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An exploration of meaning in the lives of elderly women Swanson, Elizabeth Jane 1998

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AN EXPLORATION OF MEANING IN THE LIVES OF ELDERLY WOMEN by ELIZABETH JUNE SWANSON B.A./B.S.W., McMaster University, 1985 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SOCIAL WORK in THE FACULTY OF GRADUATE STUDIES (Department of Social Work) We accept this thesis as conforming to the required standard THE UNIVERSITY OF BRITISH COLUMBIA June 1998 © Elizabeth June Swanson, 1998 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. Department of The University of British Columbia Vancouver, Canada DE-6 (2/88) ii ABSTRACT This qualitative study explores the phenomenon of meaning in the lives of community dwelling elderly women. Having a sense of meaning in one's life is important as it contributes to well-being, health and successful aging. These elderly women also demonstrated that aging is a time of continued growth and development. In this study, six elderly women were interviewed to allow them to describe what is meaningful in their lives. The interview centered around one question, "Is there something or things so important to you in your life that they give your life meaning?" The interviews were transcribed and subjected to the phenomenological method of analysis as developed by Colaizzi (1978). The final procedural step of data analysis involved integrating the results into an exhaustive description of the phenomenon of meaning. From this study, five themes emerged which captured the areas of meaning in the lives of these elderly women. Meaning was defined and redefined throughout their lives through the interconnectedness of relationships, outlook, interests, independence and health. Discussion of the findings included reviewing the similarities and differences in how young-old women (ages 65-79) and old-old women (over the age of 80) described meaning in their lives. The five themes that emerged from the data were common to both cohorts. Implications for social work and considerations for future research are discussed. iii TABLE OF CONTENTS PAGE Abstract ii Table of Contents iii List of Tables v Acknowledgements vi Chapter I INTRODUCTION 1 Purpose of this Study 1 Importance of Meaning 1 Demographics 2 Ageism 2 Heterogeneity of Seniors 3 Developmental Perspective 5 Significance for Social Work 6 Chapter II LITERATURE REVIEW 9 Research Studies on the Phenomenon of Meaning 9 Relevant Developmental Theories 18 Chapter III METHODOLOGY 29 Sample 30 Data Collection 31 Data Analysis 32 IV Chapter IV RESULTS 34 Findings for the Young-Old Women 34 Findings for the Old-Old Women 46 Exhaustive Description 59 Chapter V DISCUSSION OF RESULTS 60 Part 1 - Meaning 60 Part II - Developmental Perspective 68 Chapter VI CONCLUSIONS 72 Implications for Social Work 74 Future Research 77 Bibliography 80 Appendix 1 Posting Notice 84 Appendix II Consent Form 85 V LIST OF TABLES TABLE • PAGE 1 Relationships Young-Old 35 II Interests Young-Old 38 III Outlook Young-Old 41 IV Independence Young-Old 43 V Health Young-Old 45 VI Relationships Old-Old 47 Vll Independence Old-Old 50 VIII Outlook Old-Old 53 IX Interests Old-Old 55 X Health Old-Old 57 XI Exhaustive Description of Meaning in the Lives of Elderly Women 59 vi ACKNOWLEDGEMENTS I would like to express my appreciation to the following people who have assisted me in the completion of this thesis work: To the six elderly women who gave both of their time and of themselves. Their willingness to share what was important and meaningful in their lives provided me with an inspirational view of meaning for women both "young and old". To Elaine Stolar, my faculty advisor and committee chair, who provided encouragement and direction in writing my thesis. To Richard Sullivan for his interest in my research study and his valuable suggestions and feedback during the writing of my thesis. To Betty Andersen who so kindly agreed to be a part of my committee and give of her time and knowledge. To Shyann Hiebert at the GVHS library for her perseverance in tracking down articles and reference material that greatly enhanced the literature review for this research work. To the staff at the James Bay New Horizons, Fairfield New Horizons, Seniors Serving Seniors, and the James Bay Community Project Centre for allowing the use of their agencies in posting notices for participant recruitment. 1 CHAPTER I INTRODUCTION "Indeed, our drive to live meaningful lives is at the heart of all our needs" (Carlsen, 1991, p.81). This need is a driving force throughout one's life, regardless of age. Betty Friedan states that "a person can continue to grow and develop if one doesn't buy that self-fulfilling prophecy of deterioration and decline" (Luddington, 1993, p.53). In her book The Fountain of Age, Friedan (1993) proposes that we also look at the positive characteristics of aging, how this can be a time of personal growth and development. In her work, she found that older people wanted to talk about their life experiences, how they were presently engaging their life and what they found to be meaningful. In my work as a social worker within a Geriatric Day Program for the past seven years, I have also found that people want to talk about meaning in their lives, whether they are age 70, 80 or 90. It was through listening to their stories over the years that has led me to this research study. The purpose of this qualitative study is to explore meaning in the lives of elderly women. This study will look at what is meaningful to community dwelling senior women over the age of 65. This group was also divided into two cohorts, the young-old (age 65-79) and the old-old (over age 80). Further research in the area of meaning is important as meaning helps us to develop a sense of self and a sense of well being (Carlsen, 1991). It helps us to define who we are and to integrate our life experiences. Meaning has also been linked with health and successful aging in the literature (Burbank, 1992; Ebersole & Hess, 1990; Kaufman, 1986; Mitchell, 1993; Novak, 1985; Reker& Wong, 1988; Solomon & Peterson, 1994). A study done in Manitoba by Roosand Haven (1991), found that" a significant group of elderly do age successfully. These 2 individuals express more satisfaction with their lives and incur substantially fewer health expenditures than other elderly" (p.67). Yet despite the importance of meaning in one's life there is very little research on the topic of meaning, especially as it related to older individuals (Burbank). This research study " An Exploration of Meaning in the Lives of Elderly Women" explores meaning from the participants perspective. Kaufman (1986) believes that it is important to allow each person to define what is meaningful to them. As reported by Ebersole and Hess (1990), research that is based on academic knowledge, often does not reflect the perspective of the older persons participating in the study. Hence, in this study, it is important to hear what the participants have to say, and to allow them to define meaning for themselves. Research looking at meaning in lives of elderly women is becoming increasingly important as they are a rapidly growing segment of the population. While the total Canadian population grew by 10% between 1976-1986, the older population (over age 65) grew by 35% (Novak, 1993). Novak also projects that while seniors comprise 10% of the population in 1986, they are expected to comprise 24% by the year 2031. This will be a reflection of the aging baby boomers. Furthermore, in reviewing current statistics, it is evident that the majority of this aging population are women. In 1995, more than 2 million women were over the age of 65, comprising 58% of the total senior population. Of this group 75% were age 65-79, and 25% were over the age of 80 (Statistics Canada, 1997). Yet despite the growing number of seniors, society often views "old age as a time of weakness, sickness and dying" (Novak, 1993, p.5). Elderly people are often portrayed as dependent and in ill health. "Newspaper stories, for example, sometimes point to older people as the cause of rising health care costs in Canada" (Novak p.7). This further reinforces a negative image of the elderly in our society. As cautioned by Grant (1996), "ageism can negatively affect health care providers' professional training and service delivery and, ultimately, their clients' behavior and health 3 outcomes" (p.9). Friedan (1987) in her involvement at Harvard and gerontological meetings found that clinicians, counselors, and researchers were treating old age as a problem, similiar to what she was finding twenty years ago with the sexist attitudes toward women. "To limit discussion of aging to the negative norms of aging ignores the growth that so often accompanies aging" (Friedan, p. 123). This is important for social workers to be aware of in their work with older individuals. Ageist attitudes affect the way services are being provided, as well as potentially reinforcing these attitudes with our clients. Kenyon (1992) states that ageist attitudes and behaviours can be "a source of lowered self-respect and loss of personal meaning. This, in turn, results in decreased quality of life and well-being" (p.2). It is also important to realize that ageism is not just negative stereotypes of the elderly. It is ageist to believe that all seniors form a homogeneous group which can include attributing stereotypes of overly positive qualities or negative characteristics (National Advisory Council on Aging, 1993). Connidis (1987) suggests that we need to look at both the positive and negative aspects of aging and not get trapped in the stereotypes of either view. Research that focuses on the negative aspects of aging reinforces aging as a social problem, while research that focuses exclusively on the positive aspects often denies the reality of the aging experience. Carlsen (1991) proposes that "we look at aging from differing angles, and unless we keep the broader perspective we may lock into one side to the neglect of the other" (p. 18). In gaining a balanced perspective, we need to challenge our beliefs and assumptions about old age and learn more about the experience of aging from the elderly themselves. In fact, there is "tremendous heterogeneity associated with increasing age" (Garfein & Herzog, 1995, p.S77). As one grows older there may be greater diversity within this age strata more than ever before due to increasing differentiation throughout the life course (Nelson and Dannefer, 1992). Marshall (1987) expands upon this point by stating "that aging also increases people's stories of experiences and often, as a result, their competencies. People do not passively experience aging, but rather they take part in creating their life course" (p.2). 4 These are people who have lived a very diverse life over the years. We need to understand older people for the individuals that they are. What better way than to listen to what they have to say about meaning in their lives. Yet despite the fact that we have limited knowledge about the aging experience, much of the existing research focuses on health concerns and age related losses and it neglects the heterogeneity of this population (Novak, 1993; Rowe & Kahn, 1987). Furthermore, Mitchell (1993) believes that by focusing on the deficits and problems of aging, we are neglecting " the meanings older persons give to their life situations, or how they create health and quality of life despite limitations or chronic ailments" (p.51). More qualitative research is needed to explore the heterogeneity of this senior population. It is time to explore and present the other side of the aging experience, to look at the individual experiences of positive aging and continued growth (Bowling, 1993). Within this diverse group it is also important to consider that the needs of this growing population vary according to gender. As noted by Barer (1994), it is important for researchers to look at gender differences for men and women. This can allow for policy makers and practitioners to be responsive to their different needs. As stated by Verbrugge (1989), women and men experience a different biological and social aging process that affects health, life style and attitude. Women tend to live longer then men, have more chronic health concerns, and they often experience a lower economic status. Betty Nickerson in her book Old and Smart: Women and the Adventure of Aging (1995), reminds all of us to also recognize the strengths of an aging female population. Collectively we have had the benefits of better nutrition, extraordinary innovations in health care, better living conditions and better education than any previous generation. We live longer, have traveled further and are generally more active than our grand-5 mothers. Most aging women are eager to get on with their lives, to live fully and well. Even the helping professions are slowly shifting their focus from degeneration to life-enhancing potential, (p. 27) Her outlook on aging from a personal experience, presents another side of aging. This view is shared by Browne (1995) who emphasizes that we need to see both the positive and negative aspects of aging for women. She states that it is important to see that "older women are both at risk and strong" (p.358). To better understand both the needs and strengths of this rapidly expanding segment of the population, it is important to learn more about the aging experience for women. There has been little research conducted or even literature available for the study of older women, especially those women still living in the community (Preski & Burnside, 1992). As previously stated, there is also limited research on what elderly women find meaningful in their lives. It is for this reason that this research study will be gender specific to explore meaning in the lives of elderly women. In addition to being gender specific, this research work adopts the perspective that aging is a time of continued growth and development. Friedan (1993) acknowledges that aging has its own set of developmental challenges, but "often research doesn't look for positive characteristics that may come from the struggle" (p. 126). Despite the changes and losses, development must not be viewed as linear. Friedan states that development continues with all of a person's losses, gains and reorganization. How one views their experiences in life helps them to integrate these experiences as part of their developmental growth. From a theoretical perspective, positive aging and continued growth suggest that old age is a time of ongoing development, not a time of decline and passivity. As stated by Burnside (1988), "Developmental theory centers around growth and development, ensures change, and focuses on the process of growth and maturation" (p.96). Several theorists have 6 looked at continued development and growth into old age such as Erikson, Havighurst, Neugarten, and Peck. The work of some of the current developmental theorists will be explored in Chapter II. One of the current theorists exploring human development from women's perspective is Carol Gilligan (1993). In her book, In a Different Voice: Psychological Theory and Women's Development, she states that women have a different psychological experience than men, they face a different social reality and "they also make a different sense of experience, based on their knowledge of human relationships" (p. 172). Much of her work however, focuses on mid-life, and does not explore development into old age. This paper will instead focus on developmental theories that consider development beyond age 65. From the perspective of continued development into old age, it is also important to recognize that seniors over the age of 65 are not one homogeneous group. As stated by Novak (1985) the old-old (over the age of 80) have different needs and life experiences than the young-old (between the ages of 65-79). For example, the old-old were born before 1918, therefore part of their life experience was WWI. The young-old have a different experience. Each cohort would also be at a different stage in their development. As stated by Fisher (1995), more research is needed beyond current developmental theories to look at "additional developmental stages which recognize the differences between the young-old and the old-old" (p.241). Exploring diversity within our aging female population is very important to social workers and other professionals working in this field. As stated by Mitchell (1994), "understanding the aging experience in all its complexity and depth of meaning... as given by older individuals themselves, is critical for professionals who are interested in promoting health and quality of life" (p.70). Kosberg (1983) also emphasizes the importance of health care workers being knowledgeable about, and sensitive to the aging process. Solomon and Peterson (1994) stress the importance of social workers understanding the needs of older individuals in order to assist them to maintain quality of life. Part of this involves assisting them to see "one's life as meaningful" (p. 41). In order for social workers to assist seniors to see "one's life as meaningful" they must gain a better understanding of meaning as experienced by older individuals. As our senior population continues to grow, social workers will have increasing opportunities to work with the elderly in several areas such as clinical practice, policy and program development, and research. Research studies such as "An Exploration of Meaning in the Lives of Elderly Women" can contribute to the body of knowledge and understanding about meaning in the lives of older women and assist social workers in their work with seniors. In terms of practice, social workers can assist elderly clients to "name and understand the processes of their own aging, to guide them in developing skills in advance of being old, and to join them in the meaning-makings that go with being old" (Carlsen, 1991, p.5). In our clinical work it is also important to remember that they are telling us of experiences that we have not yet had. We must listen to their experience of aging, enhance their strengths and coping skills, and be knowledgeable about relevant community resources (Carlsen, 1991; Fahey, 1996; Hartford, 1985). Through a better understanding of what is meaningful to elderly women, social workers will also be in a better position to influence policies and program development. Social workers continually work to improve social conditions for their clients and they have the skills to be instrumental in formulating policies (Greene and Knee, 1996). "This policy practice approach calls on the profession to proactively shape and evaluate new service paradigms in the field of aging" (p.559). Furthermore, social workers can advocate and support elderly women to become more directly involved in these processes as well (Grant, 1996). In terms of research, social workers can play an active role in identifying aging stereotypes and exploring the realities of the aging experience as expressed by those who are living it (Connidis, 1987; Grant, 1996). As noted earlier, there is limited research available 8 that presents the positive or balanced approach to aging. Social workers can take up the challenge of conducting more research in the field of aging especially for women as "the experience of old age has become, more than ever before, a women's reality" (National Advisory Council on Aging, 1993, p.8). This research study "An Exploration of Meaning in the Lives of Elderly Women" intends to provide a beginning exploration of the phenomenon of meaning for older women within a developmental perspective. Chapter II will review current studies on the phenomenon of meaning, and relevant developmental theories. 9 CHAPTER II LITERATURE REVIEW The body of literature relevant to this study "An Exploration of Meaning in the Lives of Elderly Women" can be classified into two main sections: research on the phenomenon of meaning, and a review of relevant developmental theories. Research Studies on the Phenomenon of Meaning As noted in the previous chapter, existing research findings maintain that meaning is important to study as it contributes to health, successful aging and quality of life. However, an overview of the literature reveals that only a few researchers have studied meaning in the lives of seniors (Burbank, 1992; Carlsen, 1988, 1991; Kaufman, 1986; Mitchell, 1993, 1994; Mokuau & Browne, 1994; Reker, Peacock & Wong, 1987; Reker & Wong, 1988). The findings from these studies will be outlined as follows. Burbank (1992) recognized the importance of meaning in people's lives but found limited research available that looked at meaning in the lives of seniors. She found that previous research studies considered meaning in the lives of college students and adults but it neglected what was meaningful for older people. Burbank designed a study utilizing a quantitative approach where 81 participants over the age of 62 completed a Fulfillment of Meaning Questionnaire and compiled a list of 10 things that were important in their lives. Participants were selected through various programs affiliated with a local senior's centre. Of these 81 participants, 75% were women. Burbank did not discuss her findings in terms of gender differences or similarities. Her results indicated that seniors found relationships to be the most important or meaningful thing in their lives, with 57% of participants listing relationships as first. Other participants listed religion as most important 10 13% of the time, service was identified as number one for 12%, and activities was reported as most important for 10% of the respondents. The remaining 8% identified either learning, health, home and living/growth as being most important in their lives. Burbank postulated that home was identified as it may represent autonomy and stability for some older people. The quantitative approach to her study did not allow her to clarify this with the participants who identified home as most important. Burbank concluded from her study that it is very important to understand what is important to seniors. Through this understanding, health care providers can "gain insight into clients' needs and behaviors based on what is meaningful to them" (p.27). Burbank believes that it is the role of the health care provider to assist seniors in rediscovering a sense of meaning in their lives. Although her study is valuable in beginning to consider what seniors find meaningful in their lives, the findings only identify a list of things that were seen as important to seniors. The study did not allow participants to expand on why and how these items were listed as important. For example, it did not allow the reader to know what it was about relationships that made them meaningful for these participants. Or in terms of religion, was it belonging to a religious affiliation, or having spiritual beliefs that was important? Burbank's utilization of a quantitative approach, does not allow an understanding of meaning in the context of the person's life. Secondly, Burbank only discussed the results for the first ranked item. For example, 57% listed relationships as most important, what did they list as second? Finally, this study was not gender specific, therefore does not provide information about what women find meaningful in their lives. A qualitative approach would allow a fuller understanding of what participants find meaningful in their lives, why and how it is meaningful, and how the different variables of meaning are integrated for that person in the context of their life experiences. 11 On the other hand, a study by Kaufman (1986), explored meaning for seniors from a qualitative approach which considered the person in the context of their life experiences. Kaufman interviewed 60 men and women who were over 70 years of age. The purpose of her study was to look at meaning for elderly individuals "as it emerges in their personal reflections on growing old" (p.5). She wanted to gather her data by listening to and observing how older people view their life and interpret their experiences. She did not want to assume what these experiences meant to them or to assume what older people see as important. Kaufman gathered her data through a series of interviews over a two year period. She also gathered data through observing these individuals in their life situations which ranged from living in the community, retirement facilities and nursing homes. Her study focuses on the meaning in the context of the person's life story and how they reinterpret and recreate experiences for the present. She utilized an interview format that guided the person through a life review process to explore the development of meaning throughout their life. Kaufman's research work is shaped by the theoretical foundations of cultural anthropology and social gerontology. From these perspectives, Kaufman observed the individual to note how "culture continues to influence personality and behavior into old age, how identity is maintained when one is old, or how elderly individuals select and manipulate cultural goals and norms" ( p. 16). She also viewed the individual within a developmental framework drawing largely on Erikson's work in order to understand the process by which individuals integrate their life experiences. In reviewing her data, Kaufman identified several common themes that emerged from the life stories of the participants. She found that they talked about their need for relationships, their work, social status and achievements, religion, self-determination and financial security. She also found that it was the process of connecting past experiences with current circumstances that gave meaning to their lives. This process also allowed for successful adaptation to changing life situations. Kaufman concluded that "by looking at themes that 12 emerge from their stories, we can see how the old not only cope with losses, but how they create new meaning and reformulate and build viable selves" (p. 163). Unfortunately, because her work was not gender specific, it cannot be known what themes emerged for elderly women in describing meaning in their lives. Similar to Kaufman's work, Carlsen (1988) completed a qualitative study that looked at how adults and older individuals create and recreate meaning in their lives. Her study involved transcribing her counselling sessions with various clients. Carlsen then reviewed her data to look at the ways that individuals interpret their life experiences as they define meaning in their lives. The purpose of her work was to articulate an "approach to therapy framed in the metaphorical language of human life development and meaning-making" (1988, p.4). Her data included adults across the life span from young adulthood to older age. Carlsen found that people seek meaning throughout life including individuals in their senior years. From her initial findings, Carlsen (1991) applied her "meaning-making" therapeutic approach in her work with elderly clients. She found that many of her older clients were "still learning, growing and creating" (p.206). Older adults were striving to gain a sense of meaning in their lives despite the realities of aging such as unpredictable health and uncertainties caused by changing roles and relationships. Carlsen believes that those who age creatively learn to balance the challenges of aging in their search for meaning. In her therapeutic approach, Carlsen believes that it is the role of the therapist to listen to how the older person balances the challenges of aging by listening to their life experiences. In understanding their experiences, the therapist can assist them to define and redefine meaning in their lives. Another study by Mokuau & Browne (1994) also points out the importance of listening to and understanding the life experiences of older individuals. They conducted a qualitative study which reviewed the life experiences of six older native Hawaiian women. The purpose of their study was to identify life themes that were meaningful to these women in expressing their life experiences and developing a sense of identity. The six women were selected from the 13 only residential care facility on the island of Oahu. Data was collected through two recorded interviews with each participant. Mokuau & Browne identified three major life themes that were important to these women. These were relationships with people, relationships with nature, and spiritual and religious beliefs. By utilizing a qualitative approach they were able to further explore what it was about these things that was important to the women. For example, the participants identified that the most significant relationship was mother/child, with the grandparent/child relationship being identified as having a secondary role of importance. In the Hawaiian culture, the mother plays the role of caring for the children and teaching them manners, while the grandparents play the role of passing on the traditional native culture and stories to the children. Although this study utilizes a qualitative approach to focus on the life experiences of women, it looks more at life themes for the native Hawaiian culture than meaning in the lives of older woman. Furthermore, due to the cultural differences between Hawaii and Canada, the findings have limited applicability to what community dwelling Canadian older women find meaningful in their lives. Mitchell (1993, 1994) conducted a research study to look at the meaning of being a senior in Canada. She collected 600 narratives from senior men and women over the age of 65. The purpose of Mitchell's work was to generate a structural definition of the meaning of being a senior. She also used the same data to analyze how the participants expressed meaning. From her data, Mitchell (1994) identified seven common elements that encompass the meaning of being a senior. These elements included; 1) engaging the now while rolling with the vicissitudes of life. 2) grateful abiding in wondering awareness 3) buoyant unburdening amidst shifting rhythms. 14 4) anticipating new possibles with refined astuteness. 5) propelling discovery through enlivening connectedness. 6) affirming self through altruistic commitments. 7) retrospective pondering amidst everydayness. (p. 72-73) These seven elements were then combined to provide the structural definition of what it means to be a senior. Mitchell asserts that these identified elements enhance the understanding of meaning in later life. Mitchell also analyzed the data to explore how the participants expressed the meaning of being a senior. She identifies that seniors use simile, paradox and humor to describe their life experiences. She also notes that the use of simile, paradox and humor is unique to each person, therefore it is important to clarify with the individual what it means to them. She reminds health care providers to be aware that meaning may be expressed in these different ways, and that it is the individual's perception of meaning for themselves that is important. From her work, Mitchell asserts that personal meaning is important to the health and quality of life for seniors. Another Canadian study by Reker, Peacock and Wong (1987) examined meaning and purpose in life across the life span. The purpose of their study was to look at meaning and purpose in terms of gender differences and cohort differences for five developmental stages from young adulthood to the old-old. The researchers believe that "perceived meaning and purpose in life play an important role in coping with developmental crisis" (p.44). The sample for this study consisted of 300 participants, 30 men and 30 women for each of the five developmental stages. The researchers utilized the "Life Attitude Profile" questionnaire which is a 46-item 7-point Likert scale encompassing seven different dimensions of quantitatively measuring meaning and purpose. The seven dimensions included "Life Purpose", "Existential Vacuum", Life Control", "Death Acceptance", "Will to Meaning", "Goal Seeking" and "Future Meaning". The "Life Attitude Profile" had been previously tested by the 15 researchers for reliability and validity. Reker et al. (1987) found that participants in the young-old and old-old group reported a higher level of life satisfaction than those at earlier developmental stages. They also found that having a sense of "life control" was important to the psychological and physical well-being for the young-old and old-old. The gender and cohort distinction in this study allows for an interesting look at meaning for women from a developmental perspective. Unfortunately, the quantitative approach leaves the researchers and the readers speculating in terms of understanding why the participants may have responded the way that they did. For example, Reker et al. note that young-old women scored higher on the questions relating to the dimension of "will to meaning" yet the researchers are left wondering why. They speculate that women in this age group may be searching for meaning in new roles as they adjust to the "empty nest". The quantitative data does not allow the researchers to clarify with the participants, or look at how the women expressed "will to meaning". It also does not identify how the participants would define "will to meaning" for themselves. Similarly, the findings indicate that women in all age groups report more "life control" than men. In trying to understand this result, the researchers speculate that "women may score higher on life control because it primarily measures self-direction and freedom to make life choices. Alternatively, the sex difference may be the result of a greater tendency of women to respond in a socially desirable manner" (p.48). As the research design does not allow for clarification with the participants, the reasons for the various responses remains unknown. A qualitative approach would help address some of these unanswered questions. Reker & Wong (1988) also wrote an article "Aging as an Individual Process: Toward a Theory of Personal Meaning" which provides a review of several studies on meaning in an effort to support several postulates and hypothesis. Their fundamental postulate is "that every individual is motivated to seek and find personal meaning in existence" (p.222). They believe that personal meaning continues to undergo transformations as a person integrates and 16 interprets their life experiences. This belief leads to Reker & Wong's developmental hypothesis that meaning becomes "increasingly more integrated as a function of age" (p.232). Reker & Wong identify several common sources of meaning found in the various studies that they reviewed. These were relationships, personal growth, altruism, achievements, and religion. Unfortunately, the studies reviewed in this article were not specific to the elderly. They included college students, adults and older individuals. Some of the findings noted here though are similar to Burbank's findings for meaning in the lives of seniors in that relationships, service, growth and religion were identified as important. In an effort to understand the role that meaning plays in an individuals' life, Reker & Wong (1988) review several measurement approaches in studying meaning. Although most of the research studies reviewed in this article employ a quantitative approach, Reker & Wong acknowledge that a qualitative approach would enhance the research findings. They suggest that methods such as interviews, life reviews, or a guided autobiographical approach would provide important information on how a person interprets and attaches meaning to their life. In conclusion, this article supports the importance of studying meaning within a developmental perspective and it lends support for personal meaning to be explored from a qualitative approach. Another noteworthy article to consider is the one by Lapierre, Bouffard & Bastin (1997). The purpose of their study was to look at personal goals and well being in the elderly as it relates to a number of factors including the significance of meaning in their lives. The sample consisted of 708 French Canadian seniors ranging in age from 65 to 90 years. Of the participants, 501 were women and 207 were men. Data was collected with a three part questionnaire and results were quantitatively analyzed. Results from this study indicate that the participants identified the importance of health, autonomy, relationships, helping others, activities/leisure and continued self development as important personal goals which gave them a sense of well being. The 17 researchers also found that these identified factors were related to feelings of competence and meaning in life. Lapierre et al. (1997) conclude that it is important to support elderly individuals to develop and maintain meaning and meaningful life goals. They believe that through this support, elderly individuals will express greater life satisfaction and experience positive adjustment to the challenges of aging. This study further supports the importance of exploring meaning in the lives of seniors. All of the aforementioned research studies emphasized the importance of meaning in the lives of seniors. As stated by Reker & Wong (1988): We strongly believe that the derivation of personal meaning in life is a key process in successful aging that can have positive psychological, social, economic, and medical implications. Individuals are not victims of their own age. They possess personal resources and competencies. They can be active and independent and take advantage of opportunities for continued growth, (p.239) Yet despite the findings of the importance of meaning in the lives of seniors there remains limited research available and the existing studies only provide a beginning overview of the phenomenon of meaning. Of the research studies reviewed, only Carlsen (1988, 1991), Kaufman (1986), Mitchell (1993, 1994), and Mokuau & Browne (1994) provided a qualitative approach to exploring meaning. Although each of these studies included seniors, everyone over age 65 years were grouped together as one group without consideration for possible developmental differences for each cohort in terms of meaning in their lives. Only the study by Mokuau & Browne was gender specific to women but it was also culturally specific to native Hawaiian women. The study by Reker, Peacock & Wong (1987) did offer both gender and cohort data but the 18 quantitative approach only allowed for participants to respond to the questions in the "Life Attitude Profile" instead of allowing them to express and expand upon meaning for themselves in their own words. Despite the limitations of the research studies reviewed in this section, it is interesting to note some of the findings from their results. Common themes that emerged from most of these studies included the importance of relationships, independence, spiritual beliefs/religion, activities, service, life purpose, self-determination, and continued self development. They all stressed the importance of practitioners to work with seniors in exploring and enhancing a sense of meaning in their lives. They also pointed to the need for further research in the area of meaning in the lives of seniors. Many of the studies reviewed also emphasized that the senior years are still a time of engaging life and continued growth and development. This study "An Exploration of Meaning in the Lives of Elderly Women" differs from previous studies on meaning in several ways. It is gender specific to allow for the older women's perspective of meaning. The qualitative approach allows for the participants to express meaning in their lives in their own way. Participants can guide the interview process to focus on what is meaningful for them. The cohort distinction of young-old and old-old allows for a further examination at the different developmental stages for the elderly in terms of meaning. The perspective that old age is a time of continued development will now be explored in a review of relevant developmental theories. Relevant Developmental Theories Only a few developmental theorists include old age as one of the developmental stages of growth. These include Neugarten, Havighurst, Erikson and Peck. These theorists, view over the age of 65 years as one developmental stage, and do not take into account cohort differences for this potential ten, twenty, thirty plus years of life. Only the work by Brown (1978b) provided a beginning look at possible developmental differences for the young-19 old and the old-old. This section will review the work of Neugarten, Havighurst, Erikson, Peck and Brown. As suggested by Carlsen (1991) it is important to consider the ongoing development of the older person as they continue to define and redefine meaning in their lives. She draws on the work of Neugarten who suggested that aging occurs through meaning-making and reflecting on one's life. Through considering how an individual interprets their experiences and copes with the challenges of aging, one can gain a better understanding of their developmental process. Neugarten believes that development is not necessarily defined by age or stages. She asserts that there are certain issues that adults face as they age. Some of the issues that Neugarten identifies as particularly relevant to older age include; adaptation to losses of work, friends, spouse, levels of competency and authority. Others deal with reconciliation with family members and personal achievements and failures. Grief must be resolved, both over the death of others and over one's own approaching demise; one's sense of integrity must be viewed in terms of what one has been rather than what one currently is. A final issue is that of one's "legacy", traces of one's self that survive after death. (Golan, 1981, p.30) Neugarten calls the aforementioned issues as expected or anticipated life events. She also acknowledges that development includes coping with the traumatic, unexpected life events such as divorce, or the death of a child. Neugarten believes that how a person has adapted throughout their life will be an indicator of their adaption in older age (Neugarten, Havighurst & Tobin , 1968). Research by 20 Neugarten et al. found that there is increasing consistency of personality with age. "Those characteristics that have been central to the personality seem to become even more clearly delineated, and those values the individual has been cherishing become even more salient" (p. 177). As a person ages, they will continue to make choices and interact with their environment in much the same way as they have throughout their life. Neugarten et al. conclude that an individual's personality will be central to their adaptation towards life's expected and unexpected events. Even though Neugarten asserts that there is a basic continuity in personality as one ages, she also proposes that one change that does occur with reasonable consistency is that older people tend to focus more on their inner lives than on the external world. She states that as one ages "there is a change from active to passive modes of mastering the environment, and there is also a movement of energy away from an outer-world to an inner-world orientation" (Neugarten, 1978, P.21). Neugarten refers to this as the process of "inferiority" where the ego functions are turning inward as part of the personality development of older age. This inward turning of energy and focus does not necessarily mean that a person is disengaging from their social world. A study by Havighurst, Neugarten and Tobin (1968) found that people expressed satisfaction in their level of activity or withdrawal from previous activities based on their personality and patterns of adapting throughout their adult life. For some people, activity and continued involvement leads to successful aging, while others may withdraw or disengage which can be adaptive for them or a continuation of previously established patterns. Havighurst et al. conclude that "the relations between levels of activity and life satisfaction are probably influenced by personality type" (p. 172). In later work, Havighurst (1972) expands upon the concepts of activity and disengagement in his developmental work with older adults. He proposes that older individuals disengage from previous activities and roles of mid-life in order to re-engage the tasks of the developmental stage "later maturity". This last developmental stage which includes everyone 21 age 65 years and older, involves the individual learning and completing six developmental tasks. Havighurst believes that successful achievement of these tasks will lead to happiness and satisfactory growth in our society. A brief description for each of these six developmental tasks will follow. Task One: "Adjusting to Decreasing Physical Strength and Health" According to Havighurst (1972), there is a decrease in cell function and cellular systems. He identifies the cardiovascular system, the kidney's and the joints as being the weakest points of the aging body. For some people this may mean adjustment to minor changes, while for others they may have to adjust to a disability caused by a stroke, arthritis or some other disease. Many people, however, do manage to maintain an active and healthy life well into older age. Task Two: "Adjustment to Retirement and Reduced Income" This task involves the individual making choices of how they are going to invest their energy and time, as well as, how they are going to define themselves after retirement. This adjustment is applicable to most men and to many women. Adjustment depends on the value that the job held for that person and their ability to re-invest that energy in a positive direction. Part of this process involves also adjusting to reduced income which may or may not limit some choices. Task Three: "Adjusting to Death of Spouse" Although this task affects both men and women, more women than men have to deal with this adjustment, simply because they live longer (Jones, 1994). While both men and women may need to move to a different home, learn new skills and cope with the grief and loneliness, Havighurst (1972) acknowledges some possible gender differences in adjusting to this task. For example, women in particular may have to move from the family house. This may be due to economic or health reasons. The move may be to a smaller place, moving in with family members, or needing to go into a retirement or nursing home. Women may also have to learn 22 how to handle the financial matters previously attended to by their husbands. As noted by Havighurst, this can be a very challenging developmental task as "every solution requires unlearning of old ways and learning of new ways" (p. 110). Task Four: "Establishing an Explicit Affiliation with One's Age Group" Havighurst (1972) describes this task as a person accepting their status as a member of the elders of society. This includes a biological, sociological and psychological dimension. Biological factors include the physiological slowing down of the person which makes it "increasingly difficult for older people to keep up the tempo of life which they followed in middle age" (p. 110). Sociological basis means that a person becomes involved in a political or economic action group, or they might join a social or recreational group based on their interests. The psychological basis for this fourth task is related to the perceived "rewards" and "punishments" associated with participation in the middle-aged or old-age group. Continued participation in the middle-aged group may be rewarding in that it provides a feeling of achievement in doing familiar things, yet it also may be unrewarding if the person is ignored by this group, or has difficulty keeping up either due to biological or financial reasons. Participation in the old-age group may be rewarding because the "tempo of life is slower and more comfortable" (Havighurst, 1972, p. 111), or it may seem like a punishment as there is a "tacit admission that one has become old" (p. 111). The person may also experience difficulty learning to participate in new groups. Task Five: "Adopting and Adapting Social Roles in a Flexible Way" In this task, the older person must develop and expand existing roles in several areas in order to adjust to the losses of roles in middle age (Havighurst, 1972). This would include redefining family roles, community roles, developing a new hobby, and accepting a reduced "physical vigor" in activities. 23 Task Six: "Establishing Satisfactory Physical Living Arrangements" This task also consists of a biological, sociological and psychological basis. Havighurst asserts that due to biological reasons such as inability to climb stairs, do heavy housework, prepare food, or take care of oneself, may constitute a need for a person to move. From a sociological basis, a person may continue living with their spouse in their own home, or they may decide to move to a warmer climate, move to a retirement home or need to move to a nursing home. They may decide to accept services in the home to maintain independence or move in with other family members. From a psychological basis, Havighurst (1972) believes that most people want to maintain their present living arrangements for as long as possible. If they do consider a change in housing, then their decisions are affected by seven principal values. These values include "quietness, privacy, independence of action, nearness to relatives and friends, residence among own cultural group, cheapness, and closeness to transportation lines and community institutions such as libraries, shops, movies, churches, etc." (p.114). Havighurst (1972) credits his perspective and much of his work to Erikson. Havighurst believes that successful achievement of the six developmental tasks of "later maturity" depends on the completion of tasks at earlier developmental stages. This is consistent with the work of Erikson who is one of the leading developmental theorists, especially for development in the later years (Beaver & Miller, 1992). Erikson proposes that "each stage in the life cycle involves the individual reintegrating, in new, age-appropriate ways, those psychosocial themes that were ascendant in earlier periods" (Erikson, Erikson, & Kivnick, 1986, p.54). As people age, they attempt to integrate earlier developmental themes such as hope, will, purpose, competence, fidelity, love, and care into the current old age theme of wisdom. Erikson's theory is comprised of eight developmental stages from infancy to old age. The developmental stage of old age includes everyone age 65 years and older. He refers to 24 the eighth and final stage as integrity versus despair. Positive resolution of this stage results in a sense of wisdom (Erikson et al., 1986). It is during Erikson's eighth stage that a person works to integrate and affirm the meaning of life experiences in an effort to achieve a sense of integrity (Kennedy, 1978). The one and only task of Erikson's eighth stage of development involves resolving the issue of integrity versus despair. "Integrity refers to the ability to view one's past life experiences in a positive manner, despite the mistakes along the way" (Jones, 1994, p.38). Older individuals that achieve a sense of integrity often reflect on their life with satisfaction (Beaver & Miller, 1992). Erikson first proposed his eight stages of development almost fifty years ago. As he became older himself, Erikson worked with his wife Joan Erikson and a colleague, Helen Kivnick to re-examine the eighth and final stage that he now found himself experiencing. They integrated the developmental stories of 50 people who had been associated with the "Guidance Study" sponsored by the University of California, Berkeley. The participants were between the ages of 75 to 95 years. A major theme that emerged from their work was that a person needs to maintain a vital involvement in life and living. (Erikson, et al., 1986). This may appear different for each individual, but those expressing satisfaction at this stage in life, also talked about their "vital involvement". Drawing on the work of Erikson, Peck proposed that there are different kinds of psychological learnings and adjustments during the later years of life (Peck, 1968). Instead of one developmental issue to be resolved in old age, Peck believes that older adults face three challenges or tasks which include "establishing a varied set of valued activities, enjoying life through creative activities that go beyond his aging body, and feeling at ease with himself by realizing that he has contributed to future generations" (Santrock, 1989). Peck describes these three tasks as follows. 25 Task One: "Ego Differentiation vs. Work-Role Preoccupation" Peck identifies the main issue here as the value that a person places on their job and their ability to redefine their identity and self worth after retirement (Peck, 1968). He acknowledges that this task is often more applicable for men at this age unless the woman has worked outside of the home. He postulates that women may experience this challenge earlier in life when their "vocational" role as mother is removed as the grown children leave the home (Peck, 1968). "To avoid crisis related to retirement and to children leaving home, Peck has suggested that a person needs to develop valued alternatives and activities" (Jones, 1994, p.39). In this way a person can maintain a sense of continued value to self and society. Task Two: "Body Transcendence vs. Body Preoccupation" This task relates to how a person views their physical discomforts and declining physical health related to aging (Peck, 1968). "Some people become increasingly concerned with their physical state while others, with the same physical problems, minimize their discomforts and focus instead on the satisfaction they receive from their psychosocial activities and interactions" (Spier, 1989, p. 290-291). Peck asserts that even though a person experiences physical decline, in order to successfully complete this task, they need to rely on their "mental and social powers which may actually increase with age, for many people" (p. 91). Task Three: "Ego Transcendence vs. Ego Preoccupation" Peck believes that a person needs to transcend their ego and focus on the well-being of future generations and less preoccupied with their own immediate needs and mortality. The person who successfully meets this challenge will not be focused on the prospect of personal death, but instead this person will effect an "active effort to make life more secure, more meaningful, or happier for the people who will go on after one dies" (Peck, 1968, p.91). Similar to Erikson, Havighurst and Neugarten, Peck views older age as one developmental stage. Despite the differences between their perception of the number and type of tasks, none of them provide an understanding of what tasks and/or developmental 26 issues the young-old and the old-old may be faced with. In an attempt to start looking at developmental differences for these two cohorts, Brown (1978b) applied the work of both Erikson and Havighurst to propose seven tasks for each cohort. Brown (1978a) believes that the "lumping syndrome" of referring to the older generation as "those over 65", neglects the individuality of older people, their experiences and their needs. For the purposes of her work, Brown (1978b) defined the two cohort groups as the young-old (age 55 to 74) and the vulnerable-old (age 75 and over). She acknowledges that many of the people in the older cohort are still healthy and independent, but she uses the term "vulnerable-old" as she also acknowledges that this is a time of increasing health challenges and physical decline. The seven tasks of the young-old are listed below. Task One: "Preparing for and adjusting to retirement from active involvement in the work arena with its subsequent role change (especially for men)." Task Two: "Anticipating and adjusting to lower and fixed income after retirement." Task Three: "Establishing satisfactory physical living arrangements as a result of role changes." Task Four: "Adjusting to new relationships with one's adult children and their off-spring." Task Five: "Learning or continuing to develop leisure-time activities to help in re-alignment of role losses." Task Six: "Anticipating and adjusting to slower physical and intellectual responses in the activities of daily living." Task Seven: "Dealing with the death of parents, spouse, and friends." (Brown, 1978b, p. 11-13) 27 The seven tasks of the vulnerable-old are listed below. Task One: "Learning to combine new dependency needs with the continued need for independence." Task Two: "Adapting to living alone in continued independence." Task Three: "Learning to accept and adjust to possible institutional living (nursing and/or proprietary homes)." Task Four: "Establishing an affiliation with one's age group." Task Five: "Learning to adjust to heightened vulnerability to physical and emotional stress." Task Six: "Adjusting to loss of physical strength, illness, and the approach of one's death." Task Seven: "Adjusting to losses of spouse, home, and friends (possible adjusting to loss of one's children)." (1978b, p. 15-18) For each of the developmental stages, Brown asserts that the seven tasks are not separate from each other, but rather they are interdependent on one another. For example, one may have to readjust leisure activities after they are faced with the death of their partner. She also points out that the tasks of one developmental stage are not exclusive from the other stage as "a pattern of successful coping can be relied on for the familiar tasks in this next life stage" (1978b, p. 15). Brown concludes by recommending further research of the developmental tasks of these two cohorts. She acknowledges that her work is only the beginning of research in this area. The purpose of her work was to propose some preliminary ideas and discussion of how the developmental tasks, as adapted from Havighurst and Erikson, may vary for the two cohort groups. Further research work in this area would provide a better understanding of the developmental tasks facing each of the two cohort groups. 28 The current study "An Exploration of Meaning in the Lives of Elderly Women" provides a beginning look at some possible developmental differences for the cohort of young-old (age 65-79 years) and the old-old (over 80 years). It will also provide a beginning look at some developmental issues for older women. In reviewing the existing literature of relevant developmental theories, none of them were gender specific to the tasks and challenges faced by older women. For example, several theorists focused on the adjustment to retirement, most often applicable to men for the current generation. They did not consider the adjustment or possible developmental task for women as they now share the home environment with their retired husband. As noted by Walsh (1988), in a traditional relationship, the husbands' work and the wifes' role in the home brought satisfaction, meaning and self-esteem to each of them. With retirement, the husband is "invading" his wife's "turf which requires adjustments for each of them in different ways. Furthermore, more women than men are widowed in their senior years which involves developmental tasks around the adjustment of loss, living alone and possible ecomonic considerations. Chapter III will now focus on the research design for this study, including a description of sample selection, data collection and data analysis. 29 CHAPTER III METHODOLOGY In reviewing previous studies on meaning in the lives of seniors, it was evident that they all differed from the current study "An Exploration of Meaning in the Lives of Elderly Women" in several ways. Most of them included both male and female participants and they were not sensitive to the cohort of young-old and old-old. Many of them also utilized a quantitative approach which did not allow the participants to express what was meaningful for them in their own words. This did not allow for a fuller understanding of the sources of meaning or how meaning was integrated into the context of the person's life. This current research study is gender specific to explore meaning in the lives of elderly women. It is also cohort sensitive in that interviews were done with both young-old women (between the ages 65-79 years) and old-old women (over the age of 80 years). This study also utilizes a qualitative research method of in-depth interviews to allow for a purposeful exploration of meaning in the lives of elderly women. As stated by Haldemann (1993) in her editorial "Qualitative Methods: Why?" in the Canadian Journal of Aging, "The principle objective is the analysis of the meaning of the experience of individuals, captured in its lived form, with a minimal of preplanned, imposed structure" (p. 130-131). Qualitative research allows the participants to guide the interview process. As stated by Swigonski (1993), researchers need to "begin where the client is and to understand how the social structure influences the client's daily life." (p. 182) The purpose of phenomenological research is to describe the meaning of the lived experience for an individual or group of individuals (Lackey, 1991). In phenomenological research, it is important for the researcher to state their assumptions about the phenomenon under study, then suspend these assumptions during the 30 data analysis stage. For this research study there are two basis assumptions. First, I believe that people continue to search for meaning throughout their lives. Secondly, I believe that individuals continue to engage developmental tasks throughout life into old age. In proceeding with this research study, I also began wondering about possible differences for how the young-old women and the old-old women might describe meaning in their lives. This led to the decision to consider the data for each cohort group, in an effort to better understand meaning in the lives of elderly women. In this study, six elderly women (three from each cohort) were interviewed to allow them to describe what is meaningful in their lives. In order to allow as much flexibility as possible during the interview process, the decision was made to start the interview with one general question. All subsequent questions were guided by the participant's responses. During the interview, the researcher would clarify statements if needed, summarize what participants had talked about, and restate the original question until the participant had exhausted all they had to say about meaning in their lives. The interview started with the research question, "Is there something or things so important to you in your life that they give your life meaning?" Sample A total of six women participated in this study. Of these women, the young-old women were ages 67, 72 and 75 years respectively and the old-old women were ages 82, 82, and 83 years respectively. All women lived in the community, either in an apartment, condo or house. Of the young-old participants, one was divorced, two were widowed with one of them being recently remarried. All three had children and grandchildren. Of the old-old group, one was separated and subsequently widowed, one was married but lived apart from her husband for four to six months of the year, and one was now caregiving in a second marriage of 30 years. These three women all had children and grandchildren. Of the six women, only one woman 31 had a daughter and granddaughter living in Victoria. The other five women stayed in contact with their families through letters, telephone calls and annual visits. The number of participants for this study was based on the literature recommending a sample size of six when doing phenomenological research (Sandelowski, 1995; Steubert, 1991). Interviewing six participants allowed for in-depth interviews and the opportunity to recontact participants for clarification as needed. All six participants volunteered to be part of this study by responding to a notice posted on local community boards. A sample of this posting notice is included in Appendix I. This method of recruitment ensured that potential participants wanted to volunteer to be part of this study to talk about meaning in their lives. Those interested were asked to contact the researcher for further information. Once the study had been described over the telephone, respondents were again provided with the option of continuing to proceed with their participation or withdraw. Only one women decided to decline an interview after the initial telephone contact. Recruitment stopped once there had been interviews scheduled for three respondents in each cohort. Data Collection After the initial telephone contact by the participant, an interview was arranged at their convenience. Participants were provided with the option of conducting the interview in their home, the researcher's home or a neutral meeting place. All six women chose to be interviewed in their own homes. As pointed out by Domarad and Buschmann (1995), interviews in the participants home allows them to feel more comfortable and it gives them a sense of control. It also allowed the person to be seen in the context of their life which provided a richness to the data. Before the interview began, each participant signed a consent form as included in Appendix II. Each interview lasted between 60 to 90 minutes. After the initial interview, five of 32 the six participants were recontacted once by telephone as part of the final validating step. The sixth woman could not be contacted as she died in August 1997, before the final validating step was done. The interviews were audiotaped and then later transcribed by the researcher to ensure that all information provided would be accurately represented for analysis (Streubert, 1991). It also allowed the researcher to attend directly to the participant during the interview with minimal distraction such as note taking or trying to remember important data (Lackey, 1992). Directly after leaving the interview, the researcher recorded journal notes which included thoughts, feelings and impressions from the interview. The journal was also used to record decisions that were made during the research process. Data Analysis Each audiotaped interview was transcribed by the researcher to ensure confidentiality and to allow the researcher to get a better feel for the interview itself. The transcribed interviews were then analyzed using the following phenomenological method adapted from Colaizzi (1978). This method involved six steps of analysis which are outlined below. 1) The researcher read each participant's transcribed interview to acquire an overall feeling for them. 2) All significant statements/quotes were extracted from each of the transcripts that directly pertained to the phenomenon of meaning. Any similar or duplicate statements were then eliminated. 3) Formulated meanings were derived from these statements/ quotes. Here the researcher was careful to ensure that the formulated meaning reflected the participant's original description of meaning. 33 4) Significant statements and their formulated meanings were then clustered under common themes. In this study five common themes emerged from the data. a) These themes were referred back to the original descriptions of meaning in order to validate them. This ensured that all statements pertaining to the phenomenon of meaning were reflected in the common themes. b) At this point, discrepancies, if any, were noted and then clarified with the participants if necessary. 5) An exhaustive description of the phenomenon of meaning in the lives of elderly women resulted from the integration of the above results. 6) A final validating step was achieved by returning to the participants and asking if the formulated meanings and description of the phenomenon of meaning reflected their original experience or views. As noted earlier, one woman could not be contacted during this final validating stage. Her data was reviewed very carefully to ensure that the findings were consistent with her statements about meaning. Each interview transcript was analyzed using the Colaizzi method to arrive at an exhaustive description of the phenomenon of meaning. The findings for each cohort were also compared for differences and similarities in the participants description of meaning. The results for the study "An Exploration of Meaning in the Lives of Elderly Women" will now be reviewed in Chapter IV. 34 CHAPTER IV RESULTS Several common themes emerged regarding the phenomenon of meaning in this qualitative study "An Exploration of Meaning in the Lives of Elderly Women". Six elderly women responded to the research question: Is there something or things so important to you in your life that they give your life meaning? In applying the Colaizzi method of analysis as outlined in Chapter III, the following five themes emerged which captured the areas of meaning in the lives of these elderly women: relationships, outlook, interests, independence, and health. These five themes are reflected in the exhaustive description of the phenomenon of meaning in the lives of elderly women. It was interesting to note that although these five themes were common to all six participants, and the exhaustive description reflected what the women described as meaningful in their lives, the data also reflected a slightly different emphasis on how the young-old and old-old women talked about these themes. The findings for the young-old women and the old-old women will be presented, followed by Colaizzi's fifth step of data analysis, the exhaustive description of the phenomenon of meaning for elderly women. (Refer to Table XI at the end of this chapter) Similarities and differences between the two cohorts will be discussed from a developmental perspective in Chapter V. Findings for the Young-Old Women Relationships All three young-old women identified relationships as being the primary source of meaning in their lives. These relationships consisted of friendships, spouse and family. 35 Friendships were very important for two of these young-old women. They talked about the importance of long time friendships, as well as the importance of forming new friendships. Friendships seemed to provide support, a sense of connection and people to do things with. Of the three young-old women, only one was in a current spousal relationship. For her, this was the most important relationship in her life. It was a second marriage for her and almost all of her statements about this relationship related to the support and the companionship that she shared with her new husband. In addition to friendships, all three women talked about their children and grandchildren as being important in their lives. Two of the women corresponded with their families and saw them once or twice a year as they lived in other parts of Canada. Only one woman had a daughter living in Victoria. They would do things together once every couple of weeks. Examples of the significant statements and their corresponding formulated meanings are presented in Table I for the theme of relationships. TABLE I RELATIONSHIPS young-old Significant Statements Formulated Meanings My friends have been wonderful, I don't know what I would've done without them. They have been my support. (Bp) friends as a source of support Well, I have friends in Ottawa, we keep in touch. They come and visit. staying connected with friends In Ottawa we would do things for each other, and we would discuss things, I miss that, but I'm trying to make friends here. (Bp) 36 I've joined every group I can since moving here. I joined both New Horizons, the one here in James Bay and the one in Fairfield. I joined the New Comers Club, Silver Threads, you name it. I felt like that was the best way to meet new friends here, and that's important. (Bp) making new friends to maintain a support/activity network I go to the library where you can E-mail. I have about 15 people I correspond with by E-mail. I have friends all over the place. I even E-mail a friend in Paris. (Mp) staying connected with friends (talking about an acting class that she is teaching) I encourage them to laugh, cry and keep right on going so that they are working right through the emotion. And I have them doing all sorts of things. We have alot of fun with it. (Mp) social/activity network Then I have a really good friend, Pauline. We have known each other for most of our lives. Each year we make a point of spending our summers together at the cottage in Quebec. (Mp) staying connected with long time friends We got married last year. And why not, we want to be together and we have alot of fun together. We're in love...he's everything to me. (IP) spouse, companionship We cut the grass every Wednesday. He cuts the back and I cut the front. It's too much for one person. I think we make a good team. (Ip) spouse, supporting each other We play cards every Tuesday night at the club. And we go for walks together, you know, walk downtown. It's just nice doing things together. (Ip) spouse, companionship 37 Of course my family, my grand-children, they all give me meaning, and I'm closer to some of the family than others, and I think that's pretty normal. (Bp) My daughter's pretty special to me. We do things together, like go shopping or go out for lunch. (Ip) I have four children, two boys and two girls. We've pretty close, especially my daughters. I'm very close to them and their children. Well we try to stay in touch, you know, write, phone, maybe visit once or twice a year. (Bp) My daughter, my granddaughter, my grandson. This year my grandson and his wife had a little baby, so I'm a great grandmother now, and so all of these things brought me joy. (Mp) staying connected with family doing things with family staying connected with family joy from family and the joy of a new generation Interests The young-old women spoke enthusiastically of the importance of interests in their lives. For two of these women, their volunteer work was very important. This volunteer work seemed related to previous work experience as one of these women had been an actress and was now teaching acting classes to seniors. The other woman had worked for the government accessing resources for people and she was now a Senior Citizens Advocacy Counsellor. The third participant had never worked outside of the home. Her life work and interest had been in taking care of her family and their home. Her current interests reflected this in her continued enjoyment in baking and sewing which she did for her own family and others. 38 Furthermore all of these women had undertaken new interests such as writing, painting, learning the computer, taking French, enjoying travel, gardening and belonging to various classes or groups. Engaging these interests seemed to served the purpose of continued learning, staying active and belonging to a group, (refer to Table II) TABLE I N T E R E S T S Significant Statements And I really like to bake, oh I don't bake as much as I use to, I still really enjoy it. (Ip) but I also still sew a lot of my own clothes and things for the house, like those curtains over there. I just made those last week. (Ip) And I'm connected to the New Horizons over there. I'm giving a class over there....Well I'm doing something called "Express Yourself ....I got myself a nice class, there's ten in the class. (Mp) I started a library, uh, through the friends of the library. Three women, I'm one of them, and we started a, well friends of the library...we now are reading to groups in the nursing homes. (Mp) Then I was accepted to become a Senior Citizen Counsellor with the government which is different than peer counselling work. As a Senior Citizen Counsellor I help them with their GIS forms and other forms and we supply information or put them in young-o ld Formulated Meanings enjoyment of past activity extension of past interest volunteer work, extension of past work experience volunteer work, working with others, helping others volunteer work, extension of past work experience, helping others 39 touch with people who can help them. When you're a peer counsellor, usually they have an emotional problem, so I do counselling. (Bp) And I knit, not just a little, but a lot. I knit a lot. I have a box full of socks, hats, scarfs, well everything. I like to keep busy, and I use them for gifts or I give them away to places that need them. I have always knit, ever since I was a child. (Bp) staying active, giving to others And I liked my job, I worked very hard at it. I worked for the government, and I was a good worker. So I guess that's why I do what I do now, keep busy and keep working to help people. (Bp) talking about past work and how this leads to her present volunteer work And I really enjoy things like painting. I started to paint after I moved out here. (Bp) I have a very active mind, and I like to learn. For instance, I have always wanted to write a book so I'm starting a class over at the centre. (Bp) I started a writing class. I've written once or twice a couple of little short stories. They are meaningful, fun, they're hard, they're inspiring, they're irritating, they're wonderful. And I really enjoy it very much. (Mp) So I'm determined that I'm going to learn the computer. (Mp) new interest continued learning continued learning, challenging oneself continued learning I go to Sunday meetings with the Quakers, and once a month if there's an early meeting I go to what is called "Worship Sharing" and uh, that's a very small meeting. I go to adult education, I go to a women's group. Those two are twice a month. And uh, there's a couple of others I go to from time to time. (Mp) belonging to a group 40 I'm also taking a French class at the New Horizons. It's good, it keeps me up to date when I'm back in Quebec. (Mp) continued learning We're going down to Vegas next month. And last weekend we went down to Bellingham to do some shopping. We like to travel. (Ip) enjoying travel together, new interest My daughter can't believe that her new interest mom has such a green thumb. We get all our summer greens, potatoes, and berries from our own garden now. (Ip) Outlook The next area that seemed to bring meaning into the lives of these young-old women had to do with their outlook. They expressed outlook in a number of different ways. All three women described taking responsibility for their outlook. This encompassed adopting a positive, appreciative attitude towards life which seemed to have assisted them in dealing with their own personal challenges. For two of the women, spirituality played a key role in influencing their outlook. Table III provides an example of the significant statements and the corresponding formulated meanings for the theme of outlook. 41 TABLE OUTLOOK young-old Significant Statements I'm appreciative of all of the things I can do each day. I'm thankful to just get up each day. (Mp) Formulated Meanings appreciative of the day And this is what I feel, having been through these things personally. I can really empathize with people and let them know that they can fight through it, nobody can do it for you. (Bp) self responsibility My beliefs are very important to me, very deep. God has got me through alot. (Mp) spirituality I have a deep faith, but I don't go to church anymore. I like being out in nature. I talk to God there. (Mp) spirituality, faith There's no sense worrying about things. You just have to do what you can. (Mp) important to do what you can, self responsibility You've got to keep a positive attitude. (Bp) positive attitude There is as many different ways to being a Quaker as there are people in the world. It has been a great source of spiritual sustenance and nurturing, and I feel as if I've come home to myself in some kind of way. (Mp) spirituality We choose our lives, not just where we want to live but how we want to live. (Mp) self responsibility 42 What is wrong with the word old. It's an honourable word. I feel old and I feel good. And yes I do look my age. This is what age 75 looks like. Good! So look what you have waiting for you. I think that's important to hear. (Mp) affirmation of growing older And it isn't all fun, I mean, it's more than just getting half price at the movies, or half price on a bus. There are aches and pains associated with it, most certainly. So it's not always easy to feel upbeat you know about being old, but again I always say, look at the alternative. You can be old and miserable, or you can make the best of it, enjoy what you can, and you must keep a sense of humour. (Mp) positive attitude as we age, utilize humour And I like having this green belt outside here, outside my apartment here. It's a life saver. All the trees, and I lie in bed and listen to the rain in the trees. It's so quiet here. I sure do appreciate the quiet here. It's important to be appreciative of every day. (Bp) You've got to make the best of what you have. (Ip) appreciation of nature, appreciative of the day positive attitude This is a good day, everyday is a good day. They're like little gifts. (Ip) appreciative of the day 43 Independence The theme of independence was identified as a source of meaning for these young-old women. Statements that led to the theme of independence related to the importance of self reliance, or taking care of oneself. For one woman this meant making adjustments to pace herself in order to do her own housework and cooking. For another woman this meant working together in her relationship to maintain their home. Another important part of self reliance included making choices to self invest, as one woman noted "I just want to keep living my life the way I want" (Mp). Furthermore, an important variable for all of these women was living in a community that supported their independence. For example, these women talked about the proximity of services and the ability to walk places. Table IV provides an example of the significant statements and formulated meanings for the theme of independence. TABLE IV INDEPENDENCE young-old Significant Statements Formulated Meanings Between the two of us we take care of this place ourselves. He looks after the garden and helps me with the house, and I do all of the cooking and cleaning, and help him with the lawn. (Ip) working together to maintain independence and self reliance I still do all my own housework, and I bake. Even on days that I'm not feeling well, I still try to do what I can. I've just learn to pace myself. That way I don't have to depend on homemakers like the lady across the hall. (Bp) making adjustments to maintain self reliance 44 I think I'll eventually live here all year round. I think that living here is much more conducive to growing old gracefully than any other part of Canada. You can get outside all year round. I like to do my own shopping, keep active, like, walk everyday. (Mp) choosing a community that supports independence I like living here. It's so close to everything. I can walk downtown when I want. (Ip) neighbourhood supports independence I generally feel content with my life. And whatever chances I want to take, I want to take doing things, like my lectures, doing a class, writing a story, taking a walk, well even lifting weights like I was telling you. I just want to keep living my life the way I want. (Mp) self investing I really like living here, with Thrifty's right over there, and the clinic where I volunteer just down the street. (Bp) neighbourhood supports independence Health The final theme that was common to all of the participants relating to the phenomenon of meaning was health. In facing a health concern these women were likely to initiate an action step to try to deal with it. For example, one woman moved from eastern Canada to a warmer coastal climate in Victoria. Another woman took up an intense exercise program of walking and weightlifting at the YWCA to help her to deal with her osteoporosis. These women also talked about adjusting to health challenges such as slowing down and learning to pace oneself. Table V illustrates the significant statements and formulated meanings for the theme of health. 45 TABLE V HEALTH young-o ld Significant Statements Formulated Meanings My health was poor and in Ottawa the taking action to winters were very cold and the address health summers very hot, so 1 did what 1 concerns had to. It was very difficult to move but 1 figured, health wise it was a good move. (Bp) 1 have learned to pace myself. When adjusting to 1 start feeling tired, 1 know that 1 address health need to withdraw and take care of challenges myself or else 1 get very ill. You learn these things when you have a chronic condition and you want to keep going. (Bp) 1 try to take care of myself. Keep adjusting to active and you can keep going. I'm health challenges usually pretty healthy. Oh, the odd cold now and then slows me down, but 1 just take it easy til 1 can get going again. (Ip) 1 do have osteoporosis in my spine taking action to and in my left hip...l didn't want to address health take any medications....so she concern (my doctor) suggested that 1 at least go to the gym. And I'm so glad she did, because 1 walk about five miles a day, and that's good for me....l started going to the Y and 1 try to go three times a week. 1 am so busy recently, but 1 uh, like it. I'm doing weights. (Mp) 46 In summary, the young-old women expressed the five common themes of the phenomenon of meaning in the following way. Relationships especially with friends and for one woman her spouse were important for support, a sense of connection and they provided the women with a social/activity network. It was also important for these women to stay connected with their families. These women also stayed active through both long time interests and new interests which included volunteer work, belonging to senior's groups and activities for continued learning. Meaning was also identified as adopting a positive, appreciative outlook towards life and life's many challenges. This included maintaining spiritual beliefs. The young-old women expressed independence as important, with an emphasis on maintaining self reliance and choosing a community that supports independence. Finally, the young-old women spoke of their health and the importance of taking action to address health concerns and adjusting to deal with health challenges. The findings for the old-old women will now be presented. Findings for the Old-Old Women Relationships Relationships were identified as being the most important thing that brought meaning into their lives for all of the old-old women in this study. This included relationships with friends, spouse and family. The old-old women emphasized the importance of friends as a source of support and a sense of connectedness. Interestingly, all of these women had experienced the loss of friends close to them. Recognizing the importance of friendship, they all made efforts to make 47 new friends. In several cases, they talked of having younger friends as a way of maintaining friends in their lives now. Two of the old-old women were married, therefore for these participants, relationship with spouse was identified as a source of meaning. For one woman it was the long time commitment that was important to her, while the other woman spoke about being in love and the importance of providing care for her husband despite the challenges. Staying connected with family was also seen as important. For all of these women, their children and grandchildren lived in other parts of Canada and in England so contact was by phone, letters and annual visits. Table VI illustrates the significant statements and formulated meanings for the theme of relationships. TABLE VI RELATIONSHIPS Significant Statements I really do get alot of happiness out of people, you know, we get laughing about one thing or another, sometimes serious talk, it helps. (Dp) I don't have as close of friends as I did living down in Ontario, but they're all gone now, that's what it's like at my age. But I'll tell you, we have really good friends here, they're much younger than us though. (Dp) You know, sometimes there's more happiness and love between friends than family. (Dp) old-old Formulated Meanings friendships, social contacts making new friends, younger friends importance of friends 48 When I came out here, I had two making new friends friends, they were classmates actually, but one has passed away and the other moved to Nanaimo after her husband died, you know to be closer to her daughter. So, I've had to make new friends. You are having to replace people all the time, more or less. You just have to make new friends, find someone you can get along with. (Np) I meet people over there, in the social contact park but it's not the same... there's no "remember when we did that" stuff. We don't share the memories...But it's still feels better to get out, talk to people, even small talk, just be friendly. (Hp) Don't cut yourself off from your friends. I did that when my husband first got sick. That was a mistake. I could really use their support now someone to talk to, even do things with...So, now I've started going over to the senior's centre when I can. It's good to just be around other people. (Dp) friends as a source of support and companionship making new friends, My daughter and granddaughter live in England. We try to stay in touch by writing letters. (Dp) staying connected with family I trained with, you know, the ones from nursing school in Saskatoon. We still get together twice a year. (Np) I'm still in touch with the girls maintaining contact with long time friends To love people and to have people who love you too, you know, not only your relatives but other people too. To feel love and give love is very important. (Dp) importance of giving and receiving love When you get to be 83, you usually have friends that are younger than you are. That's just the way it goes. (Dp) making new friends 49 We celebrated our 56th wedding anniversary on Feb. 28th. We've known each other since highschool. (Np) commitment, long term relationship It's not the material things that make you happy, you've got to love your husband, be a good companion. (Dp) spouse, love and companionship Yes for about 2-3 years we haven't challenges of been able to do things, on account of my husband's health and oh, it nearly caregiving yet also meaningful to provide care for her husband, commitment drove me crazy because the only place I could get to was Thrifty's across the street and I never went anywhere and I didn't see people, and I thought I hate this kind of life....And oh,... it's so hard to watch him go down. He's become so, so thin. He eats well, I feed him well, but oh dear, it's just so hard sometimes. I really do try to take care of him, ...that's important to me, to take care of him the best I can. (Dp) Grandkids are very important to me. staying connected They are forever phoning me. BC Tel with grandchildren even phoned me because I had so many reversed calls on my phone. But I tell them, keep phoning me whenever you want. I'll pay for the calls. (Np) I wrote this book, well so others would know what it was like. Well I thought maybe it would help my daughter understand me more, if she knew about my life...so she would know our history I never told her. (Hp) connecting with family, wanting to pass on family story Since moving out here, I've had to make new friends. There's this one lady that I met at the New making new friends Horizon's Centre. We've become pretty close. (Hp) 50 Independence For the old-old women, independence was emphasized as being very important in their lives. All women talked about making choices and adjustments for the purpose of maintaining their independence. This included economic choices to stay in their apartments, and adjustments in means of transportation to still get around such as taking the bus and using a scooter. Neighbourhood also seemed to be a significant factor for the women in being able to continue to take care of themselves. Accessibility of services in their neighbourhood was important. Each woman demonstrated a determination to stay independent. Table Vll provides examples of the significant statements and formulated meanings for the theme of independence for these old-old women. TABLE Vll INDEPENDENCE Significant Statements I still drive my car. Mind you, I can't drive at night anymore because my vision isn't good at night, but I don't go out much at night anyway. And I don't drive very far. But I like having my car to do my shopping at the corner, go to the centre, you know, things like that.(Np) I take a bus to go up to U. Vic. for a class. Now that's challenging. I gave up driving but I didn't want to give up going places, so I take the bus and I got a scooter to get around here. I use it to go over to the park and to go up there to buy my groceries. (Hp) old-old Formulated Meanings maintaining independence by adjusting to changes maintaining independence by adjusting to changes, neighbourhood to maintain independence 51 I don't let people walk all over me. I do what I want to do. I think I've earned that right. (Np) I came out here when I was 78...alone from Nova Scotia. I just wanted to move out here. That was four years ago now and I've never regretted it for a moment. It was something I did for me. (Hp) I won't move from here, unless screaming. I'll never, never be put in a home. I won't go. I wouldn't want somebody to tell me to eat such and such at a particular time. I want some independence, and I think most old people feel like that. (Hp) We have a couple out in Oak Bay, they manage an apartment building and uh, they would love it if we'd live there you know, they kind of want to take care of us. But I don't want that. I just want to keep going myself. (Dp) The only thing is the rent is too high here for us, really. It takes alot of rent but you have to do that though, that's a way of life. If you want something then if you can, you take it and let something else go. By living here we can go across the street and get our own groceries, we also eat quite abit at that restaurant over there, and well, uh, the centre that I go to is just down the street. (Dp) I like to be independent, you know, it pays dear, it really does. To be independent and not let everyone do things. I think you can get into an awful habit of just letting people do things for you. I don't want that. (Dp) determined to maintain independence determined to move to Victoria determined to maintain independence making choices to maintain independence making choices to maintain independence, importance of neighbourhood to maintain independence important to take care of oneself, be independent 52 And I like these Chef on the Run meals. They're cheap, give me a complete meal and they're delivered right to my door. (Hp) utilizing services to maintain independence in the home I wouldn't move from here now, especially with the park right over there and Thrifty's right up there. This is my home and I have everything I need right here. (Hp) importance of neighbourhood to maintain independence I'd rather do things myself. I'd rather pay privately for any making choices to maintain independence homemaker help than accept help from Long Term Care and have them telling me what I can and can't do. Even though we can't afford it, I'd rather pay myself. (Dp) Outlook For the old-old women, the theme of outlook played a significant role in their descriptions of what was meaningful in their lives. All three women shared their experiences and perspectives about how they found enjoyment and meaning in each day. All three women spoke about their belief in God and how important that was for them in their daily lives. Each woman also emphasized the need to maintain a positive attitude despite the challenges of aging that they were faced with. In addition to remaining positive, each participant stated that it was important to adjust to their changing needs as they got older. These three women also told stories or shared words of advice that included the importance of giving to others as part of their outlook that brings them meaning at this stage of life. For two of the women this also included giving to others through writing, both as a way of sharing experiences and as a way of passing on their legacy. For the third woman, giving to others meant reaching out to those around you, whether that be in the form of a phone call to a 53 neighbour or smiling at people you pass on the street. The attitude of giving of oneself to others was important. Table VIII provides some examples of significant statements and their formulated meanings for the theme of outlook for these old-old women. TABLE VIII OUTLOOK Significant Statements I'm not a church going person but I do believe in God. (Np) And I believe what you do for somebody else you get back double. (Np) It doesn't have to be a lot, it just makes people feel better. All it takes is just a smile,...or even just picking up the phone to say hi. (Dp) I think writing for older people is a really good thing. It's a way for the older people to leave something behind that others might use, you know, your grandchildren, or just other people. (Hp) I use to have to do things, now I have time to do the things I want. (Hp) The only thing we can pass on...is our thoughts and put them in writing with all the difficulties we've had...and all the joys we've had. (Dp) You've got to be happy and make the most of your day. (Dp) old-old Formulated Meanings belief in God, spirituality giving to others giving to others giving to others adjusting giving to others positive attitude, appreciative of the day 54 You know another thing about getting older, you don't need the things that you use to have. You don't need a whole lot of things, so I gave them away to the young people. I like the way I have things now. (Dp) I think life is pretty good, I mean I know I have my pains and aches and things, and my worries, but then there is always a little bit of sunshine in life. (Dp) Well you have to just take it one day at a time, and just try to be pleasant, be friendly, do nice things for others. (Np) adjusting to changing needs, giving to others positive attitude despite the challenges of aging positive attitude, giving to others I do think too, that going to church is wonderful for people. It doesn't matter what religion you are. It's just important to believe in God. (Dp) belief in God, spirituality I think life is hard and you have to work hard at it. But it's worth it, I mean you have to work at things to make them good, you know like your marriage or your health. If you work hard at being positive and doing the best you can each day, well then you're going to get more out of life. (Dp) It's good to believe in God, you know lots of time I say "Oh dear God, thank you, thank you for the blessings." I don't know how many times a day I say that, lots, yes lots, and oh it makes me feel good. It's good to count your blessings...every day. (Dp) positive attitude despite the challenges of aging belief in God, spirituality I think what is important is to find people you can talk to, make choices about what you want to do, and oh, yes, live in your own home. You have to go after what you want, regardless of your age, and no matter what others say. (Hp) adjusting to the challenges of aging 55 Interests Next, all of the participants in the old-old cohort talked about the importance of continuing with interests that kept them both physically and mentally active. They were all involved in a local seniors centre and enjoyed doing activities with other people. Their interests also involved giving to other people. Being with people and keeping active were seen as important. This can be seen in Table IX as follows. old-old Formulated Meanings keeping active, doing things with other people TABLE IX INTERESTS Significant Statements I like to keep busy, I go play bridge at the centre, and I take day trips here and there with people at the centre. I'm going to Vegas with that group next month, and on Monday we are going to Cobble Hill together to a pub for lunch. (Np) The exercises are what drew me to the centre. (Np) Even in this building, I'm on the council. I like to get involved. I like to do what I can for others. (Np) keeping active physically giving to others I enjoy playing duplicate bridge, going shopping and I just started a computer class at the New Horizons. (Hp) keeping active mentally, doing things with others 56 I do enjoy writing. I've published a couple of things, the latest being this book here about my life. I would like to write more. I like to write to make people laugh and make them cry. (Hp) And reading, yes I enjoy reading. It's been 65 years since I graduated from Acadia with my Masters of Psychology, and to this day I still like to keep my mind active. (Hp) I think it is important to keep yourself busy and to occupy your mind. I like to go to the library or even get into one of those discussion groups over there at the centre. (Dp) I like talking with other people, but I also do exercises over at the centre two or three times a week. (Dp) Health The final theme relating to meaning in the lives of the old-old women was health. All three women noted that they had good health, and they described how they sought medical treatment to address health problems. They also expressed a determination to keep going in the face of any health challenges. Table X provides an example of the significant statements and formulated meanings for the theme of health as it relates to the phenomenon of meaning for these three old-old women. continued writing, giving to others keeping active mentally keeping active mentally keeping active physically 57 TABLE X HEALTH old-old Significant Statements Formulated Meanings And I've always been a healthy person and so has my husband. That is one of the reasons that we are able to live separately like this. He's well and so am 1, other than my blood pressure shooting up like 1 told you, but I'm on medication and it's well controlled, so 1 don't see that as a problem at all. (Np) focus on good health, get treatment for health problems I've been very fortunate with my health. Other than a thyroid problem that 1 take pills for, 1 don't have any other problems. (Hp) focus on good health, get treatment for health problems My legs bother me from time to time, but when they do 1 just take it easy. They don't stop me from doing what 1 want. (Hp) determined to keep going To keep good health, the only way is to work at it all the time. (Dp) focus on good health 1 try to take care of myself, like this afternoon 1 have an appointment, 1 go up to the naturopath up the way. 1 have a chronic cough and he was able to fix it with acupuncture a year ago and it's starting to come back again, so I'm going up for treatments. 1 don't go as far as stopping my blood pressure medications, but 1 try whatever is going to help. (Np) get treatment for health problems 1 do have very good health. Oh, 1 still have the shingles which makes me feel crabby, but you really just have to make the best of it. 1 tell myself, come on you just have to keep going. (Dp) focus on good health, determined to keep going 58 In summary, the old-old women certainly demonstrated that they were continuing to search for and define meaning in their lives. They all were also still engaging life and continuing to be active both mentally and physically. Connectedness with friends provided support and companionship, while their relationship with spouse encompassed commitment/love, support and companionship. They also talked about the importance of staying connected with family. All of these women expressed a determination to maintain their independence through making choices and adjustments which included utilizing community services and supports. In terms of outlook, these women were adopting a positive attitude to appreciate life and to face it's challenges. This included maintaining spiritual beliefs, giving to others, and adjusting as needed. The theme of interests meant keeping oneself both physically and mentally active, doing things with other people and giving to others. Finally, these women focused on their good health, sought medical treatment for health problems as needed and they all expressed a determination to keep going. The findings for the young-old women and the old-old women were similar in that the five themes which emerged from the data were common to both groups. These five themes included relationships, outlook, interests, independence and health. The next step of data analysis in the Colaizzi method involved integrating the above results and the five themes common to all participants, into an exhaustive description of the phenomenon of meaning in the lives of elderly women. The exhaustive description of the phenomenon of meaning as described by these community dwelling elderly women is presented in Table XI. 59 TABLE XI EXHAUSTIVE DESCRIPTION OF MEANING IN THE LIVES OF ELDERLY WOMEN Elderly women define and redefine meaning through the interconnectedness of their relationships, outlook, interests, independence, and health. For these women sharing experiences, feeling connected, giving and receiving support is the essence of friendship. They describe commitment, love, support and companionship to encompass relationship with spouse. A sense of connectedness defines relationships with family. Meaning was also described as adopting a positive outlook to appreciate life and to face it's challenges. Furthermore, spiritual beliefs and giving to others can enrich one's life. Staying mentally and physically active by engaging past interests and new ones with others was described as being important. These women expressed a determination to maintain independence which can be enhanced by community services and supports. And finally, focus on good health, seek medical treatment as needed, adjust, adapt, stay determined to keep going. 60 CHAPTER V DISCUSSION OF RESULTS Part I - Meaning Consistent with the literature on meaning, this study found that having a sense of meaning in one's life is important. As noted earlier, all six participants were very willing and forthcoming in sharing their experiences and describing things in their life that brought their life meaning. The emphasis of what is meaningful, and how the participants described meaning in their lives is continually evolving as these older women continue to integrate life experiences and engage developmental tasks. This section will initially discuss the findings as they relate to the phenomenon of meaning. The following section will then discuss the similarities and differences between the young-old and the old-old cohort's description of meaning from a developmental perspective. Meaning for these women was described within five common themes; relationships, outlook, interests, independence and health. Relationships were noted to be of primary importance for all participants. This finding is consistent with the studies by Burbank (1992), Lapierre, Bouffard and Bastin (1997), and Mokuau and Browne (1994). In Burbank's study, 57% of participants identified relationships to be the most important thing in their lives which brought them meaning. Yet, the quantitative approach limits the reader in terms of knowing what it was about these relationships that was important. Similarly the quantitative study by Lapierre, Bouffard and Bastin (1997) cited relationships as being important but the nature of these relationships and why they are important is left unanswered. The qualitative design of this current study "An Exploration of Meaning in the Lives of Elderly Women" provides a fuller understanding of the kinds of relationships that were important and the significance of these relationships for the participants. 61 In this study, friendships were seen to be most important as friends were a source of support, provided a sense of connection, people to do things with, and these women talked about the importance of just being with other people. As one women stated, "My friends have been wonderful, I don't know what I would've done without them. They have been my support" (Bp). Friendships also provided them with the opportunity to give to others which was important for them. It is interesting to note from a contextual perspective that three of these women were not in a current marital relationship. Another woman lived apart from her husband for four to six months of the year and one woman was a caregiver for her husband who had Alzheimers. For these two women, the support of friends was very important, in addition to the relationship that they shared with their husbands. The other married participant in this study was recently remarried and she described their relationship in terms of companionship and supporting each other, which is similar to how all women described their relationships with friends. For this woman, her spouse was her best friend. For all three married women, their relationship with their spouse was important in terms of commitment, love, support and companionship. These women also talked about both long time friendships and new friendships and acquaintances. Four of the women had recently moved to Victoria, so for them staying connected with previous friends, as well as making new friends was important. Two of the women also talked about the need to make new friends as they got older as several of their friends had died. Two of the women summed this up quite aptly. One woman said, "So, I've had to make new friends. You are having to replace people all the time, more or less" (Np). The other woman stated that, "they're all gone now, that's what it's like at my age. But I'll tell you, we have really good friends here, they're much younger than us though" and "when you get to be 83, you usually have friends that are younger than you are. That's just the way it goes" (Dp). For all of these six women, they described sharing experiences, feeling connected, giving and receiving support as the essence of friendships. 62 Relationships with family were mentioned by all of the participants. All six women had children and grandchildren. They talked of trying to stay connected with their children and grandchildren through letters, phonecalls, and annual visits. Only one woman had a daughter living in Victoria and they would visit on a regular basis. This is consistent with the work by Mokuau and Browne (1994) where they found that relationships with children and grandchildren were important to the elderly women in their study. Relationships with others is also reflected in the way these women described their interests. For all six women, the theme of interests involved doing things with other people. This included volunteer work such as peer counsellor, Senior Citizen Advocacy Counsellor, reading to seniors in nursing homes, teaching an acting class, and for one woman this meant being involved with the strata council in her condo building. For five of these women, interests were also described as belonging to the local senior's centre for activities such as bingo, exercise classes, computer classes, writing classes, french lessons and taking day trips. The other woman described playing cards, going for walks, and taking trips together with her new husband. The theme of interests was also important for these women as they described the importance of staying active both mentally and physically. This included a combination of continued long time activities and learning new interests. Certainly the variety of interests and the reasons for engaging interests became clearer with the qualitative approach of this study. Previous studies on meaning also identified interests as being important to seniors. Burbank (1992) found that 10% of seniors identified activities as most important in bringing meaning to their lives. Activities were also identified as significant in the study by Lapierre, Bouffard and Bastin (1997). Again, the quantitative method used by each of these studies limits a fuller understanding of the types of activities and the reasons that they were important to seniors. 63 Another theme identified as meaningful in this current study was outlook. All six women talked about the growing importance of their outlook on life which was an integral part of how they perceived meaning in their lives. Through their life experiences, all six women spoke about how they had learned to develop an outlook and approach to life that enhanced their appreciation for daily living and allowed them to deal with the challenges of life along the way. As one woman stated "I'm appreciative of all of the things I can do each day. I'm thankful to just get up each day" (Mp). For all of these women, adopting a positive attitude seemed to enhance their sense of meaning. In previous research studies on meaning, outlook was not identified as a theme but components of what might be considered outlook were part of their findings. Mokuau and Browne (1994) found that the theme of spiritual and religious beliefs were important for the Hawaiian women. The study by Mitchell (1994) found that "engaging the now while rolling with the vicissitudes of life" (p. 72) was part of how her participants described what it means to be a senior. The quantitative study by Reker, Peacock and Wong (1987) found that elderly women scored higher on the questionnaires related to "life purpose", "life control" and "will to meaning" which could be related to one's outlook. Unfortunately the quantitative method used for this study by Reker, Peacock and Wong does not provide the information to understand why the women responded in that manner, how they interpreted the terms used by the questionnaire, and how their responses relate to their outlook or meaning in their lives. Outlook in this current study contained a number of dimensions for these women. All six women talked about the importance of maintaining a positive attitude, making the most of each day, doing what you can, and living life one day at a time. It was interesting to note here that all of these women wanted to share their outlook with others. This included prescriptive statements or words of advice such as "You've got to be happy and make the most of your day" (Dp), "Well you have to just take it one day at a time" (Np), "There's no sense in worrying about things. You just have to do what you can" (Mp), and "You've got to make the 64 best of what you have" (Ip). They wanted to share their outlook based on their lived experiences with the researcher and with others through the research study. Several of the women even talked of passing on their outlook and life experiences to others through writing, while some of the women wanted to share their experiences and outlook through helping others. For all of these women, their outlook was also linked with their spiritual beliefs. Although religion had been identified as important for seniors in some of the literature on meaning (Burbank, 1992; Kaufman, 1986; Mokuau and Browne, 1994; Reker & Wong, 1988), for these women, religion did not reflect what they were saying when they spoke of spiritual beliefs and faith. Only one woman talked about attending a regular religious service. Instead these women saw their faith, belief in God, counting their blessings, and having an appreciation for nature as being more reflective of what was important to them. They also spoke of the importance of giving to others. All of these women saw their spiritual beliefs and giving to others as part of their outlook which enhanced meaning in their lives. Meaning for these women was also described through the theme of independence. Independence of all six women meant being self reliant, making choices and adjustments to maintain independence, and all of the women expressed a determination to stay independent for as long as possible. This included choices about housing, neighbourhood, transportation, and continuing to take care of oneself to maintain independence. All six women were living in housing arrangements that allowed them to take care of themselves. For some of the women this included the familiarity of their apartment building and association with other tenants. For others it was the proximity of services in their neighbourhoods. All six women talked about accessing their neighbourhood amenities. They also all talked about being able to walk or take the bus to get around. Only one woman still drove a car, but she was restricted to daytime driving and only felt comfortable driving in and around her neighbourhood. All of the women saw independence as making choices. 65 Sometimes this involved difficult choices like moving across the country, living apart from spouse, paying more for rent, and accepting meal services. For all of these women though the theme of independence was reflected in their discussion of meaning in their lives. Similar to this current study, Kaufman's (1986) qualitative work identified the theme of self-determination as being important to elderly people. She found that seniors who demonstrated and talked about being determined to carry on in life, expressed a greater sense of life fulfilment. Her theme of self determination seemed to parallel the theme of independence in this study. The quantitative study by Lapierre, Bouffard and Bastin (1997) found that independence was important to seniors. And finally, the work by Reker, Peacock and Wong (1987) reported that having a sense of "life control" was important to the psychological and physical well being for the young-old and the old-old women. The final theme identified by the participants in this study was health. Only two of the previous studies on meaning identified health as being important to seniors. Burbank (1992) found that 2% of seniors ranked health as being most important in their lives. The study by Lapierre, Bouffard and Bastin (1997) also reported that seniors identified health as being important. In this current study, all six participants identified health as being important. All of the women wanted to focus on the what they were doing to take care of themselves, and to focus on the good health that they had. Their perspective was one of wanting to engage life in spite of whatever health challenge they may be facing. This often required life style choices and adjustments. All of the participants identified something that they were doing to maximize their health such as walking, exercise classes, acupuncture, moving to Victoria, taking prescribed medications and learning to pace oneself. In reviewing the five themes which encompassed meaning in the lives of these elderly women, it also became apparent that they were not separate from each other. The interconnectedness of relationships, outlook, interests, independence and health, is an important factor to consider. What is meaningful to an individual will be the result of their 66 unique lived experience and the interplay of many factors. To better understand meaning in the lives of these women, it is important to consider the themes within the context of their lives. For example, this study revealed that interests for these six elderly women were interconnected with the theme of relationships. The young-old women expressed interests in terms of helping other people through volunteer work, working with others and belonging to various groups. The old-old women described interests in terms of doing things with other people and giving to others. For the old-old women the theme of interests was also related to the theme of independence. Many of the interests identified by the older women were described as keeping active physically and mentally. This in turn enabled them to continue living independently and taking care of themselves. By understanding that interests are important because they enhance one's relationship contacts, or they enhance a person's independence, provides a fuller appreciation of the person's choices to engage certain activities. Another example would be the interconnectedness of health and independence for several of these women. For the one woman who lived apart from her husband for several months of the year, she attributed her good health as the reason for making this choice possible. For another woman, she talked about learning to pace herself in order to engage her interests, as she was faced with a chronic health condition. The woman who lived six months in Victoria and six months in Quebec, talked of how her present health allowed for this life style but in the future she would settle in Victoria year round in order to "grow old gracefully" (Mp). She felt that by living in Victoria she would be able to be independent in the neighbourhood that she stayed in with the proximity of shopping and services for seniors. She also felt that living here would allow her to remain active as she would be able to walk outside twelve months of the year due to the nice weather. She was already planning ahead on how she would maintain independence if she experienced a change in her health. 67 In addition to identifying the five themes that contribute to meaning in the lives of these elderly women, the findings of this study are consistent with the findings of Carlsen (1991) when she described meaning-making as a process of defining and redefining meaning throughout one's life. It also supports her findings that older adults continue to strive for meaning despite the unexpected life events and the challenges of aging. In essence, to age successfully, one learns to balance the challenges of aging with their search for meaning. The six women in this study demonstrated their determination to strive for meaning despite various life challenges. In sharing their experiences in what they found to be important in their lives, they also shared stories of difficult childhoods, broken relationships, being a single mother, death of their spouse, and major moves across the country which meant leaving behind a network of friends and family. Yet despite the challenges, all of these women talked about how these experiences contributed to how they define meaning in their lives now. Instead of focusing on the hardships, these women were integrating these experiences as they continue to redefine and describe meaning in their lives. In summary, the findings of this study add to the existing body of knowledge on meaning in the lives of elderly women. Although this study supports the existing literature on the importance of meaning in the lives of seniors, it also highlights more specifically what is meaningful, and how meaning is described, for these elderly women. This study is gender specific in qualitatively exploring meaning for elderly women. It also explores meaning from a cohort perspective which allows for discussion of the continued growth into old age, and the developmental tasks for young-old and old-old women. The following section will discuss the results from a developmental perspective to explore the similarities and differences in how the young-old and the old-old women describe and emphasize what is meaningful in their lives. 68 Part II - Developmental Perspective From a developmental perspective, individuals continue to engage developmental tasks throughout their lives. The developmental stage and growth of the individual is reflected in and influences what they perceive as important, and why it brings them a sense of meaning. In reviewing the findings, it was evident that both the young-old women and the old-old women found relationships to be most significant in bringing meaning into their lives. Both cohorts identified friendships to be the most important relationships in their lives as friends provided support, and people to do things with. This included long time friends, making new friends and just being with other people to talk with and do things together. The exception being the one woman who was in a new marital relationship. For her, this new relationship had taken the place of other friendships. The importance of friendships is consistent with the developmental task as identified by Havighurst - "adjusting to the death of spouse." In looking at the context of these participant's lives, most of the women had lost their spouse or were anticipating being on their own. For the young-old women, two had been widowed and one was divorced. Only one of these widows remarried and was very involved in her new relationship with her second husband. For the old-old women, one was separated and two were in long term marriages. Even for the two old-old women still in a marital relationship, one was caregiving for her husband who had a progressive illness, and the other woman was living apart from her husband for part of the year. For them, they were already either dealing with or anticipating being without their spouse. The importance of friendships was common to both cohorts but the way that they described their friends was different. The young-old women described the importance of friendships as staying connected to long time friends as a source of support and the importance of making new friends especially since two of these women had moved to Victoria within the last five years. For the old-old women, they talked more about the importance of 69 making new friends or acquaintances as they had loss many of their friends due to illness and/or death. For them, it was being with other people that was important. The developmental task identified by Brown (1978b) stating that there is an adjustment to loss of friends in the older cohort group is applicable in this study. The task of adjusting to the loss of friends and the need to develop new friendships or acquaintances in later life was reflected in this current study. Another difference for the two cohort groups, was the way that these participants talked about independence. Independence was important to both cohort groups but they described it in different ways. The young-old referred to the importance of continued self reliance and choosing a community that supports independence. The old-old women all expressed a determination to maintain their independence through making choices to adapt and adjust which included utilizing community services and supports. For both cohorts, they were "living in satisfactory living arrangements" as per Havighurst's (1972) sixth development task. For the old-old, however, they talked more about it being a conscious decision to live in their particular apartments in their particular neighbourhoods to maximize independence. Both the young-old and the old-old were working on the developmental tasks identified by Brown (1978b) regarding "adapting to living alone in continued independence" and the old-old were also "learning to combine new dependency needs with the continued need for independence". Two of the young-old and one of the old-old women were living alone. For the one old-old woman who was living with and caregiving for her husband, she placed alot of emphasis on living somewhere that she could continue to take care of herself even if she had to live alone. The other old-old woman was adapting to living alone as she lived apart from her husband for four to six months of the year. For another old-old woman, accepting a hot meal service in her home allowed her to maintain her independence within her own home. 70 The young-old women also talked about independence as being self reliant and making choices to be able take care of themselves. They were starting to make some of these adjustments in terms of where they lived and how they accessed services, but for all three of these women, independence and self reliance was still a reality for them. In effect, they saw their independence as being important but also something that was still a given in their lives. They were able to look after themselves physically, financially and practically. Two of the women had been living on their own for many years. One had been living on her own for 20 years following a divorce, while the other woman had been widowed and living on her own for 10 years. The third young-old woman was still very self reliant and an equal partner in her new marital relationship. With regards to interests, this seemed to very important especially for the young-old women. This is consistent with several of the developmental tasks as outlined by Havighurst, Peck and Brown. For the young-old, interests were a part of adjustment to retirement. The young-old women were very active as volunteers, both as an extension of their past employment skills and in developing new interests. This is reflective of the developmental task, "adjusting to retirement" as identified by Havighurst (1972), the developmental task "ego differentiation vs. work-role preoccupation" as identified by Peck (1968) and the developmental task for the young-old "learning or continuing to develop leisure-time activities to help in re-alignment of role losses" as identified by Brown (1978b). For the old-old women, they spoke of interests in terms of belonging to the local senior centres to stay active both mentally and physically. They saw interests as a way of doing things with other people and as a way of giving to other people. The developmental task "establishing an explicit affiliation with one's age group" as identified by Havighurst (1972) and identified by Brown (1978b) for the older cohort, are more applicable for how the old-old described the importance of interests in their lives. 71 Outlook was described by both cohort groups as being important. The way that each group talked about their outlook was slightly different though. The young-old talked about the importance of a positive attitude, having spiritual beliefs, and appreciating things around you. Similarly, the old-old women talked about the importance of having a positive attitude, especially when dealing with the challenges of aging and the importance of their spiritual beliefs. In addition, the old-old women emphasized the outlook of adjusting to changes, giving to others and writing as a way to pass on one's experiences and one's legacy to others. Both cohorts exhibited the developmental task of "integrity vs. despair" as outlined by Erikson et al. (1986). During the interview each participant seemed to be reflecting back on their lives and integrating these life experiences into what was meaningful to them now. Furthermore, all six participants expressed a "vital" involvement in life and living. Both cohort groups were actively involved in their community, they were continuing to learn more about themselves and their world, and they were wanting to share words of "advice" with the researcher about their experiences and perspective of life. The old-old participants in particular seemed to want to share their knowledge and experiences with others and give to others which is consistent with the developmental task of "ego transference vs. ego preoccupation" as outlined by Peck (1968). Two of the old-old women talked of wanting to pass experiences on to future generations through their writing, which is consistent with the developmental issue of "legacy", leaving something of oneself behind for others, as identified by Neugarten (Golan, 1981). The final theme of health was common to both cohorts but each group described it in a different way. The young-old women talked about a health challenge and the importance of taking care of oneself. They talked about some of their health challenges in more detail than the old-old women. For the older cohort, the women all professed to have good health, yet during the interview they also briefly spoke about a health concern. In briefly mentioning a health concern, all three older women downplayed that it was a problem. They were doing 72 what they could to take care of it and they seemed to focus more on appreciating the good health that they had. They also emphasized how they would keep going despite health challenges. From a developmental perspective, the young-old seemed to be working on the task of "body transcendence vs. body preoccupation" as identified by Peck (1968). They were making the transition from being focused on their health challenges, to learning ways to deal with them and continue enjoying life. For the old-old women, they seemed to have worked through Peck's (1968) developmental task of body transcendence, as they focused on the satisfaction they received by engaging life and not being preoccupied by health concerns. Throughout their interviews the old-old women also talked more about the importance of mental activity and being with other people socially, instead of focusing on physical decline. Furthermore the old-old women seemed to talk about adjusting to health concerns which is consistent with Havighurst's (1972) developmental task of "adjusting to decreasing physical strength and health". In summary, from a developmental perspective it is important to recognize the different challenges faced by the two cohort groups, as well as the different ways that they have learned to cope and adjust throughout their lives. The additional ten to fifteen years of life experience for the old-old cohort provided them with a different emphasize on what was important to them. Hence, the developmental framework considered in this chapter provides a better understanding of what elderly women find meaningful in their lives. The importance of the , findings for this study when working with seniors will be discussed in Chapter VI. 73 CHAPTER VI CONCLUSIONS The goal of phenomenology is to describe accurately the experience of the phenomenon under study with the purpose of promoting human understanding (Morse & Field, 1995). This current study provides an exploration of the phenomenon of meaning in the lives of elderly women. It was the lived experience of these women that was the primary source of data. This data was gathered through an unstructured interview process and analyzed using Colaizzi's phenomenological method of analysis. The six elderly women who participated in this study responded to the research question, "Is there something or things so important to you in your life that they give your life meaning?" The following exhaustive description defines what these elderly women find meaningful in their lives. Elderly women define and redefine meaning through the interconnectedness of their relationships, outlook, interests, independence and health. For these women sharing experiences, feeling connected, giving and receiving support is the essence of friendship. They describe commitment, love, support and companionship to encompass relationship with spouse. A sense of connectedness defines relationships with family. Meaning was also described as adopting a positive outlook to appreciate life and to face it's challenges. Furthermore, spiritual beliefs and giving to others can enrich one's life. Staying mentally and physically active by engaging past interests and new ones with others was described as being important. These women expressed a determination to maintain independence which can be enhanced by community services and supports. And finally, focus on good health, seek medical treatment as needed, adjust, adapt, stay determined to keep going. 74 The findings of this phenomenological study are reflected in the aforementioned exhaustive description. The purpose of this work was to explore meaning in the lives of elderly women and the findings contribute to the gerontological body of knowledge. Although not theory generating, an understanding of this knowledge can assist social workers in both clinical and community practice and in the area of policy development. Implications for Social Work From this research work and from my social work practice with seniors, I have found that the following areas are important factors for social workers to consider when working with the elderly. 1) Social workers need to continually examine their own attitudes and beliefs toward the elderly. This is important as ageist attitudes affect the way services are provided, as well as potentially reinforcing these attitudes with our clients. How we perceive our elderly clients influences the quality, type and quantity of services provided. Furthermore, our attitudes toward the elderly are transmitted to our clients. This in turn can affect their perceptions of the social worker as being concerned, caring and unbiased (Kosberg, 1983). As one of the women in this study stated "What is wrong with the word old. It's an honourable word. I feel old and I feel good" (Mp). She was talking about how she felt society and other people treated her now that she was age 75. She believed that people should not be ashamed of their age, and they should not be treated as if being old was a negative thing. 2) Social workers need to continually update their knowledge base. As stated by Getzel (1985), "a social worker with a serious commitment to serve the elderly must persist in updating his or her knowledge about the nature of the aging process and the implications of 75 the environment for the older person's growth, health and social integration" (p.4). Social workers need to know about the normal aging process and the challenges faced by individuals during their senior years, such as the elderly women in this study talked about the challenges they were facing which included the loss of a spouse, health concerns and caregiving issues. Through better understanding and knowledge of these challenges, it would enable social workers to be more effective in clinical practice and in the delivery of community services and programs. This would include educating and supporting elderly individuals and their families in understanding the normal aging process. Furthermore, social workers need knowledge of a developmental framework and a recognition that seniors continue to engage life. This allows the social worker to draw on the strengths of the individual to assist them to face the challenges and transitions during later life. The strengths of older individuals was obvious in this study as these older women demonstrated strength through their positive outlook and a determination to keep going in facing their respective challenges. 3) An important role for social workers in working with elderly individuals is to assess clients regarding what is most meaningful to them. By knowing what is meaningful to that person, the social worker can plan and carry out interventions based on supporting or improving those areas of meaning. For example in this study, all of the women spoke about the importance of independence and how that contributed to meaning in their lives. As a geratric social worker, I find that it is important to listen to the individual and assess what is meaningful to them. In this above example regarding independence, the plan of intervention would include accessing community services that would support their independence, such as home support workers, meal services and accessible transportation. 76 4) The role of the social worker is to work with seniors to assist them through transitions in their life. An example would be a change in living environment which may have been necessitated by the death of a spouse, economic reasons or health factors. Social workers can help seniors to identify their changing needs and support their determination to maintain independence through accessing appropriate community supports. Another example, taken from the current study would include the one woman who was a caregiver for her husband who had Alzheimers. In this situation, a social worker could provide her with some practical assistance in the form of home support help if needed, or a day program for her husband which would provide him with an opportunity for a structured social outing and provide her with some respite. The social worker could also assist her in reconnecting with a support network and provide counselling around anticipatory grief. 5) Social workers can guide seniors to integrate their life experiences both past and present. This exploration can assist individuals to feel good about themselves and their life experiences so that they can stay vitally involved in engaging their life. For example, in the interviews that I did for this study, all of the women reflected back on their life experiences and several of them commented that talking about these experiences helped them to feel good. Furthermore, this process of integrating life experiences past and present includes social workers encouraging seniors to explore their personal history in order to create a narrative of life which can be shared with intergenerational family and others. Four of the women in this study were involved in writing about their lives and one woman had even written and published a book about her personal history. She stated that "I thought maybe it would help my daughter understand me more, if she knew about my life" (Hp). 77 In summary then, the main focus of this current study was to describe the phenomenon of meaning in the lives of elderly women. These findings contribute to the gerontological body of knowledge and social workers can draw on this knowledge to enhance clinical work and community practice. Furthermore, in terms of policy development, it is important for social workers to better understand the challenges of aging and the needs and strengths of senior women. From this perspective, they can better advocate for effective service and policy development (Silverstone, 1996). In addition, social workers can advocate and support seniors to become more directly involved in these processes as well (Grant, 1996). An example would be to include elderly women in advisory roles for such issues as affordable housing, accessible and convenient alternative transportation, and health education programs. Finally, it should be noted that urban planners and others responsible for community development need to be acutely aware of the importance that community plays in the lives of seniors. All of the women talked about how the neighbourhood supported and helped them to maintain their independence. They described the importance of accessible services, amenities, and the role that the local senior's centre played in terms of activities, as well as providing opportunities for a social support network. Future Research Other researchers studying the area of meaning have supported the use of a qualitative approach to study the area of meaning (Carlsen, 1988, 1991; Kaufman, 1986; Mitchell, 1994; Mokuau and Brown, 1994). Interestingly, the work by Reker and Wong (1988) which reviewed quantitative studies about meaning, recommended that future studies should include a qualitative approach with data collection through interviews. 78 This present phenomenological research work exploring meaning in the lives of elderly women, utilized a qualitative approach, interview format, and it was gender and cohort specific. Nonetheless, there were limitations to this current study. This work focussed on the young-old (65-79 years) and the old-old (over 80 years), but it did not consider the oldest-old or those over the age of 85 years. The oldest participant in this study was 83 years old. Although men were excluded from the sample for this study, no attempt was made to exclude any other group through the purposive sampling. However, only Caucasian women were represented in this sample. Ethnicity, sexual orientation and socioeconomic status were not sampling variables that were part of this study. Consideration of such variables may prove to be valuable in future studies on meaning in lives of senior women. From the findings of this current study, several relevant research studies could be considered for future research. It would be interesting to extend the current study by considering what women in the oldest-old cohort (over age 85 years) would describe as meaningful in their lives. It would also be interesting to interview women who had never married, or women who did not have children. Another consideration for future research would be to consider variable such as ethnicity, socioeconomic status, and sexual orientation. Furthermore, future studies on meaning in the lives of seniors could include those seniors who are housebound, live in a care facility, or seniors who live in small towns and rural communities. Finally, I would recommend a study that compared what elderly women and elderly men describe as meaningful in their lives. This would greatly contribute to the gerontological body of knowledge about meaning in the lives of seniors. 79 Summary From their lived experience and their present lives, the women in this study were very willing to share what was meaningful to them. These women described meaning through the interconnectedness of their relationships, outlook, interests, independence and health. They were able to define what was meaningful to them in the face of life's challenges. As a social worker involved in working with the elderly, what they had to say was important. 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Chicago: University of Chicago Press 83 Preski, S. and Burnside, I. (1992). Clinical Research with Community - Based Older Women. In Journal of Gerontological Nursing, June p.13-18 Reker, G.T. (1997). Personal Meaning, Optimism, and Choice: Existential Predictors of Depression in Community and Institutional Elderly. In The Gerontologist. Vol.37, No.6: 709-716 Reker, G.T., Peacock, E.J., and Wong, P.T. (1987). Meaning and Purpose in Life and Well-Being: A Life-Span Perspective. In Journal of Gerontology, Vol.42, No.1: 44-49 Reker, G.T. and Wong, P.T. (1988). Aging as an Individual Process: Toward a Theory of Personal Meaning. In J. Birren and V. Bengston (Eds.), Emergent Theories of Aging (pp. 214-246). New York: Springer Roos, N.P. and Havens, B. (1991). Predictors of Successful Aging: A Twelve-Year Study of Manitoba Elderly. In American Journal of Public Health, Vol.81, No.1: 63-68 Rowe, J. and Kahn, R. (1987). Human Aging: Usual and Successful. In Science, Vol. 237, pp. 143-149 Sandelowski, M. (1995). Sample Size in Qualitative Research. In Research in Nursing and Health. Vol. 18, pp 179-183 Santrock, J.W. (1989). Life Span Development (3rd ed.). Iowa: Wm.C. Brown Silverstone, B. (1996). Older People of Tomorrow: A Psychosocial Profile. In The Gerontologist. Vol.36, No.1, 27-32 Solomon, D. and Peterson, M. (1994). Successful Aging: How to help your patients cope with change. In Geriatrics, Vol. 49, No.4: 41-47 Spier, B.E. (1989). Life Changes Experienced by the Aged. In A.G. Yurick, B.E. Spier, S.S. Robb, N.J. Ebert, and M.H. Magnussen (Eds.), The Aged Person and the Nursing Process (3rd ed.), (pp. 287-329). Connecticut: Appleton and Lange Statistics Canada - Health Statistics Division: Births and Deaths 1995 (1997). Minister of Industry, Ottawa Streubert, H.J. (1991). Phenomenologic Research as a Theoretic Initiative in Community Health Nursing. In Public Health Nursing, Vol. 8, No. 3: 119-123 Swigonski, M. (1993). Feminist Standpoint Theory and the Questions of Social Work Research. In Affilia, 8:2 171-183 Verbrugge, L. (1989). Gender, Aging, and Health. In K.S. Markides (Ed.) Aging and Health: Perspectives on Gender, Race, Ethnicity, and Class (pp. 23-78) California: SAGE Walsh, F. (1988). The Family in Late Life, In B. Carter & M. McGoldrick (Eds.), (pp. 311-332). The Changing Family Life Cycle (2nd Ed.) New York: Gardner Press 86 If you have any questions at any time during this study, please contact the co-investigator or principal investigator. This interview is made up of one general question to begin the session. There are no right or wrong answers. The interview will be approximately 45 minutes, but you may take more time if you need it. The interview will be audiotaped for transcription. All material will be destroyed at the end of the study. There will be opportunity for a follow up interview if requested or required. Signature acknowledging that your fully informed consent to participate in this study has been freely given. Signature acknowledging that you have received a copy of this consent form for your own records. Date: page 2 of 2 

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