09/30/2011 12:11 am ET Updated Nov 29, 2011

Are You Psychologically Ready to Be Old?

Aging brings a number of virtually inevitable psychological challenges. Meeting them is often not easy. Preparing ahead of time can help.

The ultimate goal of old age, developmental psychologists tell us, is to achieve "integrity" and to avoid "despair." What they mean, roughly speaking, is that, as you near the end of your life, you should be able to look back and feel that the life you lived is truly yours, that it was not a life forced on you, not a life that left behind your greatest potentials, and not a life you now regret. If you look back with an overwhelming sense of betrayed potential, you will not have achieved "integrity," and you are not likely to be happy.

Achieving integrity also means that you can look back with pride. It does not have to be pride in a great achievement at work or in your community; it can be pride in having earned a living, in having raised a family, in having good friends, in having cared for those you loved, or simply in having led the life you wanted to lead.

Of course, satisfaction with your life when you are old is not only about looking back with pride. It is also about living well now. The essence of this is remaining active and connected with other people.

For many people, having a sense of meaning is also critical. This can come from contributing to your community or to your family. It can come from being creative or from passing on your skills and wisdom. It can come from spiritual experience.

As important as a sense of meaning can be, it appears not to matter to some people who just want to enjoy life. If meaning is the antidote to despair for many, pleasure is the antidote for many others.

Ageist assumptions may make it hard to believe, but there are plenty of opportunities for old people to live well. There is meaningful work -- volunteer and paid, opportunities to be creative or to enjoy the creativity of others, relationships to be continued and deepened with time, new relationships that can be developed, and spiritual experiences available either through an array of religions or privately. And of course there are lots of opportunities to have a good time whether on the golf course or in the senior center, at discounted movies or extended education classes, at parties or in social and sexual relationships.

Old age does not have to be a cold and barren time spent mostly waiting for death. It can be a time of pleasure, a time of giving back, or a time of ultimate fulfillment.

Can be, but not necessarily will be.

Physical, mental, and substance use disorders (especially alcohol abuse) can be major barriers to aging well.

And the developmental challenges of old age are difficult to meet. These include retirement, role changes in family and community life, coping with diminished (but not necessarily lost) physical and mental capabilities, learning to live with chronic health conditions and sometimes pain, surviving the loss of more and more family and friends over time, and coming to terms with your own mortality.

In addition, the risk of becoming physically or mentally disabled and dependent on others becomes greater and greater.

Those who are young -- or old -- and physically and mentally healthy, able, and independent generally look on the possibility of becoming disabled in old age with considerable dread.

That is understandable. From early on most of us have tried to achieve lives of independence. We take pride in taking care of ourselves and those who rely on us. The vision of our own decline into disability and dependency and especially into dementia is usually deeply troubling.

Whether that is the only way to view severe disability in old age is open to considerable debate. Some of us believe that there can be a decent quality of life for old -- and young -- people with severe disabilities. Others regard it with unmitigated horror.

By taking good care of yourself you can reduce the likelihood of disability in old age, but there is no guaranteed way to avoid it. So, just as you need to face the inevitability of death, you also need to consider the possibility of spending your final years in a physical or mental state that you now think will be intolerable but which may offer enough satisfactions to make life worth living when you get there.

It is not easy to prepare for all this. No doubt the feeling of old age when you experience it will be different in some important way from what you imagined. But much is known about aging, and it is possible to be more or less prepared. Have you begun?