Predictors of Life Satisfaction in Frail Elderly

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Predictors of Life Satisfactionin Frail Elderly

Soleman H Abu-Bader PhDAnissa Rogers PhD

Amanda S Barusch PhD

ABSTRACT This study examined the relationship between life satisfac-tion and physical status emotional health social support and locus of control in the frail elderly A random sample of 99 low-income frail el-derly living in the community was interviewed Almost 40 of partici-pants reported high levels of life satisfaction Multiple regression analysisidentified four significant predictors of life satisfaction Perceived physicalhealth social support emotional balance and locus of control Physicalhealth emerged as the most significant predictor of life satisfaction ac-counting for 14of the variance Social support emotional balance and lo-cus of control each accounted for an additional 6 of the variance in lifesatisfaction All four predictors explained 32 ( R = 57) of the total vari-ancein life satisfaction Implications for practice and recommendations are

discussed [Article copies available for a fee from The Haworth Document Deliv-ery Service 1-800-HAWORTH E-mail address ltgetinfohaworthpressinccomgtWebsite lthttpwwwHaworthPresscomgtcopy 2002 by TheHaworth Press Inc Allrightsreserved]

Soleman H Abu-Bader is Assistant Professor School of Social Work Howard Uni-versity

Anissa Rogers is Assistant Professor Department of Social and Behavioral SciencesUniversity of Portland

Amanda Barusch is Professor Graduate School of Social Work University of UtahAddress correspondence to Soleman H Abu-Bader PhD Howard University 601

Howard Place NW Washington DC 20059 (E-mail sabu-baderhowardedu)This study was funded by the Goodwill Family FoundationPaper presented at the 4th Annual Conference of the Society for Social Work amp Re-

search Charleston South Carolina January 29-31 2000

Journal of Gerontological Social Work Vol 38(3) 2002httpwwwhaworthpressinccomstoreproductaspsku=J083 2002 by The Haworth Press Inc All rights reserved 3



KEYWORDS Frail elderly life satisfaction physical health social sup-port cognitive status emotional balance locus of control life events ac-tivities of daily livings

The life satisfaction of the elderly has been widely researched and dis-cussed The construct is particularly important for professionals such associal workers whose work aims to enhance the quality of life of the el-derly Much research in this area has analyzed how life satisfaction is in-fluenced by factors such as social support financial status physicalhealth and locus of control Most of this work has been conducted withhealthy community-dwelling elders No studies to date have considered

the life satisfaction of elders who have significant physical limitations(possibly because of a tendency to assume that physical problems will re-sult in low life satisfaction) The purpose of the current study is to expand on prior studies by analyzing factors that may influence life satisfactionamong frail elders

FACTORS INFLUENCING LIFE SATISFACTION AMONG THE ELDERLY

Factors that influence life satisfaction include environmental character-istics such as the availability of social support and personal traits such asself-esteem physical health financial resources a sense of

connectedness and locus of control

Social Support and Life Satisfaction

Several studies have examined the relationship between social sup-port and life satisfaction among the elderly Most of this literature hasindicated a positive relationship between social support and life satis-faction One study conducted by Aquino Russell Cutrona and Altmaier (1996) found that social support was significantly related to lifesatisfaction Aquino et al surveyed 301 community-dwelling elders aged 65 years old and over to determine how demographic variables such as fi-nancial status educational level and work patterns affect life satisfactionResults from face-to-face interviews indicated that elders who were work-

ing or volunteering showed higher life satisfaction than those who werenot working or volunteering Further these authors found that participantswho engaged in volunteer work had more social supports than those who

4 JOURNAL OF GERONTOLOGICAL SOCIAL WORK



were not engaged in volunteer work which in turn led to higher levels of life satisfaction The findings also indicated that participants who reported low education and socioeconomic levels and who had poor physicalhealth indicated that they had few social supports and low life satisfactionConsequently participants who were not functioning well enough to work or volunteer had fewer opportunities to build social networks which af-forded fewer opportunities to engage in satisfying relationships outside of the workplace than participants who were working or volunteeringThough many of the measures used in the aforementioned study werestandardized particularly those measuring social support and life satisfac-tion it is unclear whether these instruments are appropriate for use witholder adults

In another study conducted by Newsome and Schulz (1996) 5201people aged 65+ were randomly selected from Medicare lists Partici-pants were surveyed to gather information regarding their social net-works level of functioning perceived social supports and lifesatisfaction Results indicated that participants who reported decreased physical functioning also perceived their social supports as poor Furtherparticipants who perceived their social supports as poor reported low lifesatisfaction Thus participants who reported physical difficulties also per-ceived their social supports to be poor which may have affected their level of life satisfaction

At this point the theoretical connection between physical functioningand social support remains unclear While some argue that social support enhances physical health or buffers an individual from the deleterious ef-

fects of stress these connections have not been empirically demonstrated

Personal Traits

Other studies have indicated that factors such as self-esteem per-ceived physical health and locus of control are associated with life sat-isfaction (Girzadas Counte Glandon amp Tancredi 1993 Rogers1999) Still other literature posits that financial security and a sense of closeness and connectedness with others predict life satisfaction(Fisher 1995 Girzadas et al 1993 Gray Ventis amp Hayslip 1992Kahana et al 1995 Levitt Antonucci Clark Rotton amp Finley 1986McGhee 1984 Revicki amp Mitchell 1986 Wing-Leung Lai amp McDon-ald 1995) Indeed Kahana et al (1995) found that short-term problems

such as those caused by financial difficulties and changes in relationshipsthrough retirement or death may have a significant impact on life satisfac-tion

Abu-Bader Rogers and Barusch 5



Locus of control has been another widely studied construct in relationto life satisfaction among the elderly Most research has focused on therelationship between internal external and chance locus of control and life satisfaction and conclusions as to the nature of this relationshiphave been mixed In an exploratory study conducted by Girzadas et al(1993) 258 community-dwelling individuals aged 55+ were selected from a larger study that examined the relationship between health statuslocus of control and life satisfaction The larger study recruited partici-pants from the rolls of Health Maintenance Organizations and privatephysicians Results from face-to-face interviews with participants indi-cated that functional health status was positively associated with life satis-faction Further participants who scored high on chance locus of control

also scored low on life satisfaction Specifically participants who re-ported poor physical health and who demonstrated a tendency toward be-lieving their health outcomes were based on chance also showed relativelylow life satisfaction

Results from other studies suggest that individuals with a tendency to-ward internal locus of control particularly with regard to physical healthshow higher levels of life satisfaction than those who show a tendency to-ward external or chance locus of control (eg Haber 1994 Searle M SMahon M J amp Iso-Ahola S E 1995 Wing-Leung Lai amp McDonald1995) It follows that older adults who are not internally focused mayshow a tendency toward low life satisfaction For instance Park and Vanderberg (1994) found from a sample of 154 individuals aged 58+ that those who demonstrated low levels of personal autonomy and high levels

of dependency tended to be more negatively affected by poor health and showed a need for social support in the form of a confidant than more au-tonomous and independent individuals Moreover Vallerand OrsquoConnorand Blais (1989) found that older adults living in nursing homes that did not allow for personal autonomy or self-determination showed lower lifesatisfaction than older adults living in nursing homes that allowed for more personal independence or those living independently in the commu-nity

Conversely some studies have indicated that older adults who demon-strate a tendency towards external locus of control have higher life satis-faction than those with an internal or chance locus of control (eg Haber1994 Rogers 1999) It may be that older individuals who are externallyfocused and who have developed trust in their health care provider actu-

ally demonstrate higher levels of life satisfaction than those who rely onthemselves or even chance for health care decisions Specifically the lat-ter group may experience more guilt or feelings of hopelessness when




faced with health problems poor treatment or poor decision making withregard to health care (Haber 1994)

In summary studies of life satisfaction among elderly have identified several important constructs that may influence this measure These con-structs include the following social support physical health locus of con-trol (internal external and chance) financial status and life events Usingmultiple regression analysis the current study incorporated these and other measures to develop a model that best describes factors associated with life satisfaction among frail elderly

METHODOLOGY

Sample

Recruiting Methods Participants for this study were randomly selected from clients of The Alternatives Program (TAP) in Salt Lake CountyUtah TAP provides services such as adult day care and homemakers tolow-income adults whose physicians certify that they are at risk of nursinghome placement Of the 182 TAP clients contacted 102 (56) were inter-viewed of whom 99 were 60 years old and over and thus included in thefinal analysis Of the 99 subjects 87 (88) were women Program staff provided access to demographic information on non-participants and independent t-tests and chi-square analyses were conducted to identifydifferences in age race gender income and living status (whether or

not the respondent lived alone) between participants and non-partici-pants These analyses yielded significant differences in age (t = 242 p =017) Older TAP clients refused to participate in the study more fre-quently Analyses revealed no significant differences on other variablesThe most common reason for non-participation given by 43 of thosewho declined related to poor health and cognitive difficulties Others(26) indicated they just did not want to be interviewed while the re-mainder cited other reasons

Participant Characteristics Participants in this study were predomi-nantly white (94) Their mean age was 78 years (SD = 85) with a rangefrom 60 to 101 years The median monthly income was $575 with a rangefrom $257 to $1584 per month The vast majority (81) were either wid-owed (53) or divorced (28) The majority (70) lived alone The

modal level of education was high school (34)Respondents were frail needing assistance with an average of 26 Ac-

tivities of Daily Living (ADLrsquos) and 53 Instrumental Activities of Daily




Living (IADLrsquos) Respondents reported their health to be ldquofairrdquo (38) toldquogoodrdquo (24)

Over one third (36) had a diagnosis relating to the musculoskeletalsystem primarily a form of arthritis The next most common diagnosticcategory was neurological with 24 of the sample experiencing an ill-ness of this kind This was followed by cardiovascular illness experi-enced by 19 of the sample The mean duration of illness was 14 yearswith a range from 1 to 70 Half (53) of the sample reported a steady de-cline associated with their illness Others reported that their conditionswere stable (16) or had variable ldquoup and downrdquo trajectories (14) A few respondents (10) reported their condition had recently improved

Data Collection

Interviews Trained undergraduate and graduate MSW students con-ducted in-depth interviews in respondentsrsquo homes Interviews lasted oneto three hours When participants became fatigued interviewers com-pleted the interview in a second home visit While most of the protocolwas highly structured interviews closed with a ldquoguided conversationrdquo de-signed to explore respondentsrsquo understanding of the impact of physical ill-ness on their lives and emotional well-being For individuals withsignificant cognitive impairment interviews were conducted with visualaids and additional time was allowed

Instruments A general demographic section recorded age genderrace religion education marital status participantrsquos occupation

spousersquos occupation primary diagnosis length of residency in home al-cohol and prescription drug use home ownership and living arrange-ment

The dependent variable life satisfaction was measured using the LSI-Z (Wood Wylie amp Sheafor 1969) The LSI-Z is a shorter form of theLSI-A (Neugarten Havighurts amp Tobin 1961) The LSI-Z contains 14items that respondents rate agree disagree or uncertain Possible totalscores range between 1 and 14 with higher scores indicating higher lifesatisfaction The LSI-Z is a self-report measure that has been normed on100 elderly subjects with a mean life satisfaction score of 116 and a stan-dard deviation of 44 (Sauer amp Warland 1982) The LSI-Z has a Kuder-Richardson reliability1 coefficient of 79

The Iowa Self-Assessment Inventory (Morris amp Buckwalter 1988) is

56-item scale that consists of seven subscales including economic re-sources emotional balance physical health trusting others mobilitycognitive status and social support Items are rated on a scale from 1 (usu-




ally or always true) to 4 (usually or always false) The scores for each item are summed to comprise a score that ranges from 8 to 32 This inventoryprimarily has been normed on adults 65+ years old (Morris BuckwalterCleary Gilmer amp Andrews 1992) The internal consistency reliabilitycoefficients for the seven subscales range from 74 to 86 (MorrisBuckwalter Cleary Gilmer Hatz amp Studer 1990) Construct validity hasbeen shown between each subscale and similar measures (MorrisBuckwalter Cleary Gilmer Hatz amp Studer 1989)

The Geriatric Scale of Recent Life Events (Kiyak Liang amp Kahana1976) is a 55-item scale that measures the number of life events that haveoccurred within the previous three years Subjects circle all events that they have experienced and the number of events circled is summed to

comprise a total score Item examples include ldquoDeath of a Close FriendrdquoldquoMinor Illnessrdquo ldquoGain a new family memberrdquo and ldquoGrandchild mar-riedrdquo This scale was normed on 248 individuals 60+ years old and hasshown good concurrent validity (51 to 84) (Kiyak Liang amp Kahana1976) The analysis reported here was based on a subscale of negativeevents constructed for the study It included 32 items

The Multidimensional Health Locus of Control Scale (MHLC) (WallstonWallston amp DeVellis 1978) is an 18-item instrument that rates respon-dents according to internal health locus of control (IHLC) powerful oth-ers health locus of control (PHLC) and chance health locus of control(CHLC) Respondents answer questions on a 4-point Likert-type scale (1= strongly disagree to 4 = strongly agree) Scores on each subscale are

summed and higher scores indicate more external beliefs in locus of con-trol Typical questions include ldquoNo matter what I do if I am going to get sick I will get sickrdquo and ldquoMost things that affect my health happen to meby accidentrdquo (Wallston et al 1978) Inter-item reliability has been esti-mated to range from 67 to 86 Concurrent validity with similar locus of control measures has been estimated to range from 51 to 73 This scalewas normed on the general population with a median age range from 35 to44 years

The Index of Activities of Daily Living (ADL) (Katz Ford MoskowitzJackson amp Jaffee 1963) is a widely used measure that assesses a personrsquosability to carry out daily tasks such as walking getting out of bed climb-ing stairs grooming bathing dressing toileting and feeding Items arerated ldquoyesrdquo or ldquonordquo in terms of dependence or independence for each ac-

tivity This index has shown good interrater reliability as well as strongcorrelations with measures of mobility and house confinement (Kane ampKane 1981)




Finally perceived health in general was measured by a 5-point Likert scale item ldquoIn general would you say your health is excellent very goodgood fair or poorrdquo

Data Analysis

Two multiple regression methods hierarchical and stepwise methodswere conducted to determine which psychosocial measures were signifi-cantly associated with life satisfaction among respondents Measures that have shown significant correlations (p lt 05) with life satisfaction wereentered in the regression equation These variables were number of nega-tive life events emotional balance physical health cognitive status so-

cial support powerful others locus of control and perceived health ingeneral The dependent variable was life satisfaction as measured by theLSI-Z

Prior to these analyses frequencies and histograms were generated for all variables to assess distributions and outlying cases All variables werenormally distributed and had no outliers For the regression analysis diag-nostics were performed to ensure multivariate assumptions were metBivariate correlation matrices variance inflation factor (VIF) values and tolerance criteria indicated no multicollinearity among the independent variables

FINDINGS

Descriptive Findings

Life Satisfaction To describe the life satisfaction of participants in thisstudy we computed descriptive statistics using the dependent variablelife satisfaction The mean score on the Life Satisfaction Index was 96(SD = 25) slightly below the cutoff score (116) for a normal populationof elderly as reported by Sauer and Warland (1982) Scores on the life sat-isfaction ranged from 3 to 14 with 39 of participants reporting a score of 11 or higher (61 below the cutoff score)

Cognitive Status Cognitive status was gauged using the Mini MentalState Exam as well as the cognitive status sub-scale from the Iowa Self-Assessment Inventory The mean score on the Mini Mental State Ex-

amination was 258 with a range from 13 to 30 Folstein Folstein and McHugh (1975) suggest using a criterion of 21 or less to gauge cognitiveimpairment Using this cut-off only 14 of respondents showed signifi-




cant cognitive impairment Further evidence of cognitive capacity wasprovided by the cognitive status subscale from the Iowa Self-Assessment Inventory The mean score on this measure was 217 with a range from 8-32

Locus of Control Participants in this study showed a clear tendency to-ward external causal attributions Their mean score on the Internal Locusof Control sub-scale was 56 with a range from 2 to 8 The mean score onexternal (ldquopowerful othersrdquo) sub-scale was 147 with a range from 6 to24 Respondentsrsquo mean on the chance sub-scale was 124 with a rangefrom 6 to 19 Mean scores obtained when this instrument was normed were 251 on the Internal Locus of Control sub-scale 199 on the PowerfulOthers sub-scale and 156 on the chance sub-scale (Wallston et al 1978)

Table 1 displays results for these descriptive analyses Life Events The average number of negative life events participants ex-perienced in the year prior to this study was 75 with a range from 2 to 17The most common event reported was difficulty walking experienced by85 of the sample This was followed by minor illness (84) reduced recreation (76) illness of a family member (60) hearing and visionproblems (56) and less church activity (49) Nearly half (48) of thesample had experienced death of a family member Table 2 displays thenegative life events included in this study

Predicting Life Satisfaction

Hierarchical and stepwise multiple regression methods were conducted

to estimate a model predicting life satisfaction As was previously men-tioned variables that were significantly correlated with life satisfactionwere entered in the regression equation Table 3 presents the correlationsbetween the dependent variable (life satisfaction) and the independent measures

The results of both hierarchical and stepwise multiple regressionmethods were consistent and therefore the results of the stepwise arereported in this study These results are presented in Table 4 These re-sults show that life satisfaction is a function of physical health (beta =26 p lt 0001) social support (beta = 19 p = 007) emotional balance(beta = 34 p = 039) and powerful others locus of control (beta = 28 p =003) The results show that physical health has the strongest contributionto the variance of life satisfaction It contributes 14 of the variance in life

satisfaction while each one of the other variables contributes 6 of thevariance All four variables combined contribute 32 ( R = 57) of the totalvariance of life satisfaction




DISCUSSION

This sample of frail elders reported levels of life satisfaction that weresomewhat lower than those observed in studies of more healthy elders Inthis study the mean score of life satisfaction (96) was slightly below

scores reported in studies of healthy seniors In these studies mean lifesatisfaction scores have ranged from a low of 116 to a high of 1539(Kahana et al 1995 Wood Wylie amp Sheafor 1969 Rao amp Rao 1981Gray Ventis amp Hayslip 1992 Adams 1969) This difference is smalland a significant proportion of respondents in this study reported levels of satisfaction that were well within the range of those reported by morehealthy elders Indeed these results underscore what practitioners in thefield already know Namely that not all frail elders experience low lifesatisfaction In this sample nearly half reported high scores on this mea-sure

It is tempting to attribute the samplersquos lower mean life satisfaction tohealth and functional limitations But results of the multivariate analysisdo not support this interpretation The subjective measure perceived

physical health was an important predictor of life satisfaction whereasmore objective health measures were not In bivariate analyses reported inTable 3 more objective measures of functional ability (IADL and ADL)


TABLE 1 Respondentsrsquo Cognitive and Emotional Status (N = 99)

Variable Mean Median SD Range

Life Satisfaction 96 100 25 3-14

Physical Health 154 140 47 7-26

Economic Resources 225 220 60 5-32

Emotional Balance 232 240 62 10-32

Trusting Others 281 290 43 13-32

Mobility 160 160 51 5 -30

Cognitive Status 217 220 56 8-32

Social Support 273 290 54 10-32 Activities of Daily Living 26 30 18 0-8

Powerful Others Locus of Control 147 150 34 6-24

Internal Health Locus of Control 56 60 14 2-8

Chance Health Locus of Control 124 130 33 6-19



did not show a significant association with life satisfaction In contrastpersonal health appraisal was significant in the bivariate analysis (r = 38)Further the measure was the most important predictor in our model pre-dicting life satisfaction This is consistent with findings of other studies(eg George 1993 Henderson et al 1993) that indicate that subjective

perception may be a better predictor of life satisfaction than actual func-tional ability Clearly apart from more objective measures an individ-ualrsquos perception regarding his or her health is an important correlate of life


TABLE 2 Negative Life Events (N = 99)

Event Number Reporting of Sample

Difficulty Walking 84 85

Minor Illness 83 84

Reduced Recreation 75 76

Family Member Ill 59 60

HearingVision Problems 55 56

Less Church Activity 48 49

Death of Friend 47 48

Death of Family Member 45 46

Major Illness 45 46

Financial Difficulty 36 36

Stopped Driving 26 26

Friends Turned Away 15 15

Victim of Crime 15 15

Loss of Possessions 14 14

Moved into Home for Aged 13 13

Trouble with Children 12 12

Trouble with Neighbor 11 11

Age Discrimi nation 9 9

Took Large Loan 8 8

Sexual Difficulty 8 8

Argued wit h Spouse 6 6

Divorce 3 3

Death of Spouse 3 3

Legal Violation 3 3

Separation 2 2

Unfaithful Spouse 1 1



satisfaction Practitioners who work with the frail elderly may find that perceived health status serves as a proxy for other measures of well-beingThus any assessment of this population should include this parsimonious

measureBecause this study is correlational it is unclear whether results have

identified factors that cause life satisfaction Findings mirrored those of


TABLE 3 Correlations Between Life Satisfaction and the Independent Mea-

sures (N = 99)

Variable r

Physical Health 38

Emotional Balance 34

Social Support 31

Negative Recent Life Events 226

Cognitive Status 20

Powerful Others Locus of Control 20

Instrumental Activities of Daily Living (IADLs) 13

Trusting Others 13

Internal Health Locus of Control 12

Activities of Daily Livings (ADLs) 207

Chance Health Locus of Control 05

Mobility 05

Economic Resources 02

p lt 05

p lt 001

TABLE 4 Predicting Life Satisfaction

Variable R R2

beta SE t p F p

Physical Health 38 14 26 05 279 006 1569 000

Social Support 45 20 19 04 210 039 1212 000

Emotional Balance 51 26 34 04 350 001 1078 000

Powerful Others Locus of Control 57 32 28 07 3 03 003 1108 000

Adjusted R2 = 30



other studies in the important role of social support emotional balanceand powerful others locus of control in the life satisfaction of the frail el-derly Clearly as suggested by the results of multiple regression frail el-ders who perceive their health as poor who have limited social supportsand whose emotional status is fragile should be considered likely candi-dates for low life satisfaction

This study affords some practical implications for professionals com-mitted to enhancing the quality of life of frail elders First it is important that assessments include a simple measure of perceived physical healthThis is an efficient way to appraise not only physical well-being but also life satisfaction and possibly emotional status as well Secondwhile it is unclear whether life satisfaction is amenable to clinical inter-

vention efforts to enhance the quality of life for frail elders would dowell to consider the Life Satisfaction Index a possible evaluation mea-sure as one most likely to reflect the overall success of their effortsFinally in illustrating the importance of diverse factors in predicting lifesatisfaction this study underscores the importance of holistic interventionthat addresses not only personal traits and perceptions but also social sup-port and resources

NOTE

1 For more information about Kuder-Richardson Reliability see Crocker and Algina (1986)

REFERENCES

Adams D L (1969) Analysis of a life satisfaction index Journal of Gerontology 24(4)470-474

Aquino J A Russell D W Cutrona C E amp Altmaier E M (1996) Employment sta-tus social support and life satisfaction among the elderly Journal of Counseling Psy-chology 43(4) 480-489

Crocker L amp Algina J (1986) Introduction to classical and modern test theory Fort Worth TX Harcourt Brace Jovanovich College Publishers

Fisher B J (1995) Successful aging life satisfaction and generativity in later life Inter-national Journal of Aging and Human Development 41(3) 239-250

Folstein M F Folstein S amp McHugh P R (1975) Mini-mental state A practical

method for grading the cognitive state of patients for the clinician Journal of Psychi-atric Research 12 189-198George L K (1993) Depressive disorders and symptoms in later life Generations Win-

terSpring 35-38




Girzadas P M Counte M A Glandon G L amp Tancredi D (1993) An analysis of el-derly health and life satisfaction Behavior Health and Aging 3(2) 103-117

Gray G R Ventis D G Hayslip B (1992) Socio-cognitive skills as a determinant of life satisfaction in aged persons International Journal of Aging and Human Develop-ment 35 (3) 205-218

Haber D (1994) Health promotion and aging New York NY Springer PublishingCompany

Henderson A S Jorm A F Mackinnon AChristensen HScott L RKorten A Eamp Doyle C (1993) The prevalence of depressive disorders and the distribution of de-pressive symptoms in later life A survey using Draft ICD-10 and DSM-III-R Psycho-logical Medicine 23(3) 719-729

Kahana E Redmond C Hill G J Kercher K Kahana B Johnson J R amp YoungR F (1995) The effects of stress vulnerability and appraisals on the psychologicalwell-being of the elderly Research on Aging 17 (4) 459-489

Kane R A amp Kane R L (1981) Assessing the elderly A practical guide to measure-ment San Francisco Lexington Books

Katz S Ford A B Moskowitz R W Jackson B A Jaffee M W (1963) Studies of illness in the aged The index of ADL A standardized measure of biological and psychosocial function The Journal of the American Medical Association 185 (94)

Kiyak A Liang J amp Kahana E (1976) A methodological inquiry into the schedule of recent life events In D J Mangen amp W A Peterson (Eds) Research instruments insocial gerontology Vol 1 Clinical and social psychology Minneapolis MN Univer-sity of Minnesota Press

Levitt M J Antonucci T C Clark M C Rotton J amp Finley G E (1986) Socialsupport and well-being Preliminary indicators based on two samples of the elderly

International Journal of Aging and Human Development 21(1) 61-77McGhee J L (1984) The influence of qualitative assessments of the social and physical

environment on the morale of the rural elderly American Journal of Community Psy-chology 12(6) 709-723

Morris W W amp Buckwalter K C (1988) Functional assessment of the elderly TheIowa self-assessment inventory In C F Waltz amp O L Stricklan (Eds) Measurement of nursing outcomes volume one measuring client outcomes (pp 328-351)

Morris W W amp Buckwalter K C Cleary T A Gilmer J S amp Andrews P H(1992) The development and use of the Iowa self-assessment inventory (ISAI) Factsand Research in Gerontology 373-382

Morris W W amp Buckwalter K C Cleary T A Gilmer J S Hatz D L amp StuderM (1989) Issues related to the validation of the Iowa self-assessment inventory Edu-cational and Psychological Measurement 49 853-861

Morris W W amp Buckwalter K C Cleary T A Gilmer J S Hatz D L amp StuderM (1990) Refinement of the Iowa self-assessment inventory The Gerontologist 30 (2) 243-248

Neugarten B L Havighurst R J amp Tobin S S (1961) The measurement of life satis-faction Journal of Gerontology 16 134-143

Newsome J T amp Schulz R (1996) Social support at a mediator in the relation Between

functional status and quality of life in older adults Psychology and Aging 11(1)34-44




Park D amp Vandenberg B (1994) The influence of separation orientation on life satis-faction in the elderly International Journal of Aging and Human Development 39 (2)177-187

Rao VN amp Rao VV (1981) Life satisfaction in the black elderly An exploratorystudy International Journal of Aging and Human Development 14(1) 55-65

Revicki D A amp Mitchell J (1986) Social support factor structure in the elderly Re-search on Aging 8 (2) 232-248

Rogers A (1999) Factors associated with depression and low life satisfaction in thelow-income frail elderly Journal of Gerontological Social Work 31(12)167-194

Sauer WJ amp Warland R(1982) Morale and life satisfaction In D J Mangen amp WAPeterson (Eds) Research instruments in social gerontology Clinical and social psy-chology (Vol 1 pp 195-240) Minneapolis University of Minnesota Press

Searle M S Mahon M J amp Iso-Ahola S E (1995) Enhancing a sense of independ-

ence and psychological well-being among the elderly A field experience Journal of Leisure Research 27 (2) 107-124

Vallerand R J OrsquoConnor B P amp Blais M R (1989) Life satisfaction of elderly indi-viduals in regular community housing in low-cost community housing and high and low self-determination nursing homes International Journal of Aging and Human

Development 28 (4) 277-283Wallston K A Wallston B S amp DeVellis R (1978) Development of the multidimen-

sional health locus of control (MHLC) scales Health Education Monographs 6 (2)160-170

Wing-Leung Lai D amp McDonald J R (1995) Life satisfaction of Chinese elderly im-migrants in Calgary Canadian Journal on Aging 14(3) 536-551

Wood V Wylie M L amp Sheafor B (1969) An analysis of a short self-report measureof life satisfaction Correlation with rater judgments Journal of Gerontology 24465-469

DATE MANUSCRIPT RECEIVED 11501DATE MANUSCRIPT SENT FOR BLIND REVIEW 11601

DATE MANUSCRIPT RE-RECEIVEDIN ACCEPTABLE FORM 22002




KEYWORDS Frail elderly life satisfaction physical health social sup-port cognitive status emotional balance locus of control life events ac-tivities of daily livings

The life satisfaction of the elderly has been widely researched and dis-cussed The construct is particularly important for professionals such associal workers whose work aims to enhance the quality of life of the el-derly Much research in this area has analyzed how life satisfaction is in-fluenced by factors such as social support financial status physicalhealth and locus of control Most of this work has been conducted withhealthy community-dwelling elders No studies to date have considered

the life satisfaction of elders who have significant physical limitations(possibly because of a tendency to assume that physical problems will re-sult in low life satisfaction) The purpose of the current study is to expand on prior studies by analyzing factors that may influence life satisfactionamong frail elders

FACTORS INFLUENCING LIFE SATISFACTION AMONG THE ELDERLY

Factors that influence life satisfaction include environmental character-istics such as the availability of social support and personal traits such asself-esteem physical health financial resources a sense of

connectedness and locus of control

Social Support and Life Satisfaction

Several studies have examined the relationship between social sup-port and life satisfaction among the elderly Most of this literature hasindicated a positive relationship between social support and life satis-faction One study conducted by Aquino Russell Cutrona and Altmaier (1996) found that social support was significantly related to lifesatisfaction Aquino et al surveyed 301 community-dwelling elders aged 65 years old and over to determine how demographic variables such as fi-nancial status educational level and work patterns affect life satisfactionResults from face-to-face interviews indicated that elders who were work-

ing or volunteering showed higher life satisfaction than those who werenot working or volunteering Further these authors found that participantswho engaged in volunteer work had more social supports than those who








Personal Traits

















METHODOLOGY

Sample











Data Collection





















Data Analysis




FINDINGS



















DISCUSSION













Mobility 160 160 51 5 -30














Minor Illness 83 84







Major Illness 45 46










Took Large Loan 8 8



Divorce 3 3

Death of Spouse 3 3

Legal Violation 3 3

Separation 2 2









sures (N = 99)

Variable r

Physical Health 38


Social Support 31


Cognitive Status 20



Trusting Others 13




Mobility 05


p lt 05

p lt 001


Variable R R2

beta SE t p F p

Physical Health 38 14 26 05 279 006 1569 000

Social Support 45 20 19 04 210 039 1212 000



Adjusted R2 = 30






NOTE


REFERENCES







terSpring 35-38














































Personal Traits

















METHODOLOGY

Sample











Data Collection





















Data Analysis




FINDINGS



















DISCUSSION













Mobility 160 160 51 5 -30














Minor Illness 83 84







Major Illness 45 46










Took Large Loan 8 8



Divorce 3 3

Death of Spouse 3 3

Legal Violation 3 3

Separation 2 2









sures (N = 99)

Variable r

Physical Health 38


Social Support 31


Cognitive Status 20



Trusting Others 13




Mobility 05


p lt 05

p lt 001


Variable R R2

beta SE t p F p

Physical Health 38 14 26 05 279 006 1569 000

Social Support 45 20 19 04 210 039 1212 000



Adjusted R2 = 30






NOTE


REFERENCES







terSpring 35-38





















































METHODOLOGY

Sample











Data Collection





















Data Analysis




FINDINGS



















DISCUSSION













Mobility 160 160 51 5 -30














Minor Illness 83 84







Major Illness 45 46










Took Large Loan 8 8



Divorce 3 3

Death of Spouse 3 3

Legal Violation 3 3

Separation 2 2









sures (N = 99)

Variable r

Physical Health 38


Social Support 31


Cognitive Status 20



Trusting Others 13




Mobility 05


p lt 05

p lt 001


Variable R R2

beta SE t p F p

Physical Health 38 14 26 05 279 006 1569 000

Social Support 45 20 19 04 210 039 1212 000



Adjusted R2 = 30






NOTE


REFERENCES







terSpring 35-38












































METHODOLOGY

Sample











Data Collection





















Data Analysis




FINDINGS



















DISCUSSION













Mobility 160 160 51 5 -30














Minor Illness 83 84







Major Illness 45 46










Took Large Loan 8 8



Divorce 3 3

Death of Spouse 3 3

Legal Violation 3 3

Separation 2 2









sures (N = 99)

Variable r

Physical Health 38


Social Support 31


Cognitive Status 20



Trusting Others 13




Mobility 05


p lt 05

p lt 001


Variable R R2

beta SE t p F p

Physical Health 38 14 26 05 279 006 1569 000

Social Support 45 20 19 04 210 039 1212 000



Adjusted R2 = 30






NOTE


REFERENCES







terSpring 35-38












































Data Collection





















Data Analysis




FINDINGS



















DISCUSSION













Mobility 160 160 51 5 -30














Minor Illness 83 84







Major Illness 45 46










Took Large Loan 8 8



Divorce 3 3

Death of Spouse 3 3

Legal Violation 3 3

Separation 2 2









sures (N = 99)

Variable r

Physical Health 38


Social Support 31


Cognitive Status 20



Trusting Others 13




Mobility 05


p lt 05

p lt 001


Variable R R2

beta SE t p F p

Physical Health 38 14 26 05 279 006 1569 000

Social Support 45 20 19 04 210 039 1212 000



Adjusted R2 = 30






NOTE


REFERENCES







terSpring 35-38





















































Data Analysis




FINDINGS



















DISCUSSION













Mobility 160 160 51 5 -30














Minor Illness 83 84







Major Illness 45 46










Took Large Loan 8 8



Divorce 3 3

Death of Spouse 3 3

Legal Violation 3 3

Separation 2 2









sures (N = 99)

Variable r

Physical Health 38


Social Support 31


Cognitive Status 20



Trusting Others 13




Mobility 05


p lt 05

p lt 001


Variable R R2

beta SE t p F p

Physical Health 38 14 26 05 279 006 1569 000

Social Support 45 20 19 04 210 039 1212 000



Adjusted R2 = 30






NOTE


REFERENCES







terSpring 35-38











































Data Analysis




FINDINGS



















DISCUSSION













Mobility 160 160 51 5 -30














Minor Illness 83 84







Major Illness 45 46










Took Large Loan 8 8



Divorce 3 3

Death of Spouse 3 3

Legal Violation 3 3

Separation 2 2









sures (N = 99)

Variable r

Physical Health 38


Social Support 31


Cognitive Status 20



Trusting Others 13




Mobility 05


p lt 05

p lt 001


Variable R R2

beta SE t p F p

Physical Health 38 14 26 05 279 006 1569 000

Social Support 45 20 19 04 210 039 1212 000



Adjusted R2 = 30






NOTE


REFERENCES







terSpring 35-38





















































DISCUSSION













Mobility 160 160 51 5 -30














Minor Illness 83 84







Major Illness 45 46










Took Large Loan 8 8



Divorce 3 3

Death of Spouse 3 3

Legal Violation 3 3

Separation 2 2









sures (N = 99)

Variable r

Physical Health 38


Social Support 31


Cognitive Status 20



Trusting Others 13




Mobility 05


p lt 05

p lt 001


Variable R R2

beta SE t p F p

Physical Health 38 14 26 05 279 006 1569 000

Social Support 45 20 19 04 210 039 1212 000



Adjusted R2 = 30






NOTE


REFERENCES







terSpring 35-38










































DISCUSSION













Mobility 160 160 51 5 -30














Minor Illness 83 84







Major Illness 45 46










Took Large Loan 8 8



Divorce 3 3

Death of Spouse 3 3

Legal Violation 3 3

Separation 2 2









sures (N = 99)

Variable r

Physical Health 38


Social Support 31


Cognitive Status 20



Trusting Others 13




Mobility 05


p lt 05

p lt 001


Variable R R2

beta SE t p F p

Physical Health 38 14 26 05 279 006 1569 000

Social Support 45 20 19 04 210 039 1212 000



Adjusted R2 = 30






NOTE


REFERENCES







terSpring 35-38
















































Minor Illness 83 84







Major Illness 45 46










Took Large Loan 8 8



Divorce 3 3

Death of Spouse 3 3

Legal Violation 3 3

Separation 2 2









sures (N = 99)

Variable r

Physical Health 38


Social Support 31


Cognitive Status 20



Trusting Others 13




Mobility 05


p lt 05

p lt 001


Variable R R2

beta SE t p F p

Physical Health 38 14 26 05 279 006 1569 000

Social Support 45 20 19 04 210 039 1212 000



Adjusted R2 = 30






NOTE


REFERENCES







terSpring 35-38















































sures (N = 99)

Variable r

Physical Health 38


Social Support 31


Cognitive Status 20



Trusting Others 13




Mobility 05


p lt 05

p lt 001


Variable R R2

beta SE t p F p

Physical Health 38 14 26 05 279 006 1569 000

Social Support 45 20 19 04 210 039 1212 000



Adjusted R2 = 30






NOTE


REFERENCES







terSpring 35-38













































NOTE


REFERENCES







terSpring 35-38































































































Documents

Predictors of Life Satisfaction in Frail Elderly