LONELINESS AND SELF ESTEEM AMONG ELDERLY POPULATION AT OLD AGE HOMES AND WITH FAMILY

LONELINESS AND SELF ESTEEM AMONG ELDERLY POPULATION AT OLD AGE

HOMES AND WITHIN FAMILY SET UPS

Submitted by: SIMRAN GOYAL

Guide: MISS ANITA SANU

Class: MA PART II

COUNSELLING PSYCHOLOGY

SNDT WOMEN’S UNIVERSITY, CHURCHGATE, MUMBAI.

2019-2020

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TABLE OF CONTENTS

Chapter 1: Introduction

1. Abstract

2. Aim

3. Objectives

4. Definition and explanation of the variables

5. Rationale

Chapter 2: Literature Review

Chapter 3: Methodology

1. Hypotheses

2. Sample and Procedure

3. Tools and its descriptions

4. Operational definition of the Variables

5. Design of the research

6. Proposed statistical analysis

7. Ethical issues

Chapter 4: References

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Chapter 5: Appendices

1. Consent form

2. Tools used

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LONELINESS AND SELF ESTEEM AMONG ELDERLY POPULATION AT OLD

AGE HOMES AND WITH FAMILY

ABSTRACT

Loneliness and social isolation in later life result in social exclusion, reduced well-being, and

significant health problems. Yet, we have a limited understanding of the meanings that older

people ascribe to loneliness and social isolation, and how they live through and cope with

these issues. The scarce research on the topic largely reflects the experiences of older people

living in the community. Less is known about the lived experiences of those in

institutionalized settings, despite this group's vulnerability to loneliness and social isolation.

To address this gap, a quantitative study was conducted within old age homes and family set

ups.

Aim

This study aimed to evaluate the prevalence of loneliness and self-esteem in elderly

population.

Objectives

1) To examine the level of loneliness in the elderly staying in old age homes and within

family set ups

2) To examine self-esteem in the elderly staying in old age homes and within family set

ups.

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INTRODUCTION

Loneliness in elderly

Aging is a series of processes that begin with life and continue throughout the life cycle. It

represents the closing period in the lifespan. It is the time when the individual looks back on

life, lives on past accomplishments and begins to finish off his life course. Adjusting to the

changes that accompany old age is a challenge for them and it requires that an individual is

flexible enough in all sense i.e. psychologically, physically, and socially to adjust into the

society. The need to adapt new coping strategies important to them in their lives becomes

important. The older generation is caught between the decline in traditional values on one

hand and the absence of adequate social security system on the other.

There is a growing body of evidence that suggests that psychological and sociological factors

have a significant influence on how well individuals age. A research conducted by Archana

Singh and Nishi Mishra suggested that variables like loneliness, depression and sociability

are significantly related to each other.

Aging research has demonstrated a positive correlation of someone’s religious beliefs, social

relationships, perceived health, self-efficacy, socioeconomic status and coping skills, among

others, with their ability to age more successfully. However, Loneliness is a prominent

condition amongst older people, with a significant impact on the well-being and quality of

life.

The belief persists that loneliness is synonymous with aging and that loneliness is in fact

inevitable, there has been recent research which dispels this faulty notion. Loneliness could

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also be caused due to numerous social, physical and psychological problems. These

difficulties often emerge in older adulthood, increasing the likelihood of loneliness; yet

loneliness is not a normal consequence of these problems. Studies have found that age isn’t

always significantly related to level of loneliness, and that the oldest of olds may even have

better coping skills to deal with loneliness.

A research conducted by Jane Kimm Lii Teh et al found that loneliness was found to be

associated with age, marital status, education level, sources of income, health status, and

physical limitations. Among older people, feelings of loneliness were inversely related with

co residence with adult children and participation in religious activities.

Loneliness is a subjective, negative feeling related to the person’s own experience of

deficient social relations. The determinants of loneliness are most often defined on the basis

of 2 causal models. The first model examines the external factors, which are absent in the

social network, as the root of the loneliness; while the second explanatory model refers to

the internal factors, such as personality and psychological factors. Loneliness comes in

different forms and calls for different responses. Emotional loneliness occurs when someone

feels the lack of intimate relationships. “Social loneliness” is the lack of satisfying contact

with family members, friends, neighbours or other community members. “Collective

loneliness” is the feeling of not being valued by the broader community. Some experts add

another category: “existential loneliness,” or the sense that life lacks meaning or purpose.

Many people experience loneliness either as a result of perception that other people have

rejected you or don’t care about you. Frequently, people who are lonely convey negativity or

push others away because of perceived rejection, which only reinforces their isolation.

Relationships that have become disappointing are another common cause of loneliness. This

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could be a spouse who’s become inattentive over time or adult children or friends who live at

a distance and are rarely in touch. Those in the oldest age cohort are most likely to report the

highest rates of loneliness, reflecting their increased probability of such losses.

It is now a well-known fact that the number of elderly people living alone is increasing all

over the world. Living alone in itself is a major source of suffering in the elderly. Studies

have shown that loneliness results in increased mortality and increased morbidity in the form

of presence of higher number of chronic illness, cardiovascular disease, and impaired

cognitive functions. Loneliness also significantly affects the mental health of an elderly. It

leads to fear, anxiety, and depressive thinking. It increases the tendency of negative thinking,

decreases self-confidence, decreases confidence on significant others, and increases the fear

of being abused and secluded from the society. Such a negative state can in turn lead to the

development of depression. Loneliness is also called as the “hidden killer” of the elderly. It

has also been strongly linked with the development of suicidal ideations and Para suicidal

behaviour.

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Self-esteem in elderly

Self-esteem in the broadest sense is how much value a person place on his or herself. Self-

esteem is the ability to hold favourable and positive attitude towards the self and to retain the

positive attitude in the situation which is demanding and needs validation or evaluation of

others. Self-esteem is the belief in one’s ability to think, confidence in one’s right for

achievement, happiness and worthiness, and expression of the needs and desires .Self-esteem

is associated with the beliefs and images we have about ourselves, and is a measurement of

how much we love and accept ourselves or others. Self-esteem is closely associated with a

person’s mental image about oneself as well as the coping style.

In general people possessing high self-esteem have job satisfaction, high income, higher

wellbeing, and good quality of life which include improved social relations, healthy

environment, and good care. Low self-esteem is related to substance abuse, eating disorders

and emotional problems. Self-esteem as a construct has been studied widely in terms of

wellbeing in many institutions like work, school, and sports activities. Meanwhile, only few

researches have been done in examining the role of self-esteem in developing psychiatric

problems.

Self-esteem plays an important part when adapting to new life challenges like adjusting to

new environment, new people and health problems. A research done by Kathleen I. Hunter et

al found out that the age, income, education and living arrangements didn’t determine self-

esteem. However, the low self-esteem group had poorer self-reported health, more pain and

higher disability. The low self-esteem group had higher scores on anxiety, depression,

somatisation, external locus of control.

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Self-esteem changes over a period of time as the roles in the society changes. Midlife is a

time of having a stable and consistent work life, romantic relationship and well settled family.

They acquire power and status which can further boost the self-esteem of the person.

However when the person enters into old age they experience the opposite because of the

changing roles in the society, less socialisation, less meaningful relationships, retirement and

obsolete work skills in addition to declining health. Despite of maintaining high self-esteem

in the middle hood the elderly people experiences a drop in the self-esteem because of the

inability to control the situations, significant life changes and feeling less in control.

There are many factors which determines self-esteem like being single, low-income, less

educated and unemployed elderly, those with a history of health problems and those living in

rental dwellings

There are various views about self-esteem and its effects on social and psychological

development, among which Ericson’s view about psychosocial development, owing to strong

theoretical grounds, has been attracted by many researchers. Ericson believes that

psychological development depends on specific social relations that the individual creates

during different stages of development. He also argues that the final stage of development is

in the ageing period. The more a person has efficiently coped with problems in the past, the

more he/she experiences a sense of development and perfection. The antithesis of perfection

is disappointment. An aged person who is unpleased with the past events of life feels

hopeless and desperate and views the life and social relations with spite and hatred.

Various domestic and international studies have investigated self-esteem and the factors

associated with it in the elderly. Various researches reported that the increase of self-esteem

in all age groups, especially the elderly is directly related to optimism, positive affect and a

sense of social support, and is inversely correlated with negative affect. Studies found out that

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the elderly with health behaviours such as physical activity are more probable to successfully

spend their ageing period. In line with these views, a primary objective of caring for the

elderly is helping them to preserve maximum independence in a safe environment to promote

their life quality and to minimize the healthcare costs by preventing physical injuries. The

elderly with high self-esteem can more easily cope with the threats and stressful events of life

without negative experience and psychological disorders.

This study examines factors like loneliness, self-esteem among elderly staying within a

family set up and in old age homes.

These structures also change in response to different situations as people pass through their

life cycles.

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RATIONALE

There is a growing evidence that suggests that psychological and sociological factors have a

significant influence on how well individuals age. The proportion of older people is

increasing nationally and globally. Many elderly people have good health, live a good life,

and are an asset to society. But there are also those who are in need of care; this presents a

challenge to the welfare system, which is the basis of this research on the elderly. Loneliness

is a prominent condition amongst older people with a significant impact on the wellbeing and

quality of life. There is a need to understand the relationship between the variables in old

adults due to perceived common understanding that the elderly are believed to be lonely,

hence, the need to study the variables in the Indian context in the city of Mumbai. The

research aims to increase knowledge about the elderly in terms of wellbeing, self-esteem, and

loneliness. There have been very few researches done between the institutionalised and non-

institutionalised settings among elderly so through the data we get from this study we can add

to the existing pull of data. Moreover, this data could help the individuals in the family when

contemplating whether this is the suitable accommodations for them or not. As an aspiring

psychologist I am looking forward to work with geriatric population and I hope to contribute

to safe, secure and dignified aging that might foster better health and wellbeing in older age.

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LITERATURE REVIEW

1. A study conducted by Archana Singh and Nishi Mishra investigated the relationship

between loneliness, depression and sociability. The study was carried out on 55

elderly people both men and women. Most of the elderly people were found to be

average in the dimension of sociability and preferred remaining engaged in social

interactions.

2. A research conducted by Jane Kimm Lii Teh et al found that loneliness was found to

be associated with age, marital status, education level, sources of income, health

status, and physical limitations. This study investigates factors affecting older persons'

state of loneliness in multi-ethnic Malaysia using data from the 2004 Malaysian

Population and Family Survey. The questionnaires were administered to elderly

people above 50 years old.

3. A research by Elena Antonelli, Cristina Fassone investigated the effects of allocation

in self-concept and self-esteem in non-institutionalised and institutionalised settings.

The research indicated that the institutionalised elderly have more negative self-

concept, lower levels of self-esteem and a more restricted interpersonal self.

4. A research by Nelson PB investigated social support, depression and self-esteem in

the institutionalised elderly. Findings indicated that demographic variables of the

subjects didn’t affect their feelings of self-esteem or depression. However, social

support significantly correlated with depression and there was indication that the type

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of institutionalised setting and frequency of religious participation also interacts with

the level of depression.

5. A research by Paque K studied loneliness and feelings of elderly staying in nursing

homes. The result indicated that loneliness was more than being alone. The resident’s

unfulfilled need for meaningful relationships plays a crucial role in feeling of

loneliness. Losing their self-determination due to institutionalisation was strongly

related to loneliness and caused strong emotions such as grief.

6. Research done by Darlene Mara Dos Santos et al studied quality of life and self-

esteem in the urban community of elderly people. Associations were evident that

people scoring less on quality of life will also have low self-esteem.

7. A research by Mary C. Commerford et al studied relationship of religion and

perceived social support to self-esteem and depression in nursing home residents. The

results indicated that perceived social support from family, public religious activity,

and length of stay in the home were related to self-esteem and to depression. Past

occupational status was also associated with self-esteem. Health status and having a

choice in selecting the nursing home were negatively related to depression. Intrinsic

religiosity and the resident's perceived social support from friends were not

significantly related to depression or self-esteem.

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8. Research by Tanya Koropeckyj on whether childlessness is directly related to

loneliness and depression in middle age and old age. Small but significant differences

are observed within a typology combining marital and parental statuses. Widowed

men and women report higher levels of loneliness and depression than married

parents regardless of parental status. Divorced parents are also significantly more

vulnerable. The subjective well-being of never married, childless men and women is

indistinguishable from that of their married peers.

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METHODOLOGY

Hypothesis

1) Elderly people staying within family set ups will be low on loneliness than elderly

people staying in old age homes.

2) Elderly people staying within family set ups will be high on self-esteem than elderly

people staying in old age homes.

Variables

IV is elderly population above 60 years old at two levels:-

 Elderly people staying within family set up.

 Elderly people staying in old age homes – an alternative shelter where elderly people

can share their feelings, likings, experiences with each other. They live in an

institutional set up according to some rules and regulation.

The DV’s are:-

 Loneliness: - is a subjective, negative feeling related to the person’s own experience

of deficient social relations. The scale used to measure this DV is UCLA loneliness

scale developed by Daniel Russell

 Self-esteem: - The Rosenberg Self-Esteem Scale is a tool for assessing global self-

esteem. Ten statements are included in the self-report measure that pertains to self-

worth and self-acceptance. A four-point scale ranging from “strongly agree” to

"strongly disagree.”

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Controls

1) Participants were in a relaxed emotional state.

2) The participants were not instructed a time limit to answer the two scales.

3) All the participants were residents of, and brought up in Mumbai city.

Sample size

The sample comprised of 120 elderly people in the age group of 60-80 years. The subjects

for the sample were selected from the older adults of a Mumbai-based region residing in the

housing societies and old age homes. These elderly persons were contacted personally, and

the questionnaires were administered to them. All the participants were explained about the

study and were recruited after obtaining written informed consent. These patients were

evaluated on UCLA loneliness scale and Rosenberg self-esteem scale.

Measures

1) The UCLA Loneliness Scale includes 10 negatively worded and 10 positively

worded items that have the highest correlations with a set of questions that are

explicitly related with loneliness. The revised version of the scale has high

discriminative validity. The revised loneliness scale also has a high internal

consistency, with a coefficient alpha of 0.94

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2) The Rosenberg Self-esteem Scale is one of the most common scales for self-esteem

measurement which provides an overview of the positive and negative attitudes about

self. Some of the items of this scale include: “I have positive attitude about myself”,

“I am generally satisfied with myself”, I sometimes feel I am useless”, I sometimes

think I cannot do anything” and “I feel I have some good characteristics”

The Rosenberg Self-esteem Scale used in this study comprised of 10 items based on

4-point Likert scale, including strongly agree, agree, undecided, disagree and strongly

disagree. The Rosenberg Self-Esteem Scale presented high ratings in reliability areas;

internal consistency was 0.77, minimum Coefficient of Reproducibility was at least

0.90.

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Procedure

120 participants in the age group 60 – 80 were chosen from old age homes and within family

set up. The participants were personally contacted and rapport was established with them.

The participants completed the questionnaires given to them. Standard instructions were

written on top of each questionnaire, and the participants were asked to rate themselves under

the option they felt relevant to them. It was made clear to the participants that there were no

right and wrong answers. If they had any difficulty, they were encouraged to ask questions.

After finishing the entire set of questions, they were asked to return the questionnaires. The

respondents were assured of confidentiality and privacy of responses and results.

Respondents were also informed to request for a feedback by giving their contact details.

There was no limit instructed to complete the questionnaire.

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Inclusion criteria for elderly people

1. Should be educated till fifth standard

2. Data collected from both male and female

3. Should be between 60-80 years old

4. Living in old age home for more than 6 months

5. Willing to participate in the survey

Exclusion criteria for elderly people

1. Should not have any history of major physical illness

2. There should not be any history of major neurological and psychiatric illness.

Ethical issues

Ethical clearance from the institutional ethics committee was obtained before conducting

the study. Besides, informed consent was taken from each study participant. Participants

were assured of the confidentiality and privacy of responses and results.

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Limitations

1) The sample size was restricted to few elderly persons. Hence in future, a similar study

needs to be conducted on a larger section of the elderly population.

2) The study could also determine gender differences and both male and female

constituents of the sample should be equivalent in all respects.

3) Socioeconomic characteristics such as marital status, employment, and educational

level, work status, income level can also be included in future study.

4) Cross cultural research can be done, across various religions, regions, nations.

5) Comparative studies can be conducted across various age groups, gender, regions,

religions, special population.

Keeping in view the above limitations, longitudinal studies on a larger group of elderly men

and women are needed in future.

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REFERENCES.

Halaweh, Svantesson, Ulla, & Carin. (2018, November 04). Perspectives of Older Adults on

Aging Well: A Focus Group Study. Retrieved from

https://www.hindawi.com/journals/jar/2018/9858252/

Hao, G., Bishwajit, G., Tang, S., Nie, C., Ji, L., & Huang, R. (2017, June 23). Social

participation and perceived depression among elderly population in South Africa. Retrieved

from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5491569/

Singh, A., & Misra, N. (2009, January). Loneliness, depression and sociability in old age.

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3016701/

Teh, J. K., Tey, N. P., & Ng, S. T. (2014). Family support and loneliness among older persons in

multiethnic Malaysia. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4214036/

Thakur, R., Banerjee, A., & Nikumb, V. (2013, January). Health problems among the elderly: A

cross-sectional study. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3634218/

Jafari, F., Khatony, A., & Mehrdad, M. (2015, April 15). Self-Esteem among the Elderly

Visiting the Healthcare Centers in Kermanshah-Iran (2012). Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4803852/.

Koropeckyj-Cox, & Tanya. (1998, November 1). Loneliness and Depression in Middle and Old

Age: Are the Childless More Vulnerable? Retrieved from

https://academic.oup.com/psychsocgerontology/article/53B/6/S303/618675.

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New Evidence on Sleep's Role in Aging and Chronic Disease. (2018, October 16). Retrieved

from https://www.prb.org/todays-research-on-aging/.

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Chapter: V

 Consent form:

I, Simran Goyal currently pursuing Masters (2nd year) in Counselling Psychology, From

Shreemati Nathibai Damodar Thackersey Women's University, is a women's university in the

city of Mumbai, India. I am doing my research study on the topic, “loneliness and self-

esteem among elderly population at old age homes and within family set ups” Under the

guidance of Miss Anita Sanu (Ma’am).

For Participants: I have read and I understand the provided information and have had the

opportunity to ask questions. I understand that my participation is voluntary and that I am

free to withdraw at any time, without giving a reason and without cost. I understand that I

will be given a copy of this consent form. I voluntarily agree to take part in this study.

Participant's signature ______________________________ Date __________

Investigator's signature _____________________________ Date __________

Participant’s Initials: ____________

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