Healthy ageing from the perspective of older people: a capability approach to resilience.

A policy focus on healthy ageing has been critiqued for homogenising, oppressing and neglecting the physical realities of older age. Current healthy ageing discourse places responsibility on individuals for achieving good physical health and ignores their broader circumstances. Sen's capability approach provides a basis for including the physical changes of ageing and the social environment by focusing on what older people themselves value in regards to healthy ageing. Accounts of desired living standards in 145 interviews with people aged 63-93 years in New Zealand were subjected to a thematic analysis which revealed six commonly valued 'functionings': physical comfort, social integration, contribution, security, autonomy and enjoyment. The capability to achieve the valued functionings was of high importance regardless of physical health status while this capability was often limited by social and material circumstances. The importance of an environment supportive of valued functionings provides a framework for understanding health for older adults, whatever their present physical abilities. We suggest that health psychology is in a good position to reflect critically on the impact of discourses promoting healthy ageing in the lives of older adults, and consider broader models that include understandings of resilience and capability.