Cover of Being Mortal by Atul Gawande - Business and Economics Book

From "Being Mortal"

Author: Atul Gawande
Publisher: Profile Books
Year: 2014
Category: Science

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Chapter 4: Assistance
Key Insight 4 from this chapter

Life Perspective and Shifting Motivations in Old Age

Key Insight

Traditional theories, like Abraham Maslow's 1943 'A Theory of Human Motivation,' generally propose that fundamental needs such as physiological survival and safety remain paramount throughout life, especially when one's capabilities and options diminish with age. Consequently, public policies and elder care facilities often prioritize health and safety, operating on the premise that these are everyone's primary objectives. However, human behavior reveals a more intricate reality, as individuals of all ages frequently demonstrate a willingness to sacrifice personal safety and survival for higher values like family, country, or justice, indicating that motivations extend beyond mere self-preservation.

Research by Stanford psychologist Laura Carstensen, particularly her 'socioemotional selectivity theory,' offers a contrasting perspective. Her influential studies, which tracked the emotional experiences of nearly 200 individuals aged 18 to 94 over several years, found that people did not become unhappier as they aged, as Maslow's hierarchy might suggest. Instead, they reported experiencing more positive emotions and were less susceptible to anxiety, depression, and anger. This research indicates that people find life to be a more emotionally satisfying and stable experience later on, even as their social circles and daily activities become more confined, shifting their focus to 'being' and the present moment rather than 'doing' and future achievements.

Carstensen's theory posits that this fundamental shift in priorities is not inherently determined by chronological age itself, but rather by an individual's personal perception of the finite nature of their remaining time. When one's future horizon appears vast and limitless, typically during youth, individuals pursue achievement, creativity, and self-actualization, expanding their social networks and seeking novel experiences. Conversely, as the future is perceived as finite and uncertain, focus narrows to the immediate present, everyday pleasures, and the closest personal relationships. This theory is robustly supported by experiments where young, terminally ill individuals, such as those with HIV/AIDS, exhibited preferences similar to older people, prioritizing emotionally close relationships over new connections. Similarly, healthy young people, when asked to imagine moving far away or having their lives extended by twenty years, demonstrated shifts in preferences that mirrored those of the elderly or the young, respectively. Furthermore, cultural studies conducted during periods of crisis, like the Hong Kong handover or the SARS epidemic, consistently showed that when 'life’s fragility is primed,' people’s goals invariably shift towards immediate well-being and intimate connections, confirming that one's perspective on time, not merely age, is the primary determinant.

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