Top

BMC Geriatrics

Published in:

Open Access 01-12-2021 | Mood Disorders | Research

Factors Related to Self-Confidence to Live Alone in Community-Dwelling Older Adults: A Cross-Sectional Study

Authors: So Im Ryu, BeLong Cho, Sun Ju Chang, Hana Ko, Yu Mi Yi, Eun-Young Noh, Hye Ryung Cho, Yeon-Hwan Park

Published in: BMC Geriatrics | Issue 1/2021

Abstract

Background

Many older adults prefer to live alone in their own homes, with age-related issues in physical movement, regardless of their cultural background. Importantly, however, to identify the features of successfully ageing in place (AIP), and foster independent living among these individuals, this study explored their level of self-confidence to live alone and its related factors.

Methods

We conducted a cross-sectional study using secondary data from an earlier study with older adults living alone in South Korea recruited by convenience sampling methods (N = 936, mean age = 77.1 years, 76.1% female). Data regarding the general, health-related, and social characteristics as well as self-confidence to live alone were collected via face-to-face interviews in 2019. Self-confidence to live alone was measured with a numeric rating scale of 0 to 10.

Results

The average self-confidence score to live alone was 6.59. A regression analysis showed that mould exposure at home, depression, emergency department visits, and loneliness hinder self-confidence to live alone. Meanwhile, such self-confidence was facilitated by independency in instrumental activities of daily living (IADL), interactions with family members, social service utilisation, and social support.

Conclusions

This study suggests that healthcare providers need to consider the importance of self-confidence to live alone and influencing functional, mental, social, and environmental factors to promote quality of life as well as successful AIP for older adults living alone. Further, self-confidence to live alone could be a new practical index in the field of health and ageing to screen the successful AIP of older adults living alone.

Reher D, Requena M. Living alone in later life: a global perspective. Popul Dev Rev. 2018;44(3):427–54. https://doi.org/10.1111/padr.12149.

Statistics Korea. Population projection for Korea. 2019. https://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1BZ0503&vw_cd=MT_ZTITLE&list_id=A42_10&seqNo=&lang_mode=ko&language=kor&obj_var_id=&itm_id=&conn_path=MT_ZTITLE. Accessed 10 October 2020.

Evans IEM, Llewellyn DJ, Matthews FE, Woods RT, Brayne C, Clare L, et al. Living alone and cognitive function in later life. Arch Gerontol Geriatr. 2019;81:222–33. https://doi.org/10.1016/j.archger.2018.12.014.

Roh M, Weon S. Living arrangement and life satisfaction of the elderly in South Korea. Soc Indic Res [Internet]. 2020. https://doi.org/10.1007/s11205-020-02443-3. Accessed 10 October 2020.

Srugo SA, Jiang Y, de Groh M. At-a-glance - Living arrangements and health status of seniors in the 2018 Canadian Community Health Survey. Health Promot Chronic Dis Prev Can. 2020;40(1):18–22. https://doi.org/10.24095/hpcdp.40.1.03.

Kendig H, Gong CH, Cannon L, Browning C. Preferences and predictors of aging in place: longitudinal evidence from Melbourne. Australia. J Hous Elderly. 2017;31(3):259–71. https://doi.org/10.1080/02763893.2017.1280582.

Korea Institute for Health and Social Affairs. 2017 survey of living conditions and welfare needs of Korean older persons. 2018. https://www.kihasa.re.kr/web/publication/research/view.do?menuId=45&tid=71&bid=12&division=002&ano=2298. Accessed 10 October 2020.

Bigonnesse C, Chaudhury H. The landscape of “aging in place” in gerontology literature: emergence, theoretical perspectives, and influencing factors. J Aging Environ. 2020;34(3):233–51. https://doi.org/10.1080/02763893.2019.1638875.

WHO Centre for Health Development (Kobe, Japan). A glossary of terms for community health care and services for older persons. Kobe: WHO Centre for Health Development; 2004. https://apps.who.int/iris/handle/10665/68896. Accessed 10 October 2020.

10.

Ahn M. Introduction to special issue: aging in place. Hous Soc. 2017;44(1–2):1–3. https://doi.org/10.1080/08882746.2017.1398450.

11.

Stones D, Gullifer J. ‘At home it’s just so much easier to be yourself’: older adults’ perceptions of ageing in place. Ageing Soc. 2016;36(3):449–81. https://doi.org/10.1017/s0144686x14001214.

12.

Torres-Gil F, Hofland B. Vulnerable populations. In H. Cisneros, M. Dyer-Chamberlain, & J. Hickies (Eds.), Independent for life: Homes and neighborhoods for an aging America. Austin: University of Texas Press; 2012. p. 221–32.

13.

Hillcoat-Nallétamby S. The meaning of “independence” for older people in different residential settings. J Gerontol B Psychol Sci Soc Sci. 2014;69(3):419–430. https://doi.org/10.1093/geronb/gbu008

14.

Mirowsky J. Age and the sense of control. Soc Psychol Q. 1995;58(1):31. https://doi.org/10.2307/2787141.

15.

Lawton MP. The elderly in context: perspectives from environmental psychology and gerontology. Environ Behav. 1985;17(4):501–19. https://doi.org/10.1177/0013916585174005.

16.

Pirhonen J, Pietilä I. Perceived resident-facility fit and sense of control in assisted living. J Aging Stud. 2016;38:47–56. https://doi.org/10.1016/j.jaging.2016.04.006.

17.

Dupuis-Blanchard S, Gould ON, Gibbons C, Simard M, Éthier S, Villalon L. Strategies for aging in place: the experience of language-minority seniors with loss of independence. Glob Qual Nurs Res. 2015;(2):1–9. https://doi.org/10.1177/2333393614565187.

18.

Moore BM. Self-confidence for competence. Edu Leader. 1952;12:140–5.

19.

Narushima M, Kawabata M. “Fiercely independent”: experiences of aging in the right place of older women living alone with physical limitations. J Aging Stud. 2020;54:100875. https://doi.org/10.1016/j.jaging.2020.100875.

20.

Bacsu J, Jeffery B, Abonyi S, Johnson S, Novik N, Martz D, et al. Healthy aging in place: perceptions of rural older adults. Educ Gerontol. 2014;40(5):327–37. https://doi.org/10.1080/03601277.2013.802191.

21.

Li B, Chen S. A study of residential condition and satisfaction of the elderly in China. J Hous Elderly. 2011;25(1):72–88. https://doi.org/10.1080/02763893.2011.545746.

22.

World Health Organization Regional Office for Europe. WHO guidelines for indoor air quality: dampness and mould [Internet]. 2009. https://www.euro.who.int/__data/assets/pdf_file/0017/43325/E92645.pdf. Accessed 10 October 2020.

23.

Fernández-Carro C, Módenes JA, Spijker J. Living conditions as predictor of elderly residential satisfaction. A cross-European view by poverty status. Eur J Ageing. 2015;12(3):187–202. https://doi.org/10.1007/s10433-015-0338-z.

24.

Lee YS, Kim YS, Sung CH, Shin YJ, Cho WS. A descriptive research on field situation of customized modification for vulnerable single elderly home. J Korean Hous Assoc. 2017;28(3):55–64. https://doi.org/10.6107/jkha.2017.28.3.055.

25.

Mudrazija S, Angel J, Cipin I, Smolic S. Living alone in the United States and Europe: the impact of public support on the independence of older adults. Innov Aging. 2018;2(suppl_1):769–70. https://doi.org/10.1093/geroni/igy023.2849.

26.

Park S, Han Y, Kim B, Dunkle RE. Aging in place of vulnerable older adults: person-environment fit perspective. J Appl Gerontol. 2017;36(11):1327–50. https://doi.org/10.1177/0733464815617286.

27.

Falls. World Health Organization. 2018. https://www.who.int/news-room/fact-sheets/detail/falls. Accessed 10 October 2020.

28.

Choi NG, Choi BY, DiNitto DM, Marti CN, Kunik ME. Fall-related emergency department visits and hospitalizations among community-dwelling older adults: examination of health problems and injury characteristics. BMC Geriatr. 2019;19(1):303. https://doi.org/10.1186/s12877-019-1329-2.

29.

Dingová M, Králová E. Fear of falling among community dwelling older adults. Cent Eur J Nurs Midwifery. 2017;8(1):580–7. https://doi.org/10.15452/cejnm.2017.08.0005.

30.

Lau DT, Scandrett KG, Jarzebowski M, Holman K, Emanuel L. Health-related safety: a framework to address barriers to aging in place. Gerontologist. 2007;47(6):830–7. https://doi.org/10.1093/geront/47.6.830.

31.

Care service for older adults. Ministry of Health Welfare. 2017. https://www.mohw.go.kr/react/jb/sjb030301vw.jsp.PAR_MENU_ID=03&MENU_ID=032901&CONT_SEQ=338646. Accessed 10 Oct 2020.

32.

Won CW, Yang KY, Rho YG, Kim SY, Lee EJ, Yoon JL, et al. The development of Korean activities of daily living (K-ADL) and Korean instrumental activities of daily living (K-IADL) scale. J Korean Geriatr Soc. 2002; 6(2): 107–120. https://www.e-agmr.org/journal/view.php?number=280. Accessed 10 October 2020.

33.

Lee HS, Kim HS, Jung YM. Depression and quality of life in Korean elders. J Korean Acad Commun Health Nurs. 2009;20(1):12–22. https://www.koreascience.or.kr/article/JAKO200916263468652.pdf. Accessed 7 Mar 2021.

34.

Won CW, Rho YG, Sunwoo D, Lee YS. The validity and reliability of Korean Instrumental Activities of Daily Living (K-IADL) scale. J Korean Geriatr Soc. 2002; 6(4): 273–280. https://www.e-agmr.org/journal/view.php?vol=6&issue=4&spage=273. Accessed 7 March 2021.

35.

Kee BS. A preliminary study for the standardization of geriatric depression scale short form-Korea version. J Korean Neuropsychiatr Assoc. 1996; 35(2): 298–307. https://kmbase.medric.or.kr/Main.aspx?menu=01&d=KMBASE&m=VIEW&i=0368819960350020298. Accessed 10 Oct 2020.

36.

Sheikh JI, Yesavage JA. Geriatric depression scale (GDS): recent evidence and development of a shorter version. Clin Gerontol. 1986;5(1–2):165–73. https://doi.org/10.1300/J018v05n01_09.

37.

Mortimer JA, Ding D, Borenstein AR, DeCarli C, Guo Q, Wu Y, et al. Changes in brain volume and cognition in a randomized trial of exercise and social interaction in a community-based sample of non-demented Chinese elders. J Alzheimers Dis. 2012;30(4):757–66. https://doi.org/10.3233/JAD-2012-120079.

38.

Shankar A, McMunn A, Banks J, Steptoe A. Loneliness, social isolation, and behavioral and biological health indicators in older adults. Health Psychol. 2011;30(4):377–85. https://doi.org/10.1037/a0022826.

39.

Mitchell PH, Powell L, Blumenthal J, Norten J, Ironson G, Pitula CR, et al. A short social support measure for patients recovering from myocardial infarction: the enriched social support inventory. J Cardiopulm Rehabil. 2003;23(6):398–403. https://doi.org/10.1097/00008483-200311000-00001.

40.

Jeon GS, Jang SN, Park S. Social support, social network, and frailty in Korean elderly. J Korean Geriatr Soc. 2012;16(2):84–94. https://doi.org/10.4235/jkgs.2012.16.2.84.

41.

Kim OS. Korean version of the revised UCLA loneliness scale: reliability and validity test. Kanho Hakhoe Chi. 1997;27(4):871–9. https://doi.org/10.4040/jnas.1997.27.4.871.

42.

Russell D, Peplau LA, Cutrona CE. The revised UCLA Loneliness Scale: concurrent and discriminant validity evidence. J Pers Soc Psychol. 1980;39(3):472–80. https://doi.org/10.1037/0022-3514.39.3.472.

43.

Perry GR. Loneliness and coping among tertiary-level adult cancer patients in the home. Cancer Nurs. 1990;13(5):293–302.CrossRef

44.

Lee IH. Easyflow regression analysis. Seoul: Hannarae; 2016. p. 313–6.

45.

Tang F, Lee Y. Home- and community-based services utilization and aging in place. Home Health Care Serv Q. 2010;29(3):138–54. https://doi.org/10.1080/01621424.2010.511518.

46.

Michael YL, Berkman LF, Colditz GA, Kawachi I. Living arrangements, social integration, and change in functional health status. Am J Epidemiol. 2001;153(2):123–31. https://doi.org/10.1093/aje/153.2.123.CrossRefPubMed

47.

O’Rourke HM, Collins L, Sidani S. Interventions to address social connectedness and loneliness for older adults: a scoping review. BMC Geriatr. 2018;18(1):214. https://doi.org/10.1186/s12877-018-0897-x.

48.

Stojanovic J, Collamati A, Duplaga M, Onder G, La Milia DI, Ricciardi W, et al. Decreasing loneliness and social isolation among the older people: systematic search and narrative review. Epidemiol Biostat Public Health. 2017;14(suppl 1):2. https://doi.org/10.2427/12408.

49.

Park YH, Lim KC, Cho BL, Ko H, Yi YM, Noh EY, et al. Experiences of healthcare and daily life support services in community-dwelling elders living alone: a thematic analysis using focus group interviewing. J Korean Gerontol Nurs. 2019;21(3):200–10. https://doi.org/10.17079/jkgn.2019.21.3.200.

50.

Chan E, Procter-Gray E, Churchill L, Cheng J, Siden R, et al. Associations among living alone, social support and social activity in older adults. AIMS Public Health. 2020;7(3):521–34. https://doi.org/10.3934/publichealth.2020042.

51.

Zhao L, Zhang X, Ran G. Positive coping style as a mediator between older adults’ self-esteem and loneliness. Soc Behav Pers. 2017;45(10):1619–28. https://doi.org/10.2224/sbp.6486.

52.

Ahlqvist A, Nyfors H, Suhonen R. Factors associated with older people’s independent living from the viewpoint of health and functional capacity: a register-based study. Nurs Open. 2016;3(2):79–89. https://doi.org/10.1002/nop2.39.

53.

Stahl ST, Beach SR, Musa D, Schulz R. Living alone and depression: the modifying role of the perceived neighborhood environment. Aging Ment Health. 2017;21(10):1065–71. https://doi.org/10.1080/13607863.2016.1191060.

54.

Lin IF, Wu HS. Does informal care attenuate the cycle of ADL/IADL disability and depressive symptoms in late life? J Gerontol B Psychol Sci Soc Sci. 2011;66(5):585–94. https://doi.org/10.1093/geronb/gbr060.

55.

Ko H, Park YH, Cho B, Lim KC, Chang SJ, Yi YM, et al. Gender differences in health status, quality of life, and community service needs of older adults living alone. Arch Gerontol Geriatr. 2019;83:239–45. https://doi.org/10.1016/j.archger.2019.05.009.

Title: Factors Related to Self-Confidence to Live Alone in Community-Dwelling Older Adults: A Cross-Sectional Study
Authors: So Im Ryu
BeLong Cho
Sun Ju Chang
Hana Ko
Yu Mi Yi
Eun-Young Noh
Hye Ryung Cho
Yeon-Hwan Park
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Mood Disorders
Affective Disorder
Published in: BMC Geriatrics / Issue 1/2021
Electronic ISSN: 1471-2318
DOI: https://doi.org/10.1186/s12877-021-02214-w

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2021

Life under lockdown and social restrictions - the experiences of people living with dementia and their carers during the COVID-19 pandemic in England

Effectiveness of an integrated multidisciplinary geriatric rehabilitation programme for older persons with stroke: a multicentre randomised controlled trial

Association of late-life depression with cognitive impairment: evidence from a cross-sectional study among older adults in India

Hierarchical structure in the activities of daily living and trajectories of disability prior to death in elderly Chinese individuals

Contribution of IQ in young adulthood to the associations of education and occupation with cognitive ability in older age

Reducing the use of physical restraints in home care: development and feasibility testing of a multicomponent program to support the implementation of a guideline

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage