CALIFORNIA STATE UNIVERSITY, NORTHRIDGE
SUCCESSFUL AGING IN SENIORS 65-75 YEARS OLD: AN
EXAMINATION
OF THE EFFECT OF THREE LIFESTYLE VARIABLES
A thesis submitted in partial fulfillment of the requirements
For the degree of Master of Science in
Family and Consumer Sciences
By
Amanda Joy Powell
May 2013
The thesis of Amanda Powell is approved:
Terry Hatkoff, Ph.D.
Date
Scott Williams, Ph.D.
Date
Jerry Ann Harrel-Smith, Ph.D., Chair
Date
California State University, Northridge
ii
DEDICATION
I would like to dedicate this thesis to Dorothy, Barbara, and Forrest. Grandma, even
though you are not here to witness my path in this life, I know you have been with me
through it all. Thanks for teaching me that aging can be “cool”. Barbara, you instilled
hard work and dedication into my very being, and without that a feat such as this would
not be possible. Thank you for pushing me to my limits and beyond. Forrest, thank you
for listening to my seemingly insane rants about statistical analyses, theoretical
frameworks, and writing blocks. You have been there for every moment of this long
journey, and you always reminded me not to get too caught up in it all. From the bottom
of my heart, thank you for loving me for me.
iii
ACKNOWLEDGMENT
I would like to thank my committee members who supported my efforts in writing
this thesis.
To my chair, Dr. Jerry Ann Harrel-Smith,
To Dr. Terry Hatkoff,
To Dr. Scott Williams,
Thank you so very much Terry, for engaging me in the Family Studies field over 8 years
ago. I would not be here today if it were not for your amazing class, and the opportunities
you have provided me since. I feel extremely honored to have had the opportunity to
come back and be able to help you run your class, as well as teach on my own. Your faith
in my ability means more to me than I can tell you. To Jerry-Ann, I learned so much in
your classes, and I always knew you expected the world from me. I hold myself to a high
standard, and I know your leadership and guidance are a vital reason for that standard of
excellence. I enjoyed very much our conversations and correction sessions in which we
could rely delve into aging as a real-life event. And to Scott, thank you so much for
taking a vested interest in my education. Your undergraduate classes made me put on my
thinking cap, and helped me to realize the career path I would follow. Knowing you have
followed your dream of attaining a PhD is something I look up to, and I hope is in my
future as well.
I would like to acknowledge Juan Oliva, M.F.T. for his help in narrowing my
subject matter down to a reasonable size and for taking the time to talk things out with me
when I felt like my head was going to explode. Your advice helped me to continue with
iv
my topic of successful aging, when I felt that I would be better off in another direction. I
would like to thank Dr. Angie Giordano for always being there for me when I needed
administrative, or subject related help. Your willingness to assist me when you did not
have to, made me, and continues to make me feel incredibly special. To Dr. Stephan
Chung, thank you for encouraging me to apply my education in the community and the
real world. Your ideas about changing the face of healthcare and aging have made me
look at myself, and know that it is someone like me that can help to make those changes
occur.
v
Signature Page
ii
Dedication
iii
Acknowledgment
iv
Table of Contents
vi
List of Tables
ix
Abstract
x
CHAPTER I – INTRODUCTION
1
Statement of the Problem
7
Purpose
7
Definitions
8
Theoretical Framework
8
Hypotheses
9
Assumptions
10
CHAPTER II – REVIEW OF LITERATURE
11
The New Gerontology
11
Successful Aging
15
Aging Over the Life Course
22
Social Relationships
26
Productivity and Work
31
Planning for the Future and Goal Setting
35
CHAPTER III – METHODOLOGY
38
Participants
38
Procedures
40
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Measurement
42
CHAPTER IV – RESULTS
47
Univariate Analysis
47
Gender
51
Self-Reported Illness and Injury Affecting Daily Life
52
Bivariate Analysis
53
Multiple Regression Analysis
54
CHAPTER V – DISCUSSION
60
Social Support
60
Productive Work
61
Planning for the Future
63
Conclusion
64
Limitations and Future Research Implications
65
REFERENCES
69
APPENDIX
A - Measures Used in the Thesis - Survey
77
B - Survey Coding and Variable Breakdown
82
C - Human Subjects Approval Form
87
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LIST OF TABLES
Graph 1 – Participant Age
38
Graph 2 – Participant Income
39
Table 1 – Frequency Distribution for Social Support
47
Table 2 – Frequency Distribution for Productive Work
48
Table 3 – Frequency Distribution for Planning for the Future
49
Table 4 – Frequency Distribution for Successful Aging
49
Illustration 1 – Scatter Plot Representations
54
Table 5 – Correlations
56
Table 6 – Pearson Correlation
58
Table 7 – Beta Coefficient
59
viii
ABSTRACT
SUCCESSFUL AGING IN SENIORS 65-75 YEARS OLD: AN EXAMINATION OF
THE EFFECTS OF THREE LIFESTYLE VARIABLES
By
Amanda Joy Powell
Master of Science in Family and Consumer Sciences,
Family Studies
The purpose of this study was to examine how social support, participation in
productive work, and planning for the future are related to successful aging. This
research defined successful aging as the ability to optimize circumstances given while
being actively engaged in proactive measures to obtain a high level of functioning. A
total of 68 participants, ages 65-75, filled out a self-reported survey created by the author.
A total of 67.7% of the sample population was found to be successfully aging.
Productive work had the most correlation to success in aging. Planning for the future and
successful aging were the second most correlated relationship. Another relationship of
significance was that of productive work and social support, though this relationship
between independent variables was not originally hypothesized. Final analysis was
completed using SPSS version 20 and showed that social support systems and planning
for the future did not significantly correlate to success in aging. Alternatively, productive
work was vital in the formula for successful aging.
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CHAPTER I
INTRODUCTION
“To know how to grow old is the master-work of wisdom, and one of the most difficult
chapters in the great art of living’; so wrote Henri Amiel in 1874” (Vaillant, 2002, p. 3).
This Swiss poet and philosopher had a keen insight into the wonder of aging. The study
of aging is not a new field, but has become exponentially more important as the world’s
population has aged. Hogan (2011) posited that for the next 20 years, about 10,000
individuals will turn 65 years old each day. By the year 2030, the United States
population of 65 and older individuals will more than double. This means that one in
every five persons will be above the retirement age of 65 (Myers, 2007). One of the
fastest growing segments of the United States population is the 85 years plus population,
more commonly referred to as the “oldest old” (Cavalieri, 2006). Although the aging
population is growing extremely fast, the fertility rate has been in decline for the last
century. This has created a schema, called population aging, in which the working
population will need to support the large group of older individuals, producing a growing
disproportionate relationship. Morrow-Howell, Tang, and Kim, et al. (2005) took the
stance that our aging population is a tremendous opportunity for the betterment of society.
The aforementioned authors felt that creating opportunities for engagement and
volunteerism, as well as educating the aging on varied topics such as retirement planning
and keys to successful aging would encourage a more healthful aging process. Individual
communities, and society as a whole can use this opportunity of demographic changes to
alter their outlook and create a more positive aging experience for our elders, and
eventually for themselves. Joan Erikson, at age 92 wrote, “Old age demands that one
1
garner and lean on all previous experience, maintaining awareness and creativity with a
new grace” (Erikson & Erikson, 1997, p. 9). It was my hope, as a researcher, to bring this
positivity to the field of aging, and thus the researcher drew on her background in Family
and Consumer Sciences. The author attained my Bachelor’s Degree in this field with an
emphasis on Family Studies. This enabled me to learn about not only child, adolescent
and adult development, but their relationships and interconnections as well. The
researcher’s interest in aging came from a deep relationship with my grandmother, and
for the last few years, she has helped to run a successful senior programming department
at the North Valley YMCA. Along with this, she earned a post-baccalaureate certificate
in Gerontology, and with the completion of this paper, her Master’s Degree in Family
Studies. Aging is something we partake in each day, and understanding the needs and
issues of the aging individual is vital and important to all.
Aging has previously been thought of as solely a time when the wearing down of a
person’s body becomes high, and general functioning becomes low. Elderly individuals
are unable to participate in various activities they used to enjoy, and things as near and
dear as memory, ability to drive, and even vision can start to decline. Moody & Sasser
(2012) pointed out that currently in the United States, 80% of individuals 65 and up have
one chronic illness, and about 50% of the same age group have at least two.
How, then, can researchers construct an idea that aging can be a positive and
fruitful time in the human lifespan? Moody (2005) found acute connections between
gerontology and the field of positive psychology. Martin Seligman (2004), the founder of
positive psychology, reminded the researcher that psychological interventions should not
only be aimed at fixing a problem but also at building strength. His ideology posited that
2
psychology shouldn’t be exclusive to individuals with problems, but that “normal”
individuals should be able to live their best life at any age. Lavretsky (2010), Rowe and
Kahn (1997) and Vallant (2002) also noted these connections between positive outlook
and success in aging including general wellbeing and happiness. This and other current
research showed that longevity and health have a strong connection to altruism, social
involvement and interpersonal generativity. Instead of equating aging with decline and
disease, the definition could be reinterpreted as, “…essentially a process of accumulating
and cultivating relationships, in which, when it goes well, the experience of physical
decline is eclipsed by the happiness and stimulation of human interaction.” (Moody,
2005, p. 65) One must understand that some decline is to be expected, but the ability to
see past the physical self and understanding that some compensation will be necessary is
a key component of those who successfully age. This positive light being shed on the
field of aging is what drove me, as a researcher, to delve deeper into the possibilities of
successful aging. Creating the opportunity for individuals, as well as society, to
understand and have access to educational materials related to healthful longevity is very
important. Successful aging will not, and cannot occur unless a greater understanding of
sociological, and lifestyle factors are understood.
The “new gerontology” was a concept that was born in the 1980’s by a group of
researchers working on the MacAurthur Foundation Study of Successful Aging (Rowe
and Kahn, 1997). Until this study, much research was based around disease and
disability, and not on how to lead a successfully aging existence. The concept of
“success” in aging is a fairly subjective notion, but Rowe and Kahn and others with the
mindset of success in senescence and aging attempted to quantify what it would look like.
3
Successful aging, according to Rowe and Kahn (1997), included three main and
overarching components: A low likelihood of disease and illness related disability, a high
capacity for physical and cognitive functioning, and a clear and active engagement in life.
They went on to say, “…with advancing age the relative contribution of genetic factors
decreases and the force of nongenetic factors increases” (Rowe and Kahn, 1997, p. 433).
This lead the researcher to believe that lifelong lifestyle choices as well as conscious
healthful decision making can greatly enhance the possibility of attainment successful
aging. Another definition originally proposed by Rowe and Kahn was related to the
mindset of “decrement with compensation” (Moody, 2005). “Like compression of
morbidity, decrement with compensation is easy enough to understand. In this case, the
goal of positive aging is not to stay healthy longer and longer but, rather, to adapt, to
make the best of our situation, even if it means chronic illness and decline” (Moody,
2005, p. 61). This was the first time that American researchers looked at aging with a
flash of understanding and positivity. Individuals may experience decline as they age, but
through varied methods of compensation, the effects of usual aging can be diminished,
and more successful aging will develop.
Erik & Joan Erikson (1997) designed “wisdom” and “integrity” as the two most
important life cycle virtues for the stage of old age. By understanding the background
and root meanings of these words, they found that wisdom in the Sumarian language,
thousands of years ago, was the same word for “ear”. This brought to light the
importance of listening, and learning to gain insight, enlightenment, and in turn success in
aging. The aforementioned definitions focus mostly on health and physical functioning,
but a more inclusive definition would include spiritual and emotional wellbeing
4
(Strawbridge, Wallhagen & Cohen, 2002). This research included an operational
definition of successful aging that did not automatically exclude those who have a disease
or disability. This research sought to ascertain a more comprehensive look at wellbeing
in relation to success in aging (Rowe & Kahn, 1997; Moody, 2005).
Social support, including spirituality and religiosity, was another component
associated with successful aging. This was related to Rowe and Kahn’s (1997)
“engagement with life” yet also takes into account work productivity and personal
spirituality. Iwamasa and Iwasaki (2011) researched aging within the Japanese American
subculture. Their findings, through focus group meetings, concentrated on having strong
social support and a large social network. Strong social ties have been linked to
decreased decline in functioning, as well as heightened meaning in life (Iwamasa &
Iwasaki, 2011). They also found that having spiritual beliefs and putting them into
practice were very important in coping with stress as well as maintaining one’s wellbeing
in later life. A Finnish study done by Uotinen, Suutama and Ruoppila in 2003 took into
account the “feel age” and “subjective age” for each participant. “Positive subjects more
often found their life meaningful, less often described a decrease in their zest for life, and
were socially and physically more active than the others” (Uotinen, Suutama, Ruoppila,
2003, p. 191). Understanding and operationalizing spirituality and positive self-esteem
can be challenging, and thus research has varied in this area. This lack of consensus
made the presentation of results difficult to generalize, and thus even harder to dispel to
eager public ears. Rowe and Kahn (1997) described productivity in older adults as a
highly debated topic. They explained that there are disputes regarding what productive
activity truly entails. Hogan (2011) put his spin on it by saying, “Older workers are good
5
for business, and that’s not just our experience. Studies show that older-worker
productivity is high, especially in the retail and service industries…creating environments
that are age-friendly is in the best interests of businesses.” (Hogan , 2011, p. 3) So, in this
instance, keeping productivity and positivism high was not only good for seniors, but for
businesses as well. Morrow-Howell, Tang, Kim, et al., (2005) posited that for older
adults, being employed is related to having a larger social network and, through this
association, to better health. Seniors who put into practice teaching, training and sharing
with younger generations may feel the concept of generativity. Erikson (1997, p. 112)
shared that “When no challenges are offered, a sense of stagnation may well take over.”
This stage of life cycle development, Generativity vs. Stagnation, is the longest of all
stages in Erickson’s theory, and thus important to master (Rowe & Kahn, 1997; Iwamasa
& Iwasaki, 2011; Uotinen, Suutama & Ruoppila, 2003; Hogan, 2011; Morrow-Howell,
Tang, Kim, et al., 2005).
The National Institute on Aging concluded that the aging brain has the ability to
rewire, and reconnect itself due to losses that age or injury has created (Schrof, 1994).
This idea followed the compensation and optimization portion of the decrement and
decline model of aging. This information lead the researcher to believe that successful
aging was a combination of the plasticity of an individual’s brain, their will power to
forge ahead, and their ability to maintain a positive outlook in the face of inevitable
decline. The research showed that these “proactive adaptations,” including planning
ahead for future events, may maintain psychological well-being and even act as a buffer
to many life stressors (Kahana, Kelley-Moore, Kahana, 2012). Successful aging was
found to be a multidimensional process that included three distinct yet intertwined areas
6
of interest. This research continued to explore social support systems, productive work
habits, and plans for the future, to compute the formula for successful aging.
STATEMENT OF THE PROBLEM
Freysinger (1990) summed up a popular goal of aging individuals with a life
course perspective in mind. “For many of us, physical survival is no longer the primary
issue and attention has turned to the quality and nature of that survival, to patterns of
development, and to what comprises successful aging.” (Freysinger, 1990, p. 1) Since
poor longevity and health concerns have been quelled by technological and medical
advances, we turn now to what the individual can do over their life time to increase
wellbeing as individual’s age. By staying focused on social support, productive work
habits, and plans for the future, this research developed a quantifiable framework to
understand lifestyle choices and how they relate to overall success and satisfaction in later
life.
PURPOSE
The purpose of this study was to bring a new understanding of what it meant to be
successfully aging to the forefront. The population aging this country is experiencing
brings new challenges as well as opportunities to researchers, political figures, and
individuals everywhere. By understanding the lifestyle patterns and historical context
involved with the aging process, buffers from decline and compensatory mindsets could
be understood to aid in the aging process. By exploring individuals who are aged 65-75
in three distinct areas of development, this research created an opportunity for
understanding and a platform for utilizing what was learned. This information gave aging
7
individuals the power to make well educated choices that may influence their future. The
focus of this research was on exploring a lifestyle approach of activities and habits in
which individuals engaged in the fields of social support, productive work habits, and
planning for the future.
DEFINITIONS
1. Successful Aging: The ability to optimize circumstances given while being actively
engaged in proactive measures to obtain a high level of functioning.
2. Social Support: Maintains contact with family members or friends, or actively
belongs to a group concerned with one's physical and emotional wellbeing.
3. Productive Work: Engages in work or volunteer activities including continuing
education which promote purpose and value in life.
4. Planning for the Future: Is currently planning an upcoming project or trip in the
coming year.
THEORETICAL FRAMEWORK
The life course perspective of aging provided us with a realistic understanding
that aging is not simply a stage which you reach at a certain age, but a cumulative
experience from birth to death. Along the same lines, Erikson created specific life cycle
stages that included a dilemma to overcome, for each life stage, over the life course.
Erikson introduced generativity verses stagnation as a seventh developmental task in the
1950’s (Schoklitsch & Baumann, 2012). The developmental stage of generativity versus
stagnation is one that encompassed the longest period of years of an individual’s life.
This task can be rewarding, and even be the happiest time to be alive, but if withdrawal
8
overcomes these feelings of care, a sense of uselessness can be overwhelming (Erikson,
1997). Moody and Sasser (2012) posited that the life course perspective forces us to
consider a historical perspective of the entire life of an individual. To make sense of old
age, we simply cannot look to the present. The 21st century has been, and will continue to
be a time in which roles and norms of the aging population will revolutionize our
understanding of the aging process. Technological as well as medical advances have
provided the opportunity to many people to extend their lifespan significantly. Working
to understand the life-long process of aging, and caring for oneself, will greatly enhance
the working knowledge of how one can successfully age.
HYPOTHESES
NULL HYPOTHESES
The data analyses for this thesis was guided by the following null hypotheses:
1. There is no relationship between a social support system, and determining successful
aging.
2. There is no relationship between participating in productive work, and the process of
successful aging.
3. There is no relationship between planning for the future when determining successful
aging.
RESEARCH HYPOTHESES
Based on the review of literature in Chapter 2, the following research hypotheses
were developed.
9
1. Seniors, defined as individuals ages 65-75, who maintain a social support system are
successful agers.
2. Seniors who participate in productive work have a positive relationship to successful
aging.
3. Successful aging is positively related to seniors planning for the future.
ASSUMPTIONS
This research study was created based upon certain assumptions:

Participants in this pilot study will participate on a volunteer basis.

All participants speak and read English, and are able to understand the questions
posed on the survey.

Participants will answer the questions to their best ability taking into account that
memory may be an implication in how they answer questions about their past.

The questions asked and measures used were appropriate for seniors of different
ethnic groups.

No errors were made in the data entry or in the analysis of data.
10
CHAPTER II
REVIEW OF LITERATURE
The concept of “successful aging” is becoming an increasingly more popular
construct yet the definition is often ambiguous. Previous literature has defined successful
aging in multiple, and often conflicting ways. Parslow, Lewis & Nay (2011) reviewed
previous studies on aging and found that most measures of successful aging were related
to only physical health and cognitive functioning. Few studies they assessed took life
satisfaction and well-being into account. This research utilized a multi-dimensional
definition of successful aging, and the life course perspective, to gain further insights into
the understanding of successful lifelong aging.
THE NEW GERONTOLOGY
Gerontologists have used biology and the social sciences to study aging, and this
has not only deepened the understanding of growing old, but it has shaped policy and
programming for a new generation of gerontologists. This new wave of gerontology was
born out of the MacArthur Foundation Study of Successful Aging lead by Rowe and
Kahn (1997). The emphasis of this “New Gerontology” was placed on the potential for a
healthy and engaged old age. The new wave strived to replace the long standing decline
and decrease viewpoint with a more positive and forward thinking model. This can be
understood best by thinking about prevention and compensation for any loss, or
impending loss, by living healthfully throughout a lifetime (Holstein & Minkler, 2003).
Bengtson, Parrott and Burgess (1996) reviewed the new wave of psychogerontological
theories in aging. Their research revealed three distinct theoretical time periods which
have motivated research and paradigm shifts in aging. The first theoretical time period is
11
the “Classical” time under which modernization and disengagement theories fall. We
also would see psychosocial theories and cognitive theories of personality and aging
under the classical category. The second influx of theory was called the “Modern” time
period in which life-span development, behavioral genetics, and even reduced processing
resources were present. The last wave is what we now consider the new wave of
gerontology, but in relation to theory we would call this Post-Modernism.
Gerotranscendence and gerodynamics fit into this post-modern category. Tornstam
(2005) revealed the important nature of reaching the developmental level of
Gerotranscendence, or in Erikson’s model, that of Ego-integration. Erikson (1997)
described reaching gerotranscendance as “..to rise above, exceed, outdo, go beyond,
independent of the universe and time.” (p. 127) Bengtson, et al. cited theories of
Gerotranscendence and Gerodynamics as representing new directions in psychological
theorizing, suggesting these ‘new’ perspectives reflect a larger intellectual and scientific
trend toward critical theorizing.” (Bengtson, Parrott & Burgess, 1996, p. 770)
Supplementary to the time periods that these theoretical bases cover, an
understanding of how health, economics and epidemiology coincide were vital to
understanding this new wave. “With improved economic conditions, positive changes in
physical and often social environments and improvements in health care and health care
access, many more – though certainly not all – older people can have a relatively
satisfactory old age.” (Holstein & Minkler, 2003, p. 789) This was never the case in the
past, and individuals now have more resources than ever to stay healthy as one ages. It
would be unwise to think that everyone has an equal opportunity for aging successfully,
even with the knowledge of the new wave of gerontology. Although the focus is on
12
prevention of decline, and increased health, there are simply those who equate unhealthy
habits with life satisfaction. This “new wave” of gerontology is the missing link that
bonded health, life satisfaction including wellbeing, and personal outward plans as a
cohesive unit we now call successful aging.
Success in aging is implicitly tied to the new wave in gerontology, as is the life
course perspective. The very nature of gerontology is interdisciplinary, and the new wave
combines a myriad of disciplines for a full understanding. Ferraro (2007) described this
phenomenon as a “plurality of disciplines where disciplinary boundaries are often muted
and the joint contributions of the synergy are highlighted.” (p. S2) If someone simply
looked at biology in aging, they would only get a partially painted picture of an
individual’s heath. If focused only on life satisfaction or mental health, researchers
would miss out on other important, and interconnected, areas of study. Ferraro’s
interdisciplinary mindset was an accurate designation of the field, and this research
proposed that the combination of disciplines is what makes gerontology, and especially
the new wave, so important.
Numerous theories of aging have been suggested to explain lowering of status of
aging individuals (modernization theory), and even the notion of individuals separating
themselves from greater society (disengagement theory). These theories were born out of
early modernization of society and more urbanization in cities. Neither is highly regarded
as generalizable for most aged individuals at the present time (Moody & Sasser, 2012).
These popular theories generally focused on simply the social implications of aging.
Biological theories abound including the well-known wear and tear theory. This theory
posited that the accumulation of physical wear that occurs over a life time can lead to the
13
changes associated with aging. Other theories such as the activity and continuity theories
of aging show that the more we stay engaged in life, the more we will maintain our life
satisfaction, and that we will even continue to stay healthier for a longer period of time.
Much research shows that staying social, continuing work or volunteerism, and staying
active are keys to maintain a youthful mind and body (Moody & Sasser, 2012). The
activity and continuity theories supported the idea of “use it or lose it” and encouraged
individuals to maintain a lifestyle not too distant from that of a younger version of
themselves. This segment of theorizing began to take a few disciplines into account. The
new wave of gerontology sought to revolutionize the study of aging by taking the focus
away from decline, illness and impending death, and back towards prevention strategies
and life satisfaction. This shift came from an increase in life expectancy, along with more
information being available in all fields related to aging. This shift in thinking is what
made the new wave more important than any theories before. Words such as longevity,
compensation, optimal aging, elasticity (Freund & Baltes, 2007), and even proactive
adaptation (Kahana, et al., 2012) are extremely common in the newest literature. Much
of the increase in life expectancy in the latter half of the century has been almost entirely
attributable to medical advances including sanitation as well as improved socioeconomic
conditions (Lavretsky, 2010). Due to these technological advances, compensation for
loss is more common than ever before in aging. Freund and Baltes (2007) explained;
“…traditionally, development was primarily seen as related to growth or gains, and the
multidirectionality of development has only been recognized since the advance of
lifespan theory and aging research (Baltes, 1987).” (Freund & Baltes, 2007, p.242)
Erikson (1997) cited that assistance and wisdom both flows up and down from older to
14
younger generations, showing us that as we age, individuals are both influential as well as
have the ability to be influenced. We are no longer only seeking an explanation of how
we develop from birth to adulthood, but also how we grow into late adulthood, with all of
its challenges. With an advanced understanding of aging, from a biological, psychological
and spiritual level, this research looked at aging from the lifespan perspective, and placed
more emphasis on methods to optimize what the individual still could achieve.
SUCCESSFUL AGING
Freund and Baltes (2007) addressed the often conflicting definition of successful
aging. They said, “There is currently no generally agreed upon definition of ‘successful
aging.’ What is aging, and when does it start? ...What could be the general criteria for
success?” (Freund & Baltes, 2007, p.239) Who chose when “old age” should start
anyway?” In the 1880’s, Otto von Bismark selected 65 as the age, in Europe, in which
citizens would be eligible for a pension. The average life expectancy at this time was
only 45, and if one reached 65, they were considered “too enfeebled to work” and thus
could receive aid (Dychwald, 2005). Times have certainly changed as the life expectancy
has almost doubled, and retirement often times is simply a reduction of work hours, and
an increase of leisure activities. Freysinger (1990) commented that, “For many of us,
physical survival is no longer the primary issue and attention has turned to the quality and
nature of that survival, to patterns of development, and to what comprises successful
aging.” (Freysinger, 1990, p. 10) This thinking lead Freysinger to generate a literature
review to divulge the limitations and biases involved in age related theorizing. Freund &
Baltes (2007) developed a theoretical model of successful aging based upon
compensatory strategies called, “selective optimization with compensation,” better known
15
as SOC. So, if certain activities can no longer be done, selection of new goals should
occur, or compensatory methods must be in place to alter the outcomes (Bowling, 2007).
This was echoed by Brandstadter’s (1994) definition of successful aging as a dynamic
process of balancing assimilative (maintaining activities), accommodative (flexible goal
adjustment) and immunizing (selective filtering) strategies in order to maintain a realistic
and practical sense of self.” (Bowling, 2007, p. 269) The chronological number seemed
to bear little indication of the success or failure in aging, though the changing realization
of what one can and cannot do as they age increasingly becomes more important.
“Ebner, Freund, and Baltes (2006) showed that younger adults reported a stronger
focus on growth, and older adults a stronger focus on maintenance and prevention of loss,
in their personal goals.” (Freund & Baltes, 2007, p. 248) This was important due to the
fact that physical disability is one of the most debilitating ailments for the elderly. The
differences found between disability and functional ability were qualities prominently
discussed in previous literature around this topic. “Functional ability is defined as the
activities and tasks that people do on a daily basis.” (Greenglass, Fiksenbaum & Eaton,
2006, p. 15) For example: The higher one’s level of disability, the lower their level of
functional ability. Greenglass et al. (2006) performed a study in which 224 respondents
with an average age of 75, participated in a test to underscore how proactive coping leads
to higher functional ability and thus success in aging. Results showed that coping
methods significantly lowered functional disability in both men and women.
Should the presence of a chronic illness, even if managed effectively, be criteria to
exclude one from the title of successful aging? What if an individual had two or more
16
chronic conditions? Reaching a relatively disease and disability-free advanced old age is
and was truly realistic only for a few. Bowling (2007) and Reichstadt, Sengupta, Depp,
Palinkas & Jeste, (2010) also found that much of the literature on successful aging
operationalized the term with absence of physical disease or disability, and thus less than
a third of older adults could even reach this criterion. With this exclusive definition in
mind, Reichstadt et al. (2010) performed a study in which community dwelling elders
were interviewed to understand their perspective of success in aging. This study provided
insights that revealed accepting oneself, active engagement with life and growth, and
social involvement paired with a positive attitude are what can predict, with great
certainty, who is successfully aging. Strawbridge et al. (2002) compared self-rated
success in aging to that of the principal definition given by Rowe and Kahn in the late
1980’s. Much of the reviewed research by Strawbridge found that the definition of
success in aging included those who exhibited minimal disease and disability
(Strawbridge et al., 2002). Though little could be agreed upon as a formal definition to
successful aging, it is now clear that disease and disability are very common components.
Recent studies in the field of mindfulness and meditation have suggested that when a
mental shift occurs from threat to challenge, this directly reduces stress arousal and
increases telomere length in the brain. This mental compensation, in turn, increased
longevity in study participants. Through training activities, resilience and coping was
taught to aging individuals, which was proven to increase personal growth, selfacceptance, and purpose in life (Lavretsky, 2010). Unfortunately, much of what the
media presently portrays of older individuals is not a positive experience of what success
in aging can look like. The stresses of aging and disability may be too great to overcome,
17
and mean a less likely result of success in aging. Myers (2007) said, “Old age is viewed
as a time of undesirable physical, emotional, social, and financial losses. Older persons
are viewed as a group living with poverty, disability, and depression.” (p. 57) With these
negative stereotypes abundantly flowing in American society, why would one look
forward to aging, or try to live even longer than the average life expectancy?
Freund and Baltes (2007) explored selection, optimization and compensation as
the three interconnected and important components related to successful aging. The
individuals who refused to accept the aforementioned typecast of aging implored a variety
of these interventions and theories to keep a higher functional ability as well as increase
their wellbeing. The Selection portion referred to the choice in activities one engages in,
which will decrease the amount of alternatives. This narrowing of the amount of choices
helps to increase attention to particular activities or events one chooses. Optimization is
involved in creating the best integrative approach to the circumstances one has. This led
to a higher level of coping, and in turn, higher functioning for the individual.
Compensation referred to the substitution for perceived or actual losses. The SOC
(selection, optimization, and compensation) model was not made to be exclusive to old
age, but was seen as a technique to be used throughout the lifespan. The purpose was to
emphasize the potential of all older adults to meet challenges of aging (Freund & Baltes,
2007). This model emphasized the importance of another term called “planful
engagement” (Kahana, Kelley-Moore, & Kahana, 2012) which could reduce stressors
during and after major life events. This was important because these authors felt that
focusing on the process an aging individual goes through and not simply the outcome was
18
what defined success in aging. This theory emphasized positive and hopeful aspects of
aging, and was truly a post-modern ideology of aging.
George Vaillant’s (2002) definition of successful aging brought this purely
scientific definition to a more basic, holistic, and everyday meaning. “…[S]uccessful
aging means giving to others joyously whenever one is able, receiving from others
gratefully whenever one needs it, and being greedy enough to develop one’s own self in
between.” (p. 61) This balance is something that individuals may struggle with each and
every day, on every developmental level. Brandtstadter & Rothermund (2003) explored
this balancing act with ideas about goal setting, and future planning across the life span.
They said:
Throughout life, we try to achieve self-projects to maintain desired standards of
life and functioning and preserve personal continuity, but at the same time we
have to adjust goals, plans, and self-definitions to events and changes that occur in
historical as well as ontogenetic-biographical time (Brandtstadter & Rothermund,
2003, p. 107).
With all these studies, and so many possible dimensions of success in aging, what were
the most important qualities to identify a successful ager? Bowling (2007) underscored
the need for a better understanding of who is and who is not aging successfully. Bowling
said, “A model of successful aging needs to be multi-dimensional, and incorporate a lay
perspective for social significance, use a continuum rather than dichotomous cut-offs for
‘success’ and lack of, and distinguish clearly between predictor and constituent
variables.” (p. 263)
19
This researcher has adopted the idea that a continuum in aging is most accurate in
representing the realities of aging. An adaptation of Freysinger’s (1990) thoughts on
successful aging were also used. Freysinger (1990) posited, “The higher one’s
satisfaction with life, the more successful he or she is aging.” (p. 1) Without regard to
health, the feeling of satisfaction was a key component to success in aging. This research
delved into the subjective feelings of happiness within social relationships as well as
spirituality. Another dimension of aging that was important to discuss is how we choose
to live our lives. Holstein and Minkler (2003) point out that living in a society in which
the dominant culture chooses a life, devoid of healthful ideologies, or if there is no choice
of how to live due to other restrictions, can successful aging even be an option?
Depending on the country in which individuals live, their access to food and education
may be limited. It is vital that this research acknowledge that even when a desire to live
long and healthy is present, conditions beyond one’s control may disallow the opportunity
to be successfully aging. American culture does provide a choice to live a healthful
lifestyle, and yet many Americans do not choose this way of life. A lifespan
understanding of choices made, or made for and individual, can be crucial to
understanding a whole culture’s idea of success in aging.
The sex of an individual is another inborn quality that gives either an advantage or
disadvantage to that person when it came to longevity. Thiekle and Kiehr (2012)
completed a longitudinal study in which 5888 adults were studied for up to 7 years. Their
goal was to ascertain whether these individuals identified as “sick” or “healthy,” along
with depression, strength, and cognition, during the ages of 65-74; 75-84; and 85-94.
Thiekle and Diehr (2012) said, “Men died more often than women from a state of either
20
sickness or health, remained more healthy than women when alive, and were more likely
to recover from being sick.” (p. 7) They went on to say that men are not simply on a sped
up track of dying, but did experience a greater compression of morbidity than women.
Hsu (2008) studied a group of elderly individuals from Taiwan, and tried to ascertain the
differences between men and women when it came to successful aging. Their findings
exemplified the concept of living longer, but weaker, for women, with an earlier death for
men. This study also found that many of the women who survived were unable to do
instrumental activities of daily living (IADLs) and that they were almost always lower on
successful aging due to the amount of help and care they needed (Hsu, 2008). Activities
of daily living (ADLs) are those tasks that are necessary for those who live on their own,
such as feeding oneself, using the bathroom and getting out of bed. Instrumental
activities of daily living are those like managing money, preparing meals, and even
housekeeping. (Moody & Sasser, 2012) When it came to longevity, women of many
cultures outlived men, but the nature of those extra years was not successful at all.
This research used elements from multiple disciplines and dogmas to understand
how lifestyle elements lead to success in aging. This success was assessed by
remembering that aging falls on a continuum with gains and losses on a daily basis. Selfcontrol and resilience were found to be important aspects in the process of aging, and
without attempts at compensation, success cannot occur. This research sought to
empirically decide who is, and who is not aging successfully, or to discover if the
distinction is even possible.
21
AGING OVER THE LIFE COURSE
We are aging from the day we are born, until the day we die. Our daily choices
throughout that life determine, to some extent, how successfully we age. Though some
would like to think that they can deal with getting old when they get there, more
thoughtful individuals understand that a lifetime of good decisions may make that old age
better. Spira, (2006) pointed out that Americans spend much of their time denying the
process of aging, and this lead to a lack of vision of a later life. Americans are
bombarded with images in the media selling products geared at youth and rejuvenation.
American culture currently values youth and beauty, and our market reflects all of the
“band aids” available to reduce the appearance and feeling of old age. Little is said about
how a lifetime of wearing sunblock, or flossing your teeth can prevent wrinkles and skin
problems, as well the need for dentures. These techniques are examples of “planful
competence” over the life course. “…[P]lanful competence describes goal-directed
behaviors that are specific to the life course, often covering many decades.” (Shanahan,
Hofer & Miech, 2003, p. 189) The average person, and the American marketplace can
benefit from understanding this planful competence, while purchasing preventative
products. The anti-aging product lines have, to a certain extent, helped the average man,
woman and child, to stay healthy longer.
Rowe and Kahn (1997), in their groundbreaking work on successful aging,
discussed an individual’s heritability verses lifestyle choices:
The previously held view that increased risk of diseases and disability with
advancing age results from inevitable, intrinsic aging processes, for the most part
genetically determined, is inconsistent with a rapidly developing body of
22
information that many usual aging characteristics are due to lifestyle and other
factors that may be age-related (i.e., they increase with age) but are not agedependent (not caused by age itself) (p. 434).
Much of their research on this topic came from the Swedish Adoption/Twin Study of
Aging in which a clear delineation between environment and genetics could be studied.
As a child, and through adolescence, one’s focus was not primarily on how choices may
affect the body and mind in the future, but on what feels good, tastes good, and gives
excitement to life. This can include choosing unhealthy eating and exercise habits.
Without potential gatekeeping, so to speak, children may have no adult to turn to for
healthy living education. Ziegler and Sidani (2011) researched a variety of dietary
choices, and how those choices affected longevity. They discovered that many of the
significant age-related illnesses correlated with morbidity, and dietary patterns played a
major role in their progression. This included living a lifetime of healthy dietary patterns,
and not just a periodic intake of specific nutrients (Ziegler & Sidani, 2011). They found
that a Mediterranean Style Diet, high in fruits and vegetables, low in saturated fat, meats,
dairy, refined grains and sweets, increased longevity. These dietary restrictions needed to
be followed over a lifetime to see optimal results, and less decline.
Old age, in America, is seen cynically, and not with the same enthusiasm for
sharing an era of knowledge that other countries exhibit. Erikson (1997) shared that with
lengthening longevity, revitalizations of relationships, interplay of family, and
understanding of wisdom needs to be considered. Shanahan looked back into theoretical
history to understand why the life course theory was originally created:
Elder (1998) explains, the life course emerged as a response to three challenges
23
that were confronting investigators in the behavioral sciences: (1) to replace childbased, growth-oriented accounts of development with concepts that apply to aging
across the life course,
(2) to consider how human lives are socially organized over time, and (3) to relate
lives to an ever-changing society (Shanahan et al., 2003, p. 191).
Tornstam was a Swedish sociologist who was not in sync with the aging theories of the
1960’s. In response to theories of that time, he created the idea of gerotranscendence.
The idea was that if one reached gerotranscendence, they had made it to a higher level of
wisdom, and the last stage of maturation. (Wang, 2011) Tornstam defined
gerotranscendence as an opportunity to shift one’s thinking from a rational vision to a
more transcendent one, which was often followed by an increase in life satisfaction
(Tornstam, 2005).
Flood (2003) cited gerotranscendence as, “… a coping process that occurs when
there is a major shift in the person’s worldview, where a person examines one’s place
within the world and in relation to others (Tornstam).” (p. 38) It is important for aging
individuals, and those around them, to understand that there is both a lifelong and
culminating experience in aging. This idea is similar to that of Erikson’s life stage called
generativity versus stagnation. “Thus, reconciling lifelong generativity and stagnation
involves the elder in a review of his or her own years of active responsibility for nurturing
the next generations, and also in an interaction of earlier-life experiences of caring and of
self-concern in relation to previous generations.” (Erikson, Erikson, & Kivnick, 1986, p.
73) Those who have spent many years of their lives in inward-focused, activities can now
turn their attention to more creative, generative, and fun ones. Hughes & Peake (2002)
24
described generativity as a time of genuine concern for the future generation, and felt it
can even be linked to religious maturity. Erikson, Erikson and Kivnick (1986) pointed
out that grand-generative concern for future generations can preoccupy an individual with
unrealistic concern for an infinite world on unknowns. This could undermine the idea
behind generativity, and create a sense of stagnation from the extreme sadness and
frustration one may feel about the future. The concept of giving back to the next
generation is seen as an important step in reaching old age for all of these researchers. It
is even more important to the next generations who receive the wisdom and knowledge
from their elders.
It is important to point out that there are many factors that led to greater or poorer
success in aging over the life course. Holstein & Minkler (2003) felt it was important to
point out that having an adequate income, and the opportunity to eat nutritious foods was
vital. Furthermore, they felt that living in a safe neighborhood and having access to
medical care when needed was a very important predictor of success in aging. Without
understanding the major stressors and buffers one has accumulated throughout life,
research cannot hope to understand what comprises success in aging over the life course.
The understanding of how to live one’s life, day to day, to come to a failsafe “successful”
outcome is a vision that has thus far alluded researchers. We may never find one distinct
way to eat, drink and live a life, birth to death, that guarantees success and wellbeing in
later life. This may be due to the problematic nature of each human being intrinsically and
genetically different from one another. Until a time when this is discovered, a mindful
relationship between oneself and one’s lifestyle choices can increase longevity by making
conscious and healthful decisions over a life time.
25
SOCIAL RELATIONSHIPS
Social relationships are one of the three pivotal dimensions that Rowe and Kahn
(1997) proposed as a recipe for successful aging. Their research showed that being a part
of a solid social network was very important in determining longevity, especially for men.
This worked in two ways; socio-emotional and instrumental supportive transactions
(Rowe & Kahn, 1997). Greenglass, et al., (2006) took this idea one step further, and
investigated the relationship between coping, social support and disability in the elderly.
They found that there was a very important relationship between proactive coping and
social support networks. This was explored by having participants fill out a survey which
included subscales measuring functional disability, proactive coping, depression, physical
health status and social support. Findings concluded that the higher the number of
individuals who could offer assistance to a senior led to higher proactive coping scores
for that senior. This boiled down to the idea that the more resources one can draw from,
namely people to provide support, the more coping they would exhibit (Greenglass, et al.,
2006). Sherman, Shumaker, Rejeski, Morgan, Applegate & Ettinger (2004) tested this
hypothesis with 374 older adults with chronic health conditions. Their multiple
regression analysis revealed that both in participants coping with chronic osteoarthritis,
and those without the condition, the higher their perceived social support, the higher life
satisfaction, social functioning, and the lower depressive symptoms they exhibited. This
was concluded; the more proactive individual (with more of a social support network)
would see daily trials and tribulations as a challenge, instead of a stressor. Iwamasa &
Iwasaki’s (2011) research mirrored this finding about social support and coping. They
found that having a strong social network is a major advantage especially at the age when
26
an individual may suffer many losses. The research reviewed does not differentiate about
the age of the companion of the elderly, young and old friends are equally as important.
Myers (2007) pointed out that the only age restriction on social relationships may come
from the elderly, themselves. “Older persons may fail to develop relationships with their
age peers and may become isolated because they prefer not to associate with ‘those old
people.’” (Myers, 2007, p.63) Yet, younger family members, known as the informal
support network, can be hyper-critical and try to be too overprotective of the aging family
member. This behavior did not lead to a supportive network, and thus leaves the aging
individual with less resources than desired (Myers, 2007). Sherman et al. (2004)
described the concept of social integration. “Measurement of social integration can be
used to determine whether a respondent is socially isolated or has social ties and
summarizes the number of available social contacts.” Social integration was important,
but the quality of the relationships, or the pleasure one derives, was generally more
crucial to successful aging (Sherman et al., 2004, p. 465).
Traits, related to personality and temperament that lead to increased social
networks were important to understand in successful aging. Rowe and Kahn (1997)
found that being married, which should lead to higher emotional support, helped to keep
individuals more productive. Additionally, Mhaolain et al. (2012), found that being
married, or having a long-term partner was predictive of higher life satisfaction.
Mhaolian et al. (2012) interviewed 466 aging individuals with a rigorous inquiry of
physical, cognitive and psychological factors leading to life satisfaction. Through their
multivariate analysis, they also found that more extroverted personality traits tended to
act as a buffer to neuroticism and predict higher life satisfaction as one aged. One can
27
conclude that being married, as well as being more social in nature led to success in
aging. In the follow up to the famous MacArthur Studies in 1995, those identified as the
highest functioning older adults were those with strong social ties (Iwamasa & Iwasaki,
2011).
Each culture has a distinct view about their elderly population. Japanese cultures
celebrated and embraced old age as a feat to overcome, and an honor to join. Elders were
seen as wise and knowledgeable, and were respected for simply living so long (Iwamasa
& Iwasaki, 2011). Schrof (1994) went as far as saying that some Eastern countries have
revered their elderly population as gurus who deserve the utmost respect. Schrof (1994)
went on to explain that there is a concept of a self-fulfilling prophecy when it came to
wisdom and knowledge. As a culture, understanding that the more we socialize with, and
value seniors, the more they will be able to give back to younger generations. Ridding
the younger generations of ageism and negative stigma will help both older adults and
young people alike. Through relationships with elders an understanding of living history
can be shared, and a more collective society can occur.
Hughes and Peake (2002) used Erikson’s model to understand the relationship
between spiritual wellbeing and depression in older adults.
Instead of viewing aging as a maturation process, society often implies that
growing older is a gradual decaying. Rather than focusing on wisdom, integrity,
and hope, society often maintains myths about older adults by portraying them as
inferior, inflexible, and a burden to society (Peake, 1998; Johnson & Bytheway,
1990) (p. 16).
Erikson, Erikson & Kivnick (1986) sought to remind people that elders are guardians, and
28
transmitters of ancestral values, and without them this wisdom would be lost.
Spirituality is interconnected with social support in the understanding of the process of
aging. Attendance at church, or with a group of individuals who share a common
spiritual belief can significantly affect outlook and isolation. Without a positive
perception of aging, and a network to help, an older adult could experience discrimination
and isolation from society. If the aging individual does not find an outlet to quell this
feeling, they may experience highly aversive side effects.
The work of Hughes and Peake (2002) tried to clarify the differences between
religion and spirituality. Religion was seen as a more formalized worship of God, while
spirituality was equated more with finding purpose, interconnections, and worldly
meaning (Hughes and Peake, 2002). Johnson (1995) researched the importance of
religion, and the social network it brings, on the aging population. His work found that
religion was more important to the older population than any other age group. Religion
and spirituality were excluded from Rowe and Kahn’s (1997) work on successful aging.
In a study using an ethnographic grounded-theory approach, Iwamasa and Iwasaki (2011)
reported that, “…spiritual beliefs and practices play an important role in maintaining
one’s well-being and the ability to cope with stress. Neglect of spirituality in these
previous models of successful aging may reflect the traditional tendency toward
conventional scientific research in the U.S., which de-emphasizes the importance of
spirituality in human life” (p. 275). This research came from a comprehensive study with
Japanese American elders. The researchers created many focus group sessions with
interviewers who could culturally understand and empathize with the religious and social
aspects of their lives. Vahia, et al. (2010) also researched successful aging in relation to
29
spirituality. The authors recruited 1973 women and mailed each of them a self-reported
survey questionnaire. Their findings suggested that among the almost 2000 participants,
greater spirituality was related to lower education, lower income, and lower likelihood of
being married. This same group, with high rates of spirituality, did have the highest rate
of resilience among all participants. It is clear that the demographics are different in the
groups who were studied, but having spiritual ties made a significant difference on their
life satisfaction and support network. Thus, these different groups of people may have
been seeking out a social support network in a religious environment, instead of a marital
or educational environment.
Johnson (1995) found that, “Later life can be enhanced when the religious
community provides a network for widows, a link to social services, and even an
opportunity for counseling.” (p. 190) The social nature of going to church is an often
overlooked positive habit that can help to avoid isolation for seniors. Johnson also
confirmed that the two main dimensions of support that religion provides are those of
promoting socio-emotional intimacy and belonging with others. These two traits can be
formed with a larger network, increasing both the internal and external social resources
one possesses. Lastly, religion and a belief in a higher power often helped individuals
make better health related choices including staying away from deviant behaviors.
Hughes & Peake (2002) found that the more religiously committed a participant was, the
lower the suicide rate, drug use, alcohol over use, delinquency and divorce rates. All in
all, having a social support network, inclusive of a religious community, lessened an
older adult’s inclination to disengage from society. The greater the network, the higher
the person’s life satisfaction, the more they felt success in aging. It did not matter who
30
one’s friends were, or if their family lived at a distance, if a senior could maintain a
support network and a positive attitude, isolation was unlikely and success in aging was
inevitable.
PRODUCTIVITY AND WORK
Longevity doesn’t mean simply adding more years to the end of one’s life. Very
few people would want to be old twice as long. In fact, most people would say if they
had a choice, they would love to stay younger longer, or even have time to reinvent
themselves. Others would want to change their priorities to include a better balance of
work, family time, and leisure (Dychtwald, 2005). Working full or part time was defined
as being paid for employment in this study, but productivity was a more complicated
term. The simple idea of an exchange of money for a service could be considered work
or may include aspects of productive work. A non-economic value, including
satisfaction and education, was placed on certain processes or services one completed,
and this was defined as productive work. An exchange of currency did occur, per se, but
it is not of monetary value. An underlying tone of altruism was often times a reason
behind engagement in productive work, and this work may not have even felt like work at
all. Siegrist, Knesbeck & Pollack (2004) cited care of family members, informal help to
friends or neighbors and voluntary work as forms of productive activity. The norm of
reciprocity came into play when hearing the principle of productive activity. “Ongoing
effort is given in anticipation of some benefit that reflects the value of the accomplished
task” (Siegrist et al., 2004, p. 4). Yet doing something good in the world can make an
individual feel significantly well rewarded, without the social contract tied to a job.
There is a tangible feeling created inside a person when their work/volunteerism made
31
them feel productive, and thus these types of activities could create extreme meaning and
value in life.
Historically speaking, retirement was not even an option. Prior to the early
twentieth century, one worked all of their life. During the Industrial Revolution, Social
Security was in its infancy, and policies were put in place that would force seniors out of
the workplace when they reached age 65. This made room for the younger generation of
workers, during a hard time in employment history (Dychtwald, 2005). Age
discrimination, in the form of age cut offs for hiring and overt age discrimination policies
have been illegal since 1967 under the Age Discrimination in Employment Act (Robson
& Hansson, 2007). In the late 1970’s the accepted age of retirement was pushed back to
70 years old, and in the mid 1980’s it was completely eliminated for most American
workers (Quinn, 2010). With the lifespan increasing for each generation, some of our
best work can be done into our 70’s and 80’s with no hesitation. Galileo published the
Dialogue Concerning Two New Sciences, his masterpiece, at age 74. Mahatma Gandhi
was 72 when he negotiated India’s independence from Britain. Warren Buffet, at age 82,
is still a very well respected investor (Dychtwald, 2005). The list goes on, as age 80 and
older is no longer a sentence to decline and diminish accomplishments, but a time in
which great work can still be accomplished.
The Bureau of Labor Statistics estimated that workers ages 55 and older will
increase from 13% of the labor force in 2000, to 20% in 2020 (Robson & Hansson,
2007). As of this time, America has been slow to create a supportive employment
environment for the large amount of seniors who want to continue to work into their later
years. With increasing technology, the nature of working conditions may be more
32
conducive to those who cannot handle vigorous physical labor, or long periods of
standing or walking. Improvements like computers and hearing aids help seniors to
continue to work, and have flexibility like never before (Quinn, 2010). These
improvements have been slow, and are not enough to help all 72% of seniors (65+) living
in the United States who exhibit two or more chronic conditions (Friedman & Ryff,
2012). These considerations need to be made, and accommodations put into place to
assist employees and employers to do their best for business. Robson and Hansson
(2007) conducted two studies in which the goal was to decipher which strategies were
used by employees to age more successfully. They found, from their 265 participants,
that seven major strategies are important, but only four added value beyond personal and
organizational factors. These included: Security, Relationship Development, Continuous
Learning, and Career Management strategies. The strategy of continuous learning was
proven to highly increase effectiveness on the job, as well as self-efficacy. With high
regard for oneself, as well as the interest of business, keeping workers cognitively
engaged and happy seemed to be extremely valuable in maintaining high work ethic for
seniors.
Hogan (2011) showed us that creating age-friendly environments was in fact in
the best interest of businesses. He said that seniors are often more reliable, stay in the
same job longer, and are less concerned with promotion than younger workers. So, if
seniors in the work force are good for business, are they getting individual satisfaction as
well? Aside from wages earned, over two thirds of the participants asked in Quinn’s
(2010) study said that, “continued mental stimulation and challenge” was a major
motivation to continue working. A study cited in Quinn’s (2010) research, in which
33
2,300 baby boomers were surveyed showed that more than 75% expected to continue
earning into retirement and many more felt they would leave their current jobs to start
whole new careers. An important maladaptive aspect associated with retirement was the
likelihood of disengagement from the outside world. A forced retirement could have an
extremely negative influence on mental, physical and spiritual health. Declining health
also played a role into this withdrawal from the world (Choi, 2003). Siegrist, Knesebeck,
and Pollack (2004) demonstrated a link between productive health and well-being
including the idea that social and productive activities were also associated with overall
longevity. So it seems that productivity is good for the individual, and aging individuals
have more opportunities than ever to continue in a career they love.
The brain is highly agile, and thus working or volunteering in and of themselves,
did not simply lead to success in aging. The reasoning behind working, or productive
activity, was often more compelling than the work itself. “Powell found marked
differences favoring older, highly active people who said they read widely in their spare
time for pleasure over those who felt compelled to do so in order to ‘keep up’”(Schrof,
1994, p. 4). The research went on to say that both a highly routinized lifestyle, as well as
a life filled with negative emotions forced the brain downhill faster than those who
enjoyed their experiences. Thus, if an individual is working solely because they have to,
they may not be reaping the rewards of a more social and active lifestyle. Eyler, Sherzai,
Kaup, and Jeste (2011) regarded the brain as high on “functional placticity” and noted
that with cognitive training interventions, a more youthful brain function can occur.
Without stimulating activities, one may expect to “use it or lose it.” Schrof (1994) put
this into perspective:
34
There is no doubt that idle minds decay faster than those which are engaged in
life, but scientists say there is not a straight connection between mental activity
and mental acuity (p. 4).
It seems as though, the quality of engagement, and the feeling behind the activity played
into the amount of success in cognitive aging. If a job, or volunteer position, brought
value and joy to one’s life, the benefits far outweighed the effort. With increasing
opportunity for seniors to engage in productive work, an active brain and high regard for
one’s self will be just the icing on the cake.
PLANNING FOR THE FUTURE AND GOAL SETTING
Simple goal setting is a normative event that encourages progress and planful
engagement over an individual’s life. When it came to research on aging, much of it
covered planning only for a future disability, or planning for retirement. The new wave
of gerontology, as well as the extension of the human life span, led us to the
understanding that planning for the future should include the topic of leisure. The link
between having and attaining goals, and life satisfaction is presently a widely researched
topic along the lifespan. Brandtstadter (2006) demonstrated this importance with the
finding that future goals and projects lend structure, balance, and meaning to life, which
can also increase life satisfaction. As individuals age, the projects and goals they plan
may become significantly harder to attain, thus bringing a cloud of doubt or depression
into their lives. If the amount of credence one assigns to the goal is high, the more one
identifies it as overarching their identity. Brandtstadter & Rothermund, (1994) found that
aging individuals could protect their sense of control by downgrading the importance of
goals that can no longer feasibly be attained. Thus the perception of their ability to attain
35
goals, and the importance they placed on each goal, determined much of the “success”
they may have felt in aging.
Due to the highly multifaceted nature of human behavior, there was no direct
answer as to why some individuals attain their goals, and how others fail (Shanahan et al.,
2003). Shanahan et al. (2003) again shared insights into the term, “planful competence.”
Planful competence is a concept regarding, “thoughtful, assertive, and self-controlled
process that underlie choices about involvements in social institutions and interpersonal
relationships…” (Shanahan et al., 2003, p. 194) This research described planful
competence as encompassing three distinct dimensions: intellectual investment, selfconfidence, and dependability (Shanahan et al., 2003). Without embodiment of these
three dimensions, failure to attain goals was likely.
When it came to the goals seniors were setting, this research sought to delve into
planning projects and taking trips in the subject’s immediate future. These goals were
more fluid and related mostly to leisure and personal agency, and are less tied to the
individual’s concept of self. Powell, Bray, Roberts, Goddard & Smith, (2000) researched
goal negotiation in three adult day care settings. The focus of their study was to
understand whether goal setting would lead to the frail seniors taking an active role in
their own recovery. The two main categories in which goals were set were mobility and
social interaction. It is clear to see that these two studies, Powell et al. (2000) and the
current research, although similar in setting and attaining goals, are polar in their actual
goals. Powell, et al. (2000) stipulated that being involved in one’s own decision making
and future was very important to satisfaction in later life. The amount an individual was
involved, and played an active role in their future, was what was important to success in
36
aging. Kahana, et al. (2012) also found that planning for the future was an important
feature for maintaining quality of life in the face of life stressors. Kahana, et al. (2012)
provided the insight that planning for positive future goals lead to a mindset that all plans
will come to fruition. The more positive the mindset, the more successful one can be in
attaining those goals.
This feeling was shared by Spira (2006) in the article, Mapping your Future.
Spira underscored the importance of using planning tools to engage the aging individual
in planning their life. Spira showed how planning tools bring a sense of empowerment
and meaning to an aging individual’s future. The author found the much of the planning
and discussions about important life topics do not occur until a crisis has happened.
Through use of planning ahead, and having tough discussions with key members of the
family, planning will itself offset crisis (Spira, 2006).
Though little research has been completed in the area of leisure planning, including
projects and trips in the next year, thinking ahead is the most important element.
Research showed us that if forward thinking is occurring, then crisis’ can be averted, and
empowerment of the individual is inevitable. In the research by Kahana, et al. (2012), the
authors deciphered how certain internal and external resources could promote success in
aging and higher wellbeing. They said, “Planning for the future proved to be the second
important element for maintaining good QOL in the face of stressors. This finding
underscores the value of future-oriented planning behaviors in self-regulation, problem
solving, and promoting successful aging (Aspinwall & Taylor, 1997).” (Kahana et al.,
2012) The present research sought to take these findings and translate the results into how
to promote success in aging from a leisure perspective.
37
CHAPTER III
METHODOLOGY
PARTICIPANTS
A total of 68 participants between the ages of 65 to 75 were asked to complete a
survey to assess three dimensions of successful aging. The modal age was 65, but 69 was
a close second. The median age was 68, and all respondents responded to this question.
The gender makeup included 22 males, accounting for 32.4% of the sample, and 46
females, representing 67.6% of the sample. (See Graph 1 below)
Graph 1
PARTICIPANT AGE
Fifty percent of the total sample identified themselves as college graduates, or as
achieving education past college. 13.2% identified themselves as high school graduates,
and the remaining 36.8% accomplished “some college.”
38
As for income, 10.1% of the sample provided no response to this question. The
remainder of the sample disclosed that 7.4% fell within the “$0-$20,000” per year
category, 25% fell within “$20,001-$40000”, 16.2% came in at “$40,001-$60,000”, and
the remaining 41.2% made “$60,000+” per year. With a percentage of 23.5 still working,
most of this sample was living on a fixed income. The national percentage of working
individuals ages 65 and older is 16.1%, so this sample was more likely to be engaged in
some kind of work (U.S. Census Bureau, 2012). (See Graph 2 below)
Graph 2
PARTICIPANT INCOME
The participants identified themselves within 5 categories of ethnic makeup. The
ethnic categories included White, African American, Latino, Asian, and Other. A total of
4 participants did not disclose their ethnic background. Forty-three participants identified
themselves as “White”, 1 as “African American”, 5 as “Latino”, 2 as “Asian”, and 13 as
39
“Other”. There are more White respondents than non-White minority respondents.
Each participant self-reported about various parts of their productive work, social
relationships, planning for the future, as well as demographic aspects of their lives.
Participants were recruited through print advertisement and word of mouth advertisement
at the North Valley YMCA in Northridge, California. Just 4.2% of the population was
identified as 65 years and older in this neighborhood, while 11.1% of all people in Los
Angeles County identified with this age group (U.S. Census Bureau, 2012). It is
important to note that the facility in which participants were recruited is one where a
membership fee is charged. This facility is located in an upper middle class
neighborhood. According to U.S. Census data (American Community Survey, 2011
dollars) the median household income was $102, 602 for this neighborhood. Based on
income in the neighborhood and the level of education of the respondents, the sample is
skewed toward a higher than average socio-economic status. Those who are members
choose to belong because of the gym/pool services offered and therefore are self identified as interested in being active to a certain extent.
PROCEDURES
This study was an exploratory, cross sectional design, intended to asses a group of
seniors at just one point in time. The participants were available subject sampling, or
convenience sampling, due to the proposed sample size (Babbie, 2001). Participants
were recruited by an advertisement posted at the main location of sampling. Instructors at
the facility also reminded participants in their classes to stop by at the designated times to
fill out a survey. Approval was obtained from the Executive Director of the facility to
hand out surveys on the premises. The flyer indicated that this study was about aging,
40
and outlined the age requirements for participation, as well as the results being used for a
master’s thesis.
The executive director of the facility in which most surveys were collected
allowed the researcher to set up a table in the front hallway of the facility. The researcher
used a large sign to indicate this was the location of the “Aging Study.” The sign also
indicated that any 65-75 year old passers-by were encouraged to fill out a survey. Once
potential participants were identified as interested in participation, this sequence of events
occurred: First the researcher asked the possible participants if they would like to
participate in a research study on aging. This took about10 seconds, unless the potential
participants requested more information about myself as a researcher, or if they had
further questions about the study. Next, if the individual agreed to participate, the
researcher provided the participant with the bill of rights as well as a consent form for
their reviewing pleasure. This took about 2 minutes or less dependent upon how
thoroughly participants read and reviewed the materials. Next, the researcher handed the
participants the survey, and allowed them to confidentially complete the form. The
survey was clipped on a clip board, and a long bench in the front hallway was available
for participants to sit. Filling out the survey took approximately 5-10 minutes, dependent
on the speed of each participant. When participants finished filling out the survey
questionnaire, they were asked to drop it in a box to ensure confidentiality. The
researcher then provided participants with a short debrief, including the purpose of the
study in detail, and when to expect final research. This part of the process took no more
than 1 minute. No compensation was provided for the participation in this study, but
access to final results may have been an incentive to participate. All information
41
collected on the survey documents was done so anonymously, by not asking for any
identifying factors, and asking participants to place the completed survey in a box face
down. The completed surveys will be kept in a lockable file cabinet until all research has
been completed, and will remain under lock and key for further analysis on a longitudinal
basis. The researcher, Amanda Powell, and her research team will be the only people with
access to this information. The research team included Jerry Ann Harrell-Smith, Ph.D.,
Terry Hatkoff, Ph.D., and Scott Williams, Ph.D, as thesis committee members. All
members of the committee are professors at CSU Northridge in the Family and Consumer
Sciences Department. The information was entered into SPSS version 20 by Amanda
Powell and her research team. (SPSS, 2011)
MEASUREMENT
Based upon the review of literature, this researcher created a survey questionnaire
including unique questions, not compiled on any previous measurement tool. Inspiration
was drawn from studying numerous measurement instruments including the topics of;
depression, sociodemographic measures, well-being, self-rating of health, chronic
illnesses. Questions were partly modeled after some of Strawbridge, Wallhagan and
Cohen’s (2002) measures of wellbeing; these included measures of happiness, feelings
about looking back on one’s life, and satisfaction with friends and family. Measures
focused on social support were inspired by Parslow, Lewis and Nay (2011) including
whether participants could rely on their friends and family, and frequency of contact with
these same people. Questions centered around planning for the future and goal setting
were unique to this study and were created by the researcher. The questions were
generated to operationally define the variables without using more than one measurement
42
tool, but to assess all variables. The survey method was chosen primarily to allow
individuals to confidentially share with the researcher about personal feelings and habits
they engaged in during their lives without fear of stigmatization or ridicule.
The survey questionnaire included 27 multiple choice questions, 5 Likert-scale
questions, and 2 open-ended questions. Survey participants were asked to answer these
questions across a range of demographic, caregiving, productivity, quality of friendships,
plans for the future, and spirituality features of their life. The survey questions were
designed by the researcher, with inspiration from the previous research listed above.
Three core variables were selected for research that were believed to contribute to success
in aging over the life course; social support, productive work, and planning for the future.
SOCIAL SUPPORT
Social Support is defined as maintaining contact with family members or friends,
or actively belonging to a group concerned with one's physical and emotional wellbeing.
Twelve questions were geared toward understanding the social support network, and
quality of companionship for the participants. Questions 1-2 give the researcher an idea
of marital status as well as how many living children participants had. Questions 15-16
requested information on how many close friends or family members participants had
contact with in a given week. Answers range from; none, 1-2, 3-5, and 6 or more. The
answer of none was categorized as not having social support, 1-2 meant moderate social
support, 3-5 good social support, and 6 or more meant having a very successful social
support system. Questions 18 and 22 gave the researcher an understanding of how much
the participant can rely on family and friends, in daily life and an emergency. Question
19 helped the researcher to understand the living situation of each participant, with more
43
value placed on those who live with someone. Questions 26-29 delved deeply into the
religious participation, related to the social support system, of the individual participant.
Frequency of attendance to worship, question 28, ranged from Never to 2+ times per
week. Never was categorized as not social, attending worship 1 time per week was
considered social, and 2+ was considered highly social. Question 27 asked how often one
engaged in personal prayer or meditation per week. Questions 27 and 28 were assessed
together to understand religious importance and support gained on multiple levels.
Answers were added together to create a cumulative score for social support. Coding of
the answers provided a score between 1, as having high social support, and 0, as no social
support, on each question. All 12 questions were scored then added together and
averaged to create a rank. The ranking of low social support was deemed with a score of
0-.33, .34-.66 was a medium social support score, and .67 – 1.0 were considered high on
social support.
PRODUCTIVE WORK
The second variable that was measured in this study was productive work. This
type of work meant being engaged in work for pay or volunteer activities, including
continuing education which can promote purpose and value in life. Questions 3-7
ascertained whether participants were involved in paid or volunteer work, and how often
they partook in these activities. These questions included caring for a grandchild as a
means of productive work. Question 6 requested information on how often classes or
coursework were taken for continued learning. Participants who indicated that they
participated “yes, on an ongoing basis” were deemed very interested in ongoing learning,
those who indicated “yes, occasionally” were identified as somewhat interested in
44
ongoing learning, and those who indicated “no” were considered not interested in
ongoing learning. Question 7 specifically asked “How often each week do you engage in
activities that make you feel productive?” Answers ranged from never, 1-3 days per
week, 3-5 days per week or every day. The participants who engaged in productive
activities everyday were considered highly productive, those who participated 3-5 days
per week were considered productive, and those who felt they were productive 1-3 days
per week were reasoned to have low productivity. Question 17 deciphered whether or not
participants were members of a club, group, or community organization in which they
attended regularly. Belonging to group or organization heightened productive work, and
thus an answer of “yes” indicated a higher score. There were a total of 6 questions
assessing productive work. The answers to these questions were added together with a
range of 0 to 1. A score of 0-.33 showed low productive work, .34-.66 was a medium
productive work score, and a score of .67 – 1.0 was deemed high on productive work.
PLANNING FOR THE FUTURE
Planning for the future was the third variable this research hypothesized will
affect successful aging. Planning for the future included planning a project or trip in the
coming year. Questions 13-14 specifically asked whether plans for a trip or project had
been made for the coming year with a dichotomous answer selection of yes or no.
Answers of yes for these two questions indicated that planning for the future had been
done, and an answer of no indicated that one had not planned for the future. Question 24
asked if plans have been made for a future disability with the same answer format. There
were a total of 3 questions created to assess planning for the future. The answers to these
questions were added to create a cumulative scoring, to assess 3 levels of planning for the
45
future. Scores from 0-.33 meant low planning for the future, .34-.66 was medium, and
.67-1.0 showed high planning for the future.
SUCCESSFUL AGING
The dependent variable in this study was successful aging. The researcher in this
study defined successful aging as the ability to optimize circumstances given while being
actively engaged in proactive measures to obtain a high level of functioning. Questions
8-12 measured enjoyment, fulfillment, and value felt from productivity, inspiration and
leaving a legacy on a 5-point Likert scale. One represented strongly disagree, three was
moderate, and five represented strongly agree for each of these questions. The higher the
answers to these five questions, the higher the participant’s score toward the goal of
successful aging. Question 21 represented a measurement of happiness derived from
close relationships. Answers included, “Not happy at all,” “Somewhat happy,” and
“Extremely happy.” Question 25 asked participants to assess how positive and hopeful
their thoughts were about the future. Answers ranged from “Strongly agree” to “Strongly
Disagree.” This variable was created by adding the answers to these questions together
for assessment. The cumulative scores were collapsed into 3 levels of successful aging.
Scores from 0-.33 meant low success in aging, .34-.66 meant medium success in aging,
and .67-1.0 showed high success in aging.
46
CHAPTER IV
RESULTS
UNIVARIATE ANALYSIS
Results were analyzed to distinguish which variables were associated with greater
success in aging. Statistical analysis such as linear regression, correlation, and beta
analysis were conducted to establish means, central tendencies, and modal responses
using SPSS version 20 (Babbie, 2001). These analyses were first performed to understand
how each participant scored in each of the three independent variable categories.
The survey questionnaire assessed social support using 12 questions. Three
percent of the sample population scored as low on social support; 58.8% scored with
medium success, and 38.4% were grouped into the high success category. (See Table 1
below) Both the mode and median were “medium” levels of social support. Table 1 is a
representation of the frequency distribution of the sum for all questions pertaining to
social support.
Table 1
FREQUENCY DISTRIBUTION FOR SOCIAL SUPPORT
Score
0 .33
(Low)
.34-.66
(Medium)
.67-1.0
Frequency
Percent
2
3.0%
40
58.8%
26
38.2%
(High)
Both the modal response and median response were “medium” productive work
scores. There were 6 questions aimed to assess productive work. The results showed
47
29.5% in the low productive work category, 44.2% within the medium, and 17.6% in the
high productive work area. (See Table 2 below)
Table 2
FREQUENCY DISTRIBUTION FOR PRODUCTIVE WORK
Score
0 .33
(Low)
.34-.66
(Medium)
.67-1.0
Frequency
Percent
20
29.5%
30
44.2%
12
17.6%
(High)
The third independent variable was planning for the future. Participants were
grouped into three categories of success as shown above. There were three questions
created to assess planning for the future on the survey. Results showed that 69.1% fell
within the “high” planning for the future category. For the low and medium planning for
the future sections, 27.9% and 2.9%, were scored respectively. (See Table 3 below) The
modal response and median were both found to fall into the category of “high” planning
for the future. Table 3 models the frequency of the findings for all planning for the future
questions.
48
Table 3
FREQUENCY DISTRIBUTION FOR PLANNING FOR THE FUTURE
Score
0 .33
(Low)
.34-.66
(Medium)
.67-1.0
Frequency
Percent
19
27.9%
2
2.9%
47
69.1%
(High)
A total of seven questions were used to assess successful aging. Results showed
that both the median and modal responses fell into “high” planning for the future. Three
percent of the population fell into the low success in aging category. A total of 29.3%
were in the category of medium successful aging, and the largest category was high
successful aging with 67.7% of the respondents. (See Table 4 below)
Table 4
FREQUENCY DISTRIBUTION FOR SUCCESSFUL AGING
Score
0 .33
(Low)
.34-.66
(Medium)
.67-1.0
Frequency
Percent
2
3%
20
29.3 %
46
67.7 %
(High)
This study found that the majority of participants were successfully aging. This
was not a completely unexpected finding because these individuals all chose to belong to
a fitness center that promoted health and wellness. It was a challenge to compare the
results regarding success in aging to other studies researched in the literature review.
49
This study used a unique set of criteria for successful aging, assessing three lifestyle
variables unlike those used in previous research on this topic. Flood (2005) suggested
that if an aging individual is the one receiving the title of “successful” or “unsuccessful”
ager, their personal input along with multiple dimensions of contentment, spirituality, and
self-perception are significant to the label. Holstein and Minkler (2003) also interpret
successful or unsuccessful aging as a “rubric” or guideline to interpret and to give
meaning to the experiences one has as they age. In this study, a self-reported
questionnaire was used to gain the personal reflection each participant felt about
themselves across topics of generativity, happiness, and forward thinking. Responses to
measures related to successful aging in this study found that 66.2% of respondents agreed
or strongly agreed that they engaged in activities they enjoy. Another 86.8% found
moderate to strong fulfillment with the things they were involved in at the time of survey.
A sample of 58.8% also felt that they agreed or strongly agreed that they had left a legacy
for the next generation. Physical health, among various other wellbeing assessments,
were used and thus findings differed from those of Rowe and Kahn (1997). While Rowe
and Kahn (1997) used a strict criterion for successful aging, counting those with no
disease and disability as integral to successful aging, this research sought to utilize a more
realistic criterion. Strawbridge, et al. (2002) cited that most studies since Rowe and
Kahn’s initial work have modified the definition to include “minimal (rather than no)
disease or disability” (p.727). In this study 55.9% identified themselves as having an
illness or injury that affected their daily life. It appeared that some of the 67.7% of all
participants who were found to be successfully aging fell also into this category of having
an illness or injury. This aligned with the ideology of Parslow, et al. (2011), when she
50
said, “…participants who were assessed as aging well by having a successfully aging
score in the highest quartile of the sample were clearly able to accommodate chronic
illnesses while achieving this status” (p. 2081). This accommodative process was a major
implication in understanding this relationship. The findings of this research do align with
findings in studies which include “minimal disability” or “compensatory
accommodation” as a criterion for success in aging. These studies included Brandstadter
& Rothermund (2003), Reichstadt et al. (2010), Flood (2005), and Strawbridge et al
(2002).
GENDER
More men than women participated in this study with a count of 46 men (68% of
the participants) to 22 women (32% of participants) total. A high proportion of males
participated but only 67% of men scored in the highly successfully aging category.
Proportionally, 60% of all women scored as “highly successful” in aging. Freysinger
(1990) posited that gender is integral to the definition of successful aging, and that
without differentiation and understanding of the differences of men and women, and
accurate definition of success in aging is unlikely. Thielke and Diehr (2012) surveyed
almost 6000 seniors aged 65 and older on gender disparity and successful aging. Their
results showed that men and women see differing changes over the course of time. Men
were generally more healthy, but when they do get ill, they were more likely to die.
Women seemed to exhibit more illness, and needed significantly more help with daily
tasks as they aged, but lived longer than men in the same age cohort. Thielke and
Diehr’s (2012) results, regarding men having less disabilities, were congruent with the
findings in this study. Hsu (2005) also corroborated these findings in a study on gender
51
disparity in aging in Taiwan. The author shares that, in the study, women had more
problems with physical function, cognition, and depression, but were more likely to live
longer than their male counterparts. It seemed as though all of the results show similar
findings, that men die earlier than women, but women generally suffer with more
conditions than men.
SELF-REPORTED ILLNESS AND INJURY AFFECTING DAILY LIFE
All participants answered one open ended question on the survey regarding having
an illness or injury that was causing problems in their daily lives. All participants
provided an answer to this question. A percentage of 44.1 indicated that they did have an
illness or injury that did affect their daily lives. This left 55.9% who did not have such an
illness or injury. Only one participant indicated any sort of mental illness, in this instance
it was depression, as affecting their daily life. The remainder of the illnesses indicated on
the survey questionnaire were physically based. Four collective categories of illnesses or
injuries were identified on the survey. The first category was considered a “bad back,”
without any further specification of source of their problem. Diabetic was another very
commonly indicated illness but without regard to Type I or Type II. The next most listed
issue was “leg issues,” which included bursitis in the hips, and tendonitis. Lastly, arthritis
was mentioned with specific indication of rheumatoid arthritis as well as osteoarthritis.
These were the remaining illnesses and injuries that were indicated on the survey which
were found to have low frequency of occurrence: Thyroid problems, spasmodic
torticollis, COPD, fatigue, recovering from cancer, asthma, stenosis of the spine,
fibromyalgia, osteoporosis, hearing loss, poor vision, kidney stones, lupus, heart disease,
and blood on the brain.
52
BIVARIATE ANALYSIS
The descriptive data suggests that the sample may be unique in that they are more
likely to report high levels of successful aging. This may be due to the affluent
demographics, or the membership to a health club, of the participants in which the sample
assessed. Cross tabulations were used to explore the relationships between each of the
independent variables and the dependent variable. (SPSS, 2011) Scatter plots were used
to see if a linear relationship was present, and if so, in which direction the relationship
formed. The relationship between Social Support (SS) and Successful Aging (DV)
showed a positive correlation (See Illustration 1, Chart 1), as did the scatter plot for
Productive Work (PR) and Successful Aging (DV). (See Illustration 1, Chart 2) These
correlations were considered low positive correlations due to the apparent outliers present
on these two scatter plots. The relationship between planning for the future and
successful aging was not found to exhibit any positive or negative correlational value.
(See Illustration 1, Chart 3)
53
Illustration 1
SCATTER PLOT REPRESENTATIONS FOR THE RELATIONSHIPS BETWEEN
THE INDEPENDENT AND THE DEPENDENT VARIABLE
Chart 1
Chart 2.
Chart 3
MULTIPLE REGRESSION ANALYSIS
Multiple regression analyses were performed to determine how each of the three
predictor variables (social support, productive work, and planning for the future) could
explain the variance in our DV (successful aging). Linear regression analyses were done
for each of the three independent variables in conjunction with the dependent variable
54
(See Table 5 below) (Babbie, 2001). With a response of 39.7%, scores “high” successful
aging and “medium” social support showed the greatest correlation. “High” successful
aging and “high” social support were the next most correlated relationship with 27.9% of
all participants. Next was “medium” in both categories with 17.6%, and after that with
8.8% was “medium” successful aging and “high” social support. The remaining
relationships were that of “medium” successful aging and “low” social support showing
2.9% of all participants. The last two relationships with any correlation was that of “low”
successful aging, and both “medium” and “high” social support. Both of these
relationships exhibited 1.5% of the participants in each of the categories. No correlations
were seen between “low” successful aging and “low” social support or “high” successful
aging and “low” social support.
In regards to the relationships between productive work and successful aging, a
similar trend was seen as with social support. The highest correlational value was seen
with “high” successful aging and “medium” productive work. The second most
correlated relationship was seen between “medium” successful aging, and “low”
productive work with 17.6%. Next was “high” successful aging and “high” productive
work with 13.2% of all participants. Next we saw that 11.8% of participants fell into the
“high” successful aging and “low” productive work category. “Medium” successful
aging and “medium” productive work was found to have 8.8% correlation, and “medium”
successful aging and “high” productive work has only 2.9%. The last two correlations
were that of “low” successful aging and “medium” and “high” productive work. Both
relationships had 1.5% of the participants for each category. Zero percent fell into the
“low” and “low” category.
55
The last set of correlational relationships that were explored in this section were
that of planning for the future and successful aging. With 42.6% of all participants,
“high” successful aging and “high” planning for the future was the highest correlational
relationship. The next relationship was that of “medium” successful aging and “high”
planning for the future with 25%. “High” successful aging and “low” planning for the
future was next with 22.1% of all participants. Next “medium” successful aging and
“low” planning for the future were correlated with 4.4%. Only 2.9% fell into the “high”
successful aging and “medium” planning for the future category. Both “low” successful
aging, and “low” planning for the future and “low” successful aging and “high” planning
for the future showed 1.5% of the correlations. “Low” successful aging and “medium”
planning for the future, and “medium” successful aging and “medium” planning for the
future yielded 0%. See Tables 5 and 6 below for full correlational charts.
Table 5
CORRELATIONS BETWEEN SOCIAL SUPPORT AND SUCCESSFUL AGING
Social Support
Successful
Aging
Low (0-.33)
Medium (.34-.66)
High (.67-1)
Low (0-.33)
Medium (.34-.66)
High (.67-1)
0%
1.5%
1.5 %
N=0
N=1
N=1
2.9 %
17.6 %
8.8 %
N=2
N=12
N=6
0%
39.7 %
27.9%
N=0
N=27
N=19
56
CORRELATIONS BETWEEN PRODUCTIVE WORK AND SUCCESSFUL AGING
Productive Work
Successful
Aging
Low (0-.33)
Low (0-.33)
Medium (.34-.66)
High (.67-1)
Medium (.34-.66)
High (.67-1)
0%
1.5 %
1.5 %
N=0
N=1
N=1
17.6 %
8.8 %
2.9 %
N=12
N=6
N=2
11.8%
42.6 %
13.2 %
N=8
N=29
N=9
CORRELATIONS BETWEEN PLANNING FOR THE FUTURE AND SUCCESSFUL
AGING
Planning for the Future
Successful
Aging
Low (0-.33)
Medium (.34-.66)
High (.67-1)
Low (0-.33)
Medium (.34-.66)
High (.67-1)
1.5 %
0%
1.5%
N=1
N=0
N=1
4.4 %
0%
25 %
N=3
N=0
N=17
22.1 %
2.9 %
42.6 %
N=15
N=2
N=29
Table 6 includes correlations between variables, as well as their significance. A
one-tailed analysis was done using a significance level of p < .05. The Pearson
correlations are represented in Table 6 (below), and show the highest correlations
between productive work and successful aging with a positive correlation at .306 and was
statistically significant (p<.01). (See Table 6 below) No other relationships between all
independent and the dependent variable were found to be statistically significant. Social
support and productive work had relationships to successful aging that were considered
positive correlations, but none fell over the generally accepted .5 and above for a high
57
correlation (Babbie, 2001). Social support and successful aging exhibited a correlation of
.105 and a .196 level of significance. Productive work and successful aging were
correlated with a significance of .006, and a correlation of .306. Planning for the future
and successful aging showed a correlation of .133 with a significance level of .140.
Table 6
CORRELATIONS AND SIGNIFICANCE
SS
Pearson Correlation
SS
PL
DV
.200
.105
.046
.051
.196
68
68
68
68
*
1
.100
Pearson Correlation
.206
Sig. (1-tailed)
.046
N
PL
*
1
.206
Sig. (1-tailed)
N
PR
PR
.306
**
.209
.006
68
68
68
68
Pearson Correlation
.200
.100
1
.133
Sig. (1-tailed)
.051
.209
68
68
N
.140
68
68
*. Correlation is significant at the 0.05 level (1-tailed).
**. Correlation is significant at the 0.01 level (1-tailed).
Beta coefficient analysis was done to understand which independent variable had
the greatest effect on the dependent variable. (See Table 7 below) Beta values ranked
productive work and successful aging with the highest correlation value at .290. The
second relationship, with a value of .206 was that of social support and successful aging.
The third independent variable of planning for the future displayed a relationship to
successful aging at a level of .099. This data, as well as other correlational data is
represented in Table 7.
58
Table 7
BETA COEFFICIENT
Independent Variables
Beta
Social Support
.206
Productive Work
.290
Planning for the Future
.099
59
CHAPTER V
DISCUSSION
SOCIAL SUPPORT
This research posited that seniors, defined as individuals ages 65-75, who
maintain a social support system are more successful agers. A total of 97% of this sample
population felt they had at least a medium social support network, suggesting a somewhat
skewed group of seniors. Greenglass’ (2006) research indicated that the higher the total
number of individuals who offered assistance, helped, or encouraged the seniors, the
more likely they were to be successful in aging. Their analysis found less depression and
more functional ability in seniors with this larger support network. This analysis of the
relationship between social support and successful aging, with slightly differing
definitions, did not support Greenglass’ findings. This research suggests that social
support networks, on their own, are not the most vital key to successful aging. Sherman
et al. (2004) found that social networks, or the perception of one, lead to higher
psychological functioning. This better functioning, along with the buffering affect that
social support played, led to more successful aging in Sherman’s study. Though
psychological functioning was not directly measured in the present study, Sherman’s
findings regarding social networks, were not replicated in the present research.
I believe these findings were inconsistent with previous research due to the
tremendously-social nature of the individuals who attend the particular facility in which
surveys were collected. These individuals may have had a support network which was
larger than normal, and thus social support in and of itself was not something they
identified as vitally important in their lives. This may also be affiliated with the SES of
60
the participants. The resources each person had could allow them to stay in touch
through gym memberships, access to phones and internet and even the opportunity to
drive to visit with family and friends.
Through religious affiliation, Hughes and Peake (2002) found that the more
religious a participant was, the more they were likely to have a larger support network.
Iwamasa and Iwasaki (2011) also found that spirituality lead to maintaining well-being
and coping with stress which included having a support network. Though 80.9% of this
survey’s participants said they “believe in God or a spiritual realm” only 25% of
participants attended any type of worship one time per week or more. Attendance at
worship is an important part of maintaining a support network that is religiously based.
Unfortunately, neither of the studies mentioned above, related to social support and
religious affiliation, translated into successfully aging individuals in this research.
Fone and Lundgren-Lindquist (2002), in their research on successful aging, found
that, “…involvement in social, intellectual and cultural pursuits makes as much
contribution to a person’s health as physical and sporting activities.” (p. 1050) Although
this research hypothesized that social support was more likely to lead to successful aging,
it seems as though social support is merely a component, and not a key to success in
aging.
PRODUCTIVE WORK
This research hypothesized that seniors who participated in productive work have
a positive relationship to successful aging. The analysis showed that there is a 99%
probability that being engaged in productive work is vital to successful aging. This
finding validated the hypothesis surrounding productive work. This aligned with the
61
findings of Reichstadt et al. (2010) in that “engagement/self-growth” was found to be
vital to defining success in aging for their participants. Twenty-three and a half percent
of the sample population was still employed at the time of survey and 47.1% identified
themselves as engaging in productive work every day. This percentage is higher than the
national average of 16.1% working after age 65 (U.S. Census Bureau, 2012). This
relationship is exemplified by Quinn (2010), “Since successful retirement requires
appropriate skills, a gradual withdrawal from full-time work provides the opportunity to
develop retirement interests.” (p. 52) These retirement interests, or productive activities,
in essence replace what an individual spent many years doing at work. These activities
could include volunteering or caring for a grandchild. Participants who volunteered
regularly numbered 27.9% of the sample population, and occasional volunteers numbered
32.4% of the sample. Caring for grandchildren also was deemed as a productive activity,
and 25% helped when needed, but 11.8% cared for their kin on a regular basis. Siegrist et
al. (2004) also corroborated this researcher’s finding that engagement in productive work,
when reciprocal in nature, can be very important for an individual’s health and wellbeing.
This reciprocity did not necessarily need to be monetary, but could also encompass
meaning and fulfillment one attains. Choi’s (2003) research pointed out that cessation of
work, voluntary or forced, often lead to a decline in mental and physical health. This
corroborated again that working and productivity were vital to success in aging as well as
health status.
Robson and Hannson (2007) also found that older workers will only become more
important to the infrastructure of skilled labor as time goes on. Friedman and Ryff (2012)
in their research on medical comorbidity showed that even when aging adults suffer with
62
a rising number of chronic conditions, they are likely to use various strategies to keep
well-being high. The more employers are willing to work to accommodate older workers
with differing forms of disability, the more productive seniors can be. This symbiosis
will likely lead to more than just being engaged in productive work, but a greater social
network, and a higher level of overall wellbeing. Robson and Hannson (2007) also found
that the higher self-efficacy workers hold, the more likely they are to participate in
extended learning and developmental activities. In this study 64.7% of participants
engaged in opportunities for continued learning, and 61.8% found themselves in the
medium to high productive work category. It is as Schrof (1994) put it, many cars do
break down, but with proactive maintenance many never will. This proactive maintenance
is that of keeping engaged in productive activities, and thus success in aging is attained.
The findings from this study, related to productive work, draw a parallel to past studies
that show how productivity is an essential element in successful aging.
PLANNING FOR THE FUTURE
This research hypothesized that successful aging was positively related to seniors
planning for the future. The findings in this study showed that 60.3% of the sample were
planning to pursue a project in the coming year. A group of 79.4% were planning a trip
in the coming year, and 47.1% had planned for a future disability. Similar to the data
breakdown used above, a one tailed analysis was used to test this hypothesis. In testing
the correlations between variables, a low correlation of .133 between planning for the
future and successful aging was seen.
The research done by Spira (2006) proved that the more planning and discussion
one does with their family members, the more empowered an individual can become.
63
Thus, the more one discusses the future, and makes proactive plans, the more likely they
would be successfully aging. Shanahan et al. (2003) added that unless an individual
engaged in planning ahead throughout their life, and also attained some of their goals,
they are less likely to make plans as an older adult. Planning for the future and successful
aging were correlated with a score of .133 and a significance level of .140. Powell (2000)
researched planning for the future in terms of being involved in personal decision making
and goal negotiation, and found these variables very important to success in aging. The
specific actions of taking a trip, planning for a future disability or planning a project in
the next year was not found to be as important in the formula for successful aging as seen
in the previous studies. Although the majority of our sample did plan for the future, this
did not mean that they were found to be successfully aging.
Brandtstadter (2006) proved that striving to reach goals is an important part of
planning for the future, but the process of adapting to changing circumstances was the
vital point to remember. This conclusion was not repeated in the findings of Kahana et.
al (2012) regarding goal attainment and proactive adaptation. Kahana et al. (2012), in
their research, found that personal agency, and attaining goals was likely to yield success
in aging. There was no mention of whether or not goals could be modified to help attain
those goals. Though the research reviewed had similar goals related to planning for the
future, the specific qualities of planning a trip or project, or planning for a future
disability were not found to be important to successful aging.
CONCLUSION
Findings in this study sought to bring to light a more positive and adaptive view
of successful aging, with some instruction regarding a process to attain such aging. The
64
results of this research regarding productive work and successful aging match that of
previous research. The more one participates in productive activities, the more likely
they are to be successfully aging, yet the social support network, and planning for the
future were less likely to lead to success in aging. According to this research’s
interpretation, even though many of the participants had chronic illnesses, more than half
of the sample identified as “successful agers.” This was not surprising due to the active
nature of the participants. Erikson, Erikson & Kivnick (1986) reminded us, “Perhaps
what we need today is this ‘clear insight’ into how the elders in our present society can
become more integral coworkers in community life” (p. 294). If this relationship could
be understood and adapted in a widespread fashion, more individuals who sought success
in aging, may stay the course to attainment. We are all aging, yet some of us age more
successfully than others, through this research an understanding of lifestyle variables has
helped to reveal why. As Schrof (1994) put it, “…in popular circles the ancient idea of
the elder as a sage is likely to find renewed vitality” (p .7). With this mindset and an
understanding of how social support, productive work and planning for the future affect
successful aging, the idea of “aging” may begin to become synonymous with wisdom and
experience.
LIMITATIONS AND FUTURE RESEARCH IMPLICATIONS
This thesis has added to the understanding of successful aging, however, certain
limitations to the study exist. The data collected was from self-reported questionnaires,
and personal perceptions or the “influence of social desirability” (Vahia, et al., 2010) of
the dependent and independent variables could have skewed the data. The cross-sectional
nature of this study may not have allowed this research to establish a true chronological
65
relationship due to memory loss or other time sensitive factors. Longitudinal studies
stemming from this study would create a more highly valid study base. Successful aging
is a multi-faceted construct and thus a full understanding cannot be had within a study of
small proportion. Increasing the number of participants to 500 or more would have
greatly enhanced this research.
This study was carried out in a high socio-economic status (SES) area of southern
California, and may represent a limited generalizability. Cultural affiliation was also
something that could be broadened in a future study. About 41% of all participants fell
into the “White” category. The “Other” category had groupings of a multitude of
responses including, “Jewish,” “Native American,” “Human,” among many others. This
should be addressed in future research. As our country’s demographics change, a more
representative sample of cultures would increase generalizability of results. Also, this
sample chose to belong to a fitness center which charges a monthly fee. This affiliation
with a gym facility suggests that the participants are concerned for their health and
wellbeing. It is important to point out that social relationships can utilize technology to
stay in touch. Methods such as talking on the phone, text messages, email use, facebook,
skype and the like can contribute to one’s social network. Further understanding of the
utilization of technology to support social relationships would be vital to future research.
Freysinger (1990) thought it was important to point out that culture dictates what
successful aging looks like, and thus it is experienced by everyone in different ways.
Those who are of different races, class and gender will see success in different ways.
This is important to consider as the population booms with individuals 65 years and
older. The demographic make-up of the population is and will continue to change, and
66
thus the health status and criterion for successful aging will also need to change as our
culture evolves.
Although briefly touched upon with this research, generativity as well as
gerotranscendence need to play a larger part in American culture’s understanding of
aging. According to generativity research, there is little empirical study to specifically
target older-adults in their generative methods. A scientifically validated criterion should
be developed to better understand generativity. Further study should focus on how
generative and resilient mindsets address aging, and lead to success in aging. This can be
accomplished by a multi-country assessment of perception of aging, and status’ held by
those aged individuals.
Reuter-Lorenz and Lustig (2005) summed up the physiological future directions
extremely concisely; “We expect that neuroimaging methods will become increasingly
integrated with behavioral, genetic and pharmacological approaches to investigate not
only disease processes but also the normal individual differences that underlie successful
aging.” (p. 248) Along with the previous ideas, as young people, healthy aging is
primarily due to genetic make-up and it is only with age that our genetics become less
important, and lifestyle choices become more important (Rowe & Kahn, 1997). Familial
or heritable traits have proven to be important in measuring and predicting successful
aging, but choosing to live a healthy life is more important to study now, than ever.
These good choices, as well as a better understanding of the brain and body will lead to
more opportunities for success in aging. The researcher does believe that this study
addressed the broad dimensions of successful aging although some unidentified facets
may not have been measured. These other facets could be unexpected predictors of how
67
successful one is in aging.
68
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76
APPENDIX A
MEASURES USED IN THE THESIS
Survey
This study is meant for individual’s aged 65-75 years of age. This is part of Amanda Powell’s
master’s thesis at California State University Northridge. Your participation is completely
voluntary and any data received will remain anonymous and confidential.
1. What is your current relationship status?
a. Single – Never Married
□
b. Married
□
c. Divorced
□
d. Widowed
□
e. Other:
(Describe)_____________________________________________________
2. How many living children do you have?
a. 0 Children
□
b. 1-2 Children
□
c. 3+ Children
□
3. Are you currently paid for employment, either part or full-time?
a. Yes
□
b. No
□
4. Do you participate in any volunteering opportunities?
a. Yes, on a regular basis
□
b. Yes, occasionally
□
c. No
□
5. Do you care for a child or grandchild?
a. Yes, on a regular basis
□
b. Yes, when needed
□
c. No
□
77
6. Do you participate in classes/coursework or other opportunities for continued
learning?
a. Yes, on an ongoing basis
□
b. Yes, occasionally
□
c. No
□
7. How often each week do you engage in activities that make you feel productive?
a. Never
□
b. 1-3 Days Per Week
□
c. 3-5 Days Per Week
□
d. Everyday
□
Please rate the next few questions on a scale from 1 (Strongly disagree) to 5 (Strongly
agree).
1
2
3
4
Strongly
Moderat
Disagree
e
5
Strongly Agree
8. I spend my time engaged in activities that I enjoy __________
9. The things that I am involved in these days are fulfilling __________
10. Either working, volunteering, or other activities that I do give my life meaning _____
11. I am involved with people who add value and inspiration to my life __________
12. I feel that I have left my legacy for the next generation __________
13. Have you made any plans to take a trip in the upcoming year?
a. Yes
□
b. No
□
14. Have you made any plans to start a project in the next year?
a. Yes
□
b. No
□
78
15. How many close family members do you have contact with each week?
a. None
□
b. 1-2
□
c. 3-5
□
d. 6+
□
16. How many friends do you have contact with each week?
a. None
□
b. 1-2
□
c. 3-5
□
d. 6+
□
17. Do you belong to a group/community organization/club that you attend regularly?
a. Yes
□
b. No
□
18. How much do you feel like you can rely on your friends and family?
a. Not at all
□
b. Somewhat
□
c. Very much
□
19. Do you live alone?
a. Yes
□
b. No
□
20. Are you responsible for caring for any other person in or out of your home?
a. Yes, solely responsible
□
b. Yes, I share the responsibility with someone else
□
c. No
□
21. All in all, how happy are you with your close relationships?
a. Not happy at all
□
b. Somewhat happy
□
c. Extremely happy
□
22. In an emergency, there is at least one person I could call for help.
a. Agree
□
b. Disagree
□
79
23. Do you have any illnesses or injuries that are causing you problems in your daily
life?
a. Yes
□
i. Describe:
______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
__________________
b. No
□
24. Have you made any plans to prepare for a possible future disability?
a. Yes
□
b. No
□
25. When you think about the future, your thoughts are positive and hopeful.
a. Strongly Disagree
□
b. Somewhat Disagree
□
c. Unsure
□
d. Somewhat Agree
□
e. Strongly Agree
□
26. Do you believe in God or a spiritual realm?
a. Yes
□
b. No
□
c. Unsure
□
27. How often do you spend time in personal prayer or meditation per week?
a. Never
□
b. 1-3 Times per Week
c. 4+ Times per Week
□
□
28. How often do you attend a place of worship per week?
a. Never
□
b. 1 Time per Week
□
c. 2+ Times per Week
□
80
29. My spiritual beliefs lie behind my whole approach to life.
a. Strongly Agree
□
b. Agree
□
c. Unsure
□
d. Disagree
□
e. Strongly Disagree
□
30. What is your current age? _____________________
31. What is your gender?
a. Male
□
b. Female
□
32. What is the highest level of education you have completed?
a. High School
□
b. Some College
□
c. College Graduate
□
d. Past College
□
33. What income bracket do you currently fall into? ($ per year)
a. $0 - $20,000
□
b. $20,001 – $40,000
□
c. $40,001 – $60,000
□
d. $60,001 +
□
34. What ethnicity do you identify with most closely?
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
81
APPENDIX B
Survey
This study is meant for individual’s aged 65-75 years of age. This is part of Amanda Powell’s
master’s thesis at California State University Northridge. Your participation is completely
voluntary and any data received will remain anonymous and confidential.
Social Support
Productive Work
Planning for the Future
Successful Aging
SPSS Coding
1. What is your current relationship status?
a. Single – Never Married
0
b. Married
1
c. Divorced
0
d. Widowed
0
e. Other:
(Describe)_____________________________________________________
2. How many living children do you have?
a. 0 Children
0
b. 1-2 Children
.5
c. 3+ Children
1
3. Are you currently paid for employment, either part or full-time?
a. Yes
1
b. No
0
4. Do you participate in any volunteering opportunities?
a. Yes, on a regular basis
1
b. Yes, occasionally
.5
c. No
0
5. Do you care for a child or grandchild?
a. Yes, on a regular basis
1
b. Yes, when needed
.5
c. No
0
82
6. Do you participate in classes/coursework or other opportunities for continued
learning?
a. Yes, on an ongoing basis
1
b. Yes, occasionally
.5
c. No
0
7. How often each week do you engage in activities that make you feel productive?
a. Never
0
b. 1-3 Days Per Week
.33
c. 3-5 Days Per Week
.67
d. Everyday
1
Please rate the next few questions on a scale from 1 (Strongly disagree) to 5 (Strongly
agree).
1(0)
2(.25)
3(.50)
Strongly
Moder-
Disagree
ate
4(.75)
5(1)
Strongly Agree
8. I spend my time engaged in activities that I enjoy __________
9. The things that I am involved in these days are fulfilling __________
10. Either working, volunteering, or other activities that I do give my life meaning
__________
11. I am involved with people who add value and inspiration to my life __________
12. I feel that I have left my legacy for the next generation __________
13. Have you made any plans to take a trip in the upcoming year?
a. Yes
1
b. No
0
14. Have you made any plans to start a project in the next year?
a. Yes
1
b. No
0
15. How many close family members do you have contact with each week?
83
a. None
0
b. 1-2
.33
c. 3-5
.67
d. 6+
1
16. How many friends do you have contact with each week?
a. None
0
b. 1-2
.33
c. 3-5
.67
d. 6+
1
17. Do you belong to a group/community organization/club that you attend regularly?
a. Yes
1
b. No
0
18. How much do you feel like you can rely on your friends and family?
a. Not at all
0
b. Somewhat
.5
c. Very much
1
19. Do you live alone?
a. Yes
0
b. No
1
20. Are you responsible for caring for any other person in or out of your home?
a. Yes, solely responsible
1
b. Yes, I share the responsibility with someone else
.5
c. No
0
21. All in all, how happy are you with your close relationships?
a. Not happy at all
0
b. Somewhat happy
.5
c. Extremely happy
1
22. In an emergency, there is at least one person I could call for help.
84
a. Agree
1
b. Disagree
0
23. Do you have any illnesses or injuries that are causing you problems in your daily
life?
a. Yes
□
i. Describe:
______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_____________________
b. No
□
24. Have you made any plans to prepare for a possible future disability?
a. Yes
1
b. No
0
25. When you think about the future, your thoughts are positive and hopeful.
a. Strongly Disagree
0
b. Somewhat Disagree
.25
c. Unsure
.50
d. Somewhat Agree
.75
e. Strongly Agree
1
26. Do you believe in God or a spiritual realm?
a. Yes
1
b. No
0
c. Unsure
.5
27. How often do you spend time in personal prayer or meditation per week?
a. Never
0
b. 1-3 Times per Week
.5
c. 4+ Times per Week
1
28. How often do you attend a place of worship per week?
85
a. Never
0
b. 1 Time per Week
.5
c. 2+ Times per Week
1
29. My spiritual beliefs lie behind my whole approach to life.
a. Strongly Agree
1
b. Agree
.75
c. Unsure
.5
d. Disagree
.25
e. Strongly Disagree
0
30. What is your current age? _____________________
31. What is your gender?
a. Male
□
b. Female
□
32. What is the highest level of education you have completed?
a. High School
□
b. Some College
□
c. College Graduate
□
d. Past College
□
33. What income bracket do you currently fall into? ($ per year)
a. $0 - $20,000
□
b. $20,001 – $40,000
□
c. $40,001 – $60,000
□
d. $60,001 +
□
34. What ethnicity do you identify with most closely?
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
86
APPENDIX
C
87
88