research paper on old age home

• Search Menu
• Sign in through your institution
• Advance Articles
• Special Issues
• Supplements
• Virtual Collection
• Online Only Articles
• International Spotlight
• Free Editor's Choice
• Free Feature Articles
• Author Guidelines
• Submission Site
• Calls for Papers
• Why Submit to the GSA Portfolio?
• Advertising and Corporate Services
• Advertising
• Reprints and ePrints
• Sponsored Supplements
• Journals Career Network
• About The Gerontologist
• About The Gerontological Society of America
• Editorial Board
• Self-Archiving Policy
• Dispatch Dates
• GSA Journals
• Journals on Oxford Academic
• Books on Oxford Academic

Article Contents

Research background, major components of the enable–age project.

• < Previous

Importance of the Home Environment for Healthy Aging: Conceptual and Methodological Background of the European ENABLE–AGE Project

• Article contents
• Figures & tables
• Supplementary Data

Susanne Iwarsson, Hans-Werner Wahl, Carita Nygren, Frank Oswald, Andrew Sixsmith, Judith Sixsmith, Zsuzsa Széman, Signe Tomsone, Importance of the Home Environment for Healthy Aging: Conceptual and Methodological Background of the European ENABLE–AGE Project, The Gerontologist , Volume 47, Issue 1, February 2007, Pages 78–84, https://doi.org/10.1093/geront/47.1.78

• Permissions Icon Permissions

Currently in Europe as well as in the United States, an increasing proportion of very old people remain living in their homes despite declines in physical and mental health. Together with the fact that the population of very old people is rapidly increasing ( Mathers, Sadana, Salamon, Murray, & Lopez, 2001 ; United Nations Development Programme, 2001 ), this poses new challenges to societal planning and housing development ( Gitlin, 2003 ).

In addition, the home environment is a major arena for aging research focusing on objective as well as perceived housing and relying on both quantitative and qualitative methods ( Scheidt & Windley, 2006 ). As earlier research has consistently shown, daily activities are predominantly performed in the home and its close surroundings. As people grow older, they spend relatively more time in their homes; on average, very old people tend to spend 80% of their time at home ( Baltes, Maas, Wilms, Borchelt, & Little, 1999 ). Strong cognitive and affective ties to the home environment are formed as people age, and, as a consequence, aging in place and preventing relocation are among the strongest needs of older adults as well as their families ( Gitlin, 2003 ). Thus, an important goal in health promotion is to create home environments that support healthy aging.

Promoting health framed within a person–home environment perspective requires robust knowledge underscoring the way good home environments can help to alleviate or prevent illness and declining health. Although such knowledge has been gathered in recent decades (see, for review, Gitlin, 2003 ; Iwarsson, 2004 ; Oswald & Wahl, 2004 ; Scheidt & Windley, 2006 ; Wahl & Gitlin, in press ; Wahl, Scheidt, & Windley, 2004 ), the evidence still is fragmented and scattered ( Wahl & Weisman, 2003 ).

Researchers designed the European project “Enabling Autonomy, Participation, and Well-Being in Old Age: The Home Environment as a Determinant for Healthy Aging” (ENABLE–AGE) to address this major research gap. Their main objective in the project was to examine the home environment and its importance for major components of healthy aging. In the ENABLE–AGE Project, researchers used the term healthy aging to address selected aspects of physical, mental, and social health that are assumed to be particularly relevant to housing. Among the core concepts chosen for the project were independence in daily activities and subjective well-being ( Iwarsson, Wahl, & Nygren, 2004 ). It is widely accepted that an active life is positively associated with better health ( Mendes de Leon, Glass, & Berkman, 2003 ). Engagement in activities is of crucial importance in promoting and maintaining health and well-being throughout life ( Law, Steinwender, & Leclair, 1998 ), and thus independence in daily activities constitutes an important aspect of health in very old age. The point of departure for the definition of subjective well-being is the World Health Organization's definition of health “as a state of complete physical, mental, and social well-being [and] not merely the absence of disease and infirmity” (World Health Organization, 1946, as cited in Christiansen & Baum, 2005 ). The three elements of well-being (physical, mental, and social) are part of an integrated whole, and therefore they should not be separated ( Stanley & Cheek, 2003 ). In relation to gerontological research in general, the hallmark of the ENABLE–AGE Project is the richness of variables in covering aspects of housing. What is most important, and in contrast to most other projects in this field, in this project equal emphasis was given to the assessment of objective and perceived aspects of housing.

Very old individuals, particularly those living in single households, have been described as particularly sensitive to “environmental press” ( Lawton, 1999 ), because of sensory, mobility, and cognitive declines ( Baltes & Smith, 1999 ). Because community-residing, very old participants living alone have a pronounced risk of losing independence and becoming socially isolated, the ENABLE–AGE Project targeted this group. In addition, major studies that targeted this at-risk segment of the aging population (see, e.g., Baltes & Mayer, 1999 ; Myers, Juster, & Suzman, 1997 ) narrowly focused on variables related to the person and his or her social environment, but not on the home environment.

Researchers gathered data in urban regions in five European countries representing economically well-developed “old” European Union member states, that is Germany, the United Kingdom, and Sweden, as well as “new” member states that joined the European Union in 2005 and are still in a period of major social and political transformation, that is, Hungary and Latvia ( Széman & Harsanyi, 2000 ). The goal of the project was to deliver evidence-based guidelines for home assessment and home modifications among older people (also see http://www.enableage.arb.lu.se ).

The Home Environment, Independence, and Autonomy

Several empirical studies have focused on the home environment as a potential threat to independence in daily activities and autonomy. For example, Gill and colleagues ( Gill, Robinson, Williams, & Tinetti, 1999 ) examined the home environment of 1,088 adults aged 72 years or older and found no major differences between the homes of physically impaired and unimpaired individuals in the prevalence of physical environmental barriers. Further, early research from Reschovsky and Newman (1990) , and later the “Fixing to Stay” study ( AARP, 2000 ), found that many older people undertake at least some home modifications or repairs themselves. Similarly, visually impaired older people employed a wide variety of person- and environment-related compensations to reduce person–environment mismatches ( Wahl, Oswald, & Zimprich, 1999 ). However, such compensation strategies probably do not prevent negative influences of the objective home environment on independence and autonomy. On the basis of a large German study, substandard housing conditions were found to be significantly associated with deficits in activity performance ( Olbrich & Diegritz, 1995 ; Schmitt, Kruse, & Olbrich, 1994 ). Moreover, German ( Wahl et al., 1999 ) as well as Swedish studies ( Iwarsson, 2005 ; Iwarsson, Isacsson, & Lanke, 1998 ) demonstrated that higher dependence in daily activities was significantly related to lower accessibility, a construct considering the fit between functional limitations and objectively observed barriers in the home environment ( Iwarsson & Ståhl, 2003 ). Additional support for this kind of relationship has been found in outcome studies on home modifications, though the evidence remains somewhat mixed ( Gitlin, 1998 ; Lyons et al., 2003 ). In sum, the connection between the home environment and independence or autonomy in daily activities has received some research support, but few if any studies on housing and health in very old age included data on objective and perceived aspects of housing to an extent that is sufficient for in-depth elucidation of relationships between the home and independence or autonomy.

The Home Environment and Well-Being

The typical empirical approach to the home environment and well-being relationship has focused on housing satisfaction as the sole aspect of perceived housing. Research in the 1990s replicated and extended the classic finding of earlier studies that older people tend to score high on this construct, regardless of objective home and neighborhood conditions ( Christensen, Carp, Cranz, & Whiley, 1992 ; Iwarsson & Isacsson, 1996 ). A recent meta-analysis on housing satisfaction ( Pinquart & Burmedi, 2004 ) shows that housing satisfaction steadily increases from middle to old age. Furthermore, there is a substantial link between housing quality and well-being ( Evans, Kantrowitz, & Eshelman, 2002 ). According to qualitative research on the meaning of home (e.g., Rubinstein, Kilbride, & Nagy, 1992 ), the active management of the environment in itself represents a major source of well-being for older people, especially those who are frail or living alone. Sixsmith and Sixsmith's (1991) study and more recently Rowles, Oswald, and Hunter's (2004) findings clearly underline the important role of the home as the major physical-spatial location in old age, where one (re)integrates critical life transitions, such as physical impairment or widowhood, into one's life structure by relying on the resources and enduring nature of the physical home environment. Furthermore, several studies support the notion that staying in one's home is highly desirable for older people at risk, including those who lose functional independence ( Krothe, 1997 ), have recently experienced widowhood ( Swenson, 1998 ), or live in suboptimal environments ( Crystal & Beck, 1992 ). Alternatively, home may not always exert positive influence on well-being; for some older people home can be worrisome, sad, or confining ( Rubinstein et al., 1992 ). In sum, although the assumption of a link between the home environment and well-being seems highly plausible, the available evidence is quite limited and probably biased toward positive relations. Similar to studies on independence in daily activities, few if any studies have included data on objective and perceived aspects of housing to an extent sufficient for in-depth elucidation of relationships between the home and well-being.

Research Needs and the ENABLE–AGE Project

In order to fill the knowledge gaps identified, research with a wider perspective is needed that takes into account objective as well as perceived aspects of housing alongside relevant aspects of health in very old age. In particular, the assessment of housing requires a methodological approach with the same levels of validity and reliability in assessments of the home environment as assessments of person-related variables ( Iwarsson, Wahl, & Nygren, 2004 ). The absence of such an approach has led to an imbalance in the existing research with respect to person- and environment-related assessments ( Iwarsson, 2004 , 2005 ).

Given the shortcomings in the existing literature, we, the researchers of the ENABLE–AGE Project, had several major targets distinguishing it from other projects in this field. First, we were interested in relationships between objective and perceived housing in very old age. Second, relationships between objective and perceived housing and healthy aging outcomes, namely, independence in daily activities and well-being, served as the target for our analysis. Third, we examined cross-national similarities in these relationships. In addition, the ENABLE–AGE Project sought to advance methodological quality in the assessment of home environments and very old people. Even if there are other projects that strived to attain similar goals, we argue that this project was different in that we managed to combine these goals in the same project. Having stated this, one should keep in mind that other environmental domains potentially influencing health in very old age do, of course, exist, such as aspects related to care environments, family support, or professional support from nursing and rehabilitation staff, or social and physical contexts in the neighborhood. Because it was beyond the scope of the ENABLE–AGE Project to include such aspects, one should keep this limitation in mind while interpreting our results.

Theoretical Models Guiding the ENABLE–AGE Project

The person–environment fit-oriented analysis of healthy aging that we conducted was driven by the World Health Organization's (2001) International Classification of Functioning, Disability, and Health (ICF). According to the ICF, multifaceted relationships among the components of body functions, activity, and participation, and personal and environmental factors are expected. However, the ICF does not differentiate among environmental factors in terms of objective and perceived aspects.

Regarding the role of objective housing, we used the ecological theory of aging (ETA) and the environmental docility hypothesis ( Lawton, 1999 ; Lawton & Nahemow, 1973 ; Lawton & Simon, 1968 ), which underlie many environmental gerontology studies ( Scheidt & Norris-Baker, 2004 ; Wahl & Gitlin, in press ), as the major conceptual background of the project. According to the ETA, individuals with low functional capacity are much more vulnerable to environmental demand than those with high capacity, and environmental details are critical to what they can manage in their everyday lives. The ETA, other classic person–environment conceptions (e.g., Carp, 1987 ), and the disablement process ( Verbrugge & Jette, 1994 ) underscore the notion that it is the fit between personal competencies and needs and environmental conditions that is key to understanding person–environment relations as people age, rather than personal and environmental factors as separate constructs ( Iwarsson, 2004 , 2005 ).

In contrast to the role of objective housing, the role of perceived housing has been underdeveloped in current conceptual frameworks ( Rubinstein & De Medeiros, 2004 ). Regarding perceived housing, the ENABLE–AGE Project did not rely solely on housing satisfaction, seeing this as too limited in its conceptual approach, because housing satisfaction only involves a cognitive evaluation of the home environment. Instead, the project also considered the meaning of home ( Oswald & Wahl, 2005 ; Rowles et al., 2004 ; Rubinstein et al., 1992 ), its usability ( Fänge & Iwarsson, 1999 , 2003 ), and the newly introduced concept of housing-related control beliefs ( Oswald, Wahl, Martin, & Mollenkopf, 2003 ). In a recent methodological study based on the ENABLE–AGE Project, Oswald and colleagues (in press) demonstrated that these concepts hold as a four-domain model of perceived housing.

In addition, much neglected in the person–environment and aging literature are linkages between micro and macro contexts. Therefore, besides attention to person–environment relations (micro context), the ENABLE–AGE Project also considers macro contextual differences and similarities. By selecting a set of European countries, we attempted to make cross-national comparisons. That is, because legislation, housing regulations, and socioeconomic standards are quite diverse across European countries, relationships among personal factors, housing, and healthy aging outcomes may be influenced by macro factors. On the one hand, it can be assumed that socioeconomic differences among countries should be directly linked with housing quality and concomitant outcomes. On the other hand, it could also be true that the interplay between objective and perceived housing and healthy aging outcomes is so fundamental in nature that similar relations may be observed across a diversity of national backgrounds.

We are not arguing that the person–environment approach taken in the ENABLE–AGE Project is fully comprehensive. For example, environmental forces such as caregivers or family members are not explicitly considered. The major aim of the ENABLE–AGE Project was to explicitly focus on aspects normally not addressed in studies on healthy aging in such intensity (i.e., major components related to the objective and perceived home environment).

Research Design

An advantage, a necessary prerequisite, and also a challenge for the ENABLE–AGE Consortium was the fact that the research team was composed of scholars from a wide range of disciplines (e.g., gerontology, human geography, medicine, psychology, occupational therapy, and sociology). These disciplines complemented each other and were configured in different combinations for the specific project components.

The project included three study arms: (a) The ENABLE–AGE Survey Study; (b) the ENABLE–AGE In-Depth Study; and (c) the ENABLE–AGE Update Review. We integrated the three project elements throughout the 3-year period (2002–2004), as each provided systematic input into conceptual definitions, research design, methodological development, analyses, cross-national comparisons, theory development, and dissemination of results ( Iwarsson et al., 2004 ).

The ENABLE–AGE Survey Study was based on a comprehensive questionnaire incorporating a wide range of well-proven self-report scales and observational formats, along with project-specific questions on housing and health. We collected data at two time periods spaced 1 year apart with a reduced assessment battery applied at follow-up. The ENABLE–AGE In-Depth Study involved in-depth semistructured interviews conducted with a subsample of the survey participants in each of the five countries. The interviews focused on very old peoples' understandings of the meaning and experience of home in relation to health, well-being, and aging. The ENABLE–AGE Update Review aimed to explore key policy issues in the five countries. The first component of this review concerned detailed documentation of building norms and guidelines in each country. Second, we identified national key policy topics, which in turn we compiled into a policy topic list at a cross-national level, concluding with a macro-level critical analysis of current policies and housing trends. This article as well as the two related articles that follow it (Nygren et al., this issue; Oswald et al., this issue) mainly focus on the ENABLE–AGE Survey Study.

Study Sample

Our initial sampling strategy was to draw participants at random from official national registers, in a similar way in all five countries. This was possible only in Sweden, Germany, and Hungary. In the United Kingdom and Latvia, official national registers are not made available for researchers in the way necessary for this project. Thus, in the United Kingdom our sampling strategy relied on use of general practitioners' patient lists, whereas in Latvia we recruited participants at social day care centers and through older people's voluntary organizations ( Iwarsson et al., 2004 ). Following the ethical guidelines and procedures for formal ethical consent of each country, we enrolled all participants after they gave informed consent. We handled all data with strict anonymity. We informed participants that they were allowed to withdraw from the interviews if they wished, including potential withdrawal of their data up to the time of the publication of results.

Because of differences in the population mean age and life expectancy between Western–Central and Eastern European countries, we regarded the use of the same age strata across countries as an inadequate approach, particularly for very old people. For instance, given the life expectancies at birth in 2002 (study start) in Sweden of 77 years of age for men and 82 years of age for women as compared with Latvia of 65 years of age for men and 77 years of age for women, using the same age groups would have led in Latvia to a much more positively selected group of survivors as compared with Sweden ( Iwarsson et al., 2004 ). In addition, given the fact that far fewer people in Eastern European countries reach very old age, it would have been difficult to recruit sufficient numbers of participants in Latvia and Hungary. In order to adjust for this, in Sweden, Germany, and the United Kingdom, we had the “younger” age groups composed of participants aged 81–84 years and the “older” age groups composed of participants aged 85–89 years. We selected the corresponding age groups in Hungary and Latvia as those aged 75–79 years and 80–84 years, respectively. In addition, we included only individuals living alone in urban households ( Iwarsson et al., 2004 ). We stratified the sample for sex with the original aim of 25% men in each national sample. However, we only partially achieved this goal, particularly in the Eastern European countries because of our difficulties in recruiting very old men.

The final sample for the ENABLE–AGE Survey Study at the baseline wave was composed of 1,918 participants (details of the national samples are provided in Oswald et al., this issue). For the set of articles published in this issue, we used only baseline data from the ENABLE–AGE Survey Study. In the two empirical papers, we use the term national samples to address the samples in the different countries. This is a technical naming not meant to state that samples were representative of the respective countries.

Methodological Development and Interviewer Training

Prior to the data collection within the ENABLE–AGE Survey Study, we gave major attention to methodological development and interviewer training. We integrated the first phase of this process with the ENABLE–AGE Update Review, because a review of building standards, regulations, and norms for housing design was necessary to revise the section of the instrument that covered accessibility assessment for cross-national use. Further, we had instruments and questions translated into the six languages involved (Swedish, German, English, Hungarian, Latvian, and Russian), followed by iterative piloting in all countries. We followed this with several 3-day interviewer training courses focusing on the reliable administration of all instruments. In Sweden, Germany, and Latvia, the interviewer teams consisted of occupational therapists, whereas the UK and Hungarian interviewer teams were multidisciplinary ( Iwarsson et al., 2004 ). In each country, the national project leader arranged further team training with all interviewers in their own language. Thereafter, we performed iterative pretests, administering the survey questionnaire to older adults who were not included in the ENABLE–AGE Survey Study sample, followed by subsequent revisions of the questionnaire. After several months of pretesting, the ENABLE–AGE Consortium reached consensus and decided on the final format ( Iwarsson et al., 2004 ). Finally, we carried out a separate interrater reliability study of the accessibility instrument, based on 64 pairwise assessments ( Iwarsson, Nygren, & Slaug, 2005 ). The results demonstrated moderate to good agreement across research sites, and study design issues and experiences related to interviewer competence were highlighted.

Formally, the ENABLE–AGE Project was completed at the end of December 2004. The integrated approach of the project in terms of conceptual understandings, methodological design, and forms of analysis is particularly relevant to strengthening the evidence base in the area of housing and ageing. Bringing such information together has presented, and will continue to present, exciting opportunities for new insights to emerge of theoretical and practical importance for very old people's housing, building upon the ENABLE–AGE multidimensional methodology for research on housing and healthy aging. Major parts of this methodology are now available in six European languages (see http://www.enableage.arb.lu.se ), and the experiences gained are valuable for the implementation of research on housing and health at large. Strong emphasis is currently being placed on the dissemination of knowledge within scientific as well as practical domains. The two empirical studies presented in this issue are important parts of this ongoing dissemination. Several additional research reports adding to the results given in this issue are currently available ( Haak, Dahlin Ivanoff, Fänge, Sixsmith, & Iwarsson, in press ; Haak, Fänge, Iwarsson, & Dahlin Ivanoff, in press ; Iwarsson, Wahl, Oswald, Tomsone, & Nygren, in press ; Löfqvist, Nygren, Széman, & Iwarsson, 2005) , whereas still others are in progress. The two articles following this introduction consider findings from all five countries involved in the project. In the first article (Nygren et al., this issue), the relationship between objective and perceived housing serves as the primary target for analysis. The second article addresses the relationships between objective housing, perceived housing, and healthy aging outcomes (Oswald et al., this issue).

The Enabling Autonomy, Participation, and Well-Being in Old Age: The Home Environment as a Determinant for Healthy Ageing (ENABLE–AGE) Project was funded by the European Commission from 2002 to 2004 (under Grant QLRT-2001-00334). The Swedish ENABLE–AGE team is grateful for additional funding from the Swedish Research Council on Social Science and Working Life, the Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning, and the Swedish Research Council. We thank all study participants, consortium and national team members, and subcontractors for their contributions.

Department of Health Sciences, Lund University, Sweden.

Department of Psychological Ageing Research, University of Heidelberg, Germany.

Department of Primary Care, University of Liverpool, England.

Department of Psychology and Speech Pathology, Manchester Metropolitan University, England.

Institute for Sociology, Hungarian Academy of Sciences, Budapest, Hungary.

Academic School of Occupational Therapy, Riga Stradins University, Riga, Latvia.

Decision Editor: Linda S. Noelker, PhD

AARP. ( 2000 ). Fixing to stay. A national survey of housing and home modification issues . Retrieved month 05, 2006, from http://www.aarp.org .

Baltes, M. M., Maas, I., Wilms, H.-U., Borchelt, M. F., & Little, T., ( 1999 ). Everyday competence in old and very old age: Theoretical considerations and empirical findings. In P. B. Baltes & K. U. Mayer (Eds.), The Berlin Aging Study (pp. 384–402). Cambridge, England: Cambridge University Press.

Baltes, P. B., & Mayer, K. U., (Eds.) ( 1999 ). The Berlin Aging Study. Aging from 70 to 100 . Cambridge, England: Cambridge University Press.

Baltes, P. B., & Smith, J., ( 1999 ). Multilevel and systemic analyses of old age. Theoretical and empirical evidence for a fourth age. In V. L. Bengtson & K. W. Schaie (Eds.), Handbook of theories of aging (pp. 153–173). New York: Springer.

Carp, F. M., ( 1987 ). Environment and aging. In D. Stokols & I. Altman (Eds.), Handbook of environmental psychology (Vol. 1, pp. 330–360). New York: Wiley.

Christiansen, C., & Baum, C., ( 2005 ). Occupational Therapy. Performance, participation, and well-being (3rd ed.). Thorofare, NJ: SLACK.

Christensen, D. L., Carp, F. M., Cranz, G. L., & Whiley, J. A., ( 1992 ). Objective housing indicators as predictors of the subjective evaluations of elderly residents. Journal of Environmental Psychology, 12 , 225 -236.

Crystal, S., & Beck, P., ( 1992 ). A room of one's own: The SRO and the single elderly. The Gerontologist, 32 , 684 -692.

Evans, G. E., Kantrowitz, E., & Eshelman, P., ( 2002 ). Housing quality and psychological well-being among the elderly population. Journal of Gerontology: Psychological Sciences, 57B , P381 -P384.

Fänge, A., & Iwarsson, S., ( 1999 ). Physical housing environment – Development of a self-assessment instrument. Canadian Journal of Occupational Therapy, 66 , 250 -260.

Fänge, A., & Iwarsson, S., ( 2003 ). Accessibility and usability in housing – Construct validity and implications for research and practice. Disability and Rehabilitation, 25 , 1316 -1325.

Gill, T. M., Robinson, J. T., Williams, C. S., & Tinetti, M. E., ( 1999 ). Mismatches between the home environment and physical capabilities among community-living older persons. Journal of the American Geriatric Society, 47 , 88 -92.

Gitlin, L. N., ( 1998 ). Testing home modification interventions: Issues of theory, measurement, design, and implementation. In R. Schulz, G. Maddox, & M. P. Lawton (Eds.), Focus on interventions research with older adults (Vol. 18, pp. 190–246). New York: Springer.

Gitlin, L. N., ( 2003 ). Conducting research on home environments: Lessons learned and new directions. Gerontologist, 43 , 628 -637.

Haak, M., Fänge, A., Iwarsson, S., & Dahlin Ivanoff, S., in press. Autonomy and independence at home – Experiences among very old Swedish people. Scandinavian Journal of Occupational Therapy. .

Haak, M., Dahlin Ivanoff, S., Fänge, A., Sixsmith, J., & Iwarsson, S., in press. Home as the base and starting point for participation – Experiences among very old Swedish people. Occupational Therapy Journal of Research. .

Iwarsson, S., ( 2004 ). Assessing the fit between older people and their physical home environments: An occupational therapy research perspective. In H-W. Wahl, R. J. Scheidt, & P. G. Windley (Eds.), Annual review of gerontology and geriatrics. Aging in context: Socio-physical environments (pp. 85–109). New York: Springer.

Iwarsson, S., ( 2005 ). A long-term perspective on person–environment fit and ADL dependence among older Swedish adults. The Gerontologist, 45 , 327 -336.

Iwarsson, S., & Isacsson, Å., ( 1996 ). Housing standards, environmental barriers in the home, and subjective general apprehension of housing situation among the rural elderly. Scandinavian Journal of Occupational Therapy, 3 , 52 -61.

Iwarsson, S., Isacsson, Å., & Lanke, J., ( 1998 ). ADL dependence in the elderly: The influence of functional limitations and physical environmental demand. Occupational Therapy International, 5 , 173 -193.

Iwarsson, S., Nygren, C., & Slaug, B., ( 2005 ). Cross-national and multi-professional inter-rater reliability of the Housing Enabler. Scandinavian Journal of Occupational Therapy, 12 , 29 -39.

Iwarsson, S., & Ståhl, A., ( 2003 ). Accessibility, usability, and universal design – Positioning and definition of concepts describing person–environment relationships. Disability and Rehabilitation, 25 , 57 -66.

Iwarsson, S., Wahl, H.-W., & Nygren, C., ( 2004 ). Challenges of cross-national housing research with older people: Lessons from the ENABLE-AGE project. European Journal of Ageing, 1 , 79 -88.

Iwarsson, S., Wahl, H-W., Oswald, F., Tomsone, S., & Nygren, C., in press. Environmental barriers and housing accessibility problems in three European countries. Journal of Housing for the Elderly. .

Krothe, J. S., ( 1997 ). Giving voice to elderly people: Community-based long-term care. Public Health Nursing, 14 , 217 -226.

Law, M., Steinwender, S., & Leclair, L., ( 1998 ). Occupation, health and well-being. Canadian Journal of Occupational Therapy, 65 , 81 -91.

Lawton, M. P., ( 1999 ). Environmental taxonomy: Generalizations from research with older adults. In S. L. Friedman & T. D. Wachs (Eds.), Measuring environment across the life span (pp. 91–124). Washington, DC: American Psychological Association.

Lawton, M. P., & Nahemow, L., ( 1973 ). Ecology and the aging process. In C. Eisdorfer & M. P. Lawton (Eds.), The psychology of adult development and aging, Washington, DC: American Psychological Association (pp. 619–674).

Lawton, M. P., & Simon, B., ( 1968 ). The ecology of social relationships in housing for the elderly. The Gerontologist, 8 , 108 -115.

Löfqvist, C., Nygren, C., Széman, Z., & Iwarsson, S., ( 2005 ). Assistive devices among very old people in five European countries. Scandinavian Journal of Occupational Therapy, 12 , 181 -192.

Lyons, R. A., Sander, L. V., Weightman, A. L., Patterson, J., Jones, S. A., & Lannon, S., et al ( 2003 ). Modification of the home environment for the reduction of injuries. The Cochrane Database of Systematic Reviews 2003, Issue 4, No. CD003600 [DOI: 10.1002/14651858.CD003600].

Mathers, C. D., Sadana, R., Salomon, J. A., Murray, C. J. L., & Lopez, A. D., ( 2001 ). Healthy life expectancy in 191 countries, 1999. The Lancet, 375 , 1685 -1691.

Mendes de Leon, C., Glass, T., & Berkman, L., ( 2003 ). Social engagement and disability in a community population of older adults. American Journal of Epidemiology, 157 , 633 -642.

Myers, G. C., Juster, F. T., & Suzman, R. M., ( 1997 ). Introduction. Journal of Gerontology: Social Sciences, 52B (Special Issue), v–viii.

Nygren, C., Oswald, F., Iwarsson, S., Fänge, A., Sixsmith, J., & Schilling, O., et al ( 2007 ). Relationships between objective and perceived housing in very old age. The Gerontologist, 47 , 85 -95.

Olbrich, E., & Diegritz, U., ( 1995 ). Das Zusammenwirken von Person- und Umweltfaktoren im Alltag: Eine kritische Diskussion von Aktivitäten des täglichen Lebens und instrumentalen Aktivitäten des täglichen Lebens [Interation of person and environmental factors in daily life]. Zeitschrift für Gerontopsychologie und -psychiatrie, 8 , 199–212.

Oswald, F., & Rowles, G. D., ( 2006 ). Beyond the relocation trauma in old age: New trends in today's elders' residential decisions. In H.-W. Wahl, C. Tesch-Römer, & A. Hoff (Eds.), New dynamics in old age: Environmental and societal perspectives (pp. 127–152). Amityville, NY: Baywood.

Oswald, F., Schilling, O., Wahl, H.-W., Fänge, A., Sixsmith, J., & Iwarsson, S., in press. Homeward bound: Introducing a four domain model of perceived housing in very old age. Journal of Environmental Psychology. .

Oswald, F., & Wahl, H.-W., ( 2004 ). Housing and health in later life. Reviews of Environmental Health, 19 , (3–4), 223 -252.

Oswald, F., & Wahl, H.-W., ( 2005 ). Dimensions of the meaning of home in later life. In G. D. Rowles & H. Chaudhury (Eds.), Coming home: International perspectives on place, time, and identity in old age (pp. 21–46). New York: Springer.

Oswald, F., Wahl, H.-W., Martin, M., & Mollenkopf, H., ( 2003 ). Toward measuring proactivity in person–environment transactions in late adulthood: The Housing-Related Control Beliefs Questionnaire. Journal of Housing for the Elderly, 17 , (1/2), 135 -152.

Oswald, F., Wahl, H.-W., Schilling, O., Nygren, C., Fänge, A., & Sixsmith, A., et al ( 2007 ). Relationships between housing and healthy aging in very old age. The Gerontologist, 47 , 96 -107.

Pinquart, M., & Burmedi, D., ( 2004 ). Correlates of residential satisfaction in adulthood and old age: A meta-analysis. In H.-W. Wahl, R. Scheidt & P. G. Windley (Eds.), Annual review of gerontology and geriatrics. Aging in context: Socio-physical environments (pp. 195–222). New York: Springer.

Reschovsky, J. D., & Newman, S. J., ( 1990 ). Adaptations for independent living by older frail households. The Gerontologist, 30 , 543 -552.

Rowles, G. D., Oswald, F., & Hunter, E. G., ( 2004 ). Interior living environments in old age. In H.-W. Wahl, R. Scheidt, & P. G. Windley (Eds.), Annual review of gerontology and geriatrics. Aging in context: Socio-physical environments (pp. 167–193). New York: Springer.

Rubinstein, R. L., & De Medeiros, K., ( 2004 ). Ecology and the aging self. In H.-W. Wahl, R. J. Scheidt, & P. G. Windley (Eds.), Annual review of gerontology and geriatrics. Aging in context: Socio-physical environments (pp. 59–84). New York: Springer.

Rubinstein, R. L., Kilbride, J., & Nagy, S., ( 1992 ). Elders living alone: Frailty and the perception of choice . Hawthorne, NY: Aldine de Gruyter.

Scheidt, R. J., & Norris-Baker, C., ( 2004 ). The general ecological model revisited: Evolution, current status, continuing challenges. In H.-W. Wahl, R. J. Scheidt, & P. G. Windley (Eds.), Annual review of gerontology and geriatrics. Aging in context: Socio-physical environments (pp. 34–58). New York: Springer.

Scheidt, R. J., & Windley, P. G., ( 2006 ). Environmental gerontology: progress in the post-Lawton era. In J. E. Birren & K. W. Schaie (Eds.), Handbook of the psychology of aging (6th ed., pp. 105–125). Amsterdam: Elsevier.

Schmitt, E., Kruse, A., & Olbrich, E., ( 1994 ). Former der Selbständigkeit und Wohnumwelt – ein empirischer Beitrag aus der Studie “Möglichkeiten und Grenzen der selbständigen Lebensführung im Alter” [Patterns of competence and housing conditions – Some empirical results from the study “chances and limitations of independent living in old age.” In German, with summary in English]. Zeitschrift für Gerontologie, 27 , 390 -398.

Sixsmith, A., & Sixsmith, J., ( 1991 ). Transitions in home experience in later life. Journal of Architectural and Planning Research, 8 , 181 -191.

Stanley, M., & Cheek, J., ( 2003 ). Well-being and older people. A review of the literature. Canadian Journal of Occupational Therapy, 70 , 51 -59.

Swenson, M. M., ( 1998 ). The meaning of home to five elderly women. Health Care for Women International, 19 , 381 -393.

Széman, Z., & Harsanyi, L., ( 2000 ). Caught in the net in Hungary and Eastern Europe . Budapest: Hungarian Academy of Sciences.

United Nations Development Programme. ( 2001 ). Human development report 2001 . New York: Oxford University Press.

Vaillant, G. A., ( 2002 ). Aging well: Surprising guideposts to a happier life from the Landmark Harvard Study of Adult Development . Boston: Little, Brown.

Verbrugge, L. M., & Jette, A. M., ( 1994 ). The disablement process. Social Science and Medicine, 38 , 1 -14.

Wahl, H.-W., & Gitlin, L. N., in press. Environmental gerontology. In J. E. Birren (Ed.), Encyclopedia of aging (2nd ed.). Oxford, England: Elsevier.

Wahl, H.-W., Oswald, F., & Zimprich, D., ( 1999 ). Everyday competence in visually impaired older adults: A case for person–environment perspectives. The Gerontologist, 39 , 140 -149.

Wahl, H.-W., & Weisman, G. D., ( 2003 ). Environmental gerontology at the beginning of the new millennium: Reflections on its historical, empirical, and theoretical development. The Gerontologist, 43 , 616 -627.

Wahl, H.-W., Scheidt, R., & Windley, P. G., (Eds.) ( 2004 ). Annual review of gerontology and geriatrics. Aging in context: Socio-physical environments . New York: Springer.

World Health Organization. ( 1991 ). Sundsvall statement on supportive environments. June 9–15, Sundsvall, Sweden . Geneva, Switzerland: WHO.

World Health Organization. ( 2001 ). ICF: International classification of functioning, disability, and health . Geneva, Switzerland: WHO. Available at http://www.who.ch/icidh .

Email alerts

Citing articles via, looking for your next opportunity.

• Recommend to Your Librarian

Affiliations

• Online ISSN 1758-5341
• Copyright © 2024 The Gerontological Society of America
• About Oxford Academic
• Publish journals with us
• University press partners
• What we publish
• New features  
• Open access
• Institutional account management
• Rights and permissions
• Get help with access
• Accessibility
• Media enquiries
• Oxford University Press
• Oxford Languages
• University of Oxford

Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide

• Copyright © 2024 Oxford University Press
• Cookie settings
• Cookie policy
• Privacy policy
• Legal notice

This Feature Is Available To Subscribers Only

Sign In or Create an Account

This PDF is available to Subscribers Only

For full access to this pdf, sign in to an existing account, or purchase an annual subscription.

• DOI: 10.5958/2394-2061.2015.00010.5
• Corpus ID: 57733810

A study on quality of life between elderly people living in old age home and within family setup

• R. Panday , M. Kiran , +1 author Saurav Kumar
• Published 2015
• Open Journal of Psychiatry and Allied Sciences

Tables from this paper

21 Citations

Impact of quality of life between old age homes and family households in geriatric population, original research article assessing the quality of life of elderly people in different settings of chitwan district, nepal, a comparative study of health status and quality of life of elderly people living in old age homes and within family setup in raigad district, maharashtra, quality of life and geriatric depression among elderly residents in old age homes and domestic environments in kerala., psychiatric morbidity, quality of life, and perceived social support among elderly population: a community-based study, determinants of quality of life among the elderly population in urban areas of mangalore, karnataka, health related quality of life among rural elderly using whoqol-bref in the most backward district of india, health related quality of life of home dwelling vs. nursing facility dwelling elderly - a cross-sectional study from karachi, pakistan., physical activity levels among community dwelling and care home dwelling elderly population, efficacy of psychosocial care training programme for the staff working in old age homes, 12 references, physical needs and adjustments made by the elderly, comparison between elderly chinese living alone and those living with others, quality of life of elderly men and women in institutional and non- institutional settings in urban bangalore district, cognitive status of persons under guardianship living in a social welfare institution, the association between activity and wellbeing in later life: what really matters, quality of life and attitudes to ageing in turkish older adults at old people's homes, whoqol-hindi: a questionnaire for assessing quality of life in health care settings in india. world health organization quality of life., related papers.

Showing 1 through 3 of 0 Related Papers

• Get new issue alerts Get alerts
• Submit a Manuscript

Secondary Logo

Journal logo.

Colleague's E-mail is Invalid

Your message has been successfully sent to your colleague.

Save my selection

Quality of life (QOL) among older persons in an urban and rural area of Bangalore, South India

Krishnappa, Lalitha; Gadicherla, Suman; Chidambaram, Priyadarshini; Murthy, Nandagudi S.

Department of Community Medicine, MS Ramaiah Medical College, Bangalore, Karnataka, India

Address for correspondence: Dr. Priyadarshini Chidambaram, Department of Community Medicine, MS Ramaiah Medical College, MSR Nagar, MSRIT Post, Bangalore 560 054, Karnataka, India. E-mail: [email protected]

Received June 23, 2020

Received in revised form September 08, 2020

Accepted October 08, 2020

Introduction: 

The increasing ageing population of India has unique challenges due to changing social structure, health issues and inaccessible healthcare facilities. These challenges can adversely affect the quality of life (QOL) of older persons. Hence, this study was undertaken with the objective of assessing the QOL among older persons in an urban and rural area of Bangalore.

Materials and Methods: 

Cross-sectional study was done among 977 older persons 60 years and above. Census enumeration blocks in urban areas and villages in rural areas were randomly selected and all older persons meeting the inclusion criteria were administered the WHOQOL-Bref questionnaire.

Results: 

Mean QOL scores (SD) in the physical, psychological, social relationship and environmental domains were 50.5 (5.5), 49.2 (5.5), 49.4 (6.5) and 49.3 (5.1) in rural areas and 57.4 (8.9), 58.6 (8.8), 64.6 (10.8) and 60.0 (9.4) in urban areas, respectively. Compared to urban, rural older persons uniformly have lower QOL irrespective of sex, education or financial dependence.

Conclusion: 

Inequitable health resource distribution and inadequate social support systems must be addressed to improve the QOL of older persons, especially in rural areas. Primary care providing essential services can bridge this urban–rural divide and improve QOL of older persons.

Introduction

Ageing population is a global phenomenon due to increasing survival and life expectancy. India has the second largest population of older persons in the world and the proportion of older persons and is projected to increase from 8% in 2015 to 19% by 2050.[ 1 ] The longer life expectancies have not necessarily translated to healthy ageing and the older population is plagued by unique challenges in accessing health care.[ 2 ] The health resources in India and access to it are also inequitably distributed and more urban biased making rural older persons face greater restrictions in access to health care.[ 2 3 ] The changing social structure and existing health systems perpetuate the challenges faced by older persons and may adversely affect their quality of life (QOL).

QOL is an individual's perceptions of their life position in context of the society and culture they live in.[ 4 ] QOL of older persons should not decline simply because of ageing. A good QOL could mean that the older population is ageing healthily and positively. It could mean that the older persons perceive a low risk of disease and disability, high mental and physical function and active engagement with life.[ 5 ] Hence, it is important to study the QOL and the factors that affect QOL among older persons in urban and rural areas. Hence, this study was undertaken with the objective of assessing the QOL among older persons in an urban and rural area of Bangalore, South India.

Materials and Methods

The study was a cross-sectional study conducted in urban and rural field practice areas of a tertiary medical college hospital in 2017. The study was part of a larger study assessing disabilities among older persons in urban and rural Bangalore. The rural part of the study was conducted at Aradeshnahalli Primary Health Centre area of rural Bangalore with a population of approximately 11,000 in 19 villages. The urban area was Mathikere health centre area of urban Bangalore consisting of 89,000 population in 120 census enumeration blocks (CEBs). The study included all older persons 60 years and above residing for a minimum of 6 months in the study area and excluded those who were not willing to be examined or those not present in their homes even after three home visits.

The original study of which this study is a part had a minimum sample size of 963 older persons from 6500 urban and 6500 rural population. In a study by Usha and Lalitha conducted at Kottayam, South India,[ 6 ] it was found that the mean QOL scores among study participants in rural area were 12.21 (1.88) and in urban area were 13.09 (1.65). In the present study, considering a mean difference of 0.4 in QOL, power of 80% and α error of 1%, the minimum sample size was calculated to be 458 in each area. The minimum sample size needed for this study was met in the original study. Based on older persons' proportion of 8% as per SRS 2011,[ 7 ] it was necessary to cover 5,725 population in rural and urban areas to reach 916 older persons. To cover the required population in Mathikere and Aradeshnahalli, 9 CEBs and 11 villages were randomly selected, respectively, and covered entirely. The final number of older persons covered in the house-to-house survey was 977 [ Figure 1 ].

Ethical clearance was obtained from MS Ramaiah Medical College Ethics Committee (ECR/215/Inst/Ker/2013 dated 12.09.2015). A training manual was developed which explained the operational aspects of the study. Medicosocial workers (MSW) were trained with the help of the manual and for collection of data from the field and posted in ophthalmology, ENT and orthopaedics outpatient departments to train under specialists for clinical examination. House-to-house survey was conducted and all older persons who met the inclusion criteria were included in the study. Following written informed consent of the older persons, a semistructured questionnaire was administered to collect demographic details and WHOQOL-Bref with 26 questions in 4 domains to collect details on QOL. Older persons were examined for locomotor, visual, hearing, speech and mental disabilities. Older persons diagnosed with disability were referred to the tertiary medical college hospital or nearest health centre for services.

Statistical analysis

Data were entered in an MS Excel sheet and analysed using SPSS v18. QOL was calculated in four domains—physical, psychological, social relationships and environmental domain based on the WHO scoring system.[ 4 ] The scores have been represented as mean and standard deviation (SD). Data were checked for normality using Kolmogorov–Smirnov test and since the QOL scores were not normally distributed, Mann–Whitney U test has been used to test for significance in median score. P value of 0.05 has been considered for statistical significance. The median scores in each domain were also calculated and median score was used as cut-off score to classify good and poor QOL. Univariate analysis and forward logistic regression were done to find the determinants of QOL in rural and urban areas.

Among the 977 older persons, 540 (55.2%) were females. The age distribution was significantly different with 322 (65.1%) in the 60–69 and 37 (7.5%) in the ≥80 years age group in urban areas compared to 245 (50.8%) and 37 (18.5%) in rural areas. Twenty-seven per cent (130) of rural older persons were currently employed in rural areas compared to 17.8% (88) in urban areas. However, 8.9% (43) older persons in rural areas were independent financially compared to 18.4% (91) in urban older persons [ Table 1 ].

The mean QOL scores (SD) in the physical, psychological, social relationship and environmental domains were 50.5 (5.5), 49.2 (5.5), 49.4 (6.5) and 49.3 (5.1) in rural areas and 57.4 (8.9), 58.6 (8.8), 64.6 (10.8) and 60.0 (9.4) in urban areas, respectively. The urban males had the highest QOL scores in all domains and rural females had the lowest QOL scores in all domains except in the psychological domain where they scored marginally more than their male counterparts [ Table 2 ]. Using Mann–Whitney U test, P value was <0.001 in all domains when comparing overall QOL scores between rural and urban areas.

The median score in each of the domains was 52.6, 53.3, 53.3 and 54.0. All those with scores less than the median scores were considered to have poor QOL scores and those above median scores were considered to have good QOL scores.

Living alone was significantly associated with poor QOL scores in the physical and social relationship domain in the rural areas. Being disabled and unemployed was associated significantly with poor QOL scores in the psychological and environmental domain, respectively [ Table 3 ]. In urban areas, being female, not literate and financially dependent were associated with poor QOL score in the physical domain. The above factors along with current occupational status were significantly associated with QOL scores in the psychological, social relationships and environmental domains. However, being currently unemployed had lesser odds of having a poor QOL score in the above three domains in the urban area [Tables 4 and 5 ].

Various studies have used various questionnaires to measure QOL of older individuals. QOL has been shown in various studied be dependent on factors that are both clinical and behavioural.[ 8 ] The study of QOL assumes importance in that it provides the perspective of the patient. Whilst physicians may assume that treatment provided is sufficient, QOL indicates how the patient feels about the management. This can help provide services that are tailored to the needs of individuals to make their QOL better. Assessing an individual's QOL reflects the effects of disease and health interventions had on them.

The mean scores were higher for the urban older persons in all domains with highest score observed in social relationships domain (64.58). The lowest score was in the psychological domain of the rural older persons (49.22).

In various studies conducted across India, the QOL domain scores of older persons are varied. Social domain scores tend to be low in most of the reported studies except for a couple of studies from rural Tripura (67.32 ± 15.3) and rural Tamil Nadu (56.6 ± 19.5).[ 6 9 10 11 12 13 14 15 ] All studies excepting studies done in urban Gujarat (64.9 ± 17.0) and urban Karnataka (63.5 ± 12.2) have revealed poor scores in the physical health domain of older persons.[ 12 14 ] In the current study, older persons in rural areas have poor QOL physically compared to the urban population. This is expected as older persons suffer from a number of chronic ailments and morbidities and their lesser than optimal health is seen as leading to poor QOL among them.

The psychological domain scores are consistently low in studies. In the current study, the psychological domain score was better off in the urban older persons but was poor in rural older persons much like the above studies.[ 6 9 11 13 15 ] This shows that the psychological domain is an oft-neglected area in the health of the ageing population and services catering to mental health of elderly are minimal or absent.

A study conducted in Kottayam has shown that urban older populations have better QOL in all domains excepting the social domain than the rural older population.[ 6 ] The better scores for the urban older population seen in rural urban comparative studies and the current study indicate that there are better services available and accessible to urban population leaving the rural relatively disadvantaged.

Community-dwelling older persons tend to have better QOL compared to those residing in old age homes; however, there are two contradictory studies one from urban Lucknow showing poor QOL among inmates and one from Kolkata interestingly showing better QOL among OAH inmates.[ 15 16 ] The QOL scores among the community-dwelling older persons of Lucknow were still lesser compared to the urban older persons in the current study. From the Kolkata study, we can possibly infer that training voluntary community individuals to provide assistance for elderly at home where caregiver support is absent may help improve QOL.

The above evidences show that QOL assessment and scores are widely varying even across the country and QOL is a reflection of the circumstances and is very contextual. Hence, it enables customization of services that serve the population best.

Determinants of QOL among older persons

In the current study, it can be seen that sex, education, occupation and financial dependence were significantly associated with QOL in urban older persons. However, the current study has not found many significant factors for QOL scores among rural older persons.

Most studies have not studied the factors and predictors which affect QOL among older persons. The commonest factors emerging as strong predictors for QOL are financial dependency of the individual, educational status, socio-economic status, presence of health problems and comorbidities, sex and age of the individual.[ 9 11 12 14 15 17 18 ] A study in Portugal has shown that socio-economic position of an older person and the presence or absence of social support are important in determining their QOL.[ 19 ] The presence of physical ailments has considerable negative impact on the QOL; however, increasing ability to socially mobilize and actively participate in community activities improves the QOL of older persons.[ 20 ]

Similar results have also been observed in the current study among the urban older population. It shows that older people tend to have better QOL when they feel financially secure and have a good social support system. Good working pension systems in place for older people will provide them with more confidence and improve their QOL. As older persons tend to age, their physical QOL tends to deteriorate and this gives a good indication to the more equitable services needed to be provided as people age. Women tend to report lesser QOL which again shows that even as women age they remain neglected. This shows that women continue to be vulnerable and gender-sensitive policies and services are a must even for the aged.

Compared to urban, rural older persons uniformly have lower QOL irrespective of whether they are male or female, educated or not and whether they are financially dependent or not. This shows that just belonging to a rural area is associated with poor QOL among older persons. Rural areas have inequitable resource distribution and strengthening resource allocation and support like primary healthcare and old age pension schemes could improve QOL among rural older adults. Provision of community centres for rest and recreation of older persons may also serve to improve their QOL. The government must ensure that public health facilities, which provide all encompassing primary care services, are present. The public health infrastructure with emphasis on sustained care through primary care practitioners who can provide not only curative but also promotive, preventive and rehabilitative services must be built. All older persons coming to the healthcare facilities must be screened using a QOL tool to see if their QOL has improved with the interventions provided.

The strength of the study lies in the community-based setting where it was conducted and also the large sample size it has covered. The study area was also the field practice area of the medical college, and hence, there was good rapport with the community. There could have been possible information bias as both areas employed different MSWs for data collection in urban and rural areas. However, the MSWs were adequately trained before data collection and the investigators closely supervised the MSWs and cross-checked and validated 5% of the data collected in the field. The study results are context specific and can be limitedly generalized to similar settings because appropriate sampling methods have been followed.

The QOL of older persons in rural areas is significantly lower in rural areas compared to urban areas and factors such as sex, education, occupation and financial dependence were significantly associated with QOL of urban older persons. Rural older persons had considerably poor QOL irrespective of most factors. Healthcare and social support services in rural areas for older persons need to be improved to improve their QOL. The determinants of QOL seem to vary in urban and rural areas and further studies are required to study the reasons for these differences.

Financial support and sponsorship

The authors disclose receipt of the following financial support for the research: This work was supported by the Rajiv Gandhi University of Health Sciences, Karnataka [grant number M-55:2015-16 dt: 05.01.2016].

Conflicts of interest

There are no conflicts of interest.

• Cited Here |
• Google Scholar
• View Full Text | PubMed | CrossRef |

Ageing; elderly; older adults; WHOQOL-Bref

• + Favorites
• View in Gallery

Readers Of this Article Also Read

An epidemiological study on quality of life among elderly in an urban area of..., determinants of quality of life of geriatric population in rural block of..., study on morbidity pattern among elderly in urban area of barpeta, assam, india, smartphone use and the quality of life of medical students in the kumaun..., a study of morbidity profile among geriatric population in uttarakhand: a....

Modelling retirement resources, home environment and quality of marriage for greater well-being

• Original Research
• Published: 02 September 2024

Cite this article

• Mary Pang 1 ,
• Ming-Ming Lai   ORCID: orcid.org/0000-0002-7102-7062 2 ,
• Lee-Lee Chong   ORCID: orcid.org/0000-0003-0041-7829 2 ,
• Yvonne Lee   ORCID: orcid.org/0000-0002-8584-256X 2 &
• Siok-Hwa Lau 3  

To retire comfortably with one’s well-being ensured is a common goal. The transition to retirement potentially introduces a destabilising element towards one’s financial, health, emotional, cognitive, motivational, and social resources. This paper examines the relationships between these components of the retirement resources inventory, home environment, quality marriage and subjective well-being which consists of life satisfaction, positive affect, negative affect and happiness elements. The study utilized the purposive sampling method where questionnaires were administered to 650 retirees at senior activity centers with high memberships and at states with high old-age dependency ratios. The respondents’ demographics reflect Malaysia’s ethnic composition, with half of them with secondary education. The constructs were developed using exploratory factor analysis and further confirmed through structural equation modelling (partial least squares). Analysis indicates that all seven retirement resources significantly contribute to retirees’ subjective well-being. Retirees’ subjective well-being is strongly related to having a home environment that is elderly friendly. Quality marriage mediates the relationship between retirement resources inventory and subjective well-being, as marriages mean more financial and social resources are pooled together in addition to the positive emotions that exist in the union. The findings implied that relevant authorities should increase institutional and public awareness of the urgency for future retirees to prepare, maintain as well as gain these retirement resources before they reach retirement age. This allows for the retired population to better cope with challenges brought by ageing and old age as Malaysia moves rapidly towards becoming an aged nation by the year 2044.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save.

• Get 10 units per month
• Download Article/Chapter or eBook
• 1 Unit = 1 Article or 1 Chapter
• Cancel anytime

Price includes VAT (Russian Federation)

Instant access to the full article PDF.

Rent this article via DeepDyve

Institutional subscriptions

Similar content being viewed by others

Health, financial and social resources as mediators to the relationship between planning and satisfaction in retirement

How older adults fulfill their retirement plans relates to positive mental health: a path model analysis of social activity and self-esteem

Multidimensional Retirement Planning Behaviors, Retirement Confidence, and Post-Retirement Health and Well-Being Among Chinese Older Adults in Hong Kong

Explore related subjects.

• Medical Ethics

Data Availability

The data can be found at figshare with DOI 10.6084/m9.figshare.14872179. The web link to the file is: 10.6084/m9.figshare.14872179.

As mentioned earlier, our previous study (Pang et al., 2020 ) explored the psychological well-being of retirees utilising an improved psychological well-being measure by Ryff and Keyes ( 1995 ). Our study evaluated the dimensions of psychological well-being among Malaysian retirees through in-depth interviews with fifty retirees from seven states in West Malaysia. The interviews then underwent thematic analysis using NVivo software, which concluded that the cohort’s responses during their respective interviews were in concurrence with the Theory of Self-Determination as well as Ryff and Keyes ( 1995 )’s improved measure of psychological well-being.

Adedeji, A., Olonisakin, T.T., Buchcik, J, & Idemudia, E.S. (2023). Socioeconomic status and social capital as predictors of happiness: evidence and gender difference. Humanities and Social Sciences Communications, 10 (119). https://doi.org/10.1057/s41599-023-01606-0

Allianz Research. (2023). Allianz Global Pension Report 2023 . Retrieved April 21, 2023, from https://www.allianz.com/content/dam/onemarketing/azcom/Allianz_com/economic-research/publications/specials/en/2023/april/2023-04-19-PensionReport.pdf

Asante, S., & Karikari, G. (2022). Social relationships and the health of older adults: An examination of social connectedness and perceived social support. Journal of Ageing and Longevity, 2 , 49–62. https://doi.org/10.3390/jal2010005

Article   Google Scholar  

Asian Development Bank. (2023). Malaysia Ageing and Retirement Survey Wave 2 (2021–2022): Survey Report. Retrieved September 6, 2023, from https://doi.org/10.22617/TCS230314-2

Aziz, A. (2023). Cost of living issues to persist even as growth moderates. Available via The Edge . Retrieved September 6, 2023, from https://theedgemalaysia.com/node/649873

Baily, N., Martinent, G., Ferrand, C., Gana, K., Joulain, M., & Maintier, C. (2016). Tenacious goal pursuit and flexible goal adjustment in older people over 5 years: A latent profile transition analysis. Age and Ageing, 45 , 287–292. https://doi.org/10.1093/ageing/afv203

Baltes, M. M., Maas, I., Wilms, H.-U., & Borchelt, M. (1999). Everyday competence in old and very old age: Theoretical considerations and empirical findings. In P. B. Baltes & K. U. Mayer (Eds.), The Berlin Aging Study: Aging from 70 to 100 (pp. 384–402). Cambridge University Press.

Google Scholar  

Becker, C., Kirchmaier, I., & Trautman, S. T. (2019). Marriage, parenthood and social network: Subjective well-being and mental health in old age. PLoS ONE, 14 (7), e0218704. https://doi.org/10.1371/journal.pone.0218704

Becker, G. S. (1973). A Theory of Marriage: Part I. Journal of Political Economy , 81 (4), 813–846. https://www.jstor.org/stable/1831130

Bowling, A., & Gabriel, Z. (2004). An integrational model of quality of life in older age. Results from the ESRC/MRC HSRC quality of life survey in Britain. Social Indicators Research, 69 , 1–36. https://doi.org/10.1023/B:SOCI.0000032656.01524.07

Bronfenbrenner, U. (1977). Toward an experimental ecology of human development. American Psychologist . https://doi.org/10.1037/0003-066X.32.7.513

Cabello, R., Sorrel, M. A., Fernández-Pinto, I., Extremera, N., & Fernández-Berrocal, P. (2016). Age and gender differences in ability emotional intelligence in adults: A cross-sectional study. Developmental Psychology, 52 (9), 1486–1492. https://doi.org/10.1037/dev0000191

Campbell, I. A., Converse, P. E., & Rodgers, W. L. (1976). The quality of American life . Russell Sage Foundation.

Carr, D., Cornman, J. C., & Freedman, V. A. (2016). Marital quality and negative experienced well-being: An assessment of actor and partner effects among older married persons. Journals of Gerontology: Social Sciences, 71 (1), 177–187. https://doi.org/10.1093/geronb/gbv073

Chen, Y., Hicks, A., & While, A. E. (2014). Loneliness and social support of older people living alone in a county of Shanghai, China. Health and Social Care in the Community, 22 , 429–438. https://doi.org/10.1111/hsc.12099

Chung, H. (2023). Malaysia’s pension system gets below average rating in Allianz's global report. The Edge. Retrieved April 21, 2023, from https://www.theedgemarkets.com/node/664279

Cornwell, E. Y., & Waite, L. J. (2009). Social Disconnectedness, Perceived Isolation, and Health among Older Adults. Journal of Health and Social Behavior, 50 (1), 31–48. https://doi.org/10.1177/002214650905000103

Dause, T. J., & Kirby, E. D. (2020). Aging gracefully: Social engagement joins exercise and enrichment as a key lifestyle factor in resistance to age-relate cognitive decline. Neural Regeneration Research, 14 (1), 39–42. https://doi.org/10.4103/1673-5374.243698

Delhom, I., Satorres, E., & Meléndez, J. C. (2020). Can we improve emotional skills in older adults? Emotional intelligence, life satisfaction and resilience. Psychosocial Intervention, 29 (3), 133–139. https://doi.org/10.5093/pi2020a8

Department of Social Welfare Malaysia (2017 ). National senior citizen policy . Retrieved March 6, 2023, from https://www.jkm.gov.my/jkm=portal/left&id=WjFUdFBURTV0Zis0N0NxYm05Qk9XQT09

Diener, E. (1984). Subjective well-being. Psychological Bulletin, 95 (3), 542–575. https://doi.org/10.1037/0033-2909.95.3.542

Diener, E., & Biswas-Diener, R. (2002). Will Money Increase Subjective Well-Being? Social Indicators Research, 57 (2), 119–169. https://doi.org/10.1023/A:1014411319119

Diener, E., & Fujita, F. (1995). Resources, personal strivings, and subjective well-being: A nomothetic and idiographic approach. Journal of Personality and Social Psychology, 68 (5), 926–935. https://doi.org/10.1037/0022-3514.68.5.926

Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The Satisfaction With Life Scale. Journal of Personality Assessment, 49 (1), 71–75. https://doi.org/10.1207/s15327752jpa4901_13

Diener, E., Suh, E. M., Lucas, R. E., & Smith, H. L. (1999). Subjective well-being: Three decades of progress. Psychological Bulletin, 125 (2), 276–302. https://doi.org/10.1037/0033-2909.125.2.276

Diener, E., Gohm, C. L., Suh, E., & Oishi, S. (2000). Similarity of the Relations between Marital Status and Subjective Well-Being Across Cultures. Journal of Cross-Cultural Psychology, 31 (4), 419–436. https://doi.org/10.1177/0022022100031004001

Diener, E., Tay, L., & Oishi, S. (2013). Rising income and the subjective well-being of nations. Journal of Personality and Social Psychology, 104 (2), 267–276. https://doi.org/10.1037/a0030487

Diener, E., Oishi, S., & Tay, L. (2018b). Advances in subjective well-being research. Nature Human Behaviour, 2 (4), 253–260. https://doi.org/10.1038/s41562-018-0307-6

Diener, E., Lucas, R. E., & Oishi, S. (2018). Advances and Open Questions in the Science of Subjective Well-Being. Collabra: Psychology , 4 (1), 15. https://doi.org/10.1525/collabra.115

Erickson, E., Wejaker, M., Danhard, A., Nilsson, A., & Kristofferzon, M. L. (2019). Living with a spouse with chronic illness – the challenge of balancing demands and resources. BMC Public Health, 19 , 422. https://doi.org/10.1186/s12889-019-6800-7

Eriksson, E., Wazinski, K., Wanka, A., Kylén, M., Oswald, F., Slaug, B., Iwarsson, S., & Schmidt, S. M. (2022). Perceived Housing in Relation to retirement and relocation: A qualitative interview study among older Adults. International Journal of Environmental Research and Public Health, 19 , 13314. https://doi.org/10.3390/ijerph192013314

Fiori, K. L., McIlvane, K. M., Brown, K. K., & Antonucci, T. C. (2006). Social relations and depressive symptomatology: Self- efficacy as a mediator. Aging & Mental Health, 10 , 227–239. https://doi.org/10.1037/0882-7974.12.1.189

Fornell, C., & Larcker, D. F. (1981). Evaluating Structural Equation Models with unobservable variables and measurement error. Journal of Marketing Research, 18 (1), 39–50. https://doi.org/10.1177/002224378101800104

Garand, L., Dew, M. A., Urda, B., Lingler, J. H., DeKosky, S. T., & Reynolds, C. F. (2007). Marital quality in the context of mild cognitive impairment. Western Journal of Nursing Research, 29 (8), 976–992. https://doi.org/10.1177/0193945907303086

Gobbens, R. J. J., & Assen, M. A. L. M. (2017). Associations of environmental factors with quality of life in older adults. The Gerontologist, 58 (1), 101–110. https://doi.org/10.1093/geront/gnx051

Halid, S. (2023). 71 pct of EPF contributors aged 55 and below do not have enough to rise above poverty level. Available via New Straits Times. Retrieved September 6, 2023, from https://www.nst.com.my/news/nation/2023/02/882811/71-pct-epf-contributors-aged-55-and-below-do-not-have-enough-rise-above

Han, C.-K., & Hong, S.-I. (2011). Assets and Life Satisfaction Patterns Among Korean Older Adults: Latent Class Analysis. Social Indicators Research, 100 (2), 225–240. https://doi.org/10.1007/s11205-010-9613-8

Han, S. J., Koh, S., & Scollon, C. N. (2015). Subjective wellbeing and culture. In J. D. Wright (Ed.), International encyclopedia of the social & behavioral sciences (2nd ed., pp. 643–647). Elsevier. https://doi.org/10.1016/B978-0-08-097086-8.25095-2

Chapter   Google Scholar  

Hansson, I., Buratti, S., Thorvaldsson, V., Johansson, B., & Berg, A. I. (2020). Disentangling the Mechanisms of Retirement Adjustment: Determinants and Consequences of Subjective Well-Being. Work, Aging & Retirement, 6 (2), 71–87. https://doi.org/10.1093/workar/waz021

Hardie, J. H., & Lucas, A. (2010). Economic factors and relationship quality among young couples: Comparing cohabitation and marriage. Journal of Marriage & Family, 72 (5), 1141–1154. https://doi.org/10.1111/j.1741-3737.2010.00755.x

Hasan, A.A, & Ambrammal, S.K. (2022). Healthcare system: Policies and performance in India and ASEAN countries. International Journal of Health Sciences , 9960–9980. https://doi.org/10.53730/ijhs.v6nS4.10877

Heaven, B., O’Brien, N., Evans, E. H., White, M., Meyer, T. D., Mathers, J. C., & Moffatt, S. (2016). Mobilizing Resources for Well-being: Implications for Developing Interventions in the Retirement Transition. The Gerontologist, 56 (4), 615–629. https://doi.org/10.1093/geront/gnu159

Hobfoll, S. E. (1988). The ecology of stress . Hemisphere.

Hobfoll, S. E. (1989). Conservation of resources: A new attempt at conceptualizing stress. American Psychologist, 44 (3), 513–524. https://doi.org/10.1037/0003-066X.44.3.513

Hobfoll, S. E., & Freedy, J. (1993). Conservation of resources: A general stress theory applied to burnout. In W. B. Schaufeli, M. Tadeusz, C. Maslach, & T. Marek (Eds.), Professional burnout (1st ed., pp. 115–130). Routledge. https://doi.org/10.4324/9781315227979

Holmgreen, L., Tirone, V., Gerhart, J., & Hobfoll, S. E. (2017). Conservation of resources theory. In C. L. Cooper & J. C. Quick (Eds.), The handbook of stress and health (pp. 443–457). John Wiley & Sons, Ltd. https://doi.org/10.1002/9781118993811.ch27

Hong, S. L., & Han, C. K. (2013). Asset impacts on life satisfaction in an Asset-Rich Country: Focusing on Older Adults in Singapore. Social Indicators Research . https://doi.org/10.1007/s11205-013-0410-z

Hu, L. T., & Bentler, P. M. (1998). Fit indices in covariance structure modelling: Sensitivity to under parameterized model misspecification. Psychological Methods, 3 (4), 424–453. https://doi.org/10.1037/1082-989X.3.4.424

Jabatan Kebajikan Masyarakat (JKM). (2017). Dasar Warga Emas Negara [Government] . Portal Rasmi Jabatan Kebajikan Masyarakat. https://www.jkm.gov.my/jkm/index.php?r=portal/left&id=WjFUdFBURTV0Zis0N0NxYm05Qk9XQT09

Jaques, E. (1965). Death and mid-life crisis. The International Journal of Psychoanalysis, 46 (4), 502–514.

Joshanloo, M. (2018). Longitudinal associations between subjective and psychological well-being in Japan: A four-year cross-lagged panel study. Personality and Individual Differences, 134 , 289–292. https://doi.org/10.1016/j.paid.2018.06.033

Joshanloo, M. (2019). Investigating the relationships between subjective well-being and psychological well-being over two decades. Emotion, 19 (1), 183–187. https://doi.org/10.1037/emo0000414

Keyes, C. L. M., Shmotkin, D., & Ryff, C. D. (2002). Optimizing well-being: The empirical encounter of two traditions. Journal of Personality and Social Psychology, 82 (6), 1007–1022. https://doi.org/10.1037/0022-3514.82.6.1007

Kim, J. E., & Moen, P. (2002). Retirement Transitions, Gender, and Psychological Well-Being: A Life-Course, Ecological Model. The Journals of Gerontology: Series B, 57 (3), P212–P222. https://doi.org/10.1093/geronb/57.3.P212

Krueger, A. B., & Stone, A. A. (2013). Subjective Well-Being: Measuring Happiness, Suffering, and Other Dimensions of Experience (p. 18548). National Academies Press. https://doi.org/10.17226/18548

La Rue, C. J., Haslam, C., & Steffens, N. K. (2022). A meta-analysis of retirement adjustment predictors. Journal of Vocational Behavior, 136 , 103723. https://doi.org/10.1016/j.jvb.2022.103723

Lai, D. W. L., Ruan, Y.-X., Wang, J. J., Liu, E. H. S., & Zhou, J.-J. (2023). Experience of Chinese Recent Retirees on the Effects of Retirement on Healthy Ageing in Shenzhen and Hong Kong. International Journal of Environmental Research and Public Health, 20 (4), 4. https://doi.org/10.3390/ijerph20042820

Langer, N. (2020). Introduction: Reinventing retirement. Educational Gerontology, 46 (11), 667. https://doi.org/10.1080/03601277.2020.1806510

Lavalekar, A., Julkarni, P., & Jagtap, P. (2015). Emotional intelligence and marital satisfaction. Journal of Psychosocial Research, 5 (2), 185–194. https://www.proquest.com/scholarly-journals/emotional-intelligence-marital-satisfaction/docview/862714042/se-2?accountid=28110 .

Lawton, M.P., & Nahemow, L. (1973). Ecology and the aging process. In Eisdorfer C. & Lawton, M.P. (Eds.), The psychology of adult development and aging , pp. 619–674. American Psychologist . https://doi.org/10.1037/10044-020

Lee, R. M., & Robbins, S. B. (1995). Measuring belongingness: The social connectedness and social assurance scales. Journal of Counseling Psychology, 42 (2), 232–241. https://doi.org/10.1037/0022-0167.42.2.232

Leung, C. S. Y., & Earl, J. K. (2012). Retirement Resources Inventory: Construction, factor structure and psychometric properties. Journal of Vocational Behavior, 81 (2), 171–182. https://doi.org/10.1016/j.jvb.2012.06.005

Levine, D. A., Gross, A. L., Briceño, E. M., Tilton, N., Giordani, B. J., Sussman, J. B., Hayward, R. A., Burke, J. F., Hingtgen, S., Elkind, M. S. V., Manly, J. J., Gottesman, R. F., Gaskin, D. J., Sidney, S., Sacco, R. L., Tom, S. E., Wright, C. B., Yaffe, K., & Galecki, A. T. (2021). Sex Differences in Cognitive Decline Among US Adults. JAMA Network, 4 (2), e210169. https://doi.org/10.1001/jamanetworkopen.2021.0169

Lewis, R. A., & Spanier, G. B. (1979). Theorizing about the quality and stability of marriage. In W. R. Burr, R. Hill, F. I. Nye, & I. L. Reiss (Eds.), Contemporary theories about the family (Vol. 1, pp. 259–268). The Free Press.

Lyubomirsky, S., & Lepper, H. S. (1999). A measure of subjective happiness: Preliminary reliability and construct validation. Social Indicators Research, 46 (2), 137–155. https://doi.org/10.1023/A:1006824100041

Maher, J., Pincus, P. A. L., Ram, N., & Conroy, D. E. (2015). Daily physical activity and life satisfaction across adulthood. Development Psychology, 51 (10), 1407–1419. https://doi.org/10.1037/dev0000037

Mayordomo, T., Viguer, P., Sales, A, Satorres E., & Meléndez, J.C. (2016). Resilience and coping as predictors of well-being in adults. The Journal of Psychology, 150, 809–821 measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology , 54(6), 1063–1070. https://doi.org/10.1080/00223980.2016.1203276

Meng, A., Nexo, M. A., & Borg, V. (2017). The impact of retirement on age related cognitive decline-a systematic review. BMC Geriatrics, 17 , 160. https://doi.org/10.1186/s12877-017-0556-7

Molinsky, J., & Forsyth, A. (2018). Housing, the built environment, and the good life. Hastings center report, 48 , S50–S56. https://doi.org/10.1002/hast.914

Moore, S., & Diener, E. (2019). Types of subjective well-being and their associations with relationship outcomes. Journal of Positive Psychology and Wellbeing, 3 (2), 112–118. https://journalppw.com/index.php/jppw/article/view/34/32 .

Morgan, T., Wiles, J., Park, H.-J., Moeke-Maxwell, T., Dewes, O., Black, S., Williams, L., & Gott, M. (2019). Social connectedness: What matters to older people? Ageing and Society, 41 (5), 1126–1144. https://doi.org/10.1017/S0144686X1900165X

Mustaffa, N., Lee, S.-Y., Mohd Nawi, S. N., Che Rahim, M. J., Chee, Y. C., Muhd Besari, A., & Lee, Y. Y. (2020). COVID-19 in the elderly: A Malaysian perspective. Journal of Global Health, 10 (2), 1–4. https://doi.org/10.7189/jogh.10.020370

Norton, R. (1983). Measuring marital quality: A critical look at the dependent variable. Journal of Marriage and Family, 45 (1), 141–151. https://doi.org/10.2307/351302

Oswald, F., & Wahl, H.-W. (2004). Housing and health in later life. Reviews on Environmental Health, 19 (3–4), 223–252. https://doi.org/10.1515/reveh-2004-19-3-405

Pang, M., Lai, M. M., & Chong, L. L. (2020). Psychological Well-Being is Essential to Well- Being: Malaysia Evidence. International Journal of Psychosocial Rehabilitation, 24 (6), 1475–7192. https://www.psychosocial.com/article/PR261045/23296 .

Perelli-Harris, B., Hoherz, S., Lappegård, T., & Evans, A. (2019). Mind the “Happiness” Gap: The Relationship Between Cohabitation, Marriage, and Subjective Well-being in the United Kingdom, Australia, Germany, and Norway. Demography, 56 (4), 1219–1246. https://doi.org/10.1007/s13524-019-00792-4

Rohwedder, S., & Willis, R. J. (2010). Mental Retirement. The Journal of Economic Perspectives, 24 (1), 119–138. https://doi.org/10.1257/jep.24.1.119

Rook, K. S., & Charles, S. T. (2017). Close social ties and health in later life: Strengths and vulnerabilities. American Psychologist, 72 (6), 567–577. https://doi.org/10.1037/amp0000104

Russel, A., Bergeman, C. S., & Scott, S. B. (2012). Daily social exchanges and affect in middle and later adulthood: The impact of loneliness and age. International Journal of Aging and Human Development, 74 (4), 299–329. https://doi.org/10.2190/AG.74.4.c

Ryff, C. D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology, 57 (6), 1069–1081. https://doi.org/10.1037/0022-3514.57.6.1069

Ryff, C. D., & Keyes, C. L. M. (1995). The Structure of Psychological Well-Being Revisited. Journal of Personality and Social Psychology, 69 (4), 719–727. https://doi.org/10.1037/0022-3514.69.4.719

Saunders, M., Lewis, P., & Thornhill, A. (2009). Research methods for business students (5th ed.). Pearson Education.

Sekaran, U., & Bougie, R. (2013). Research methods for business: A skill-building approach (6th ed.). John Wiley & Sons Ltd.

Suanet, B., & Antonucci, T. C. (2017). Cohort differences in received social support in later life: The role of network type. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 72 (4), 706–715. https://doi.org/10.1093/geronb/gbw075

Swarts, T. T. (2009). Intergenerational family relations in adulthood: Patterns, variations, and implications in the contemporary United States. Annual Review of Sociology, 35 , 191–212. https://doi.org/10.1146/annurev.soc.34.040507.134615

Tan, T. H., & Idris, I. (2023). Assessing the significance of first place and online third places in supporting Malaysian seniors’ well-being during the pandemic. Humanities and Social Sciences Communications, 10 (149), 1–10. https://doi.org/10.1057/s41599-023-01655-5

Tejativaddhana, P., Chuakhamfoo, N. N., & Hue Vo, M. T. (2022). A review of the long-term care policies under COVID-19 in Thailand’s aging society: Implications for ASEAN countries. Public Administration and Policy, 25 (1), 37–49. https://doi.org/10.1108/PAP-02-2022-0013

The World Bank. (2020). A Silver Lining: Productive and inclusive aging for Malaysia. The World Bank. Retrieved 6 March, 2023, from https://www.worldbank.org/en/country/malaysia publication/a-silver-lining-productive-and-inclusive-aging-for-malaysia

Thomas, P. A., Liu, H., & Umberson, D. (2017). Family relationship and well-being. Innovation in Aging, 1 (3), igx025. https://doi.org/10.1093/geroni/igx025

Thomas, V. (2023). Allocate budget to support senior citizens. Retrieved March 6, 2023, from https://www.thesundaily.my/opinion/allocate-budget-to-support-senior-citizens-GA10671601

Toepoel, V. (2013). Ageing, leisure, and social connectedness: How could leisure help reduce social isolation of older people? Social Indicators Research, 113 , 355–372. https://doi.org/10.1007/s11205-012-0097-6

United Nations, Economic and Social Commission for Asia and the Pacific (ESCAP). (2022). Asia-pacific report on population ageing 2022 (T/ESCAP/3041). https://www.unescap.org/sites/default/d8files/knowledge-products/AP-Ageing-2022-report.pdf

United Nations Department of Economic and Social Affairs. (2015). World population prospects: The 2015 revision (working paper ESA/P/WP.241). United Nations. https://population.un.org/wpp/Publications/Files/Key_Findings_WPP_2015.pdf

Vallerand, R. J., & O’Connor, B. P. (1989). Motivation in the elderly: A theoretical framework and some promising findings. Canadian Psychology / Psychologie Canadienne, 30 (3), 538–550. https://doi.org/10.1037/h0079828

Van Orden, K. A., Bower, E., Lutz, J., Silva, C., Gallegos, A. M., Podgorski, C. A., Santos, E. J., & Conwell, Y. (2020). Strategies to promotes social connections among older adults during “social distancing” restrictions. The American Journal of Geriatric Psychiatry . https://doi.org/10.1016/j.jagp.2020.05.004

Wang, M., & Shultz, K. S. (2010). Employee retirement: A review and recommendations for future investigation. Journal of Management, 36 (1), 172–206. https://doi.org/10.1177/0149206309347957

Wang, M., Henkens, K., & Van Solinge, H. (2011). Retirement adjustment: A review of theoretical and empirical advancement. American Psychologist, 66 (3), 204–213. https://doi.org/10.1037/a0022414

Waterman, A. S. (1993). Two conceptions of happiness: Contrasts of personal expressiveness (eudaimonia) and hedonic enjoyment. Journal of Personality and Social Psychology, 64 (4), 678–691. https://doi.org/10.1037/0022-3514.64.4.678

Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54 (6), 1063–1070. https://doi.org/10.1037/0022-3514.54.6.1063

Yeong, U. V., Tan, S. Y., Yap, J. F., & Choo, W. Y. (2016). Prevalence of falls among community-dwelling elderly and its associated factors: A cross-sectional study in Perak Malaysia. Malaysian Family Physician, 11 (1), 7–14.

Zaidi, F. Z., Lai, M. M., Jumaat, A., & Lee, Y. (2023). Modelling Well-Being with mindfulness intervention on Bottom- and Middle-40% income earners in Malaysia. International Journal of Environmental Research and Public Health, 20 , 3480. https://doi.org/10.3390/ijerph20043480

Zayed, K. N., Ahmad, M. D., Niekerk, R. L. V., & Ho, W. K. Y. (2018). The mediating role of exercise behaviour on satisfaction with life, mental well-being and BMI among university employees. Cogent Psychology, 5 (1), 1430716. https://doi.org/10.1080/23311908.2018.1430716

Zhan, Y., Froidevaux, A., Li, Y., Wang, M., & Shi, J. (2023). Preretirement resources and postretirement life satisfaction change trajectory: Examining the mediating role of retiree experience during retirement transition phase. Journal of Applied Psychology, 108 (5), 871–888. https://doi.org/10.1037/apl0001043

Zhu, X., Luchetti, M., Aschwanden, D., Sesker, A. A., Stephan, Y., Sutin, A. R., & Terracciano, A. (2023). Multidimensional Assessment of Subjective Well-Being and Risk of Dementia: Findings from the UK Biobank Study. Journal of Happiness Studies, 24 (2), 629–650. https://doi.org/10.1007/s10902-022-00613-3

Download references

This research was funded by the Ministry of Higher Education (MoHE) Malaysia, [FRGS/1/2016/SS01/MMU/01/1].

Support was also obtained from the relevant government authorities that approved the researchers’ access to the government’s Senior Activity Center. The authors also extend their appreciation to all the participants of this study and to Multimedia University for all the support received.

Author information

Authors and affiliations.

Faculty of Business, Hospitability and Humanities, Nilai University, Persiaran University, Putra Nilai, 1, Persiaran Kolej BBN, 71800, Nilai, Negeri Sembilan, Malaysia

Faculty of Management, Multimedia University, Cyberjaya, Persiaran Multimedia, 63100, Cyberjaya, Selangor, Malaysia

Ming-Ming Lai, Lee-Lee Chong & Yvonne Lee

Faculty of Business, Multimedia University, Jalan Ayer Keroh Lama, Bukit Beruang, 75450, Melaka, Malaysia

Siok-Hwa Lau

You can also search for this author in PubMed   Google Scholar

Contributions

Conceptualization and Methodology: Mary Pang, Ming-Ming Lai; Implementation of study and Formal investigation: Mary Pang, Writing – original draft preparation: Mary Pang; Validation, Formal Analysis and Visualization: Mary Pang; Writing – review and editing: Yvonne Lee, Siok Hwa Lau; Funding Acquisition and Project Administration: Ming-Ming Lai, Resources: Mary Pang, Ming-Ming Lai; Supervision: Ming-Ming Lai, Lee-Lee Chong.

Corresponding author

Correspondence to Yvonne Lee .

Ethics declarations

This research received approval number of EA1812021 from the Research Ethics Committee of Multimedia University, Cyberjaya, Malaysia.

All participants were informed of the purpose of the study. The consent form assured the respondents of confidentiality and anonymity. The participants were also informed of the primary investigator’s contact information.

Competing Interests

The authors have no competing interests to declare that are relevant to the content of this article.

Consent for Publication

All parties involved agreed for the publication.

Additional information

Publisher's note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Pang, M., Lai, MM., Chong, LL. et al. Modelling retirement resources, home environment and quality of marriage for greater well-being. Applied Research Quality Life (2024). https://doi.org/10.1007/s11482-024-10366-1

Download citation

Received : 15 December 2023

Accepted : 19 August 2024

Published : 02 September 2024

DOI : https://doi.org/10.1007/s11482-024-10366-1

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Retirement resources
• Subjective well-being
• Quality marriage
• Home environment
• Find a journal
• Publish with us
• Track your research

Academia.edu no longer supports Internet Explorer.

To browse Academia.edu and the wider internet faster and more securely, please take a few seconds to  upgrade your browser .

Enter the email address you signed up with and we'll email you a reset link.

• We're Hiring!
• Help Center

Elderly Living in Old Age Homes-a study in some Old Age Homes of Manipur, India

Background: Old age was never seen as a problem in India. But recently ageing issues have begun to emerge as a case of social concern. Demographic, socioeconomic and structural challenges are also taking place within the family institutes. India is now facing a unique situation in providing care for the elderly section and old age homes is one of alternate care facilities. Thus studying elderly in old age homes has become a significant area of social research. Objectives: The study aims to examine the socioeconomic profile of elderly who are living in four old age homes in Manipur, India. It also probes into the factors that have compelled the elderly to stay in these institutions as well as examine the facilities available in the old age homes. Material and methods: The paper is based on the study conducted in different old age homes of Manipur by taking a sample of 69 institutionalized elderly. The data was collected using a specially designed interview schedule and observation technique. Results: The study reveals that majority of the respondents are females (75.36%) and are hailed from rural areas (66.66%). Regarding age distribution, more than half of the respondents (52.17%) are aged between 70-79 years and majority (69.56%) of them belongs to OBC category. Majority of them (76.81%) are widowed, follows Hindu Religion (66.66%), 55.07% of them are illiterate. 68.11% of them came from nuclear family and earlier doing business, followed by agriculture. The most common reasons for shifting to old age homes were verbal abuse of daughter in law, financial constraints , verbal abuse of son, nobody to look after, physical abuse, tarnishing self-respect, health issues and many more. Majority of the respondents are satisfied with the facilities provided by the institute but there are rooms for improvements in many ways.

Related Papers

shamsi akbar , Rakesh Tripathi , ambrish kumar

Background: Now-a-days, almost all the old age homes (OAHs) in India are fully occupied with residents. Why Indian elderly have to reside in old age homes? It was explored during the Ph.D. study titled „A Study of Psychiatric Morbidity, Quality of Life and Expectations of Inmates of Old Age Homes in Northern India‟. The object of this study was to explore the factors compelling elderly to reside in old age homes. Methods: This study was carried out on 174 elderly residing in 14 different OAHs of Uttar Pradesh, India. Factors responsible for their settlement in OAHs were explored using interview method. Results: Misbehaviour of son and daughters-in-law (29.8%) was found to be most common reasons for residing in old age home. Conclusions: Many elderly in India are opting OAHs as their place of stay in their later life. Foreseeing the future the government and voluntary agencies in India must make arrangements for institutional support and care for the elderly.

Manjunath S Mokashi

A study of factors compelling elderly to stay in old age home with special reference to Kundapur city old age homes Abstract Government endeavors are expanding quickly in the field of contemporary, social, financial, open interest and different components to lessen abuse against the old age people. However, in the present time, the circumstance against the old people is evolving,individuals have begun despised them, they strongly made them to move from their own particular homes. Because of this they get to be destitute and may move to old age homes. This article depends on the different requests of old age people.The object of this study was to explore the factors compelling elderly to reside in old age homes. This article has been taken from a old age homes of Kundapur city Udupi district.

International Journal of Indian Psychology

shamsi akbar

Background: Now-a-days, almost all the old age homes (OAHs) in India are fully occupied with residents. Why Indian elderly have to reside in old age homes? It was explored during the Ph.D. study titled ‘A Study of Psychiatric Morbidity, Quality of Life and Expectations of Inmates of Old Age Homes in Northern India’. The object of this study was to explore the factors compelling elderly to reside in old age homes. Methods: This study was carried out on 174 elderly residing in 14 different OAHs of Uttar Pradesh, India. Factors responsible for their settlement in OAHs were explored using interview method. Results: Misbehaviour of son and daughters-in-law (29.8%) was found to be most common reasons for residing in old age home. Conclusions: Many elderly in India are opting OAHs as their place of stay in their later life. Foreseeing the future the government and voluntary agencies in India must make arrangements for institutional support and care for the elderly.

QUEST JOURNALS

There has been a rapid ageing of the earth's population and in a few decades, Asia could become the oldest region in the world. In India, due to the reorganization of the family system, the traditional joint family system is on the decline. Due to the emergence of the nuclear family and the high cost of living, family members who previously cared for the elderly need to find employment outside the home. A rapid increase in nuclear families and an exceptional increase in the number of 'older adults' in the country have compelled them to live in old age homes. Literature has accentuated the difficulties and apprehensions experienced by older adults during the ageing process and the need for old age homes in order to create an environment that fosters a meaningful existence for them in their twilight years. India's old age homes are trying to uphold the needs, desires and values of older adults. There is a lack of studies that attempt to give older adults a chance to communicate their experiences in a care home. Older adults are an invaluable resource for younger generations and change is needed in society's attitude towards ageing. This review can help psychologists, social workers and caregivers gain insight into the needs of older adults in terms of mental wellbeing, economic and social security and elder abuse and create awareness among the people.

isara solutions

International Res Jour Managt Socio Human

There has been a progressive increase in both the number and proportion of the aged in the World and also in India over time, particularly after 1951. India has acquired the label of “An ageing nation” with 7.7% of its population being more than 60 years old. The longer life expectancy and their higher number per 1000 males is showing increase in population of elderly females. With an increase in the geriatric population and an expected decline in the Population of the middle aged, the burden of care giving is bound to increase and lead to some unforeseen problems, one of them being institutionalization of elderly thus giving the concept of old age homes. It should be noted that the proportion of 60+ female populations is invariably higher than that of the male population. By the year 2025, the male and female population will be 11.9% and 13.4% respectively, and by the year 2050, the comparable figures will be 20.2% for males and 22.4% for females. This is because of in the higher life expectancy of females compared to that of males.

Journal of Politics and Governance

Hakim Singh

Atlanta Talukdar

IJIRT Journal

With the disintegration of the Joint family system in India to nuclear family system, at both rural and urban levels, the care and the responsibility of the aged in the families has reduced. This lack of personal care and loneliness in the family has led the elderly of the family to constant search for new forms of care. Factors like Urbanisation, Modernisation, Good employment opportunities have altered the traditional roles of elderly in the society and in the family as well. As a result of the same, the provision for the care of the elderly is increasingly being passed on to the institutionalised caring. Thus the concept of Old Age Homes came into existence. Majority of the elderly people who do not have any security or are widowed or are abused or disrespected by their own family members take shelter in old age homes in the hope of getting social and familial environment. There is a large no. of financially and physically fit elderly that find an old age home as their last home for their emotional, physical and psychological well being.

MANTHAN: Journal of Commerce and Management

Rohini Sudhakar

Globalisation has resulted in increased mobility of people for pursing their profession, which in turn, has caused the society getting used to living in small unit nuclear families. Focus group discussion with the residents of Old Age Home. An increasing number of senior citizens are now staying in residential old age homes that are designed to cater to the needs of the aged. Most of these old age homes provide help with personal care and hygiene, meals, social interaction and bedside care. This paper is based on a series of Focus group discussions (FGDs) that were held with the senior citizens of Mumbai to know their views on various aspects of elderly life especially regarding the alternative arrangement for aged, that is, old age homes. On the basis of the study, it was generally seen that elderly people who are very sick or dying prefer to stay in their own homes. Moreover, if the aged person stays in the home, it is cost-effective for the family members too. In this situation, ...

Loading Preview

Sorry, preview is currently unavailable. You can download the paper by clicking the button above.

RELATED PAPERS

Tharaka N. Perera

Dhananjay Bansod

https://www.ijrrjournal.com/IJRR_Vol.6_Issue.8_Aug2019/Abstract_IJRR0031.html

International Journal of Research & Review (IJRR)

Dristikon: A Multidisciplinary Journal

tanka poudel

International Journal of Case Studies in Business, IT and Education (IJCSBE)

Srinivas Publication

The International Journal of Indian Psychology

Dr Mohammad Amiri

Dulal Nandy

Ghazanafar hussain

Annu Baranwal

Euro Asia International Journals

Pradeep Panda

International Journal of Health Sciences and Pharmacy (IJHSP)

Journal of Geriatric Care and Research (JGCR)

National Journal of Community Medicine

National Journal of Community Medicine , Rajkumar Bansal

Zeitschrift für Gerontologie und Geriatrie

Kusuma Yadlapalli

Journal of Geriatric Care and Research (JGCR) , Dr.Namita Rath

Indian Journal of Community Medicine

Asha Kamath

Dhaulagiri Journal of Sociology and Anthropology

Pradeep Acharya

Asian Journal of Agricultural Extension, Economics &amp; Sociology

Beena Yadav

Prakash Bhattacharya

Dr. RISHI Panday

Mary-Ann Khoo

Lubna Siddiqui

Habibullah Ansari

•   We're Hiring!
•   Help Center
• Find new research papers in:
• Health Sciences
• Earth Sciences
• Cognitive Science
• Mathematics
• Computer Science
• Academia ©2024

OLD AGE HOMES AND TRADITIONAL SUPPORT SYSTEMS

• XCII-XXXVII(July 2021):29-37
• This person is not on ResearchGate, or hasn't claimed this research yet.

• Govt. Higher Secondary school Qaimoh

Discover the world's research

• 25+ million members
• 160+ million publication pages
• 2.3+ billion citations

• Indian J Psychiatr

• Indrapal Singh
• Indian J Psychol Med

• K Lokesh Kumar
• C M Pavan Kumar Reddy

• GERONTOLOGIST

• Recruit researchers
• Join for free
• Login Email Tip: Most researchers use their institutional email address as their ResearchGate login Password Forgot password? Keep me logged in Log in or Continue with Google Welcome back! Please log in. Email · Hint Tip: Most researchers use their institutional email address as their ResearchGate login Password Forgot password? Keep me logged in Log in or Continue with Google No account? Sign up

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Indian J Psychiatry
• v.54(2); Apr-Jun 2012

Mental health problems among inhabitants of old age homes: A preliminary study

S. c. tiwari.

Department of Geriatric Mental Health, Chhatrapati Sahuji Maharaj Medical University, Lucknow, Uttar Pradesh, India

Nisha M. Pandey

Indrapal singh, background:.

An exceptional increase in the number and proportion of older adults in the country, rapid increase in nuclear families, and contemporary changes in psychosocial matrix and values often compel this segment of society to live alone or in old age homes. As this group of people is more vulnerable to mental health problems, therefore a pilot study was carried out by the Department of Geriatric Mental Health, Lucknow with following aim.

To study mental health and associated morbidities among inhabitants of old age homes.

Materials and Methods:

It was an exploratory study in which information about available old age homes at Lucknow were obtained and three of them were randomly selected. All the heads of these institutions were contacted and permission to carry out the study was obtained. Consent from the participants was obtained. Survey Psychiatric Assessment Schedule (SPAS), Mini Mental State Examination (MMSE), Mood Disorder Questionnaire (MDQ), and SCAN-based clinical interviews were applied for assessment by a trained research staff.

Forty five elderly inhabitants who had given their consent to participate in the study were interviewed. Depression (37.7%) was found to be the most common mental health problem followed by anxiety disorders (13.3%) and dementia (11.1%).

Conclusions:

A majority of the inhabitants (64.4%) were having psychiatric morbidity and no one was observed physically fit. Large sample studies are needed to substantiate the observations.

INTRODUCTION

The changing demographic scenario and population projections of India indicate that the growth rate of Indian older adults (aged 60 years and above) is comparatively faster than other regions of the World. Since recent past, due to marked increase in life expectancy, rise in number and proportion of older adults the population of older adults is increasing at a fast pace. In India at present, older adults constitute 7.6% of total population. Within three decades, the number of older adults has more than doubled i.e. from 43 million in 1981 to 92 million in 2011 and is expected to triple in the next four decades i.e., 316 million.[ 1 , 2 ] This clearly reveals that the growth rate of Indian older adults is comparatively faster than in other regions of the World. The life expectancy at birth has also increased from 62.5 years in 2000 to 66.8 years in 2011.[ 3 ] Rapid growth in percentage and proportion of older adults in the country is associated with major consequences and implications in all areas of day-to-day human life, and it will continue to be so. As a result, the aged are likely to suffer with problems related to health and health care, family composition, living arrangements, housing, and migration.

Traditionally, the family has been the primary source of care and material support for the older adults throughout Asia. And, the Indian family system is often held at high position for its qualities like support, strength, duty, love, and care of the elderly. The responsibility of the children for their parents′ wellbeing is not only recognized morally and socially in the country, but it is a part of the legal code in many states in India. But urbanization, modernization, industrialization, and globalization have brought major transformations in the family in the form of structural and functional changes.[ 4 ] As a result of these socio-demographic changes, older adults at times are forced to shift from their own place to some institutions/old age homes.[ 5 – 7 ]

This segment of population is more vulnerable to health-related problems including mental health problems. Various prevalence studies have reported mental health problems among older adults to be very higher than other age groups.[ 8 – 11 ] The available literature indicates that there are hardly any effort to understand the morbidity and the needs of such elderly people and specific studies related to the issue are hardly available.[ 12 – 15 ] Viewing it, to assess mental health and other associated morbidities among inhabitants of old age homes, a study was planned and carried out by the Department of Geriatric Mental Health, Lucknow.

MATERIALS AND METHODS

It was an exploratory study and was carried out in old age homes of Lucknow city. Prevalence of mental and physical health problems among inhabitants of old age homes was explored. Out of seven old age homes, three were randomly selected and heads of these institutions were contacted regarding permission to carry out the study. Three different types of old age homes were selected for the study. One of them was established by a religious organization-Gayatri Pariwar, in which the inhabitants had to pay a sum of Rs. 2500.00 as charges for their accommodation. The other two old age homes were free of cost.

Contact was made with older adults of these old age homes and their consent to participate in the study was taken. Survey Psychiatric Assessment Schedule (SPAS),[ 16 ] Mini Mental Status Examination (MMSE),[ 17 ] Mood Disorder Questionnaire (MDQ)[ 18 ] Schedule for Clinical Assessment in Neuropsychiatry (SCAN)[ 19 ] were used as screening and assessment tools. These tools were applied by a qualified and SCAN trained research staff. To find out the physical morbidity among these subjects, information was obtained from them by enquiring about their physical health and scanning the relevant documents (prescriptions of the doctors/ medications etc.). MMSE, MDQ and SPAS were used to screen the old age home inmates. The categorization into positive and negative cases was done on the basis of the available norms for the particular tool. Subjects who were found to be positive on these screening tools were further interviewed by SCAN-based clinical interview to arrive on to a diagnosis. The screening and SCAN-based clinical interview was done by qualified and trained mental health professionals. For assessing physical morbidities in the inhabitants, qualitative information like prescriptions and test reports as well as their own explanations (regarding physical symptoms/illness) were taken into account.

All the participants were categorized into three sub-groups—young-old: 60 to 69 years; old-old: 70 to 79 years; and oldest-old: 80 years and above[ 20 , 21 ] and data analysis was done by employing percentages and test of significance.

The study was carried out in three of the old age homes, the details of inhabitants of these old age homes are given in Table 1 .

Details of inhabitants and participants of old age homes

A total of 45 inhabitants (20 males and 25 females) of three old age homes had given their consent to participate in the study. Age wise and socio-demographic details of participant older adults are given in Figure 1 and Table 2 , respectively. Further, data is analyzed in view of age and gender.

Inhabitants of old age home by age and sex

Socio-demographic details of participants

Figure 1 reveals that a majority of the elderly were in old-old age subcategory (Male=50%; Female=64%) followed by young old (M=35%; Female=20%), and oldest old (Male=15%; Female=16%). Among these inhabitants, a majority were females (55.6%). As the inhabitants in different age categories were not found to be equally distributed or representative as per the proportions in the community, the socio-demographic details are done accounting the gender only.

A majority of inhabitants were illiterate (28.9%), followed by primary level education (20%) and graduate and above (17.8%). Only 6.7% of inhabitants had professional qualifications. Proportionately majority of females were either illiterate (32%) or having less education (primary = 28%; just literate = 12%). A majority of the inhabitants were widowed (females = 88%; males = 65%). Among males, 15% of habitants were married and similar proportion of males was unmarried; whereas in females only 12% were having married status. A majority of the females were financially dependent (84%), whereas a majority of the males (75%) were financially independent.

Pattern of mental health problems

Table 3 reveals that a majority of inhabitants were suffering from depression (Males = 50.0%; Females = 28%). In males, the subsequent disorder was found to be dementia (20%) followed by anxiety (10%) and schizophrenia (5%). Anxiety disorders were found to be second leading disorders in females (16%). Dementia was found to be prevalent more in males (20%) than females (4%). Mental health problems were found to more common in the young-old group. In males, all elderly except one in each age group were suffering from one or other mental health problem. In the group of young-old females, everyone was suffering from one or the other mental disorders. Sixteen percent old-old females were found to have depression followed by dementia (8%) and anxiety (4%) disorders. Surprisingly, in the oldest-old group, none of the female was found to be mentally ill. However, Fishers’ Exact P -value was found to be non-significant for various age categories of males and significant for females i.e., Fishers’ Exact P -value=0.2379 (males) and 0.0212 (females).

Inhabitants suffering from mental health problems

Pattern of physical illnesses

Figure 2 shows that all old age home inhabitants were having one or the other physical health problem. A majority of the subjects were having multiple physical morbidity in male and female both and females outnumbered males (Male=60%; Females=68%).

Percentage of inhabitants of old age homes suffering with physical morbidity

A total of seven old age homes were found to be functional in Lucknow. Only 72.6% of inhabitant older adults had given consent to participate in the study. Majority of the older adults (56.45%) were residing in Dharmarth old age home (established by a trust), followed by Samarpan -a religious institute (35.5%) and government old age homes (8.1%). All of these old age homes were residential and having the provision to help and accomodate both male and female older adults.

A majority of the inhabitants of these old age homes were between the age group of 70 and 79 years followed by young old and oldest old (57.8%; 26.7%; and 15.5%, respectively). In old-old and oldest-old groups, females outnumbered males (Males = 50% and 15%; Females = 64% and 20%), but in the young-old group, males outnumbered females (Males = 35%; Females = 20%) signifying the current trend of feminization of the older adults.[ 22 ] Educationally females were maximally illiterate (32%) compared to males (25%) which is in accordance to Census of India, 2001 report.[ 1 ] Females (88%) outnumbered males (65%) in terms of their widowed/widower status supports findings of a recent epidemiological study.[ 11 ] A majority of females were dependent (88%), whereas a majority of males were independent (75%) in terms of their financial status.

The overall prevalence of mental health problems in inhabitants of old age homes provides a surprising finding that male suffers more than females (Male = 85% and Females = 48%) not in consonance with the latest epidemiological study.[ 11 ] Depression was found to be the most common mental disorders. Dementia, anxiety, and schizophrenia in males and anxiety and dementia in females supports earlier findings.[ 10 ] Others have also reported that the contribution of depressive disorders was highest in the community studies of elderly.[ 10 , 11 ] Cognitive impairment was found to be the second highest in the disorders however; the prevalence of dementia in India has been reported to be variable, from 1.4% to 9.1%.[ 10 , 23 – 25 ] Surprisingly, all females of the old-old group were mentally fit, which is against the previous findings, report of an epidemiological study reveal that aged females are found to be more vulnerable to mental health problems than their counterpart males.[ 11 ]

All the inhabitants of old age homes were suffering from one or more (multiple) physical illness, no one reported herself as healthy. A majority of the inhabitants were having multiple morbidity (Male = 60%; Female = 68%) supporting the findings of previous studies where it is reported that mental health morbidity is seldom an isolated event in elderly and a minimum of two/three other clinical diagnoses is a rule.[ 20 ]

The prevalence of mental health problems as well as physical problems were found to be higher in inhabitants of old age homes in comparison to community. The reason could be significantly more psychological stressors, negligible family support, lack of medical (physical/mental) care and facilities, restricted environment of old age homes and financial constraints, etc.

Mental illnesses were found to be very common among old age home inhabitants. There is need to screen out various stressor and reasons responsible for developing psychiatric problems in inmates of old age homes. Further, similar studies are needed to evaluate the findings of this study.

CONCLUSIONS

• More than half of the inhabitants of old age homes were suffering from one or other mental health problems.
• Depression was the most common mental health problems.
• The inhabitants suffering from psychiatric illness had one or more associated physical morbidity(ies).
• All inhabitants of old age homes were having one or more physical morbidity(ies).

Limitations

The study was carried out in a limited time period on a small sample of old age home thus may not be generalized on general population.

Source of Support: Nil

Conflict of Interest: None declared