This chapter begins with literatures about life satisfaction and important personal and situational predictors of life satisfaction in older persons, then in order to provide a theoretical background for this study attempt to define the most important components of structural and functional support. The next portion will focus on the ways in which significant personal and situational characteristics might affect on structural and functional components. The focus will then shift to the effect of structural and functional components specifically on life satisfaction. And finally specific theories and models that have been proposed to explain the role of structural and functional components in the life satisfaction of older adults will be addressed.
Over the past few years, the world’s population has continued on its remarkable transition from a state of high birth and death rates to one characterized by low birth and death rates. At the heart of this transition has been the growth in the number and proportion of older persons. Such a rapid, large, and ubiquitous growth has never been seen in the history of civilization (Norman & Henderson, 2003). when the older population will be nearly 2 billion, surpassing the population of children for the first time in human history (United Nations, 2006). For the first time in history, Asian populations and their governments are faced with increasing numbers of older adults, and this raise various social and economic issues, (Chan, 2005) specially issues concerning the life satisfaction (Wu & Rudkin, 2000).
2.1 Life Satisfaction
The use of different terms such as “psychological well-being”, “subjective well-being”, “life satisfaction”, “happiness” and “morale” for the same underlying construct has led to considerable confusion in the literature over exactly what is being measured, however, these concepts and their definitions are not identical, “all of them involve a psychological response by the individual to socio-environmental situation encountered in life and demonstrate no significant difference in meaning.”(Cloutterbuck, 1987).
Stock, Okun, and Benin (1988) defined subjective well-being as combining concepts together; mood, happiness, life satisfaction, and morale. Factors such as morale, life satisfaction and happiness are considered to be important in determining subjective well-being in the elderly (Kim, Hisata, Kai, & Lee, 2000). Subjective well-being is composed of two elements: cognitive and affective. Life satisfaction, the cognitive component of subjective well-being, refers to a global judgment of a life as a whole (Jin, 2001).Life satisfaction has also been defined in various ways, including happiness, adjustment, morale, physical health, subjective well-being, and the balance between aspirations and achievements (Nutt, 2001).
Life satisfaction has been defined two major ways in the literature: first as an objective entity, usually the quantity of social interactions; and second as an internal and subjective perception, the individuals’ evaluation of their lives, the second approach is now more widely used (Miller, 1997). Life satisfaction is a very personal assessment, one must decide one’s own life satisfaction criteria. Two individuals may share very similar lives, and one may find life satisfactory and the other may not (Quadhamer, 1999). Havighurst proposed that measuring life satisfaction as an “inner” assessment was a better measure of successful aging. Such a measure would accommodate individual differences in conceptions and values of growing older. Specifically, the individual whose personality most values an active life style could be as satisfied with his life as one who is more passive (Havighurst, 1961).
Distinction between life satisfaction and quality of life is not clear and the concepts are sometimes used interchangeably (Borg, Hallberg, & Blomqvist, 2006). Jeffres and Dobos (1995) proposed that quality of life consists of two distinct global concepts with underlying domains. The first concept, perceived quality of life or life satisfaction, is a consequence of satisfaction with the personal domains of life. These domains include satisfaction with family life, friends, health, partner and oneself. The second concept refers to quality of life in the broader social environment, environmental quality of life (Jeffres & Dobos, 1995). Environmental quality of life domains include satisfaction with housing, schools, health services, safety and security, roads and transport (Evans, 1994) . Personal quality of life is associated with quality of life in the broader social environment (Jeffres & Dobos, 1995), but the two domains are not identical (Fadda & Jiro´n, 1999). For example, some individuals rate their quality of life as very good whilst living under extremely difficult environmental conditions, whereas others rate their quality of life as poor even though their environmental conditions are excellent (Westaway, 2006).
2.1.1 Life Satisfaction in elderly
Among elders the predictors of life satisfaction were found to be perceived level of activity (Osberg & McGinnis, 1987), age, gender (Fadda & Jiro´n, 1999; Kudo, Izumo, Kodama, Watanabe, Hatakeyama, Fukuoka, Kudo, Yaegashi, & Sasaki, 2007), satisfaction with family life (Medley, 1976), the availability of confidants (Strain & Chappell, 1982), subjective health rating (Downe-Wamboldt & Tamlyn, 1986; Gfellner, 1989; Spreitzer & Snyder, 1974) , physical health status (Joia, Ruiz, & Donalisio, 2007; Kudo et al., 2007; Bowling, 1990) , satisfaction with financial status and socio-economic status (Antonucci & Akiyama, 2007; Borg et al., 2006; Spreitzer & Snyder, 1974; Welsch, 2007), religious affiliation and private prayer (Korff, 2006; Markides, Levin, & Ray, 1987; Sagaza, 2004), marital status, and educational level (Subasi & Hayran, 2005), living environment (Subasi & Hayran, 2005; Rehdanz & Maddison, 2008), personal factors (Borg, Fagerström, Balducci, Burholt, Ferring, Weber, Wenger, Göran Holst, & Hallberg, 2008; Sanchez, Jr., 2006) , social support (Abu Bader, Rogers, & Barusch, 2003) and sociopolitical capital (Abdallah, Thompson, & Marks, 2008).
Based on the International Study in 1994 and 1999, indicates that the level of satisfaction of the elderly is generally lower in large cities, and lower for those who are in the first half of their 60s, who constitute single-person households, who are not in good health condition, who live in rented housing (Sagaza, 2004) another study showed that good health, high self-esteem, and the absence of worry were associated with life satisfaction (Borg et al., 2008).
Analyses of associations with life satisfaction in the study of elderly persons in Hong Kong showed significant associations between life satisfaction and a number of variables including age, education, marital status, self-rated financial situation, religious belief, living arrangement, social support, social network, self-rated health status, functional capacity, number of chronic illnesses and activity level. Multivariate analysis confirmed that the strongest predictors of life satisfaction were self-rated financial situation, activity level and social support (Chou & Chi, 1999). Borg et al., (2006) identified several factors of importance for life satisfaction among older people with reduced ability to perform daily activities: social contacts, health, activities, family, negatively losing family members (Borg et al., 2006). Recent work has identified a relationship between personality traits and life satisfaction (Thakral, 2006; Fogle, Huebner, & Laughlin, 2002). Among people with reduced ADL capacity in 6 European countries, it was found that personal factors, rather than environmental factors such as social or financial resources, influence life satisfaction (Borg et al., 2008).
Life satisfaction and Gender
Up to age 65, women tended to report higher rates of life satisfaction than men; however, after age 65 men were more likely than women to report a high degree of life satisfaction (Spreitzer & Snyder, 1974). Significant predictors of life satisfaction were found in female respondents: age, financial strain and depression. In male respondents, the significant predictors of life satisfaction were education and financial strain (Chou & Chi, 1999). Medley found standard of living to be a more important predictor of life satisfaction in women, whereas satisfaction with health was more important to men (Medley, 1976).
Life satisfaction and Age
As age increases there is a slow decrease in life satisfaction (Melendez, Tomas, Oliver, & Navarro, 2005) Indeed, survey researchers have noted that older people show consistent increases in life satisfaction with age but a leveling off of more affective characteristics such as happiness (Antonucci & Akiyama, 2007).
Life satisfaction and Income
Previous studies have indicated that financial strain was consistently and negatively associated with life satisfaction and financial situation was a significant predictor of satisfaction (Chou & Chi, 1999; Chou & Chi, 1999) and satisfaction with financial status was a stronger predictor of life satisfaction than objective financial state (Spreitzer & Snyder, 1974).
Life satisfaction and Educational level
Education is found to have a significant effect on life satisfaction. Higher education attainment is associated with improved socioeconomic status, higher wage rates, and better health, all of which lead to better living standards (Bukenya, Gebremedin, & Schaeffeaer, 2003).
Life satisfaction and Ethnic
Barger, Donoho, & Wayment., (2009) evaluated racial/ethnic disparities in life satisfaction, and explored the relative contributions of SES, health status, and social relationships to life satisfaction among two very large, diverse probability samples of U.S. adults. That was the first major evaluation of Hispanic life satisfaction in the U.S. and is the largest U.S. population based life satisfaction study to date. They found that Blacks and Hispanics have lower life satisfaction than Whites, but controlling for SES and health status weakened these differences for Blacks and eliminated them for Hispanics. They also found a modest Hispanic benefit for being very satisfied in multivariable models. The consistently higher explained life satisfaction variance among Whites could represent substantive cultural variation in the types of support relevant to well-being judgments (Barger, Donoho, & Wayment, 2009).
Life satisfaction and marital status
Marital status was found to be positively related to life satisfaction by some investigators (Markides et al., 1987; Strain & Chappell, 1982) whereas others failed to show this relationship (Osberg & McGinnis, 1987). Marital status significantly affects satisfaction, with being single having a negative effect on both health and quality of life satisfaction. Proponents of social role explanations suggest that men derive greater benefits from marriage than women do because men’s roles are less stressful and more gratifying compared to women (Bukenya et al., 2003).
Hansen et al., (2004) in a study with title: “Age, marital status and life satisfaction” found, having a partner (in the household) was strongly associated with higher levels of life satisfaction for both genders. The results showed no differential effect of having a partner by gender. However, for both genders, older cohorts without a partner had higher life satisfaction than their younger counterparts. No age-differential effect of having a partner was found. Interestingly, the effect of having a partner decreased with age for both genders, and significantly more so amongst women (Hansen, 2004).
Life satisfaction and Employment
Researchers examining employment status and life satisfaction have found a positive relation between these variables. Results of several studies have further suggested that persons 65 years of age and older who remain active in the labor force have higher levels of life satisfaction and morale than do retired persons in the same age cohort (Aquino, Russellc, Cutrona, & Altimaier, 1996).
Life satisfaction and Strata (rural/urban)
Evans., (2005) studied differences in the social supports of rural and urban elders to determine what those differences meant in terms of three markers of successful aging: activity level, life satisfaction, and depressive symptoms. Results showed that urban older adults reported more depressive symptoms as compared to rural older adults. Furthermore, subjective level of social support (perceived satisfaction with support) was positively correlated with life satisfaction and negatively correlated with depressive symptoms for both rural and urban older adults, however, there were no mediating effects of social support in the relationship between residence and levels of activity, life satisfaction, and depressive symptoms (Evans, 2005).
2.2 Functional and Structural components of support
In this section a broad overview of structural and functional components of support will be provide and each of these concept consider separately, because each has different properties that can potentially influence the life satisfaction.
The concept of social support has been a popular subject of research since the late 1970 and publications on social support increased almost geometrically from 1976 to 1981 (Phillips, Siu, Yeh, & Cheng, 2008).The concept of social support has been variously addressed in terms of social bonds, social contacts, and availability of confidants (Johnson, 1996; Seeman, Bruce, & McAvay, 1996) and early research frequently unclear the distinctions between four concepts: social relations, social network, social support, and social integration (Antonucci & Akiyama, 2007). social support and social support resources such as: social network, social interactions or social contacts, reported as related but distinct concepts (Seeman, Lusignolo, Albert, & Berkman, 2001).
Social support includes interpersonal communication and interaction, love and understanding, caring and concern, affection and companionship, financial assistance, and respect and acceptance (Antonucci & Akiyama, 2007; Loue & Sajatovic, 2008). Definitions of social support range from the actual supportive acts that are exchanged between individuals to a personality-like factor based in early interpersonal experiences that then influences how an individual views the likelihood that someone is supportive. The concept of social support has been investigated by researchers in anthropology, epidemiology, medicine, nursing, psychology, and sociology. Given the different backgrounds of researchers in these fields one can appreciate why reaching consensus for a definition of social support has been difficult (Rudkin, 2006).
There is a lack of general consensus on how social support should be specifically defined. One useful way to conceptualize social support is that it has both structural and functional aspects, qualitative (subjective) and quantitative (objective) aspects, and social network-based and support-based aspects (Phillips et al., 2008).
2.2.2Functional Component of Support
More recent studies of social support conceptualize it as the functions that are provided by social relationships. Although the question of what exactly is provided by supportive individuals varies between researchers, many agree that supportive individuals provide or make available what can be termed emotional support, informational support, tangible support, and belonging support .These functional aspects of social support are often highly related to each other and not easily separated in everyday life.
Emotional support, provides individuals with the belief that they are loved and cared for, emotional support involved such things as giving advice, expressing affection, and providing morale support (Johnson, 1996). Emotional support is probably what most of us imagine when we think about a supportive individual. Emotional support is thought to be beneficial because it provides the recipient with a sense of acceptance and may strengthen one’s self-esteem during life challenges (Loue & Sajatovic, 2008). Informational support can be a very powerful form of support to the extent that it provides useful direction. Such advice and guidance may also carry an emotional message, it is often the case that useful guidance from close friends can be seen as emotionally supportive in that the person cares enough to speak with you about important decisions (Cohen , Underwood , & Gottlieb , 2000). Appraisal supportincludes feedback given to individuals to help them in self-evaluation or in appraising situations. The intangible forms of support; emotional, informational, and appraisal support, can be difficult to disentangle (Rudkin, 2006).
Tangible support, is conceptualized as the assistance from others in one‘s daily functioning. Emotional social support contributed to positive affect, while tangible social support contributed to life satisfaction as well as reducing psychosomatic and emotional distress (Seeman et al., 2001). For older people tangible support may be as simple as providing a ride to the grocery store or mowing the lawn (Loue & Sajatovic, 2008), involves being able to help with everyday jobs around the house, providing financial assistance, and helping in the process of taking care of children (Johnson, 1996). Research findings regarding instrumental support are more mixed. Receipt of higher levels of instrumental support, specifically help with various tasks, has been associated with greater declines in physical functioning. More moderate levels of instrumental support appear to promote recovery and slow decline in functioning. In many studies, however, the direction of causation has not been clearly established (Rudkin, 2006). Belonging support is defined as the presence of others with whom to engage in social activities. An example of it would be a friend with whom to go shopping or to watch a basketball game. Belonging support may be beneficial because such positive social and leisure activities may enhance one’s mood and sense of acceptance by others (Cohen et al., 2000).
Social support functions are often intertwined those who provide tangible support may also be providing reassurance and emotional support. Furthermore, different network members provide different types of support. People tend to turn to their families for instrumental support, friends for emotional support, and during times of illness, health care workers for advice and aid (Loue & Sajatovic, 2008). Higher levels of emotional support, both perceived and received, improve outcomes, whereas the effects of instrumental support have been questionable. Older individuals who have more interaction with others and who report more available emotional support, experience fewer and slower declines in cognitive and physical functioning (Rudkin, 2006).
The effectiveness of any form of support will depend on the extent to which it meets the demands of the particular stressful event. For controllable stressful events, support such as informational or tangible is predicted to be more important. However, if the event is less controllable, then emotional or belonging support may serve to facilitate adjustment (Uchino, Cacioppo, & Kiecolt-Glaser, 1996).
22.214.171.124 Functional component: perceived or received
Function components of support are usually organized along two dimensions: what support is perceived to be available (available support) and what support is actually received or provided (received support) by others (Cohen, 2004; Kafetsios & Sideridis, 2006). These measures are not highly related and are often associated with different effects on well-being. What is perceived as available may or may not correspond to what is actually provided (Kahna, Hesslingb, & Russellc, 2003). Studies suggest that received support is not related to the perceived availability of support in a straightforward manner, one reason is that measures of available support are related to one’s cognitive representation of social support, a person might perceive a high availability of support but decide not to utilize it because of concerns about network members’ perception of their competence (Cohen et al., 2000). when elderly individuals indicated that others were available to provide social support, they were more likely to report greater use of proactive coping (Greengalss, Fliksenbaum, & Eaton, 2006).
However, the benefits of social support are most strongly related to the perception that support is available. In other words, the highest levels of well-being are found among people who believe that they have a high level of social support, regardless of how much support they receive or how many people they know (Karademas, 2006; Kim et al., 2000; Phillips et al., 2008).National study of economically stressed older adults shows that those who believed that no one would come to their aid in the future had the greatest number of depressive symptoms (Loue & Sajatovic, 2008) and a higher level of support was reported in those who perceived the provider as supportive (Pierce et al., 1992).
126.96.36.199 Buffer against stressful life events
Social support may act as a buffer against stressful life events and, thus, reduce exposure to the resultant cumulative pathological effects of stress. Alternatively, social support may be a constant, more generally available resource, across time and situations (Alan, Alison, Martha, Lawrence, & Ian, 2007; Antonucci & Akiyama, 2007).The two type of support are not mutually exclusive and may be viewed as complementary, there is evidence to support both types of effects. It should also be emphasized that the particular pathways or mechanisms by which social relationships affect well being likely depend upon the characteristics of the individual, his or her socioeconomic situation, the health outcome of interest, and the measure of social relationships (Rudkin, 2006).
Murrell and Norris (1984) postulated that social support may not only buffer individuals from stressful life events, but may actually be important for the general maintenance of psychological well-being and life satisfaction in old age, independent of adversity or stress (Tho , 2001). Social support can act as a buffer to soften the effects of negative life occurrences, this might explain why some people maintain good health when exposed to stressful life events which would be expected to have a negative effect on health (Bowung , Farquha , & Browne , 1991) and those older adults who are going through the loss of a loved one and have a strong social support system report a higher sense of life satisfaction and well-being (Gray , 2007). Coleman suggests that social relationships can act as a form of social insurance, provide communication and information networks, and create norms and sanctions that facilitate social action (Celia & Lenore, 2004).
2.2.3 Structural Component of Support
Support Network refers to objective characteristics of the network such as total network size (Janevic, Ajrouch, Merline, Akiyama, & Antonucci, 2000; Antonucci, Lansford, Akiyama, Smith, Baltes, Takahashi, Fuhrer, & Dartigues, 2002), the number of family members, age, sex, proximity, or frequency of contact with network members and living arrangements (Yoshida, Sauer, Tidwell, Skager, & Sorenson, 1997).
Social networks define as “webs of relationships that link the individual directly and indirectly to other people”. Social networks include friends and family, as well as familiarity. The size of a social network depends on the person , some people have large families and numerous friends, whereas others may have smaller families and smaller friendship networks (Phillips, 1986; Phillips et al., 2008; Quadhamer, 1999). The Properties of the person and situation significantly influence the structure of the individual’s network. Since one occupies a large number of roles, such as child, spouse, and parent, it is natural that this is a time when there are numerous members of the support network, and that they differ widely in age and gender (Antonucci, Akiyama, & Merline, 2001; Berke, 1991; Fiori, 2006).
188.8.131.52 Formal social support
Formal social support is in many cases essential to an older adult’s well-being because it provides practical support that becomes increasingly dependent as a person ages. Formal support comes from those individuals and institutions one depends upon for services and assistance such as health care providers, social workers, case managers, shopkeepers, delivery persons, and others in institutional settings (Loue & Sajatovic, 2008; Quadhamer, 1999).
184.108.40.206Informal social support
There are several aspects of the structure of social networks that have received much attention in the literature on social relations and aging. Including family versus friend relationships, under the umbrella term of structural component is somewhat arbitrary, as this issue also touches on functional component.
220.127.116.11 Family versus Friends
Informal Social Support systems are typically those supports such as family and friends and developed over a period of time through interactions with others (Nutt, 2001; Quadhamer, 1999). Informal support members are generally the primary caregivers to the older adult who needs assistance. Psychologically, social interactions with family and friends provide feedback to the individual regarding his/her social role and behavior (Rosenhand, 1999) and both of family and friends social support increase life satisfaction (Miller, 1997). The study of social relations must take into account that convoys of close friends and family members may be both pleasant and unpleasant, supportive and unsupportive (Antonucci & Akiyama, 2007).
Findings showed that, reliable alliance, or instrumental assistance, was more strongly related to well-being when provided by kin than by nonkin (Felton & Berry, 1992). Surveys of elderly people have documented that the most frequently mentioned helpers are wives followed by daughters, particularly in the case of widowed parents (Bowung et al., 1991). Couples who do not have children may intentionally develop strong relationships with relatives such as nephews and nieces because these relatives serve as informal support to them when children would otherwise assume support (Loue & Sajatovic, 2008).
Social support, especially from children and family members, had a significant positive effect on the life satisfaction of older adults when support was provided at a low level. However, excessive support was found to diminish the sense of well-being in the elderly as well as wear away their autonomy and independence (Silverstein & Bengtson, 1994). In fact, increasing contact with family members could be viewed by older adults as a sign of lost independence (Fiori, 2006).
Older people who are married are much less likely to need formal supports, such as home nurse care or Meals on Wheels, than unmarried people. Family relationships, under normal circumstances, make an important contribution to well-being (Antonucci & Akiyama, 2007) however, if the relationship is not supportive and positive, the opposite is true. In fact, intimate relationships that are not supportive, trusting, and loving have negative influences on the physical and mental health and overall well-being of the elderly. Additionally, the very old tend to have smaller circles of social support as many people have outlived spouses, other family members, friends, and sometimes even children (Loue & Sajatovic, 2008).
Although it is clear that families play important roles in the lives of older adults, providing sometimes extraordinary care giving efforts and instrumental help, friends are also invaluable resources. Indeed, research initially designed to examine the impact of family members alone often finds that the friends are mentioned as a significant support source (Antonucci & Akiyama, 2007).The need for friendships among the elderly is self-evident (Hanafy, 1992).When confronting loneliness or needing assistance with social issues, older adults prefer friendships to family Social Support ( specifically spouses and children). The reasons that older adults prefer friendships to family in cases of emotional support are primarily due to sense of continuity with the past that friends can provide (Loue & Sajatovic, 2008). Older people obtained a sense of emotional support from having intimate friendships with neighbors and friends and at least one child living close by with whom they have frequent contact (Loue & Sajatovic, 2008).Friendships have significant positive effects on the mental health of the elderly (Antonucci & Akiyama, 2007) and tend to be a matter of choice rather than birth. People choose friends because of shared interests and desire for contact and friendships share a form of reciprocity that may be absent in family relationships and reciprocity has a strong effect on the satisfaction level of seniors and their friendships (Loue & Sajatovic, 2008).
In one study of friendships among people over 60 year, 68% reported long-term friendship ties throughout their lives. There were some gender differences, with more than half the women reporting that they remained friends with a close friend from childhood or adolescence, whereas men showed high levels of continuity with close friendships developed at midlife. In one sample of people over 85 years old, it was found that more than half still had at least one close friend, and three-fourths were in weekly contact with people they considered their friends. Furthermore, almost half reported that they had made new friends after age 85, although the criteria for those friends tended to involve less expectation for intimacy or shared history than was common among younger people (Antonucci & Akiyama, 2007).
2.3 Functional and Structural Support in elderly
The findings from several studies suggest that the social network of elderly adultsmay differ from those of younger persons on a number of dimensions. In modem societies the networks of the aged are generally smaller than those of younger people. There is some controversy in the literature as to whether social networks of the aging decrease in size, frequency of contact with persons in the network, and degree of given and received support (Dorman, 2001).
It has been widely recognized that social networks among men and women differ in complex ways, particularly in relation to life stage (Antonucci et al., 2001). In terms of gender, women report providing more support, having more frequent contact with network members, being more satisfied with their friends, and having larger and more multifaceted social networks than do men (Fiori, Antonucci, & Cortina, 2006). Male got more support from fa