Life Satisfaction and Activity Level for Residents in Long-term Care Facilities

Joy Bamford, Lindsay Taylor, Shelley Chaffin, Wayne Priest*
Huntington University

Abstract

This study investigated the correlation between life satisfaction and level of social activity of residents in long-term care facilities. It was hypothesized that the degree of life satisfaction would be positively correlated with level of activity. Thirty participants, aged 65 and older, were selected using convenience sampling from rural Indiana. They were asked to record their daily social activity on provided activity logs for 17 days. On the 18 th day, life satisfaction was measured using the Life Satisfaction Index-Z. A Pearson r correlation coefficient was used to analyze the data. No significant correlation was found between social activity and degree of life satisfaction. Certain study limitations provide insight for the design of future research on this population.

Life Satisfaction and Activity Level for Residents in Long-term Care Facilities

According to the 2000 US Census Bureau, it is projected that the population of those 65 and older will reach 60 million in the next 20 years. As the population ages, we face newfound challenges that prompt further research in this area. This research has become important especially since the baby boomers are approaching this phase of life. As family members age, questions arise about their quality of life, future, and life satisfaction.

Studies on aging suggest that life satisfaction is dependent upon a variety of variables, including physical exercise, living standard (economic condition), relation with spouse and children, and gender (Qun, 2005). A relationship has been found between life satisfaction and activity level (Morgan & Bath, 1998; Warr, Butcher, & Robertson, 2004); however, opinions differ concerning causality of the two variables. Lang and Baltes (1997) found an association between greater levels of social activity and everyday life satisfaction in those between the ages of 70 and 103. Increasing levels of activity have also been reported to result in less depression and enhanced life satisfaction in those 75 and older (Calderon, 2001). Menec (2003) found a significant relationship between activity level and life satisfaction when data were analyzed cross-sectionally. However, when this same data set was analyzed longitudinally the research failed to find that activity level was a predictor of life satisfaction (Menec, 2003).

Previous research on activity level and life satisfaction has given rise to several theories of aging. According to the disengagement theory, people tend to disconnect from the social system as they age. Life satisfaction is derived from acceptance of the inevitable social and psychological withdrawal from the social system (Madigan, Mise, & Maynard, 1996).

Individuals develop unique behaviors and patterns for coping as they adjust to changes in life. The continuity theory predicts that these behaviors and patterns will continue as one ages. Therefore, activity changes will be based on lifetime patterns of coping with circumstances as opposed to specific changes due to age (Madigan, Mise, & Maynard, 1996).

The selectivity theory focuses on selection of activities that can be viably maintained with age. Activities that individuals find enjoyable and that can be maintained are most beneficial. Those who are able to adjust to this new lifestyle have a higher degree of life satisfaction (Madigan, Mise, & Maynard, 1996).

A final theory is the activity theory, which considers the relationship between the level of activity and life satisfaction, and suggests a positive correlation between the two (Madigan, Mise, & Maynard, 1996). Roles that are lost with age can negatively affect self-esteem. However, desirable activity can serve as a replacement for these roles promoting self-esteem maintenance. Thus, those with a greater level of activity have higher self-esteem resulting in improved life satisfaction (Calderon, 2001).

In support of this final theory, suggested reasons for activity include fulfillment of the need for companionship, novelty, escape, and need for expression (Purcell & Keller, 1989). Activity can include physical, cognitive, affective, and social realms of life (Calderon, 2001). Individual activity may encompass actions such as gardening, cleaning, or reading. Social activities may include volunteer work, group exercise, or organized events. Though both types of activity have an effect on personal wellbeing (Calderon, 2001), social activity has been found to have a greater effect on life satisfaction (Lang & Baltes, 1997).

Life satisfaction is generally defined as overall contentment with life. This contentment can be affected by thoughts, feelings, and concerns one has about one’s future. Various theories suggest that one’s thoughts and feelings can be affected by the activities in which one engages. Many life satisfaction scales measure these thoughts and feelings; therefore, it is reasonable to expect that activity level might impact how one thinks and feels about life in general.

In this study, we examined the relationship between activity level and life satisfaction of long-term residents age 65 and older. Participants were included from three long-term residential care facilities in rural Indiana. Activity level was defined as length of time spent in voluntary interaction with one or more persons or collectively within a group setting. Life satisfaction was defined as emotions, attitudes, expectations, and thoughts about one’s situation in life. We hypothesized that a positive linear correlation exists between level of activity and degree of life satisfaction.

Method

Participants

Twenty-four residents from three long-term care facilities in rural Indiana were included in this study. Participants were selected through convenience sampling, chosen by referral from the social worker or director of each long-term care facility. Participants were all age 65 and older. Participants with more than a mild level of dementia, as reported by the facility director or social worker, were excluded from this study. The level of physical ability of participants covered the entire spectrum. Three men and twenty-one women participated in this study. The average age of the population was 80.63 years.

Measures

The life satisfaction of the participants was measured by the Life Satisfaction Index-Z (LSIZ). This 18-item life satisfaction scale was designed specifically for those 65 and older. LSIZ has validity levels which correlate with the Life Satisfaction Rating Scale from which it was derived. Exceptional inter-observer agreement was reported for the original Life Satisfaction Rating Scale (Turner & Hudson, 1987).

Activity levels of each participant were measured by the total minutes of daily voluntary social interactions experienced over a 17-day period. This was recorded using an activity log designed specifically for each location. Each log listed various activities provided by the facilities, as well as other social activities such as family/friend visitations or interactions. The participants were asked to record the number of minutes spent involved in each activity using these logs (example in Appendix A). Although individualized logs were tailored for each facility, they covered roughly the same activities for each location.

Procedure

To begin this study, social workers or directors of each facility were informed of our intent and they granted permission to proceed. The social workers or directors compiled a list of names of residents likely to participate in the study. Then, they distributed the consent forms which informed participants of the study’s intent and ensured confidentiality.

At the beginning of the 17-day period, each participant was given an activity log folder for one week. Each day the participants recorded the amount of time spent in social activity. This was either completed independently or with staff assistance. After the first week, the first activity packet was collected and a second packet was distributed with enough activity logs for the remaining 10 days. Following the completion of the 17-day period, a brief session was held with each resident individually and the Life Satisfaction Index-Z was administered. The collected data were then compiled.

Results

A Pearson r correlation coefficient was used to analyze the data. An alpha level of .05 with a 16 degree of freedom was used. Scores for the LSIZ were compared with the average minutes spent in social activity. The r obtained was 0.184. When the obtained r was compared to the critical r value (r = 0.468), the null hypothesis was retained. No significant correlation was found between social activity and degree of life satisfaction. The mean of participants’ minutes of daily social activity was 158.77 and participants’ mean LSIZ score was 9.96.

Discussion

No significant correlation was found between level of activity and degree of life satisfaction. In this study, convenience sampling was employed to avoid using participants who did not have the physical or mental capacity to fulfill all requirements. Although these findings cannot be generalized to the greater population, this research has implications for residents, their families, facility directors, and future studies in this area.

Research findings related to life-satisfaction for those in long-term care facilities have great value for the daily lives of residents. Knowledge of the effects of social activity could significantly alter the motivation of residents to live active lives. Such information instructs family members on what to seek in long-term care facilities. This information also informs facility directors on activities that should be provided. Research brings to light new areas for further inquiry. Exploration in this field is beneficial to every family as loved ones grow older.

As the children of baby boomers begin to consider options for their aging parents, research in this area will become increasingly essential. Studies will allow the younger generation to search for the best option for the care of their parents. Consistent with the findings of Menec’s (2003) longitudinal analysis, this study found no significant correlation between life-satisfaction and activity level. However, most cross-sectional research has produced differing results. An association has been found between these two variables in those between the ages of 70 and 103 (Lang & Baltes, 1997). Some research has suggested that life-satisfaction is dependent on several variables, including different forms of activity (Qun, 2005). Social activity, specifically, has displayed the strongest correlation with life satisfaction (Lang & Baltes, 1997). Hence, this study concentrated solely on this form of activity.

This study focused mainly on the principles of the activity theory. Our research did not support this theory; however, aspects of several other theories of aging may be useful in understanding our findings. If, as stated in the disengagement theory, people withdraw from the social world as they age, residents would be expected to have less activity. Residents’ level of adjustment would influence their life satisfaction having an effect on results. According to the continuity theory, changes in a person’s activity are based on coping techniques that are developed earlier in life. If so, participants’ life satisfaction would have been based solely on these previously developed coping mechanisms as opposed to their current level of activity. The selectivity theory assumes that life satisfaction is dependent on the ability of an individual to maintain certain favorable activities. If residents could no longer perform individually desirable activities, life satisfaction would have been low even if overall activity was high.

A stronger correlation of activity level and life satisfaction may have resulted with the elimination of certain limitations. One limitation was the lack of completed data in many residents’ activity logs. Missing data could have been due to lack of participation, forgetfulness, or illness. It was often difficult to determine the reason for this absence. Influenza confined several participants to their rooms and restricted activity, further limiting this study. Unwillingness to participate, unavailability, and a death contributed to a smaller sample group. Poor handwriting and confusion about the definition of social activity left some data open to interpretation, creating more subjectivity.

Finally attention from researchers could have induced some motivation for activity and thereby increased life-satisfaction, exhibiting characteristics of the Hawthorne effect. However, there was little interaction with participants, reducing the likelihood of these effects. In summary, then, though no statistically significant correlation was found, our research shows the problems and limitations that future studies need to address.

REFERENCES

Calderon, K. (2001). Making the connection between depression and activity levels

among the oldest-old: A measure of life satisfaction. Activities, Adaptation & Aging, 25(2), 59-73.

Corcorcan, K., &Fisher, J. (Eds.). (1987) Measures for clinical practice. New York: Macmillan.

Lang, F., & Baltes, M. (1997). Being with people and being alone in late life: Costs and benefits for everyday functioning. International Journal of Behavioral Development, 21(4), 729-746.

Madigan, M., Mise, D, & Maynard, M. (1996). Life satisfaction and level of activity of male elderly in institutional and community settings. Activities, Adaptation & Aging, 21(2), 21-36.

Menec, V. (2003). The relationship between everyday activities and successful aging: A 6-year longitudinal study. Journal of Gerontology: Social Sciences, 58B(2), S74-S82.

Morgan, K., & Bath, P. (1998). Customary physical activity and psychological wellbeing: A longitudinal study. Age and Aging, 27(3), 35-40.

Purcell, R., & Keller, M. (1989). Characteristics of leisure activities which may lead to leisure satisfaction among older adults. Activities, Adaptation & Aging, 13(4), 17-29.

Qun, Z. (2005). An investigation on life satisfaction of Macao elderly and the influence factors. Chinese Journal of Clinical Psychology, 13(3), 285-287.

Schroeder, J., Nau, K., Osness, W., & Potteiger, J. (1998). A comparison of life satisfaction, functional ability, physical characteristics, and activity level among older adults in various living settings. Journal of Aging and Physical Activity, 6, 340-349.

Warr, P., Butcher, V., & Robertson, I. (2004). Activity and psychological well-being in older people. Aging & Mental Health, 8(2), 172-183.

Appendix A

Sample Activity Log

Sample Activity Log Continued

Appendix B

Figure 1 Level of Social Activity and Life Satisfaction

Appendix C

Introduction Conversation

Hello my name is ­­­__________ from Huntington University. We are here to talk to you about the research project that you have agreed to participate in. We have received the consent form that you have signed and we would like to answer any questions you might have about the study. We will be asking you to record the amount of time you spend in daily social activity for 17 days using the provided daily activity logs. On the 18th day we will collect these logs and you will be given a survey consisting of 13 questions. As stated in the signed consent form, your name will not be used in any way and we ensure confidentiality. Thank you very much for your willingness to participate. It is greatly appreciated.

Appendix D

Instructions

In your folder you have been given an activity log. This log lists the activities provided by __________. Please record, as accurately as possible, the number of minutes you spend in each activity. Write this number in the space corresponding to the date and type of activity. We are interested in all your daily social activities. In the extra spaces provided at the bottom of this log, please record any additional social activities and your time spent in each. When this current log is completed we will provide you with a blank log.

Appendix E

Life Satisfaction Index-Z

Here are some statements about life in general that people feel different ways about.

Read each statement on the list and indicate at left the number that best describes how

you feel about the statement.

1 = Agree

2 = Disagree

3 = Unsure

__ 1. As I grow older, things seem better than I thought they would be.

__ 2. I have gotten more of the breaks in life than most of the people I know.

__ 3. This is the dreariest time of my life.

__ 4. I am just as happy as I was when I was younger.

__ 5. My life could be happier than it is now.

__ 6. These are the best years of my life.

__ 7. Most of the things I do are boring or monotonous.

__ 8. I expect some interesting and pleasant things to happen to me in the future.

__ 9. The things I do are as interesting to me as they ever were.

__ 10. I feel old and somewhat tired.

__ 11. As I look back on my life, I am fairly well satisfied.

__ 12. I would not change my past life even if I could.

__ 13. Compared to other people my age, I make a good appearance.

__ 14. I have made plans for things I’ll be doing in a month or a year from now.

__ 15. When I think back over my life, I didn’t get most of the important things I wanted.

__ 16. Compared to other people, I get down in the dumps too often.

__ 17. I’ve gotten pretty much what I expected out of life.

__ 18. In spite of what some people say, the lot of the average man is getting worse, not better.

Gender: M or F Age: _________

Month and year of arrival (in facility): _____________

Appendix F

Consent Form

I have been asked to participate as a participant in a research project investigating activity levels and life satisfaction.

This project is under the direction of Joy Bamford, Michelle Chaffin, and Lindsay Taylor, undergraduate students at Huntington University and fulfills a requirement for a course in the psychology major taught by Wayne Priest, Ph.D. HSPP.

I understand that there are no known risks associated with participating in this project and that I will be asked to complete daily activity logs and a life satisfaction questionnaire.

I understand that information gathered from me during this project will not be reported to anyone outside the project team in any manner which might personally identify me. A report of combined and generalized results involving multiple participants will be prepared. This information will be presented in a scholarly public forum, and will be available to participants upon request.

My signature indicates that I understand and voluntarily agree to the conditions of participation described above and that I may withdraw from the study at any time without prejudice.

_____________________________ _____________

Name Date

Joy Bamford 260-356-5359

Michelle Chaffin 614-570-0487

Lindsay Taylor 765-860-0608