An excerpt from this editorial was published on the HIV-Age.org website.  Here is the full article:

Making meaning in middle age: The challenge of living longer than expected

It is easy to feel stuck at middle age. Looking back can stir regret for missed opportunities; ahead, the prospects of aging and mortality. Even satisfaction with our present lives involves reckoning with the reality that things are not quite what we anticipated. Unless we see the value in relationships with friends and family, work and social involvement, we can sink into stagnation at midlife.

This challenge can be even more profound for people with HIV who never imagined living to age fifty or beyond. Having spent decades caring for themselves and others AIDS has knocked them off their life course. A magnitude of loss has decimated their social networks, removing the very people with whom they expected to grow old. And, subtle adjustments to physical challenges, financial limitations, and changing priorities have further diminished circles of social involvement.1

Stagnation: “What am I doing it for?”

Stagnation was a significant theme in my study of aging with HIV. Hector, age fifty,2 said he “got into t.v.” rather than pursue work opportunities. Jamie, 57, acknowledged he, “doesn’t get out much.” Joe, age 64, spoke of the losses that accompanied aging with HIV. Not only had all of his close friends died of AIDS, but physical challenges, leaving work to care for his health and the financial limitations that followed all coalesced to create what he called, “a shrinking kind of life.”:

“Then, the other question comes into point, what for? Why should I eat properly, exercise, stay active, not just lay back and wait to die, and go without medication and all those other things?”

For Joe the threat of stagnation at middle age had serious implications.

Generativity: “Mature man needs to be needed”3

The antidote to stagnation is generativity. In middle age we can stagnate into self-absorption or we can give our lives meaning by passing on our experience to the next generation. When we are generative we use our strengths creatively to engage with others through teaching, mentoring, volunteering, or leading.

There were examples of generativity throughout the narratives of the men I interviewed. Arthur, age 64, talked about his writing as a way to “leave something behind”, Luis, 51 volunteered at an AIDS service organization in order to “make a difference.” Tim, at 50, described his activism as honoring friends who died of AIDS:

For my friends that are dead… but it’s not for me, it’s for the future as my friends did it for me, I want to do it for them. I want to make the future better for the people, whether they’re related to me or not that follow me.

I met with Joe several times over the eight months of my study and during that period he made significant changes to his life. He continued his rigorous health care regimen. He got into therapy and rejoined a support group for older people living with HIV. He even attended a family reunion and was surprised that rather than feel ostracized for his HIV-status, he felt included and involved. What motivated Joe to emerge from stagnation? He attributed his adaptation to aging with HIV to concern for others and desire to stay engaged:

“You have to care about other people, and try to integrate your life with other people.”

Generativity vs. Stagnation

In adulthood we continue our psychological development through mastering the challenge of generatively vs. stagnation. For Luis the solution was obvious: “I refuse to be stagnated.” Sometimes the decision to be generative involves more subtle choices regarding how and with whom we spend our time. This challenge was evident as Patrick, age 55, expressed his ambivalence about reconstructing a career at middle age:

“There are those things about 55 that make you want to say, oh just relax…But on the other hand, because that was snatched out of my life in my late 30s and throughout my 40s, I’m scrambling to have those experiences that I should have had when I was younger. You know?. . . so I’m conflicted between being 55 and going, “Well, you’re 55, you know, it’s hard to get out of bed, just relax! Enjoy your life, you know? Don’t . . . don’t work so hard.” And then this other part that’s still hungry.”

Generativity has additional psychological benefits. Generative activities can help people living with HIV rebuild social relationships, reclaim goals relinquished to HIV/AIDS, and remind middle aged and older people of what they have to offer.

Here are a few strategies for generativity that emerged from my study of aging with HIV4:

Teach a class or workshop
Lead a social group
Tutor a child
Provide companionship to a homebound person
Become politically active
Be an HIV peer educator
Serve on a community advisory board
Join a chorus
Create an inter-generational art project
Mentor gay teens
Join a professional organization
Start a blog
Write an editorial on aging with HIV

It’s never too late to pursue a goal, find new interests or impact someone’s life in a positive way. You have a great deal to offer the world, but you are of no service to anyone, including yourself, if you don’t put yourself out there.

References

Masten, J.E. (2014) A Shrinking Kind of Life: Gay Men’s Experience of Aging with HIV, Journal of Gerontological Social Work. 58(4):319-37.
All names changed
Erikson, E. H. (1963). Childhood and society. New York, NY: W.W. Norton and Company.
Excerpt from: Masten, J.E. (2011) Aging with HIV: A Gay Man’s Guide. Oxford University Press: New York.