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Hong Kong Journal of Occupational Therapy 71
2010 Elsevier. All rights reserved.
HKJOT 2010;20(2):7179
Department of Occupational Therapy and Art Therapy, School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom.
Reprint requests and correspondence to: Akehsan Dahlan, Department of Occupational Therapy and Art Therapy, School of Health
Sciences, Queen Margaret University, Edinburgh EH21 6UU, United Kingdom.
E-mail: [email protected]
ELEMENTS OFLIFESATISFACTION AMONGST
ELDERLY PEOPLELIVING ININSTITUTIONS IN
MALAYSIA: A MIXEDMETHODOLOGY APPROACH
Akehsan Dahlan, Margaret Nicol and Donald Maciver
Background: Changes in demographic characteristics, social structure and economic status have
shifted the direction of care of elderly people in Malaysia. Subsequently, nursing homes and institu-
tions for elderly people becoming a significant care option. The aim of this study is to identify the level
of life satisfaction and to examine the elements of life satisfaction amongst the elderly people living inthe institutions.
Methods: In this mixed methodology, a survey using translated version of Satisfaction with Life Scale
(SWLS) was conducted to 82 participants who conformed to the inclusion criteria. Twenty participants
who volunteered to discuss about their live experience regarding life satisfaction living in a public elderly
institution in Malaysia. The participants were stratified according to age group and gender. Four focus
groups were conducted and the Interpretative Phenomenological Analysis were used to identify the key
themes emerged from the focus groups.
Results: The level of life satisfaction is equivalent to the norms and there is no statistical significant
difference between the levels with the demographic variables. Two main themes were developed, con-
tentment and acceptance, reflecting the elements of life satisfaction of the participants in the institution.
Conclusion: The findings are inconsistent with previous findings. However, it identified new elements
of life satisfaction for elderly people in the institution.
KEY WORDS: Institutionalised elderly people Life satisfaction
Mixed methodology Occupational therapy
Introduction
It is anticipated that the elderly people population in Malaysia
will increase up to 9.9% by the year 2020 (Pala, 2005), whilst
life expectancy has increased from 66.4 to 70.2 years old in
males, and from 70.5 to 75.0 in females (Ministry of Health,
2008). These increased changes have implications for health
services, as people living longer will require more health care
and hospitalisation for chronic illness, functional dependence,
mental health, sensory deficiency and cognitive impairment,
thus increasing the government expenditure for health services.
(Chen, 1987; Jamaiyah & Hanafiah, 2006; Sherina, Lekhraj, &
Mustaqim, 2004; Yeoh, 1980).
The Malaysian family has long been regarded as a care insti-
tution, which bears the responsibility for looking after the elderly
people. This belief derived from the teaching of Islam and
Confucians ethics of filial piety that put a strong emphasis on
respect for the elderly people. Therefore, elderly people in
Malaysia are greatly respected and are usually cared for by their
family. In addition, Kim et al. (2005) indicated that 62% of adults
surveyed believe that they should support their elderly people
parents and they should not send their parents to nursing homes.
ORIGINALARTICLE
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A. Dahlan, et al HKJOT 2010;20(2)
The social characteristics of people in Malaysia are chang-
ing as a result of urbanisation and modernisation of the pop-
ulation, for example, the changing role of women and their
participation in the labour force, delay in marriage, smaller
family size, migration of the younger generation to urban areas
with more jobs and education opportunities (Aminah, 1996;
Arpita, 2000; Hew, 2007; Sim, 2002). These changes have
social implications for elderly people. The extended family
structure is being replaced by a nuclear family structure, con-
sequentially affecting and putting a strain on the family as the
role of the care giver for elderly people (Cheng, 2003; Hew,
2007; Martin, 1989; Mubarak, 1997; Ng, Lim, Jin, & Shinfuku,
2005; Selvaratnam & Tin, 2007). For example, the urban pop-
ulation has increased from 33.5% (as a percentage of total
populations) in 1970 to 65.1% in 2005, the elderly people who
lived in an extended family decreased from 57.8% in 1991 to
43.8% in 2000, whilst the average household size decreased
from 5.2 people in 1980 to 4.6 people in 2000 (Department of
Statistics Malaysia, 2008). In addition, the fertility rate has
continuously declined, for example the fertility for all races is
4.9 children born per women in 1970 to 2.95 in 2009. The
birth rate has also continuously declined from 23.7 birth to
22.24 per 1000 populations in 2009.
These changes have created a vacuum that has seen the
development of many private and public nursing homes and
other institutional care facilities which reflect the demand and
ability to purchase, and are perceived as a significant care
option. For example, the first nursing home was established in
1983, and by the year 2001, there were 50 moderate-sized nurs-
ing homes which contained 40 beds, but there are hundreds
more smaller homes in operation (fewer than 10 beds) which
are located in bungalows and private residences (Sim, 2002).
By the year 2007, there were 209 moderate size nursing homes
and 7 institutions for elderly people (Social Welfare Department
of Malaysia, 2009).
As the need and demand increases, placing elderly people in
institutions or nursing homes is becoming increasing common
practice in spite of the cultural expectation and assumption
that placing the elderly people in a nursing home is a violation
to tradition and personal beliefs.
Elderly people institutions have negative effect on health
and well-being as the institutional environment creates feelings
of dependency and reinforces a sick role amongst the residents
(Dommenwerth & Petersen, 1992). In addition, the institutions
and nursing homes are viewed as dumping place where one
would idle till death, close to death and possessing an un-
controlled future (Lee, 1997, p. 333). The elderly people also
feel dissatisfied with the quality of care, erosion of personal
autonomy, loss of meaning and sense of belonging in life as a
result of institutional policy, stiffness of general routine and
the hierarchical structure of the institution (Berglund, 2007;
Bowling & Formby, 2002; Brooker, 2008; Brown, 1995; Lee,
1997). As a result, elderly people feel isolated and lonely
(Fessman & Lester, 2000; Kim, Jeon, Sok, & Kim, 2006) and
depressed (Brooker, 2008; Sabariah & Hanafiah, 2006). A
study by Jones, Marcantonio and Rabinowitz (2003) indicated
that 20.3% of the elderly people who resided in the nursing
home or institutionalised type of care were depressed. Sherina,
Rampal, Hanim and Thong (2006) who conducted a study of
elderly people in an institution in Kuala Lumpur reported that
54% of the elderly people were depressed. In addition, Oksoo
et al. (2009) reported that 66.7% of Korean elderly people and
41.7% of Japanese elderly people who live in nursing homes
were depressed. Choi, Ransom, and Wyllie (2008) indicated
that depression amongst elderly people in the institutions and
nursing homes is due to loss of independence, inability to
continue previous occupations, feelings of isolation and lone-
liness, lack of privacy and meaningful occupations.
Depression causes the failure to thrive in the institution
(Bergland & Kikrevold, 2006), thus they are likely to comply
and participate in the programme, processes and routine occu-
pations run by the institution. As a result, the elderly people have
a low level of life satisfaction and quality of life (Hjaltadottir &
Gustafsdottie, 2007; Subasi & Hayran, 2005).
Research Aim
The aim of this research is to identify the level of satisfaction
with life and to examine the relationship between life satisfac-
tion and the sociodemographic characteristics of the elderly
people living in the institution. In addition, the study aims to
describe the elements which constitute to the life satisfaction
experience living in the institute.
Methodology
Overview of the Design
A mixed method of both quantitative and qualitative designs
was chosen to answer the research aims. The method will pro-
vide strong inference and complement the strength of each
methodology to provide more meaningful in-depth data
(Barbour, 1998; Brannen, 2005; Creswell, 2003; Morse, 2005;
Shin, 1998; Tashakkori & Teddlie, 1998). The simultaneous
strategy models were used to obtain the data, thus the data can
be collected and analysed concurrently in a short period of
time (Schulenberg, 2007; Tashakkori & Teddlie, 2003). Aligned
with this, a cross-sectional survey was conducted to identify
the level of life satisfaction followed by focus group interview
that aimed to understand the elements of lived satisfaction
72 Hong Kong Journal of Occupational Therapy
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LIFE SATISFACTION IN INSTITUTIONALISED ELDERLY PEOPLE
through the life experience of the participants who are living
in the institution.
Research Setting and Participants
The participants were located at the public funded elderly peo-
ples institution in Malaysia. The institution houses independent
elderly people, 60 years old and above. There are seven hostel
types of buildings, occupied by 3040 residents per house.
The institute could house about 250300 residents at one time
and is currently staffed by 64 people. Medical staff consisted
of two full time nurses and a physiotherapist. The institution
provides free basic amenities to the elderly people such as six
meals per day, clothes and items for personal hygiene. There
were no structured activity for the elderly people, and they
were free to move around the compound of the institution.
All of the residents were sampled and 82 participants were
found fit into the inclusion criteria which was elderly people
aged 60 and above, independent in basic self-care skills, able
to understand and or speak fluently in either in Bahasa or
English, scores of 22 and above in the Mini Mental State
Examination (MMSE; Folstein, Folstein, & McHugh, 1975)
and scores below 7 in the Geriatric Depression Scale (GDS;
Yesavage et al., 1983).
Survey and Focus Groups Interview
The survey was conducted through face to face interview
using Satisfaction with Life Scale (SWLS) (Diener, Emmonas,
Larsen, & Griffin, 1985). The scale was translated into Malay
language and the translated version has a good internal con-
sistency of 0.83 across demographic variables (Swami &
Chamorro-Premuzic, 2009). The scale consists of five items
intended to measure life satisfaction. Participants indicate their
agreement or disagreement with the statements on a 7-point
Likert type of scale and the scores range from 5 to 35 with
higher scores indicating a greater life satisfaction. The psy-
chometric properties were tested in numerous studies (Diener
et al., 1985; Hultell & Gustavsson, 2008) and the internal con-
sistency generally exceeds .80. Pavot, Diener, Colvin, and
Sandvik (1991) obtained an alpha coefficient of .83 and the
results were correlated with other types of life satisfaction
measurement such as the Life satisfaction Index-A (p< .01).
This measurement is considered suitable for the participants
in view of their education level. Assistance was given if the
participants needed further clarif ication about the scale.
The focus groups were conducted using semi-structured
interview to collect data regarding the life satisfaction experi-
ence of the elderly people living in the institute. Semistruc-
tured questionnaires were prepared. To ensure representation
and homogeneity, 20 participants who volunteered for focus
groups were stratified through stratified purposeful sampling
strategy. The participants were divided based on two age cate-
gories (6075 years old and above 76 years old) and gender
(male and female group). There were four focus groups in the
study and each group consist of 46 elderly people. The focus
groups will preserve the life experience of the participants and
provide rich data as a result of the opportunity for the partici-
pants to reflect, cross-check and clarify their shared experience
(Bradbury-Jones, Sambrook, & Irvine, 2009).
Data Analysis
The survey was analysed using the PASW v18. Spearmans rho,
one-way between groups analysis of variance (ANOVA) with
post hoc were conducted to determine whether there are any
differences between the life satisfactions with the subgroups
within the demographic variables. The critical value for sig-
nificant were set atp< .05 with 95% confidence interval and
Cohens (1988) guideline will be used to determine the strength
of the relationship.
The interview transcripts was analysed using four stages
of Interpretative Phenomenological Analysis (IPA) as outlined
by Smith, Flowers, and Larkin (2009). Initially the first transcript
from the first group was read over several times and the left
margin of the transcripts was used to annotate the key points
and provide comment on language, linguistic differences, con-
tradictions and what was considered important from the respon-
dents words, then the key points were compiled into the list.
The lists were reviewed and the points that had similar
characteristics were clustered together to form subsumma-
tions of themes. Further analyses were conducted to ensure all
of the important key points were compiled and clustered
accordingly. When all key points are included, masters of
theme were developed alongside with the participants details
and the quotes from the participants. This process was
repeated for the remainder of the focus groups transcripts.
After each transcript was analysed, a further analysis was con-
ducted to highlight disparities and resemblances within the
groups. Constant reflection and re-examination of the themes
was conducted throughout the analytical process to ensure
that the themes were interconnected. Subsequently, some
themes are expended or dropped from the master themes.
The quotes and themes developed were translated into
English using forward translation (Heij, Hooglander, Kerling,
& Velden, 2006; World Health Organisation, 2008). The
quotes were used to validate the research findings and to pro-
vide clear examples for the research report (Sandelowski
1994). Few measures were taken to ensure trustworthiness of
the themes developed as outlined by Curtin and Fossey
(2007). Detailed descriptions of the participantsbackgrounds
Hong Kong Journal of Occupational Therapy 73
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A. Dahlan, et al HKJOT 2010;20(2)
and situation of the phenomena understudy are obtained, so
that the meaning and experience of the elderly participants
can be fully understood. In addition, the focus groups were
facilitated by three different individuals and an external
researcher was invited to validate the themes which emerge
from the focus groups. The quantitative and qualitative data
were integrated into a coherent whole and inference between
the data was made aligned with the principles of mixed meth-
ods data synthesis (Onwuegbuzie & Teddlie, 2003).
Ethical Consideration
The confidentiality and anonymity of the participant infor-
mation was obtained from the participants and the study was
approved by Research Ethic Committee of the Queen Margaret
University. In addition, the study was registered and approved by
the Ministry of Women, Family and Community Development
in Malaysia.
Results
Demographic Characteristics
The sample consists of 68.3% male (n=56), 31.7% female
(n= 26) and 68.3% (n=56) are Malay elderly people. There
are 43.3% (n= 36) of the participants who never attended
school, the mean age of the participants is 74.1 year old and
the duration of living in the institute is 42.2 months. There are
51.2% (n=42) did not have contact with their family members
and 45.1% (n=37) were referred by family members or friends.
Survey on Satisfaction With Life
The scores indicated that 59% (n=48) have an average life sat-
isfaction, 30.5% (n=25) are below average satisfaction with
life and 8.5% (n=7) are dissatisfied with their life. The mean
for life satisfaction is 20.2 (4.1).
In spite of 55% (n = 45) of the elderly people stating that
they did not have the opportunity to engage in important occu-
pations in life such as work and leisure, 66% (n = 54) state that
their life is in an excellent condition and 63% (n = 52) are sat-
isfied with their life condition.
The relationship between life satisfaction (as measured by
SWLS) and the demographic variables indicated that there was a
positive correlation between life satisfaction with duration of liv-
ing in the institute, rho=0.23, n=82,p< .05 as shown in Table 1.
The assumption for homogeneity using Levines test for
homogeneity of variance indicated that the assumption for one-
way between groups ANOVA is not violated (p> .05) in all the
groups in the socio-demographic variables. A one-way between-
group ANOVA was conducted to explore the impact of demo-
graphic variables such as age group, duration of staying in the
institute, number of friends outside the institute, number of
family members who keep in touch and reason for admission on
life satisfaction, as measured by SWLS. There was no statisti-
cal significant differences at thep< .05 level in SWLS scores for
the demographic variables. Demographic variables measured
did not influence SWLS as shown in Table 2.
Themes Generated From Focus Groups
Two key themes emerged from the analysis of the residents
experience in relation to their life satisfaction living in the insti-
tute: (a) Contentment (Syukoor) (b) Acceptance (Redha). The
themes and the subthemes are summarised in Table 3.
Theme 1: Contentment (Syukoor)
Three subthemes from contentment were identified from the
analysis, these included contentment to the benefits obtained,
hospitality from staff and the institute, and health and content-
ment with health and safety. These superordinate themes were
shared amongst six focus groups. The participants were con-
tented with the benefits. Thus this theme was closely related
to the living situations, facilities obtained and benefits
gained by the participants living in the institute.
Subtheme 1: Benefits
This subtheme was shared by many participants. One participant
said,
I feel happy with my life here, I feel happy to live here
[break] syukoor I have what I need, I am contented,
I am not worried about work and means to look for
74 Hong Kong Journal of Occupational Therapy
Table 1. Spearmans Rho correlation between Satisfaction with Life Scale (SWLS) with demographic variables
Scale SWLS Age Duration Friend outside In-touch No. of health problems
1. SWLS .94 .02* .94 .69 .42
2. Age .43 .82 .72 .46
3. Duration .59 .58 .71
4. Friend outside the institute .02* .77
5. In-touch with family member .56
6. No. of health problems
*Correlation is significant at .05 (2-tailed).
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LIFE SATISFACTION IN INSTITUTIONALISED ELDERLY PEOPLE
money to buy food, everything is prepared, I have six
meals a day, and then I relax all day I feel free from
the pressure to work, house maintenance and so on
I dont even have to clean my plates, I dont have to
worry about anything anymore (72-year-old male).
Another acclaimed, Nobody ask me to do anything or
forced me to do anything (69-year-old male).
Master Themes 2 and 3: Hospitality, Health and Safety
The staff hospitality and feeling safe living in the institute
were also indicated as a mean for contentment. One partici-
pant described,
I feel safe in here, nobody is teasing me because I am
old, I feel that I am respected... [The staff] call me Mak
Cik (Auntie). They really take care of me, I can go to
the clinic if I am not feeling well at anytime and I dont
have to worry about my children and my relatives and
they dont have to worry about me in here, they can
come and visit me anytime (78-year-old female).
Another explained that he was contented with the current
health status and the benefits of living in the institute and
described that,
Syukoor, I am still be able to walk although I am very old,
I can do my daily activities without any help from other
inmates, I can perform daily praying, go the mosque and
to the dining halls, not like other people here nobody
can force me to do anything (73-year-old female).
Superordinate Theme 2: Acceptance (Redha)
This superordinate theme coveyed a sense that the participants
were accepting of their current life conditions and this sense
was shared among almost all of the participants. One partici-
pant said that
It is ok, Redha with what happen in my life, what was
determine in my life, [break] left by my husband for
another women. I cant stand staying with my children,
they have a small house in the city, I felt that I lived in a
prison and I dont have friends there. I redha that I have
a place to stay, at least, I am not homeless. Even though
the food here sometime is not nice, thats ok [break],
at least I have food to eat (68-year-old female).
Discussion
There is substantial literature indicating the effect of health
status, demographic characteristics, social relationships and
occupations towards life satisfaction for elderly people in the
community (Chou & Chi, 1999; Depaola & Ebersole, 1995;
Iwatsubo, Derriennic, Cassou, & Poitrenaud, 1996; Melendez,
Tomas, Oliver, & Navarrow, 2009). However, there is a
scarcity of recent literature regarding the life satisfaction of
elderly people who lived in an institution or a long term type
of care, especially in the developed countries. The changes in
government policy of elderly peoples care which focus on
Hong Kong Journal of Occupational Therapy 75
Table 2. Analysis of variance between demographic
variables and life satisfaction, as measured by Satisfaction
with Life Scale (SWLS)
VariablesSWLS
F pMean (SD)
Age group (yr)6069 (n=23) 20.7 (3.6) 4.60 .37
7079 (n=29) 21.7 (4.0)
80 (n=30) 20.2 (4.6)
Duration of stay in the
institution (mo)
1260 mo (n=65) 20.4 (4.0) 1.90 .16
61120mo (n=14) 22.8 (3.5)
120180mo (n=3) 21.0 (4.1)
Friends outside the institute
None (n=29) 20.8 (4.4) 0.15 .93
15 (n=34) 21.1 (4.3)
610 (n=17) 19.5 (3.5)
1134 (n=2) 20.9 (4.1)
In-touch with family members
None (n=42) 21.2 (4.0) 0.31 .74
15 (n=29) 20.5 (4.5)
612 (n=11) 20.5 (3.5)
School qualification
Never gone to school (n=36) 20.8 (4.4) 0.57 .63
Up to standard six 21.1 (3.8)
(612 yr) (n=37)
Lower certificate 18.6 (5.3)
(1315yr) (n=5)
Others/certificate (n=4) 21.5 (2.9)
Referral agencies
Self-referral (n=14) 20.1 (3.2) 0.57 .63
Referred by others (n=37) 20.1 (3.9)
Directly referred by the 20.6 (4.7)
Department of Social
Welfare (n=29)
Referred by the enforcement 23.5 (0.7)
agency (n=2)
Table 3. Overview of the themes and subthemes
1. Contentment (Syukoor)
Subtheme 1.1: Semua ada (everything available)
Subtheme 1.2: HospitalitySubtheme 1.3: Health and safety
2. Acceptance (Redha)
Subtheme 2.1: Personal changes
Subtheme 2.2: Adjustments and adaptations
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A. Dahlan, et al HKJOT 2010;20(2)
community orientation services and smaller size type of care
like nursing homes, dominated recent literature.
This study attempted to identify the level of satisfaction
and the relationship between life satisfaction with sociodemo-
graphic characteristics of the elderly people (60 years and
above) and the elements that constitute the level of life satis-
faction. The statistical analysis shows that the duration living
in the institute weakly influences the SWLS scores. However,
one way between groups ANOVA indicated that there are no
significant differences in the life satisfaction as measured
with SWLS with other socio-demographic variables.
The SWLS scores indicated that there are no significant
differences with the norms of elderly people living in the com-
munity (20.24.1 and 22.417.74 respectively). According
to Swami and Chamorro-Premuzic (2009), this value is com-
mon amongst elderly people in the developing countries. The
majority of the people are satisfied in most areas of their life,
but they need to see an improvement in other areas (Diener
et al., 1985). Another possible reason for the value could be
predicted by looking at the base line demographic characteris-
tic of the participants, for example the reasons for admissions
and education level. Many of the participants come from low
economic background status, thus the opportunity to live in a
modest environment (which is better than previous living envi-
ronment) could contribute to the current level of life satisfac-
tion. The qualitative findings indicated that they are happy with
their life which is free from pressure of life, expectations and
obtaining free amenities. Happiness and life satisfaction is a
synonymous term and one of the important predictor for life
satisfaction for people in Asian countries (Jagodzinski, 2005),
thus this provides an important finding. To ensure life satis-
faction is achieved for elderly people who lived in the institu-
tion, the living environment in the institution should surpass
the previous living environment in the terms of the physical
infrastructure, hospitality and social connection.
Although the participants are disconnected from main-
stream society and have limited social connections (as a result
of the institutes regulations) as indicated in quantitative f ind-
ings, they, on average found life to be satisfying. This was hy-
pothesized as an effect of the self adjustment and adaptation,
in addition to the level of hospitality and relationship that shows
counter dependency or interdependency amongst the residents
and the relationship with the staff. For example, the partici-
pants volunteered to help the disabled elderly people and the
way they are addressed by the staff, which indicates respect
and closeness in Asian context. The elderly people in the insti-
tute were addressed in personal way such as mother, father,
uncle or auntie as indicated in qualitative findings. Pre-
vious literature indicated that the need for social gratification,
intimate relationships which involved mutual disclosure and
continues ties with familiar people had a great impact on moral
and life satisfaction for individuals who live in the institution
(Harel, 1981).
The harmonious reciprocal relationship between the resi-
dents and the staff facilitate the elderly people to thrive in the
institute (Bergland & Kirkevold, 2008; Jacelon, 1995). Fur-
thermore, the institute adopted an open policy, thus there is an
encouragement for the public and any organisation to visit the
centre, providing social visits or donations especially during
the festive seasons. Although the opportunity to socialise with
the community outside the institute is limited, it was compen-
sated by the intensity of the relationship among inmates and
the staff. Intensity of relationships was determined as one of
the variables that improve satisfaction with life for the Chinese
elderly people who live in the community (Silverman, Hecht, &
McMillan, 2000). Other variables that contribute to the life
satisfaction are social supports, active socialisation and en-
gagement in meaningful occupational activities (McGuinn &
Mosher-Ashley, 2000; Nimroad, 2007; Parker, 1996; Subasi &
Hayran, 2005; Yeung & Fung, 2007). Qualitative findings in-
dicated that there is a lack of opportunity for the residents to
engage in meaningful occupational activities due to the lack of
resources, the custodial elements and authoritarian type of care
that were shown through the rules and regulations imposed
on the residents. However, the f indings from this study indicated
that although they lack occupational opportunity, the partici-
pants are satisfied with life. Life satisfaction can be obtained as
a result of acceptance and contentment with the unavoidable
social and psychological changes and withdrawn from others
in the social system (Madigan, Mise, & Maynard, 1999).
Contentment is defined as the feeling of happiness and ease
with ones life situations which is synonymous with good life
(Carson, 1981). A degree of contentment is required to adjust
and adapt to a new environment (Clare, Rowlands, Bruce,
Surr, & Downs, 2008). The respondents indicated their content-
ment with the benefits obtained through indigenous words,
such as alhamdullilah orsyukoor. Both words have a religious
connotation. Syukoor is an Arabic word frequently used by
Malay Muslims to show gratitude and gratefulness towards God
who is providing a fortune, whilst alhamdullilah literally means
thank you God or all praise to God and it is similar to the
Hebrew word of Halelu Yah. Both words are frequently used
by Malay to indicate thankfulness and contentment with what
was given regardless of what it was. This indicated that the par-
ticipants are grateful and contented with the experience of living
in the institute which is further exemplified with moderate
level of satisfaction as measured by SWLS in spite of the limita-
tions in the institute. Feeling of contentment with life conditions
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LIFE SATISFACTION IN INSTITUTIONALISED ELDERLY PEOPLE
was identified as one of the factors to perceived health status
amongst elderly people in spite of problem associated with
hearing, mobility, sleep and fear of fall (Lindgren, Svardsudd,
& Tibblin, 1994). However, being contented is not compatible
with having no desire to change or improve the life situations
which facilitate the highest level of potentials (Carson). The
findings indicated that the participants are contented but
describe their expectations to have the opportunity to perform
various occupations, exercising autonomy, independence and
various physiological expectations thus changing life situations.
The findings provide ideographic explanations and patterns
amongst the themes, thus a life satisfaction model for institu-
tionalised elderly people was developed as shown in Figure 1.
The model shows that connection between contentment with the
benefits obtained, feeling of safe and good relationship with
the staff. In addition, the life satisfaction was also contributed
by acceptance with the changes in life and ability to adjust
and adapt with the institutional environment.
Conclusion
This study has indicated that the elderly people who lived in the
institution could have a satisfaction with life in spite of con-
strains, occupation and social deprivation and improvised living
situations as a result of adjustment, acceptance and contentment
with current life. Occupational therapy could facilitate adjust-
ment and integrate or encourage acceptance and contentment to
facilitate life satisfaction through engagement in meaningful
activities and traditional occupational therapy techniques such
as the Life Review or the reminiscence therapy.
Acknowledgements
This study was not supported by any research grant and is a
small part of a PhD thesis entitled The Development and
Testing of Lively Later Life Programme (3LP) for institution-
alised elderly people.
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Hong Kong Journal of Occupational Therapy 77
Theme 1:
CONTENTMENT
(Syukoor)
Subtheme 3:
Health & safety
Subtheme 1:
Personal
changes
Subtheme 2:
Adjustment &
adaptation
Subtheme 1:Benefits
LIFE
SATISFACTION
Phenomena & strategies Consequences
Theme 2:
ACCEPTANCE
(Redha)
Subtheme 2:
Hospitality
Figure 1.Life satisfaction model for the institutionalised elderly people.
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