The survey of the middle-aged was carried out by Milvi Sepp who has a master’s degree from the Tallinn University, Institute of Social Work, in spring 2008 in Puhja rural municipality, which is an average municipality in Estonia in terms of its size and number of residents (2413 persons 01.01.2008).

Questionnaire survey was used in order to gather research data. In Puhja rural municipality there are 326 men and 336 women between ages 40-60. Since the objective was to retain the ratio of men and women as it actually was among the residents of the municipality, then the sample was formed in case of men and women according to age-defined list, by including in the sample every third person, starting counting from the third person on the list. The sample included 112 women and 108 men. The questionnaires (220) were given personally by the researcher to the respondent, giving at the same time an overview of the research objective, clarifying requirements for fulfilling the questionnaire and answering questions. The respondents fulfilled the questionnaires at a time suitable for them and brought them to a previously specified place (municipality government, libraries, local shop). The number of returned questionnaires was 210: from 107 women and 103 men. The participation in the research was voluntary; the respondents were informed about the confidentiality of their personal data and of using the research results only for scientific purposes.

Two hypotheses were raised for the research.

• First hypothesis – the attitudes of the middle-aged towards ageing and old age are mostly negative and have not been replaced by the conception of successful ageing – is negation of Marin’s (2) statement that “old age is being re-evaluated as part of the life-span: it is no longer seen as a hopeless phase of life, but instead negative attitude towards ageing and old age has been replaced by the conception of successful ageing”.

• Second hypothesis – the middle-aged know that preparation for ageing should start early, but some of them have made no conscious efforts for that – is based on Taimi Tulva’s idea that “it is reasonable that preparations for ageing start already in early age, but this way of thinking is not yet wide-spread in Estonia” (22).

Figure 1

Figure 1. Schema of analysis: attitudes of the middle-aged and preparations for ageing

The attitudes and every-day life of the middle-aged depend in large extent on the gender aspect. Therefore the entire research data is analysed in terms of men and women, trying to emphasise the gender differences of ageing. The data has been coded: woman – 1; man – 2.

Middle-age can bring with it special condition for the person, which has been called the sandwich generation phenomenon, i.e. where people have been pressed between requirements coming from two generations. On one hand, children need support and help and, on the other hand, elderly parents (23, 24). In the current research we concentrate on one direction of this triple relationship – the attitudes of the middle-aged towards their elderly parents, characterised by agreement with the following statements: adult child is duty-bound to support his parent who is unable to work; elderly people cope with their lives independently in their homes, and what action is taken when it is necessary to nurse an elderly person.

The health and mental state of the middle-aged is evaluated using the following indicators: 1. Evaluation of one’s health condition (from very good to very bad); 2. Evaluation of one’s state of mind (from very happy to unhappy); 3. Evaluation of deterioration of health when ageing (yes, no, don’t know); 4. First emotions when thinking about own ageing (fear, emptiness, sadness, indifference, etc (no, yes)) and death (angst, sadness or fear (no, yes)).

The problem of the middle-aged is the nearing old age. What the future will be like, depends on one hand on attitudes in middle-age, on the other hand to what degree a person is prepared for old age. And thirdly – whom to rely on in an old age.

These three aspects are analysed in our work using for this different opinions and evaluations, with which the respondents agreed or not.

1. Sentiments and opinions about ageing: questionnaire contains 8 statements that characterise successful ageing (old age is normal and natural state in a person’s life; old people are ill and infirm; elderly person is active member of society; old age causes poverty and exclusion; old age begins with retirement; elderly people have the same needs; elderly can influence society; elderly are a burden for younger because of the need to take care of them).

2. Preparation for ageing: economic preparation (making a life insurance contract or testament; gathering monetary savings; joining pension insurance), health conscious preparation (giving up alcohol or smoking; going to medical check-ups, going on a diet to normalise body weight; practising sports; staying outdoors for a long time), constructional preparation.

3. Whom the middle-aged would rely on in an old age, whom would they turn to: (children; spouse; sisters/brothers; other relatives; friends/relatives; care-giving institution, state).

When developing the system of successful ageing we relied on the ideas of Koskinen, Aalto, Hakonen, Päivarinta (10). In order to assess the strength of statements the Likert scale was used. Every statement was accompanied by a 5-point scale that began with “agree very much”, progressed with “don’t know” and ended with “do not agree at all” at the other end of the scale. Likert scale was used for the reason as it can give information about both the strength and content of the statement. Questions that characterised preparation for ageing and whom to rely on in an old age were accompanied mainly by no- don’t know - yes answers.

The quantitative data was analysed by using comparative frequency distribution (the answers of men and women were compared). In order to find differences between the two parts of the sample, the opinions of men and women, the Pearson correlation coefficient was used. In order to study different types of opinions towards ageing, correlation analysis was used. In order to see to what extent different evaluations or situations can influence the chance in mental balance (i.e. if one feels happy or not), ANOVA analysis was used.

There were 8 statements about the conception of successful ageing in the questionnaire: three positive and five negative. The evaluations of men and women about these eight statements about successful ageing are depicted in table 1.

Figure 2

Table 1. Answers of middle-age men and women about the statements of the conception of successful ageing, %, R and p, 2008.

On the bases of the general division it can be concluded that the attitude of the middle-aged towards ageing is positive, although not very strongly. The answers to the first statement “old age is normal and natural stage in person’s life” show strong agreement. Also to the other two positive statements every second respondent answered with yes. Most of the respondents disagreed with all of the five negative statements. The negative statement that respondents agreed with most was that “elderly are a burden to take care of for younger people” (34%) and that “elderly are ill and infirm” (41%).

Table 1 gives also an overview of the differences of attitudes for men and women. The statement “old age is normal and natural stage in person’s life” was evaluated by women and men most highly. Men and women agree also that elderly are a burden to take care of for younger people. But there are several attitudes in terms of which women are more positive. Among women there are less those who think that elderly are ill and infirm, and those who find that old age causes poverty and exclusion; at the same time there are more those respondents who think that an elderly person is an active member of society. We see that women agreed with positive statements to the same extent or somewhat more than men. In case of negative statements it becomes apparent that they are somewhat less widespread among women. On the bases of these results we venture to conclude that women have more positive attitude towards old age than men.

In order to emphasise contradictory types of attitudes, we concluded correlation analysis of the inside connections of opinions on the basis of Pearson’s R. The results are presented in table 2. Only strong correlations have been presented, i.e. where p=0.000.

Figure 3

Table 2. Correlation tree of opinions (Pearson’s R)

Table 2 shows clearly two contradictory attitudes. On one hand the different statements grouped around „ Elderly person is active member of society”. This statement has positive correlations with statements elderly can influence society and old age is normal and natural stage in person’s life. At the same time there were negative correlations with statements that elderly are a burden for society, that elderly are ill and infirm, that old age causes poverty and exclusion and that old age begins with retirement.

Another attitude that had a lot of correlations with different statements was ,elderly are a burden to take care of for younger people “. The respondents who agree with this statement tend to agree also with the statements that old age causes poverty and exclusion, that elderly are ill and infirm and that old age begins with retirement. And on the contrary – they don’t agree with statements that old age is normal and natural stage in person’s life, that elderly person is active member of society and that elderly can influence society.

Person’s point of view is an important factor as agreeing either with positive or negative statements about ageing reflects the overall state of mind and approach to life. Among the respondents with positive attitude there are more happy people (r=0.23, p=0.001) and those who don’t worry that their health deteriorates in the future (r=0.20, p=0.004). It became also apparent that agreement with statement that elderly person is active member of society was more frequent in the group with higher educational level (r=-0.14, p<0.04). On the other hand the statement that elderly are a burden to take care of for younger people is more frequent among respondents with lower educational level (r=0.18, p=0.01). People with this attitude tend to feel more unhappy (r=-0.16, p=0.01) and complain about their health (r=-0.17, p=0.01).

The independent coping of elderly through the eyes of the middle-aged was studied with a statement “elderly usually cope themselves with their independent lives at their homes”. This statement brought positive reactions from both men and women, among women 73% agreed, among men 65%. The respondents could answer the question who should be responsible for elderly receiving assistance for every-day activities if necessary, by choosing in the questionnaire up to three answers among the following (state, local government, spouse, children and heirs). The middle-aged thought that the responsible parties should be in the first place local government and children (71% of all respondents). There was a notable difference between the answers of men and women in terms of children’s responsibility (p=0.03). Children were considered to be responsible by 78% of women and by 64% of men. One woman explained the responsibility of local government with the opinion that “since a person has worked for 30-40 years and his income tax has been allocated to local government, then the municipality should help the person when he grows old”.

91% of the middle-aged had children or grand-children. The middle-aged have to take care of their children and help them enter independent life, but assist also their parents who need help. 58% of respondents had elderly parents who needed help, for whom they are ready and willing to care (90%). In terms of caring for parents there were differences among men and women: almost all women were ready to assist (96%), but 83% of men (r=0.23, p=0.000). Helping was seen in very different activities: house-keeping tasks, gardening and farming, storing fire-wood, taking to a doctor, bringing medicine, going to shop, visiting graveyard, doing repairs, using the internet, mowing lawn, with transport, financially, just by giving advice and help, in everything where help is needed and which the elderly cannot do alone. But only women stated that they would help in doing laundry, preparing food, cleaning the house, washing in sauna and nursing an elderly in bed. As one man said: “I’m ready to help my parents, but not to nurse them”. Women add: “I help parents in everything that is necessary and the opposite would be unthinkable”. 10% of the middle-aged answered that they are not ready to take care of their parents who need help. The reasons given were long distance, own bad health and poor economic situation.

There was in the questionnaire also a task consisting solving a situation: how would you act when your elderly parent has to stay in bed and needs long-time nursing. The respondents had to choose one suitable behaviour. Women were more ready than men to nurse their parent either at their home or at parent’s house. Men were more willing to pay for nursing or find if necessary a place for their parent in a nursing home. 11% of respondents didn’t know what to do in order to solve the situation.

When answering the statement “adult child is obliged to support his parent who needs help and is unable to work (Family law §64)” there was a difference between men and women (table 3). Female respondents elaborated their agreement as: “this parent raised me”. It is partly unexpected outcome that respondents thought that children do not have to support their elderly parents who are unable to work and need help. Among women as much as 27% stated so. One of the women explained: “Family and children/grandchildren – of course they help their parents, but this cannot be made an obligation! The economic and medical condition has to be taken into account, also the need to take care of children who go to school”.

Figure 4

Table 3. Evaluations of statement: adult child is obliged to support his parent who needs help and is unable to work, %, 2008

When thinking about their own ageing the middle-aged men and women felt different emotions (p=0.01): 44% of women referred to such feelings as fear, emptiness or sadness. Men stated firstly indifference (34%), women noted also an open answer “something else”, which was complemented by the following statements: “feeling of inevitability”; “ageing is a natural process”; “calm”; “god won’t leave me”; “glad expectation as with the new experience come grandchildren”; “natural time for oneself and the family”; “mixed feelings”; “there is time to do what you want, so I don’t see any negative emotions”. In addition we asked about feelings that were experienced when thinking about death. Among men and women 64% stated angst, sadness or fear.

The middle-aged were asked which worries or scares them most in terms of ageing. The answers are presented in figure 2.

Figure 5

Figure 2. Fears of the middle-aged when thinking about ageing (summarised frequency of three choices), %

Most often, almost every second respondent was worried about deterioration of his health. Women were almost two times more scared of developing dementia in an old age. Women were also more afraid of remaining alone. Men were more afraid than women of becoming economically dependent on someone, becoming powerless and needing help in everyday activities.

General opinion about preparation for ageing was studied with a statement “preparation for ageing should start already in youth in order to avoid crises related to ageing”. 65% of women and 58% of men “agreed” or “agreed very much”, so the middle-aged are aware that you need to prepare for ageing. Preparations for ageing can be done in many ways. In the survey the questions were about economic, health and construction related preparations for ageing that the middle-aged had made. Results are presented in table 4.

Figure 6

Table 4. Preparations of the middle-aged for ageing, %, 2008.

In terms of economic preparations most middle-aged had joined the pillar II of pension insurance (40%), whereas twice as many women had joined it than men. Men had on the other hand made a testament more often. Only fifth (24%) had made construction related preparations, whereas the answers stated mostly renovations at home. Men gave such examples as: “I lost the door blocks”, “we built the house with only one story”, “we made one bedroom also on the ground floor”. In terms of health preserving preparations both men and women had most often went to the doctor during the previous year. Women had been more than men on a diet to normalise weight and done sports. Men stated more than women giving up alcohol and smoking. This can be explained by one woman’s statement: “I have never smoked and drink only little alcohol”. Those who had done no preparations were very few (one woman and seven men).

People consider health as one of the most important values. Big part of the middle-aged found their health to be satisfactory (table 5). Almost half of middle-aged women thought their health was good or very good, one-third of men gave the same evaluation. It follows that middle-aged women evaluated their health more highly than men (r=0.14, p<0.04). 60% of respondents gave their evaluation how they thought their health would change when ageing, the others answered to this with “don’t know”. Biggest part (90%) of those who gave an evaluation thought that their health will certainly deteriorate with age. Men and women had different opinions about how their health would change when ageing: men were more pessimistic than women. Health deterioration was noted by 61% of men and by 47% of women.

Figure 7

Table 5. Evaluation of the middle-aged about their health, %, 2008

A person always wishes to cope independently. When it is impossible to cope on our own in an old age, there is need for outside assistance. Two-third (66%) of the middle-aged wish to spend their old age at their home. Men rely more than women on people close to them. 18% of respondents would like to live in a home for elderly. When the respondents chose home for elderly as their answer, then the justification was: “Wouldn’t want to be an extra burden for children who need to go to work and raise their own children”. So one motive for choosing a home for elderly was the wish not to be a burden for children.

Figure 8

Figure 3. The opinion of the middle-aged whom they would firstly rely on in an old age in case their health worsens, %, 2008

As the figure 3 shows women rely in an old age firstly on their children or grandchildren, whereas men rely on their children two times less. In terms of this question there was the biggest difference between the answers of men and women.

Men rely in an old age mostly on their wives; there are two times less women who rely on their husbands. They are reluctant to rely on children as illustrated by one man that “there should be decent old age pension so that there is no need to depend on children or grandchildren. I have worked for that during my entire life”. Women think that it is difficult to rely on husband. Relatively fewer respondents rely on sisters/ brothers, relatives, friends and also on local government.

There was a big difference between men and women in terms whether the middle-aged person will take up new hobby or participate in the activities of some society/ association. Women answered both of these two questions more positively. Three-fourth (76%) of women but less than half (45%) of men would take up a new hobby (r=0.32, p=0.000). Among middle-aged women every second considers it necessary to participate in an old age in the work of some society, association or hobby circle, among men only 15% think this way, this is three times less (r=0.29, p=0.000). When a person reaches the pension age, s/he can decide whether to keep on working or stay at home. 42% of the middle-aged planned to work and 26% to stay at home. Third did not know how they would act.

More than half (55%) of the middle-aged thought that they were rather or very happy. There is notable difference between women and men: among women 64% and men 46% (r=0.18, p<0.01). Thinking about the future state of mind every tenth said that ageing should not make him/ her unhappy; at the same time 40% of respondents noted that they would become happier with age or stay in the same state as now. Using ANOVA method we analysed which attitudes and activities increase or decrease the happiness of a middle-aged person (see table 6).

Figure 9

Table 6. ANOVA analysis about the impact of different statements for the mental balance, feeling of happiness, of men and women, F, p

• The analysis shows that the statements of successful ageing influence the person’s mental balance in a considerable way, among women in the extent of 25% and among men 26%. The changes in the feeling of happiness are influenced most, in the extent of 26%, by the conviction that old age causes poverty and exclusion (for women, F=13.08, p=0.000; for men, F=15.40, p=0.000).

• The feeling of happiness is also influenced by the fact whether the middle-aged are prepared to help their elderly parents, if this is not considered a heavy task. Women think it is natural to take care of parents and this does not disturb them emotionally or they refuse straight away by referring to difficulties in their own families. This influence is bigger (8%) for men , F=4.27, p<0.04

• The influence of higher emotionality and anxiety was apparent in several ways. When the first reaction when thinking about ageing is fear, emptiness or sadness then this attitude inhibits the development of the feeling of happiness to the extent of 10%, firstly for women (F=10.56, p=0.002). Women’s feeling of happiness is also influenced negatively, although to a lesser extent (4%), when they feel already at middle-age angst, sadness or fear when thinking about death (F=3.89, p<0.05).

• The state of health is also an influencing factor. Also here the influence for women’s well-being is stronger than for men. Women’s state of mind is influenced by satisfaction with health (F=28.79, p=0.000) and by conviction that health will worsen with age (F=16.55, p=0.000). For the first statement the influence was 24%, for the second 15%.

• When thinking about ageing women are upset by the thought (in the extent of 7%), that there could be situations in an old age when outside help is needed for every-day activities (F=7.37, p=0.008).

• State-of-mind is influenced also if preparations have been made for ageing. In case of women 13% are affected by the fact whether health related preparations have been made, whereas especially important for the development of feeling of happiness is the success of dieting to normalise weight (F=4.87, p<0.04). In terms of economic preparations 7% are influenced by the fact whether they have joined pillar II of pension insurance (F=4.02, p<0.04). For men constructional preparations are important (in the extent of 6%) (F=5.64, p<0.02).

• When thinking about ageing for women free time activities and self-fulfilment are important: having hobbies (F=6.45, p<0.01) and participating in the activities of some society, association or hobby circle (F=6.96, p<0.01). The sum influence of these factors for women’s feeling of happiness is 7%.

We can conclude that the middle-aged women have circumstances that contribute to or inhibit the development of their feeling of happiness much more than is the case for men. Men were firstly characterised by attitude that old age causes poverty and exclusion (26%) and satisfaction with health (17%). Well-being is also influenced by the fact whether one is prepared to help elderly parents (F=4.27, p<0.04) and whether constructional preparations have been made for ageing (F=5.64, p<0.02). The impact of last two situations for the feeling of happiness is 6-8%.