Life contexts and health-related selves in old age: Perspectives from the United States, India and Congo/Zaire

Although aging and declines in health appear to be intrinsically related all over the world, there are large cultural differences in the meaning of health in old age. From a perspective on subjects who give meaning to themselves and their life world health-related selves were examined in relation to biological decline and social systems of caring for and curing the ill in the USA, India, and Congo/Zaire. Two hundred fifty-two elderly filled out a sentence completion questionnaire which asked for self-descriptions. For the American elderly health was an important value; they expressed fears of becoming ill and dependent, hopes for maintenance of autonomy, health and cognitive functioning, and intentions to health behaviors. The Congolese elderly expressed fears of death, hopes for a good death, expectations for decline in mobility and strength, and for support by their children. The Indian elderly generally fall between the Congolese and American extremes, but culture-specific cognitions about meditation and a peaceful death are also found. The differences in health-related selves are interpreted in relation to chances of healthy aging, specific illnesses, medical systems as well as care systems in each country. The findings are discussed in terms of universal and culture-specific themes of aging and their consequences for gerontological theory.