Keywords: mortality salience; terror management theory; aging

The transitions from youth to middle age to late life tend to be subtle. Rarely do we identify the point at which we become “old.” Of course, by middle age we may have days when we feel old; when joints ache or memory fails us. But Oliver Wendell Holmes’ sentiment that “Old age is fifteen years older than I am” accurately conveys the sense that we are prone to think others are old, not me. Despite the fact that the internal self may feel as young as ever, the external self is inevitably altered with age: New diagnoses are given, medications prescribed, bodies weakened, and the losses experienced are followed by funerals attended. In many ways then, our own bodies, as well as the aging of friends and family, become reminders of mortality and life’s unavoidable end. Intellectually, death is accepted as part of life, but increasing signs of age and its many side effects, result in much more personally salient and powerful cues that life is finite and coming closer to its end.

Terror management theory

Terror management theory (TMT; Greenberg, Pyszczynski, & Solomon, 1986) posits that whether young or old, people have to, in some way, deny the reality of death as an ultimate end. Based on the writings of Ernest Becker (1973), the theory proposes that the biological predisposition toward continued survival, which we share with other animals, has the potential to create overwhelming anxiety in humans because we are uniquely aware of our vulnerable and mortal nature – we know that we ultimately will not survive, and further that our survival could be terminated at any time by a host of threats beyond our control. Fortunately, rather than living under the weight of overwhelming death-related anxiety, most people develop ways of minimizing their potential to experience such existential dread. People do so by maintaining faith in a meaningful worldview in which they play a significant part. Individuals feel they are playing a significant part in the world when they are living up to the standards of value of their worldview; from this perspective, self-esteem is the feeling that one is a significant contributor to a meaningful world. The meaningful conception of reality and sense of value we derive from it help manage the potential for existential terror by giving us the sense that we are enduring beings in a permanent, meaningful reality, rather than mere animals fated only to perish entirely upon physical death. By having an everlasting soul or making a permanent impact on the world, we can feel like physical death is not the end; rather, our symbolic identity will live on.

The most heavily researched hypothesis derived from TMT is based on the idea that if faith in one’s cultural worldview and self-esteem serve as buffers from existential anxiety, then with greater awareness of death, people will become increasingly likely to behave in ways that bolster their cultural worldview and self-worth. In other words, awareness of mortality initiates processes to manage existential terror; specifically, affirmation of one’s values, beliefs, and sources of meaning, as well as one’s own self-worth. To test hypotheses derived from this analysis, researchers have people think about their own mortality, referred to as a mortality salience induction. Researchers have increased mortality salience in many ways: asking open-ended or true/false questions about their own mortality, exposure to subliminally presented death-related words, viewing video footage of fatal automobile accidents, encountering death-related words in a word search puzzle, or walking past a funeral home. To ensure that effects are due to reminders of mortality and not simply a response to anything that is unpleasant, various control conditions are used for comparison. Among the many aversive topics that have been used, studies have included such topics as have included going to the dentist, taking an upcoming exam, dental pain, experiencing intense unpredictable pain, uncertainty, failure, social isolation, meaninglessness, and becoming paralyzed. All are unpleasant to experience but unrelated to death, and the vast majority of studies shows they don’t produce the same effects as reminders of death.

Younger adults exposed to these primes of death become increasingly defensive and protective of their cultural worldview and self-worth. To illustrate, younger adults reminded of death show increased self-esteem striving via increased effort on ego relevant tasks and attributions that are more self-serving (e.g., Mikulincer & Florian, 2002; Peters, Greenberg, Williams, & Schneider, 2005) and increased defensiveness of the cultural worldview via derogation (Florian & Mikulincer, 1997) and aggression toward people who challenge their cultural values (McGregor et al., 1998).

You might wonder what protection of self-esteem and cultural worldviews has to do with death. Defense of these constructs are referred to as distal defenses (see glossary). Although not logically or semantically related to death, distal defenses provide protection against existential anxiety by enabling people to view themselves as valuable contributors to a meaningful and enduring universe. Other, more direct defenses against death also exist, referred to as proximal defenses (see glossary). These include more logical attempts to cope with death anxiety that are directly related to distancing one’s self from death: Eating healthier, exercising, and taking other steps aimed at delaying physical decline and death. Proximal defenses tend to surface when death is in focal attention; because of the intense anxiety associated with death, people prefer to push death into the distant future, and increasing one’s intentions to engage in healthy behaviors and denying factors associated with early death and embracing factors associated with longevity (for a review, see Goldenberg & Arndt, 2008) are two common ways of doing this. Distal defenses surface when death is no longer in focal attention; when death thoughts linger on the fringes of consciousness, people bolster their cultural worldview and self-worth (see Pyszczynski, Greenberg, & Solomon, 1999, for an overview of this dual model of defense against death).

Terror management in late life

When we consider that younger adults perceive the future as more expansive than older adults (Lang & Carstensen, 2002), it seems logical that responses to thoughts of death would also vary as a function of age. Given the defensiveness that younger adults exhibit when reminded of death, despite their more expansive view of the future, it seems likely that older adults, whose time perspective is more limited, would be even more bothered by reminders of death and its encroachment. Additionally, increased experience with death via the passing of loved ones or awareness of one’s own significant health problem(s) would seem likely to create a chronically heightened state of mortality salience (see glossary). To make matters worse, inevitable changes in cultural values may leave their cultural worldviews outdated and less effective. Older adults are also likely to be less able to meet cultural standards of beauty, strength, or productivity, which could negatively impact self-esteem. Extrapolating from the defensiveness and aggression observed among younger participants, we might envision roving gangs of angry, defensive older adults.

However, although the occasional grumpy older adult is not unheard of, anyone with substantial exposure to older people is aware that later life is not usually characterized by anger and resentment. Before we get too worried about defensive, death-fearing older adults, recall the keys to effective terror management. Doing so suggests a more optimistic trajectory of advancing age. Older adults may have had greater opportunities to establish and maintain their cultural worldviews and self-worth and may thus be better equipped to deal with both life and death. Perhaps as a result, older adults indicate greater positive affect and lower negative affect than younger adults (e.g., Mroczek & Kolarz, 1998), and are less prone to most psychological disorders than younger adults (e.g., Kessler et al., 2005), suggesting generally intact psychological well-being.

Aging may contain many bittersweet moments, presenting opportunities for poignant reflection on one’s life. Retirement can be viewed as a time to look back on one’s achievements and consider future opportunities for focusing on hobbies and relationships. On the other hand, some may see retirement as the time they have to let go of the career that defined them and hope that they will find a way to fill the days, perhaps occasionally feeling as though their best days are behind them. Luckily, we know that development and adaptation do not stop in later life, so when faced with the transitional periods of adulthood, people make transitions as well. Developmental shifts in how people cope with the problem of death are likely an important part of aging – it seems unlikely that 80 year olds would think of mortality in the same way 18 year olds do.

Although much terror management research has used college aged students, and those in their 30s, recently, older adults have been included in this research. In terms of explicit fear of death, research suggests that, with age, people report lessening death-related anxiety (e.g., DePaola, Griffin, Young, & Neimeyer, 2003). However, terror management research suggests that self-reported death anxiety does not always accurately reflect how people respond to mortality salience; in fact, younger people reporting lower death anxiety have responded more defensively to death reminders (e.g., Greenberg et al., 1995). So at the outset of research concerning older adults’ terror management strategies, it was unclear whether older adults would be less responsive to reminders of mortality, more responsive, or responsive in a different way.

As a starting point, older adults were included in traditional TMT paradigms in order to compare older and younger adults’ responses to reminders of mortality. Maxfield et al. (2007) found that older adults reminded of death displayed decreased punitiveness toward violators of mainstream cultural worldviews – standing in direct contrast to younger adults’ increased punitiveness. Perhaps with the many life experiences acquired over 70 or 80 years, people learn more positively-oriented ways of responding to increased awareness of mortality. Interestingly, older adults were not more lenient overall; in the control condition, older adults were significantly more punitive than younger adults, suggesting that the decreased punitiveness is activated by contemplation of mortality, rather than an overall shift toward leniency.

In a follow-up study (Maxfield, Pyszczynski, Greenberg, Pepin, & Davis, 2012), participants’ memory, executive functioning, self-reported health, and general psychological well-being were also assessed. Executive functioning (uniquely human cognitive functions, such as planning, reasoning, and self-control) influenced older adults’ responses to death reminders: Greater executive functioning predicted decreased punitiveness following reminders of mortality, whereas lesser executive functioning predicted increased punitiveness. Younger adults’ executive functioning did not affect responses to mortality, and memory, health, and well-being did not affect responses to mortality salience for either age group. These findings suggest that maintenance of higher-order cognitive functioning is important to adaptation to (and perhaps even acceptance of) mortality in later life.

Aside from reducing punitiveness among older adults, recent work suggests that older adults respond to death reminders with increased generativity, the desire to contribute something to future generations (Maxfield et al., 2014). In two studies, older adults displayed increased generative concern following death reminders; younger adults’ generative concern was not impacted. This increased generativity striving among older adults goes beyond simply leaving an egotistic legacy or monument to oneself: Reminders of death increased older adults’ preference for leaving a legacy that would improve the welfare of other over one that would lead them to be remembered. These findings suggest that a pro-social altruistic orientation might be particularly useful way of coping with the approach of one’s own mortality.

A handful of studies regarding age differences in proximal defenses yield mixed results (e.g., Bevan, Maxfield, & Bultmann, in press; Bӧzo, Tunca, & Simsek, 2009; Taubman Ben-Ari & Findler, 2005). The general tenor of the findings seems to be that both younger and older adults responded with increased intention to engage in healthy behaviors immediately following reminders of mortality. It appears that among younger and older adults (but perhaps not middle-aged ones), there is a strong tendency to postpone death by rational means (proximal defenses), such as by engaging in more health-promoting behaviors, even though older adults do not seem to be engaging in the same symbolic (distal) defenses as younger adults. These are tentative findings though, so additional investigation of proximal defenses among persons of differing ages is needed.

In sum, as one ages, it becomes increasingly difficult to view death as an abstract problem for the distant future. The greater proximity to death that comes with advancing age poses a developmental challenge to which some, but not all, older people respond by changing the way they relate to death and adopting a more flexible, tolerant, and socially-oriented approach to their remaining years. The reduced availability of one’s long-standing sources of emotional security creates the impetus for finding new sources of meaning and self-esteem. But making the transition to new ways of coping with death and life requires resources. Thus far, our studies point to executive functioning as a particularly important resource in this regard. This makes good sense, in that adjusting one’s goals and meanings requires considerable flexibility and adaptability. The good news is that many older adults do seem capable of making this transition to a more flexible mode of coping, which appears to play an important role in positive adaptation to the challenges of their later years.

Future directions

Given what we’ve found so far regarding older adults’ responses to reminders of death, it may be that many of them manage their concerns about death in particularly constructive ways that the rest of us could emulate. One next step is to better understand what allows high functioning older people to respond in these pro-social ways. One possibility is that they view death in a more realistic, concrete way that allows them to think about their identification with continuity of life in deeper and less superficial ways.

Returning to the wisdom of Oliver Wendell Holmes, recall his statement that “The young man knows the rules, but the old man knows the exceptions.” Future research concerning how older adults cope with their mortality will need to identify the strategies or protective factors they are able to use to ward off the negative defensiveness that younger adults typically exhibit in response to increased awareness of death. To date, it is clear that executive functioning is one of those protective factors related to positively oriented responses, but certainly other variables come in to play. The aging process can entail emotionally and physically painful processes, and research so far has not addressed how the number and intensity of emotional losses or number and intensity of chronic health conditions impact older adults’ responses to mortality salience. We have also considered the possibility that there may fates worse than death – perhaps living with a health condition severely limiting your physical mobility or cognitive ability would be more aversive than death. Indeed, research concerning “dementia worry” suggests that developing cognitive impairment is a significant area of concern for middle-aged and older adults (e.g., Kessler, Bowen, Baer, Froelich, & Wahl, 2012). Memory loss may represent an existential anxiety regarding the death of self, rather than physical death – indeed, the person built up over six, seven, or eight decades may seem to be fading away with the loss of one’s personal memories. It may be that physical death becomes less of a core fear for older adults as the prospect of a life that is not worth living increases.

Going forward, we see two key general directions for new research and consideration of real world applications. First, by identifying ways in which older adults develop more positively oriented responses to thoughts of death, perhaps this could provide ways that other age groups could adopt strategies to decrease their own defensiveness. Second, by understanding the existential fears older adults may experience aside from death, perhaps clinicians can address these fears (e.g., memory, relationship losses) more directly in an effort to ameliorate the inevitable pains associated with aging.

Glossary

Distal defenses. They address thoughts of death indirectly by protecting the cultural worldview and bolstering self-esteem. Examples include defending the cultural worldview via increasingly positive evaluation of those who support and increasingly negative evaluation of those who violate one’s cultural worldview.
Proximal defenses. They address thoughts of death directly by engaging in behaviors aimed at denying/delaying death. Examples include denial of vulnerability to death and increased intention to engage in healthy behaviors which may forestall death.
Mortality salience. It is a state of increased accessibility of death-related thoughts, which is typically achieved in studies by asking people questions about their own mortality, showing videos depicting fatalities, or interviewing them near a funeral home.

References

Becker, E. (1973). The denial of death. New York, NY: The Free Press.
Bevan, A., Maxfield, M., & Bultmann, M. (in press). The effects of age and death awareness on health-promoting behaviors. Psychology and Health.
Bӧzo, Ö., Tunca, A., & Şimşek, Y. (2009). The effect of death anxiety and age on health promoting behaviors: A terror-management theory perspective. The Journal of Psychology, 143, 377-389.
DePaola, S. J., Griffin, M., Young, J. R., & Neimeyer, R. A. (2003). Death anxiety and attitudes toward the elderly among adults: The role of gender and ethnicity. Death Studies, 27, 335-354.
Florian, V., & Mikulincer, M. (1997). Fear of death and the judgment of social transgressions: A multidimensional test of terror management theory. Journal of Personality and Social Psychology, 73, 369-380.
Goldenberg, J. & Arndt, J. (2008). The implications of death for health: A terror management model of behavioral health-promoting. Psychological Review, 15, 1032-1053.
Greenberg, J., Pyszczynski, T., & Solomon, S. (1986). The causes and consequences of a need for self-esteem: A terror management theory. In R. F. Baumeister (Ed.), Public self and private self (pp. 189-212). New York, NY: Springer-Verlag.
Greenberg, J., Simon, L., Harmon-Jones, E., Solomon, S., Pyszczynski, T., & Lyon, D. (1995). Testing alternative explanations for mortality salience effects: Terror management, value accessibility, or worrisome thoughts? European Journal of Social Psychology, 25, 417-433.
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replications. Archives of General Psychiatry, 62, 593-602.
Kessler, E., Bowen, C. E., Baer, M., Froelich, L., & Wahl, H. (2012). Dementia worry: A psychological examination of an unexplored phenomenon. European Journal of Ageing, 9, 275-284.
Lang, F. R., & Carstensen, L. L. (2002). Time counts: Future time perspective, goals, and social relationships. Psychology and Aging, 17, 125-139.
Maxfield, M., Greenberg, J., Pyszczynski, T., Weise, D., Kosloff, S., Soenke, M., Abeyta, A., & Blatter, J. (2014). Increases in generative concern among older adults following reminders of mortality. Manuscript under review.
Maxfield, M., Pyszczynski, T., Greenberg, J., Pepin, R., & Davis, H. P. (2012). The moderating role of executive functioning in older adults’ responses to a reminder of mortality. Psychology and Aging, 27, 256-263.
Maxfield, M., Pyszczynski, T., Kluck, B., Cox, C., Greenberg, J., Solomon, S., & Weise, D. (2007). Age related differences in responses to thoughts of one’s own death: Mortality salience and judgments of moral transgressors. Psychology and Aging, 22, 343-351.
McGregor, H., Lieberman, J., Greenberg, J, Solomon, S., Arndt, J., Simon, L., et al. (1998).Terror management and aggression: Evidence that mortality salience motivates aggression against worldview-threatening others. Journal of Personality and Social Psychology, 74, 590-605.
Mikulincer, M., & Florian, V. (2002). The effects of mortality salience on self-serving attributions: Evidence for the function of self-esteem as a terror management mechanism. Basic and Applied Social Psychology, 24, 261-271.
Mroczek, D. K., & Kolarz, C. M. (1998). The effect of age on positive and negative affect: A developmental perspective on happiness. Journal of Personality and Social Psychology, 75, 1333-1349.
Peters, H. J., Greenberg, J., Williams, J. M., & Schneider, N. R. (2005). Applying terror management theory to performance: Can reminding individuals of their mortality increase strength output? Journal of Sport & Exercise Psychology, 27, 111-116.
Pyszczynski, T., Greenberg, J., & Solomon, S. (1999). A dual process model of defense against conscious and unconscious death-related thoughts: An extension of terror management theory. Psychological Review, 106, 835-845.
Taubman Ben-Ari, O., & Findler, L. (2005). Proximal and distal effects of mortality salience on willingness to engage in health promoting behavior along the life span. Psychology & Health, 20, 303-318.