather than making inferences (e.g., behaviour change). We argue that the experience of telling one’s lived life is not only an empowering interventional experience, but also an accessible tool more inherently embedded as part of everyday human life through which older people can naturally express the authenticity of self, reflecting on and re-telling experiences from across their life histories^19,. As such, biographical storytelling has significant methodological value, providing convenient and engaging channels to gain access to the lived experiences of older people, whose voices and needs may be otherwise overlooked or unheard¹⁸ .

Given growing older may be closely connected to varied emotional challenges as a result of facing increased risks of multifaceted loss (e.g., health, social resources, loved ones)^1,, we believe biographical storytelling as a methodological tool can offer particularly deep insights into older people’s worries, fears and hopes alongside their ageing. The “Life Story Interview” method^11,23 has provided a valuable direction to show how to use in-depth life review interviews to capture the ongoing construction of self-narratives and how the sense of self-continuity can inform future identity development. However, its generalised approach to interview participants from a wide range of age groups (varied from teenagers to late mid-agers) and its emphasis on linking lived experiences to future goals may be less relevant to older people who face unique challenges and whose ongoing lives may be defined more by the past than the future.

In order to better understand older people’s unique emotional challenges, it is of great importance to develop a tailored biographical storytelling method to centre their ageing lives within their life stories. As such, older people are afforded appropriate means of reconstructing the emotional challenges faced in their ongoing lives through stories about their own lived experience and wider socio-historical backgrounds. These understandings can further enable researchers to capture both the ‘surface’ emotional reactions (e.g., sadness, anger and anxiety) and the deeper pain that is biographically/historically rooted in older people’s lived lives and identities. This in-depth lens afforded by storytelling as a research method is applicable to not only those marginalised and without a voice but also to older people more generally, as ageing is a universal experience that often gives rise to a dynamic process in which individuals lose and try to restore their long taken-for-granted lives and self⁴.

Constructing theoretical framing for biographical storytelling

Growing older may afford people unique opportunities to reflect on their lived lives. Old age is not a fragmented life stage that can be viewed in isolation, but instead is built upon, constructed and shaped by one’s prior life experiences. As aforementioned, older people may face a myriad of complex emotional, physical and social challenges; as they grow older, they may also increasingly lose their defence (to these emotional pains), in the form of social connections, physical strength, independence and confidence that they have accumulated across their life span⁴. Therefore, it is important to understand how and why older people experience emotional challenges, in the context of their life histories. This biographical lens can shed light on their taken-for-granted habits and values, and how these may be challenged, compromised and even lost in their ageing lives. Despite this, researchers are placed in a ‘disadvantaged’ position as they often have little knowledge about their participants (older people) prior to research activities, such as interviews. Unlike conventional interviews in which the focus of the conversation is largely on the participant’s present lives or experiences in recent time or in relation to specific research topics in question, biographical storytelling can enable the participant, within limited spatial-temporal frames, to explain and reflect on their experiences, feelings and their taken-for-granted meaning/being and how these may be deeply rooted in their biographies and wider socio-cultural-historical circumstances over time.

From a social constructionist perspective, individuals’ lives are not a static entity but are both dynamic and ongoing. As shown in Fig. 1, lifespan consists of varied phases, starting from childhood all the way to old age and ultimately terminating at the end of life ^8,9. Throughout their lifetime, humans experience and often learn from others about what is considered to be (or not to be) important, valuable and real at different stages. Meanwhile, they also tend to internalise these experiences and knowledge (despite being positive or negative, for example, personal growth or trauma) to construct a thread of narratives to nurture and maintain their sense of self as a unique being. These narratives are not always distinct but are often closely connected with each other, contributing to a sense of self-identity which can be understand and made whole over time⁹. As such, people’s past experiences can be habitualised as a complex of meanings and resources providing references for them to make sense of who they are at present and further envisage their future self¹¹. As life moves on, this spatial-temporal construction of identity is also ongoing across the life stages, in which individuals encounter varied experiences and socio-cultural scripts to continuously affirm, revise and justify their self-narratives³¹. To understand older people’s experiences, as will be showcased by our study, it is vital to link their ageing lives to and within their biography as a system of narratives imbued with individual life histories and intersected with broader socio-historical backgrounds. Such an approach can provide an insightful lens to capture the enriched and long process of older people’s interconnected life stages and their continual (re)construction of identity²⁷.

To research the biographical construction of older people’s lived experiences of emotional challenges, we argue an interpretivist epistemological position is required. This position is important when seeking to understand how older people recollect and make sense of their ‘cumulative fragments of a lived autobiography’ in order to reconstruct their life stories and meaning^27,. Older people often draw upon language and other discourses to talk about and interpret their subjective experiences situated within the contexts of broader socio-historical circumstances and the particular situation where this reconstruction takes place. Biographical storytelling, thus, can provide older people with a unique social situation, in which they can enact upon their personal biography (life histories in different stages) to sequentially and consequentially reconstruct and represent their lived experiences to others. This can further allow for a phenomenological lens to provide insightful interpretations of what it means to be a person for older people in their unique life-world²⁷. As such, we as researchers can access their lived experiences not necessarily as these actually happened but in a manner shaped by their meaning and identity that have been long taken for granted. Despite the subjective constraints of the retold life stories, biographical storytelling can provide us with an integrative tool to gain insight into older people’s experiences within their biography as a whole rather than as a stream of fragmented events.

A large qualitative study was conduct between 2019–2021, to explore the emotional challenges of 80 older people (25 male and 55 females, aged between 55–93 with an average age of 79 and a standard deviation of 7.6) living in retirement communities in the UK and Australia¹. Biographical storytelling was employed and operationalised in the form of in-depth and semi-structured interviews with older people to retrospectively explore their emotional lives across the lifespan and how these could shape their emotional challenges in old age. We aim to use this study to showcase the methodological value of biographical storytelling in the context of ageing research.

Interview design

We designed our interviews to explore emotional challenges in old age through a lens of loneliness. The understanding of loneliness we adopted in this study was not just simply feelings associated with lacking meaningful relationships and interactions. Instead, we understood loneliness more broadly as a condition for eliciting emotional challenges, in which older people may lose resources and capability to retain the integrity of self in relation to others and the external world. As such, semi-structured interviews were used as a socially constructed vehicle encompassing and organising the dynamic aspects of how these older people engaged with scripts at different levels and phases of their lives to deal with and make sense of their emotional voids and losses. Adopting a biographical lens, these interviews enabled the older people to lead the conversation to tell their stories containing the following aspects (not necessarily in a strictly chronological order): (1) their lives up to this point (including childhood, adolescence, career, family, and anything else they wished to share and discuss), (2) their closest relationships, (3) their experiences of loss, (4) feelings of loneliness, isolation and other challenges, (5) their current living environments, and (6) their future concerns/plans. Such a structure is by no means limited to these topics and a biographical approach of this nature would encompass a wide breadth of research interests.

The interview questions focused on each of the above areas, such broad outlooks enabled an enriched interview, where the intertwined nature of topics often became evident and sections often intersected with each other. A narrative approach was adopted, empowering the older people to freely tell their stories around these core subjects across their entire lifespan. These questions were used as guides rather than verbatim, providing the interviewer with a thread of topics and directions to assist the interviewee (older people) to verbally reconstruct their ongoing emotional lives. We were not intended to capture their emotional lives in ongoing lives as a linear process. Instead, we deliberately designed the interview questions to contextualise and focus on interviewees’ lived experiences of their emotional lives and challenges in old age within the spatial-temporal dimensions of their biography (see Appendix 1). In so doing, we also aimed to minimise the distress of the storytelling experience and to more holistically understand their emotional challenges and needs in old age.

Interview collection

In light of the carefully designed interview schedule as outlined in Appendix 1, all the interviewers were professionally trained in sessions organised by the Principle Investigator of the study (the third author) prior to the interviews. Five researchers, including the three authors, conducted semi-structured interviews with 40 participants in the UK and the other four researchers interviewed the remaining 40 interviews in Australia. Approximately 8,000 minutes of rich audio data with the 80 older people were collected from both countries between 2019–2020. These Interviews ranged from 70 to 200 minutes and averaged around 100 minutes, capturing an in-depth picture about how older people’s emotional challenges and subsequent responses could be deeply rooted in their earlier life experiences. The interviews also highlighted the responsiveness of the older interviewees to such a biographical method, often being very receptive to the lines of questioning resulting in rich biographically informed data.

Reflexivity

We acknowledged that talking about earlier life experiences and current emotional challenges may be detrimental for some older people. Therefore, we were keen to be ‘a safe, interested stranger’ with whom the older people could feel at ease to share their sometimes painful and previously unspoken and overlooked life experiences³⁰. While all our participants reported positive interview experiences, we as researchers and interviewers were conscious of the importance of our role in navigating and protecting these older people while walking them through their lived lives with a specific focus on emotional challenges. We felt it was particularly vital in the process of both designing and conducting the interviews, to ensure the participants’ needs and wellbeing were rigorously understood and addressed by the interviewers. Measures, such as organising interview questions in a certain order as outlined in Appendix 1, finishing the interview with uplifting conversations (e.g., psychological growth, hopes) and providing information on further support resources following the interview, were all in place to minimise the impact of the potentially sensitive topics addressed.

This biographical storytelling method also allowed us to create a collective transformational space, to not only co-construct knowledge about emotional challenges in old age but also to deepen understandings about the value of reviewing lived experiences in life histories. It was only possible for us to collect such rich biographical interview data because of a trusting relationship between us and the participants. This trusting relationship was often developed in the conversations we had about their experiences of relationships, challenges and support at different life stages. Such conversations fostered a sense of empathy, by which we could more closely understand the older people’s feelings based on experiences of ourselves and our close others (e.g., our own (grand)parents). The experience of conducting the biographical storytelling interviews afforded us as researcher a transformational experience, granting us an insightful and vivid lens (not only for data analysis but also in our everyday lives more generally) to appreciate the value of both understanding the life stories of others and sharing our own. Despite the above benefits of being embedded in the biographical storytelling process with the older people, we were also aware of the potential risks of being overwhelmed by the relationships and the data we developed from the research. Therefore, regular meetings were held between the team members to debrief and resources on further/professional support were also provided throughout the project.

Data analysis

We adopted a reflexive thematic analysis method to interpret the rich data about these older people’s emotional challenges within their life stories. An inductive approach was embedded throughout to allow us (as researchers and also as ‘strangers’) to understand the older people’s lived experiences and nuanced feelings from their own perspectives, without being dominated by the assumptions and our pre-existing frameworks. We followed the six-phase thematic analysis process recommended by Braun and Clarke⁴⁰, which involved familiarizing ourselves with the data, generating initial codes, searching for themes, reviewing and discussing potential themes, refining and naming themes, and writing themes up. The analysis was conducted by all authors, who read the interview transcripts and notes thoroughly before conducting independent coding of each interview transcript. A combination of NVivo 12, a qualitative analysis software package, and more traditional reading and coding was used to manage and analyse the data. The authors met frequently to discuss and compare findings and codes. If there was disagreement or divergence on codes, further reading and discussion were conducted until a consensus was met.

To more systematically capture the complex experiences of emotional challenges in old age, we adopted an organising framework from Ettema et al., to contextualise our findings in three dimensions: (1) circumstances from which emotional challenges may arise, (2) experiences of multifaceted emotional challenges (3) responses to deal with these challenges alongside ageing. Figure 2 shows our coding process step: 1 captures an illustration of an early iteration of codes under the three dimensions above; step 2 was conducted for this article, aiming to re-categorise a wealth of qualitative findings to methodologically showcase how a biographical lens can be applied to more comprehensively analyse older people’s emotional challenges (for other qualitative findings, see ^1,4). By employing our study as an example, we seek to illustrate why it is both important and useful to interpret older people’s life stories not as a series of segmented experiences but as rich and complex composites “embedded in a coherent, meaningful context, a biographical construct” (p.3).

We contextualised the older people’s reported life stories in their ongoing lives, in which the boundaries between past, present and even future were fluid and interconnected. As such, we sought to explore how both the explicit and hidden meanings of their experiences, not as a completely new composite but rooted in their biography, have been continuously constructed and negotiated alongside their life course. Four interconnected themes have been developed for this section: (1) biographical construction of emotional barriers, (2) biographical pain, (3) diminishing selfhood and (4) sharing life stories as a means of retaining biography. Theme 1 underlines the biographical circumstances that gave rise to emotional challenges in old age. Theme 2 and 3 capture the experiences of how life histories may persist, overshadowing older people’s emotional lives and conversely how losing these lived lives alongside ageing could also prompt deeply painful emotional distress. Theme 4 highlights the older people’s responses to various emotional challenges and how their emotional strength and growth were fostered or reaffirmed during the interview process. In so doing, we aimed to show the significance of retaining the integrity and consistency of biographies and how older people sought to do so by interacting with socio-cultural scripts and by constructing individual meanings. To protect the confidentiality of our participants, pseudonyms are used throughout and all identifying materials are removed.

Biographical construction of emotional barriers

In our study, many older people reported progressive declines in physical activity, social connections and emotional-cognitive strength due to bodily deterioration, immobility, bereavement and terminal illness. When conducting the analysis, we scrutinised these challenges not as isolated circumstances resulting from the process of ageing but as experiences deeply entwined within life histories⁴¹ .

Evident in these older people’s accounts of their ageing-related challenges is a myriad of barriers in retaining emotional strength in their ongoing lives. Our participants were often faced with challenging circumstances of losing people and things that have long helped them retain meanings and resources central to their identity. More than half of our participants had recently lost their spouse and other close families/friends. By analysing their reported experiences connected to their life histories, we found that these losses might not only prompt emotional voids of attachment, security and connectedness in old age, but could also shatter the long-term emotional resources that they had always employed to (re)affirm their taken-for-granted lives and identities. Paula (aged 72) felt she was nobody after losing her husband whom she had long lived with and cared for:

Paula: “[W]hile he was alive and I was his full-time carer, companion, friend, we had a ball even though he was in a wheelchair, but when he was gone I didn’t know where I fitted anymore. I didn’t know who I was anymore because I wasn’t…”

These emotional barriers could also arise from the loss of good health and physical capabilities that to date had determined their strength in fulfilling their roles and responsibilities in their lived lives. After suffering a stroke, David (aged 80) strongly conveyed his sadness and frustration about the changing caregiving roles between him and his wife and ultimately about the loss of his ‘old’ self as a healthy and capable husband. Only by employing such a biographical approach can one begin to appreciate the constructions of self that David’s loss of autonomy in old age confronted:

David: “Well, my wife has always had a difficult hip and right from the days of ironing her blessed skirts I’ve been the one who can do things. I just got on with it… But now, it’s her who has to put my shirt on me. And at this present time, with my left arm sitting pretty well useless in my lap, I’m finding it so, so difficult.”

The risks of losing one’s emotional strength in the past were not only attributed to ageing-related losses but might also be deeply rooted in their earlier life histories. By embedding their varied emotional barriers in the ongoing process of their lives, we discovered that many older people (especially men) embodied a ‘stiff upper lip’ mentality, which reflects unique cultural, generational, gendered and familial circumstances many of the older people shared in their earlier life. Like many others, Simon (aged 92) showed us how older people’s abilities to express emotions and seek support could be historically smothered and how this could undermine their strength in facing varied challenges in old age:

Simon: “You had to keep a stiff upper lip as it was called and I suppose that’s stuck with me. I mean, people in my generations who came through the war, not that we were fighting, I was too young, a child, a boy, you had to get on with all sorts of things… [but] I feel sorry for myself at times when you are sat and you think oh god, I do wish she [my wife] was here and I do miss her.”

From a methodological perspective, by situating our analysis within the framework of the participants’ biography and life history, we were afforded a useful analytic lens to more fully consider how the older people’s emotional barriers (circumstances) intersected with their prior lived experiences. Further, the analytic approach allowed us to more fully elucidate the significance of our findings not just in the now but across the life span of the older people, making succinct connections between events across their biography in relation to their current emotional challenges. In so doing, we were then provided a platform, from which to explore the older people’s experiences and responses to these varied emotional challenges in the ongoing construction of their biography moving forward (as shown below).

Biographical pain

By conducting a deep reading of these older people’s life stories, we were able to capture some profound emotional pains that they carried with them from across their life course. Whilst sharing the benefits and contentedness of growing older, these older people often also hinted at the (re)surfacing of painful and distressing narratives and memories that had previously been buried in the busyness of independent living and excitement of being ‘young’. Coined as ‘biographical pain’ by gerontologists, such deeply painful recollections may become increasingly difficult to ‘put right’ as older people lose close others and things key to their emotional strength alongside ageing³⁰.

When reflecting on their lived lives, the older people often reported traumas and regrets in the past deeply ‘engraved’ on their biography. Such deep pains might remain or even intensify in old age, as reported by Jane (aged 80) who spoke about her the insecurity and lack of confidence due to mistreatment during childhood that continued to haunt her emotional life in old age:

Jane: “So from an early childhood I learnt that I was a bad person. My brother certainly told me that. I was stupid, ugly, etc… I mean, last year my daughter-in-law, the French one, started suddenly explaining to me what a worthless person I was and I burst out in tears and it took me months to think, well, poor you, if you are not able to like me, how horrible must that be for you, how horrible to hate.”

As a result of losing resources to retain emotional strength when growing older, the regrets accumulated in earlier life could be revived, deeply questioning the worthiness of their lived lives and the integrity of self. Again, as we found from Jane’s interview, after having a busy life spending her time to the fullest, she felt guilt for not having provided enough support to her sons – she burst into tears and said:

Jane: “I hope they forgive me for all the things I did not do and all different things they needed.”

Such biographical pain was vividly illuminated by the storytelling approach outlined above. Key in our analysis was the focus on the coherence of human biography and how not only growth but also pain in earlier life may remain influential in old age. By contextualising confrontation of profoundly painful emotional challenges in old age within the life course, we were afforded a biographical lens to more holistically and historically understand the deeper roots of the older people’s emotional pains.

Diminishing selfhood

Prior to this point we have elucidated how our method can be used to extrapolate links to participants lived lives and to understand their emotional challenges in relation to their previous biographical experiences. This theme will now illustrate how the biographical construction of their current ‘self’ in relation to their past is carried forward and confronted in the future as they age. Integral to their emotional challenges was a realisation that their lives, memories, narratives and identity were increasingly forgotten, unimportant and had been irretrievably lost alongside their ageing²⁹.

After living a long life full of experiences and memories, many older people talked about their fear of fading away in a sense that their lives would be forgotten as they grow older. As experienced by Iris (aged 90), living to be old could prompt deep and often growing pains of feeling disconnected and alienated from the external world due to varied ageing-related losses:

Iris: “The only other thing is of course that most of my friends are dead. I’m 90 on Christmas day and when I go through my life, my school friends, most of them are gone, my college friends, most of them are gone. I’m the only in-law left, I’m the only great grandparent left. So that aspect of the extended family becomes less and less… Yes, then it becomes lonely as regard your future and your past life and the people that I was familiar with, people that I worked with, of course, and the people that I had social contact with and relatives. My own family, I’ve only got one brother left and my husband was Dutch, and the Dutch family, one sister-in-law. So I’m finding that I’m standing alone as regards my former life.”

The older people could further confront pains of feeling that their lives no longer mattered and their biography was becoming increasingly unimportant. This finding was only unveiled by understanding what the participants perceived as important in their lived lives to date and then exploring what elements of their lived experiences may be confronted and undermined in the future. Both Emma (aged 77) and Harold (aged 91) highlighted their emotional struggles of longing for the authenticity of their own being:

Emma: “Absolutely, and ‘who am I?’ This is why old people talk about their lives, their past, or whatever, because they want you to know who they really are inside of the old visage.”

Harold: “My life? Nobody wants to know about my life!”

Underneath these pains of fading away, we found that there was also a more existential awareness of the approaching mortality and the finite nature of their lives. As they age and continuously confront a multitude of losses and challenges, many older people felt death closer than it had ever been before. Robert (aged 72) painfully realised that death was no longer a distant reality after losing his friends:

Robert: “I did sort of think, a couple of years back, ‘Oh, I’m now at the age that Jim died.’ But it’s one of the things that you come to learn, these things happen in life, I’m afraid. There was a young lady, younger than us, again died of cancer. That was one of our bridge group. We sort of knew it was going to happen, but it happened quicker than was expected, and again, that brings home your mortality.”

The rich lives lived by the older people, as illustrated above, could come under threat as a result of ageing, losing others and ultimately confronting the inevitable fate of death. Our analysis ascribed a deeper meaning to older people’s emotional challenges of helplessness, worries and even fears. That is, we drew upon their biographical life stories to capture how their cherished memories and relationships (which have long defined who they are) could be left behind, thus causing emotional pain at a more existential level.

Sharing life stories as a means of retaining biography

Employing our methodological approach of integrating older people’s narratives and experiences into their life histories afforded us a meaningful context to better understand why (circumstances) and how (experiences) these older people encountered varied emotional pains alongside ageing. Such an approach has also illuminated their dynamic responses to adopt, reject and revise existing resources to (re)negotiate meaning for varied emotional challenges. Research has long highlighted older people’s agency to reclaim their resilience and strength in facing challenges in varied life aspects. Our analysis has further enriched this understanding by shedding light on these older people’s emotional needs, and more precisely how their emotional needs in old age may be shaped, undermined and restored, in alignment with their life histories and lived experiences.

The above analysis has shown that the older people’s emotional challenges could be experienced in a pervasive and often deeply painful manner as a result of multifaceted losses threatening their taken-for-granted lives and meaning. We found that the older people’s efforts to alleviate emotional challenges focused on maintaining/restoring key resources (e.g., family connection, social and community support) that have long help them stay strong and consistent. The unique biographical lens we employed further illuminated a deeper dimension of their responses, that was to preserve the meaningfulness of their lived lives and their being, potentially in the face of painful memories and fading existence in the world. For example, after moving closer to his daughter and her family, Craig (aged 72) and his wife Jacqueline (aged 71) confronted a profound need to carry on their memories and identities in the family beyond the finitude of their lives:

Craig: “We are creating a memory box for each of them [grandsons] where we’ve written a kind of autobiography each of our life, the interesting bits anyway, the bits that we want them to know… We are finding it quite cathartic and quite nice and I would like to think that in 50 years’ time, our grandson will show this information to his grandchildren.”

Some older people also demonstrated a concern with passing on their lived experiences as wisdom to others in wider society. Helen (aged 64) found sharing her views on positivity in life to be fulfilling and it helped her to reaffirm her meaning and being in old age:

Helen: “So, my mantra is focus on strengths, which makes your weaknesses irrelevant … ‘we appreciate our strengths rather than constantly looking for problems?’ So that has become part of my thing here as well, when I’m talking to people. It’s very much reminding them of their life experiences and their strength and wisdom and things like that.”

Despite this, we also noticed that not many older people had only realised the power of life-story-telling until the interview (much like Helen who felt the experience was eye-opening after talking about her fondness with her late parents), in which they were able to talk freely about their concerns and memories across their lifespan, helping them further make sense of their lived experienced and appreciate their lives:

Interviewer: “Yes, it’s just such an extraordinary story.”

Helen: “Well, relating it to you makes me appreciate it more, because it’s something I just took for granted and never questioned. But the depth of it suddenly, talking to you, I thought oh wow, I must tell my brother and sister that.”

By putting older people’s often under-recognised and undervalued stories into their broader social and biographical contexts, our analysis suggested that these older people faced a lack of accessible platforms to share their life stories in everyday life; this may have been due to losses of long-lasting resources for emotional support alongside ageing. This situation was further compounded by the deprivation of a story-telling literacy in wider society where both older people and others had little knowledge about the benefits of sharing and listening to life stories. This issue was illuminated by Jennifer (aged 75), who lost cherished resources to face and deal with her long-lasting emotional pains. After seeing her adult children become independent and moving from a long-lived neighbourhood to a retirement village, she found:

Jennifer:” This is what I miss a lot, a private space to talk … All my life I’ve suffered … and some things I do find very hard, like this illness now. With everything that’s gone wrong, I would have liked to talk to somebody, no advice, I want to let off steam, I suppose. But it doesn’t happen…”

It was only by adopting our biographical approach and enabling participants to tell their life stories so openly that the participants began to see the evident benefits/needs of storytelling and that we as researchers fully appreciated its methodological significance. This methodological value lies in better capturing older people’s emotional challenges and their dynamic responses to said challenges. The biographical lens could act as ‘cathartic’ tool for the older people, and also as an insightful analytical approach to understanding their emotional needs in old age more accurately and acutely within their broader biographical context.

Our study has highlighted the methodological value of biographical storytelling to collect and interpret older people’s emotional challenges. We believe this storytelling method is of particular relevance and importance to research older people’s experiences and needs as they tend to have accumulate more stories throughout their life histories that they may wish to share. By using our loneliness study as a showcase, we illustrated how a retrospective lens could be afforded in research design and interview collection to capture the biographical construction of older people’s emotional challenges. A biographical analysis approach was also exampled to show the methodological values of interpreting older people’s emotional needs within the wider context of their biography (and associated socio-historical backgrounds). Our methodological procedures and the findings, as highlighted in the case study, have reaffirmed the value of life-story interviews for understanding older people’s present experiences within their life histories^11,17. In addition, this article has further expanded the methodological scope of life-story interviewing methods by developing a more dedicated framework for researching (not seeking to change behaviour of) older people, who may focus more on past rather than future and may be more vulnerable to changes and challenges⁴¹.

Our exploration of biographical storytelling has also highlighted the continuity and fluidity of identity construction across the human lifespan, providing an insightful and integrative methodological tool to illustrate how identity construction continues into old age. Much emphasis has been laid thus far on identity development in earlier stages of life such as childhood, adolescence, or the broader stage of adulthood. Conversely, old age is often seen as the last stage of life, and thus as reported by researchers and some older people themselves, ageing is closely connected a sense of tiredness and withdrawal from active human development of identity^,. By conducting a deep listening and reading exercise of the older people’s enriched life stories, we illuminated the older people’s dynamic needs and actions to (re)construct their identity alongside ageing (and even beyond physical death) and how these processes were shaped by their earlier life experiences. As such, we methodologically showcased the importance of connecting biographical gaps between earlier life stages and old age. That is, to provide a more longitudinal context to understand how the older people’s emotional lives have been continuously shaped by the ongoing construction of their meaning and identity throughout their lifespan, and more importantly how their emotional challenges in old age may arise from losing the consistency and integrity of their sense of self moving forward.

By depicting an insightful picture of each participant’s life stories pertaining to their emotional lives, we further demonstrated the power of biographical storytelling to capture the nuanced experiences of emotional challenges in old age. Given emotions, particularly painful feelings, can be subtle and subjective, existing literature on qualitative methods in ageing studies has emphasised the importance of empowering older people to express their emotions, feelings and needs using their own voices and from their own perspectives^12,14. Our study furthered such methodological approaches by encouraging older people to reconstruct varied stories across their life course, including not only big stories (major or life-changing events such as, moving home, illness and bereavement) but also small stories as lived and enriched within everyday settings (e.g., daily interactions and conversations with others). Although small stories may be easily forgotten or overlooked, the focus on such subtle but meaningful experiences is of particular methodological significance to capture how small emotional turbulences may accumulate and unknowingly contribute to the ongoing construction of older people’s meaning and identity¹⁵. We afforded the older people a unique opportunity to freely and reflexively tell both their big and small life stories, with which they were able to provide more enriched materials to revisit, reveal and even re-appreciate their memories and feelings of pains, worries and fears in varied aspects. From a data analysis perspective, the sensitivity to small stories could also avoid over-simplification and over-categorisation of only connecting the nuanced and complex experiences of older people’s emotional challenges to grand narratives of their life, but not through the lens of their own lived experiences and smaller contributing stories that can accumulatively significantly shape constructions of self.

In addition to the above methodological benefits, our study has demonstrated the importance of developing appropriate tools and skills when implementing the biographical storytelling method with older people. First, a comprehensive and flexible interview schedule is key to allow for in-depth conversations about older people’s life stories while staying broadly on track about their emotional lives and challenges in old age. As shown in our study, the guide needs not to strictly follow a chronological trajectory but allow for the smooth progression of conversation to facilitate the development of a good rapport with the older people. Such rapport enabled researchers to gently walk older people through their lived lives to elicit recollections and reflections on their emotional ups and downs. The above caution about not too strictly prescribing an interview structure is also connected to the second requirement, that is to equip researchers (as interviewers) with transferable skills to learn how to be empathetic, supportive and focused throughout and across the often long-lasting interviews (e.g., over one hour and even longer). Given the sensitive and even painful nature of emotional challenges in old age, training prior to initial interviews and frequent follow-up self/group reflection sessions may be of use to help researchers develop their own ways to deal with unexpected and challenging disruptions confronted during or as a result of an interview (e.g., the participant suddenly bursting into tears or feeling distressed by certain conversations). Third, a biographical analytical lens is also needed for researchers (as interpreters) to examine older people’s emotional challenges within a wider context of their individual life histories and the associated social-historical circumstances. To gain such an integrative lens, researchers could benefit from developing in-depth theoretical understandings about the human life course and the construction of identity (see Fig. 1).

Finally, the insightful responses by these older people have also highlighted the merits of extrapolating the biographical storytelling approach outside of this research paradigm and in a more societal setting. Extant research³⁰ and our findings have both shown a lack of ‘safe and interested’ others and accessible platforms to facilitate life story telling between older people, their family, communities and wider society. Therefore, it would be of significant value to encourage older people and those in their support networks to further recognise the values of biographical storytelling and develop suitable knowledge about how to tell and/or listen to life stories¹⁷. We also believe that the practice of telling one’s life stories is not restricted solely to verbal forms (e.g., interviews or conversations) but has the potential to be developed through varied accessible and often creative forms depending older people’s preferences and capabilities. For example, the memory box approach as reported by Craig and Jacqueline in our study and other verbal and non-verbal mediums (e.g., music, painting, life-story writing, filming) may offer more diverse and participatory societal literacy to understand the circumstances, experiences and responses of older people’s emotional challenges and to further clarify their emotional needs as a biographical construct.

By illuminating how we explored older people’s emotional challenges in the context of their life histories, our study has promoted further questions about the applicability of this biographical storytelling method. The value of this method elucidated throughout this paper suggests that this method may be more broadly valuable in the paradigm of ageing studies. Despite our primary finding that older people’s emotional barriers, pains and responses may be rooted in their experiences during earlier life, we are aware of a risk in future qualitative inquires of mis- and/or over-interpreting the retrospective elements of biographical narratives and the impacts this may have on older people’s nuanced emotional experiences. This could be manifested in the application of a psycho-analytical lens that too heavily stresses causalities between certain emotional challenges in old age and traumatic experiences in early life.

Instead of focusing on such a mechanical and prescriptive approach to linking specific and fragmented snapshots of experience between past and present, we feel it would be beneficial to embed more longitudinal elements into the biographical storytelling method to continuously follow up older people’s emotional experiences. For example, there is great potential to engage with cohort studies to use their longitudinal qualitative data often collected over years to explore the ongoing and dynamic construction of how cohort members deal with their emotional challenges as they grow older. Further, biographical storytelling interviews can be conducted with cohort members to collate stories (especially small stories) that have not been picked up by previous qualitative data collections. Likewise, where longitudinal data is not yet available for a research topic, the biographical storytelling methodology outlined above may begin to allow researchers to draw links between lived life and current experience in a way which is not afforded by non-biographical approaches.

Ethical approval and consent to participate.

This study was approved by the Social Sciences Research Ethics Committee (SSREC) at the University of Bath (SSREC reference S19-052). The study was conducted according to the guidelines of the Declaration of Helsinki. All participants provided their written informed consent prior to data collection and were informed that their anonymized data will be used in publications.

Statement of funding

This project was supported by a research grant (RE-ED1100) from Guild Living Ltd. The authors confirm that the funder played no role in the design, execution, analysis and interpretation of data, or writing of the study.

Declaration of contribution of authors

All three authors contributed to the conception and design of this article. The first author developed and drafted the overall structure of this article. The second author contributed to the writing up of the theoretical frameworks, reflexive explanations of analysis methods in the finding section as well as the discussion and implications. The third author contributed to developing the theoretical foundation of biographical storytelling and also helped shaped the qualitative findings that have inspired this article. All authors approved the final version to be submitted for publication.

Consent for publication

All participants gave permission to use their anonymized data for publication purposes.

Statement of conflict of interest

The authors declare none.

Availability of Data

The datasets used in this article are available from the corresponding author upon reasonable request.

Acknowledgements

We would like to acknowledge the following people and organisations for their kind support of this project: (1) Professor Malcolm Johnson, (2) Guild Living, (3) Dr Kate Barnett, (4) the research teams in the UK and Australia, (5) Life Care, Australia, (6) Inspired Villages Group, UK, and (7) he participants who kindly shared their life stories with us.

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No competing interests reported.

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“They want you to know who they really are inside of the old visage” - biographical storytelling as a methodological tool to explore emotional challenges in old age

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Abstract

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Introduction

Background

Methods

Data analysis

Results

Interviewer: “Yes, it’s just such an extraordinary story.”

Discussion

Implications

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Ethical approval and consent to participate.

Statement of funding

Declaration of contribution of authors

Consent for publication

Statement of conflict of interest

Availability of Data

Acknowledgements

References

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Supplementary Files

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