Individual values and spirituality and their meaning for affective well-being and engagement with life in very old age

According to models of cognitive discrepancy, value-based preferences as a central reference frame for subjective evaluations of actual living conditions are crucial to understand quality of life (QoL) outcomes [29, 30]. Extending previous perspectives on QoL, the challenges and potentials (CHAPO) model of QoL of the very old [43] thus considers the system of individual goals and values an important resource for QoL outcomes. Addressing QoL outcomes beyond the hedonic realm, the model also includes eudaimonic conceptions of QoL. These are expected to be of particular relevance in very old age as older adults face significant challenges in maintaining a sense of purpose in life [13, 20, 34]. By considering individual values and spirituality, this article describes two constructs representing the standards of the individual and examines their relation to both hedonic and eudaimonic QoL outcomes in very old age (VOA; i.e. 80 years and above).

According to Schwartz’s theory, individuals ascribe a certain importance to each value in relation to the other values. For instance, an individual striving for power will ascribe high importance also to its neighboring values within the value circle, but low importance to opposite values. The resulting individual profile of value priorities guides action and serves as a transsituational reference system for the evaluation of one’s reality.

Empirical research has examined the relations of individual values with well-being both in student samples and in representative samples from the European Social Survey. Studies reported a tendency of power values being negatively related to well-being, and benevolence, stimulation, self-direction, and hedonism values being positively related to well-being (for an overview, see [39]); however, findings are not completely consistent, and they revealed differences across social contexts (e.g. [40]).

Besides social contexts, there is reason to suggest age-related differences in the relevance of individual values and their relations to well-being. Due to the tipping of the balance between gains and losses that develops in later life, life span theories predict that older persons would place higher importance on goals focusing on loss prevention (i.e., anxiety-based values) instead of growth (i.e., anxiety-based values) [7]. Furthermore, a decreased self-centeredness and a stronger focus on the welfare of others can be expected based on Erikson’s stage theory of human development [8]. This is also in line with the model of gero-transcendence [41] and its idea that older people focus more strongly on social and emotional values than on material values. In line with this, empirical research including studies drawing on large multinational datasets (European Social Survey, World Values Survey) has observed an age-related shift from self-enhancement to self-transcendence and from openness to change to conservation values (e.g., [5, 33, 42]), even across individualistic and collectivistic cultures [12]. Against this theoretical and empirical background, one could expect that people in VOA clearly prioritize and benefit from socially focused values. On the other hand, psychological threat is expected to increase the priority people give to micro-worries (problems close to the self) compared to macro-worries (problems external to the self) [4]. This has been confirmed empirically in a sample of palliative care patients [9]. In the light of age-related changes and losses, thus, one could claim a returning rise of values with personal focus in VOA. So far, it has not yet been investigated which values are prevalent in VOA and how they relate to QoL outcomes in this particular phase of life.

Numerous studies have reported a positive relation of spirituality/religiosity with well-being, sense in life, and aims in life [19, 28]. Several models of health consider spirituality a protective factor and a means of resilience to cope with diseases and critical life events [26], which has become a main focus of quantitative research on the functions of spirituality. Especially in end-of-life care, spirituality is therefore implemented as an independent dimension besides physical, psychological, and social health [44]. As a source of subjective interpretation of the self and the world offering a sense of personal meaning, control beyond one’s own resources, and comfort [25], spirituality might be an important resource to encounter the challenges and existential questions arising in VOA; however, research on spirituality mostly focuses on its role for specific subgroups (e.g., the chronically or terminally ill). Furthermore, most instruments ignore the multifaceted nature of spirituality [26] and do not clearly distinguish spirituality from religiosity, often rather assessing religiosity than spirituality [19]. Moreover, most studies on spirituality have been conducted in America. Knowledge about the understanding and role of spirituality in the very old population of Germany therefore remains limited.

Table 1 summarizes the descriptive characteristics of the very old population of NRW. Security was the most important value, followed by self-direction, tradition, and universalism. As the observed hierarchy of value priorities indicated a generally higher relevance of values with social focus compared to values with higher personal focus, we decided to conduct further analyses at this point. For this purpose, we aggregated the five values with higher social focus and higher personal focus. They showed acceptable internal consistency (social focus: Cronbach’s alpha = 0.61; personal focus: Cronbach’s alpha = 0.51). A paired-samples t‑test confirmed a very large difference between means on values with a higher social focus (M = 3.2, SD = 0.6) and those with a higher personal focus (M = 2.5, SD = 0.5; t(1862) = −48.132; p < 0.001; d = 1.14).

Regarding spirituality, environmental connectedness was most important to the very old population, followed by interpersonal and transcendental connectedness. Religious institutions and practices were of subordinate but still moderate importance. With respect to QoL outcomes, very old persons showed a moderate AWB, but a rather high EwL.

Table 2 shows the results retrieved from regression models. Tolerance values for the included variables varied between 0.29 and 0.92, showing no indication of multicollinearity. The final model predicting AWB explained 32.1% of variance in AWB. A positive association with AWB was found for environmental and interpersonal connectedness, self-direction, benevolence, universalism, hedonism, and stimulation, whereas conformity and power related negatively with AWB.

Regarding EwL, 38.4% of its variance could be explained with the final model. Environmental and interpersonal connectedness as well as institutionalized religion had a positive association with EwL, while high importance of religious practices predicted lower EwL. Self-direction, universalism, benevolence, achievement, stimulation, and hedonism were positively related to EwL. None of the values related negatively to EwL on a significant level.

In our representative data of very old persons, the most important individual values belonged almost exclusively to the dimensions of conservation and self-transcendence, both of which focus on social relationships and one’s influence on others rather than on personal interests [38]. Additional analyses confirmed significantly higher means on values with a higher social focus than on those with a higher personal focus. Taken together, our findings support assumptions of a decreased self-centeredness and increased concern for the welfare of others in old age [8, 41] and are consistent with previous research on value priorities in later life (e.g. [5, 33, 42]), replicating it for VOA.

However, the second most important value found in our study was self-direction, which represents strivings for personal growth [38]. One could argue that in VOA, living and acting self-determinedly is less self-evident, no longer necessarily representing growth but evolving into a state that needs to be protected from the threat of depending on others, for example due to health restrictions. Borg et al. [5] have identified age-associated differences in the understanding of and relations between values, i.e. the circular structure of value relations, before. The hierarchy of value priorities, as well as the factor structure of the scale found in our study equally failed to reflect several of the suggested relationships between values, further highlighting age-related deviations from the theoretical structure of value relations. Future research should further examine the theoretical structure of the value system in VOA.

Linear regression showed that only values representing strivings for growth predicted a higher AWB. This is contrary to the idea that in older age, the pursuit of further growth is no longer adaptive due to lacking functional or temporal resources. Rather, while universalism (growth-oriented with social focus) has not been found to be positively related to well-being in some samples of younger persons ([21, 31, 35], or even negatively [23]), it did predict higher AWB in our sample of very old persons. On the other hand, stimulation (growth-oriented, but with personal focus) was unrelated to AWB in our sample, while it was positively related to well-being in other samples [3, 15, 35, 40]. The same applies to achievement, another personally focused value which was positively related to well-being in student samples [31, 35]. Extending previous research on age differences in value priorities, these findings indicate that age not only comes with an increasing concern for one’s human and non-human environment, but that individuals in VOA also profit from it more clearly in terms of their well-being.

For protective goals, in contrast, we found either no significant or a negative relation to AWB. For example, security and tradition, which related negatively to well-being in other samples [3, 21, 35, 40], were unrelated to AWB in our study. It is possible that their social focus outweighs their negative features in VOA; however, what stands out is that they are the most and third most important values respectively in this sample of very old persons, without being positively associated with AWB. In the light of age-related losses in different areas, this supports Bilsky and Schwartz’s [2] assumption that deficiencies increase the importance of goals that would compensate for them. Thus, the values that are most important to an individual are not necessarily those that they benefit from, and people in VOA may be particularly likely to pay less attention to the values that they can actually benefit from. Alternatively, a possible reverse causality can be suggested: people with a higher well-being might have the resources to pursue autonomy and to care for others, whereas individuals with a lower well-being may focus on protective values “whose realization promises relief from anxiety and uncertainty” [35, p. 181].

Relationships between individual values and EwL were similar to those between values and AWB; however, none of the values showed a significant negative relation to EwL. This is in line with the description of valuation of life being mainly predicted by positive features rather than negative ones [20], and indicates that even though the protective features of some individual values lead to a decrease in AWB, they can still provide a purpose for individuals. This could also explain the observed higher level of EwL than AWB and emphasizes the utility of EwL for strength-based interventions of positive psychology [13].

Spirituality was found to be of high relevance to the target group, although less in the sense of institutionalized religion or religious practices. Rather, spirituality of the oldest old predominantly consisted in environmental and interpersonal connectedness as well as a connectedness with God or a higher power. Despite the so-called graying-pattern observed in institutionalized religion and religiosity, this supports previous research on the multidimensionality of spirituality and how it differs from institutionalized religion [16] and highlights that spirituality in a multidimensional understanding that captures more than just religiosity is of importance to people even in VOA [18]. This is further supported by the fact that environmental and interpersonal connectedness were significant predictors of both AWB and EwL. Especially those forms of spirituality offering a sense of communion with the human or non-human environment might thus help to maintain positive affect and purpose in spite of the challenges coming with VOA.

Moreover, institutionalized religion related positively, but religious practices related negatively to EwL. This can be explained by the distinction between extrinsic religiosity, which refers to a social-participative function of religion (such as visiting a mass motivated by a feeling of communion), and intrinsic religiosity, which refers to an individual belief that is embodied in religious practices such as praying [11]. Again, these findings illustrate that it is these aspects of spirituality—representing feelings of community, belonging, and social engagement—which predict high QoL in VOA. This also mirrors our conclusions with respect to the importance of socially focused values in VOA.

All in all, our results confirm that the system of personal goals, beliefs, or strivings can be an important resource, but also a threat for QoL outcomes, as suggested by the CHAPO model of QoL of the very old, although there might also be an interrelation between individual standards and QoL outcomes [43].